In my obsession to figure out the cause of Collin's vomiting, I began to wonder if it could be related to his reflux. At home he had been on Zantac and Prevacid, but for some reason he had been taken off the Zantac somewhere along the line here. So I questioned one of the doctors and asked that it be restarted.
The speech therapist came again to see Collin. At this point she doesn't feel that feeding Collin orally is appropriate right now. He gets agitated if we try offering him anything, and she explained that with a 24 hour tube feeding, he doesn't feel hungry, and children don't have interest in eating if they're not hungry. The continued vomiting doesn't leave him with an interest in food either, and forcing the issue will only make the problem worse. Then she talked about how the type of feeding tube he has can exacerbate his reflux, because it doesn't allow the lower esophageal sphincter, between the esophagus and the stomach, to close all the way, which can allow stomach acid to come up. She said in the future we may want to consider switching to a gastrostomy tube the would be surgically placed directly into the stomach through the abdomen. He wouldn't have to be fed continuously for 24 hours, so he could have the chance to feel hungry, and it could still be used for medications so he doesn't have to taste them. The problem with placing one right now is that another surgery is another chance for infection, and infection of any kind need to be avoided with chemotherapy. Perhaps between rounds of chemo the switch could be made.
The oncologist visited Collin again today, and said there could be many reasons for the vomiting. Along with the possibility that it is a side effect from medication, she said it could also be because of where the tumor was; however she feels it's pretty likely that the vomiting and agitation are due to the tumor cells that are still in his body causing irritation. She doesn't want to delay the start of chemo anymore, and encouraged me to ask for morphine for him when he seems uncomfortable, because there's no reason he needs to be uncomfortable. Since neurosurgery is for the most part done with Collin, he will be switched from neurosurgery as his primary doctors over to oncology as of tomorrow morning, and the chemo is still scheduled to start Friday May 14.
Collin did have morphine early in the evening, but a few hours later was very agitated and constantly rubbing his head again. I believe the head rubbing is his way of telling me his head hurts, so I am concerned whenever I see him do it. He was very difficult to calm down even after another dose of morphine, which is how he was the night they had to place the EVD. Neurosurgery came to the room around 11:00 PM, and decided to have another CT scan done to rule out increased cranial pressure. I was so afraid and didn't want him to go through the same experience, and I prayed and begged and pleaded that the CT scan would show no change. For the second time in the middle of the night I took my baby down to the basement of the hospital, a place that now makes me extremely anxious since that is where we were told of the tumor in the first place, to have another CT scan. With my heart pounding I placed him on the CT scan and helped strap him securely so he couldn't move. Then a few minutes later we were back in our room, waiting for the results. The nurse knew the scan had been read but legally couldn't reel me what the results were; I asked her to give me a hint as to whether I should start packing our things, or if I could try to rest. She told me to rest, so I tried to start breathing again. Eventually I fell asleep.
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