Very interesting results!

(Warning, picture below may be graphic for some people!)

Jax results from his procedure are quite interesting. His GI called me this morning. She is this very soft spoken, very young women. She has only been out of her fellowship for a couple of years, but comes very highly recommended to us from other moms!

She said she was very glad that she did this tube change and scoped him, instead of having IR do the change. She was very surprised at the results.

The picture below is of some of the scope. The middle top picture is his esophagus, you can see it is very red and angry. There are some nodules in there, which she biopsied. She is not concerned about those. In an adult it could mean cancer, but she see's them in kids often. The redness is interesting, since he has never eaten by mouth. What is making it so irritated? She said the biopsies will be our biggest answer. It may be because of his SVC syndrome. That even the blood vessels in his esophagus are affected by his poor blood flow in his chest. That would be a good question for hematology. Or is it irritation from reflux? Again, the biopsy will show that.

The other very strange thing to her was his small intestine. The middle bottom picture shows it. You can slightly see ulcers in this picture on the top of his intestine. She said his small intestine was covered in them! These were also biopsied. She is not sure if he has a lot of acid, so we increased his prevacid to twice a day. But when I let his tummy vent, I get what she considers a normal amount of bile out. Again, the biopsies will tell us how irritated it is.

The bottom right is his nissen. I have absolutely no idea how to read it! She said it was slightly loose, but not undone. I asked her if it would be ok to make it extra tight in a kid that you know is never going to eat by mouth. She said probably not, because it makes it hard to even swallow secretions, and that could cause problems.

These biopsies are key in telling us if we need to tighten up his nissen. She's hoping increasing prevacid will keep acid low and keep him from retching it up and aspirating. Jaxson has been really wheezy lately, which is really strange for him. That only confirms to me that he is aspirating more. She may also give him something to try and get his tummy to empty faster. I don't know if that helps a kid that doesn't get any food into his tummy though.

He is also going to have a barium enema while he's inpatient, she is hoping to get answers about why Jax doesn't poop on his own at all!

Its just a day in the life of Jax's little body!