Suggested iron supplements and recheck full blood count and ferritin after three months. And fresh sample of stool (fantastic!) to be sent to look for reducing substances. And no routine follow up.
tots100
Showing posts with label iron. Show all posts
Showing posts with label iron. Show all posts
Monday, 14 November 2011
Doctor Poo
I got a letter today from the man we call the Poo Doctor. Really he is a Consultant Paediatrician in the area of gastroenterology. We went to see him in September because B has persistent loose stools and it's proving difficult to toilet train him. The results of the poo sample (that was fun collecting that I can ensure you - not) indicated a normal haemoglobin but a slightly low serum ferritin. Plasma, lactate and uric acid were normal. Eosinophil count was very mildly elevated but there was no history available of any allergic diathesis or food allergy. Elastase was normal. And not sufficient to test for reducing substances.
Wednesday, 20 May 2009
Letter from the health clinic
I've got a letter today about B's review at the health clinic. The results of the investigations show CF phenotype no mutation identified. Anaemia with low haematocrit and low ferritin. Renal function, liver function, bone profile and TSH all normal. Immunology including auto-antibody screen and Elat screen - pending.
She reports that B is pale and bright-eyed and interested in his surroundings, his siblings, and her. He is well perfused with warm peripheries. His feet were not purple and she did not feel they were particularly swollen. Lying prone he would rest on his elbows with his neck to one side but not pushing up. He did reach out for a toy outside of his reach and kick his legs a little but gave up. He showed good resistance to her hand held against his feet. Place in supine he just lay contentedly. He sat well unsupported and had sideways and backwards saving reflexes. He has normal forward and downward parachute reflexes and normal tone posture and movement. His calves were a normal size.
In summary B does have some gross motor delay. He weight has significantly dropped through the centiles and he has iron deficiency anaemia.
So the plan for action is get B referred to a dietician. I agree to this so that we can be sure he is getting enough calories and appropriate food types. Check his stools for fat globules and alpha 1 antitriptazones to look for evidence of fat or protein mal-absorption. I get advice for helping his gross motor development. I've got to get B weighed in two months. And review him in the health clinic in 3 month's time. He is prescribed iron Sytron (sodium feredetate). And I have to get a change of prescription from prophylactic dose to treatment dose.
She reports that B is pale and bright-eyed and interested in his surroundings, his siblings, and her. He is well perfused with warm peripheries. His feet were not purple and she did not feel they were particularly swollen. Lying prone he would rest on his elbows with his neck to one side but not pushing up. He did reach out for a toy outside of his reach and kick his legs a little but gave up. He showed good resistance to her hand held against his feet. Place in supine he just lay contentedly. He sat well unsupported and had sideways and backwards saving reflexes. He has normal forward and downward parachute reflexes and normal tone posture and movement. His calves were a normal size.
In summary B does have some gross motor delay. He weight has significantly dropped through the centiles and he has iron deficiency anaemia.
So the plan for action is get B referred to a dietician. I agree to this so that we can be sure he is getting enough calories and appropriate food types. Check his stools for fat globules and alpha 1 antitriptazones to look for evidence of fat or protein mal-absorption. I get advice for helping his gross motor development. I've got to get B weighed in two months. And review him in the health clinic in 3 month's time. He is prescribed iron Sytron (sodium feredetate). And I have to get a change of prescription from prophylactic dose to treatment dose.
Wednesday, 8 April 2009
Health Clinic
We're back in the health clinic today regarding the motor delay, faltering growth, puffy feet and now iron deficiency anaemia.
B is 13 months now. He has been put on the waiting list for Physiotherapy. He's been taking prophylactic dose of Ironorm for the last week. And been switched to follow on milk instead of cow's milk. He is doing well and eating a normal diet. He's been more "lively" since the last visit. He is now sitting up mostly unaided and can save himself sideways but we're putting cushions behind him just in case he falls backwards. He will now weight bear through is feet if he is held standing. He can roll from front to back and vice versa and get round a whole room this way. He is pushing up onto forearms and kicking his legs. We're happy he has made some progress in the last two months. Caeliac screen result is outstanding
This time I remembered to bring in his sibling's red books. I wanted to prove that both older children dropped down the centiles and are proportionate height for their weight. We're talking about everyone's milestones. A was a bit late he crawled at 15 months and walked at 18 months. L was much quicker. She cruised at 10 months and was walking by her first birthday. We put this down to the fact she was a second child who needed to act fast to get away from her older brother! I reported that I was a bottom shuffler and walked before my second birthday. B's daddy couldn't remember when he walked. I told the registrar that I thought B being left on the floor to play with his siblings was making him lazy and impacting on his development.
B is 13 months now. He has been put on the waiting list for Physiotherapy. He's been taking prophylactic dose of Ironorm for the last week. And been switched to follow on milk instead of cow's milk. He is doing well and eating a normal diet. He's been more "lively" since the last visit. He is now sitting up mostly unaided and can save himself sideways but we're putting cushions behind him just in case he falls backwards. He will now weight bear through is feet if he is held standing. He can roll from front to back and vice versa and get round a whole room this way. He is pushing up onto forearms and kicking his legs. We're happy he has made some progress in the last two months. Caeliac screen result is outstanding
This time I remembered to bring in his sibling's red books. I wanted to prove that both older children dropped down the centiles and are proportionate height for their weight. We're talking about everyone's milestones. A was a bit late he crawled at 15 months and walked at 18 months. L was much quicker. She cruised at 10 months and was walking by her first birthday. We put this down to the fact she was a second child who needed to act fast to get away from her older brother! I reported that I was a bottom shuffler and walked before my second birthday. B's daddy couldn't remember when he walked. I told the registrar that I thought B being left on the floor to play with his siblings was making him lazy and impacting on his development.
Wednesday, 11 March 2009
Blood test results
This week I get some results from B's blood tests. They show low haematocrit and Serum Ferritin. He is prescribed an iron supplement.
And Cystic Fibroses is not confirmed. Immunological results are still outstanding. I'm relieved it's not CF. Still living without a diagnosis but in this case the news is good.
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