AM Nausea & School Tardies

Crohn's Disease Forum

Help Support Crohn's Disease Forum:

Mehita

Mehita

Joined
Nov 12, 2011
Messages
2,412
I just realized that DS doesn't have anything written into his 504 plan about tardiness so I sent an email today asking for that accommodation. Does anyone have text I can copy? And for those of you whose kid are often tardy (especially the high schoolers), how does it work? I mean, how do they catch up and what do they do about missed work when they're late?

Awhile ago I mentioned that breakfast isn't going so well around here. He is often nauseous when he wakes up so he skips breakfast (6:30am), but then is starving by lunch time (12:05pm). Lately he's been trying to eat breakfast, but often vomits after, so we're coming to accept that breakfast before school is just a no go. He says he starts to feel better and hungry around 9:30am so starting tomorrow I'm going to cut up protein bars in to mini chunks and he's going to try to eat one between each class period when he's at his locker. It's not that the school doesn't let him eat, it's that he chooses not too and for the life of me I cannot figure out why. Hopefully he holds up his end of the bargain and this works. Teenagers can be so frustrating!
 
Oh the joy of teens. C was the same way. Nauseated in the morning and didn't want breakfast but starving by lunch. Oddly enough me and my non IBD daughter have always been this way and more so than C.

For him, when he was at his original high school we arranged his schedule so that it was his elective first thing in the morning. Because he was at a military prep school he had to take a physical elective each year so I always asked for those to be his first class. Others have made the first class a study hall.

As for food, he was also one not to want to eat in class or nurse office or whatever. We opted for shakes at one time since all kids were allowed drinks in closed containers but he rarely swung by the nurses office to pick them up. Uggh.

At his most nauseated the GI had pxed zofran so he'd take it upon waking up then otw to school would eat a granola bar or scrambled eggs.
 
My daughter arranged to have study hall in the morning so that she didn't miss class. I wonder if that would be an option for him next year? She thought of it before junior year, so she had study in the morning for only two years.

Before that, she was just late a LOT. She often missed first period, and as a sophomore, I think first period was chemistry and it was very hard. I can't remember if we had something specific about tardies in her 504 plan, I'll look and get back to you. She did have something about extra absences so maybe we just used that?

Unfortunately, she just missed a lot (22 days one year) and made the work up by herself. It was rough but she did it.

Since he isn't tolerating breakfast, the protein bars are a great idea!! Maybe he doesn't want to eat in class because other kids aren't eating? My daughter never liked doing anything "special". Personally, I think kids wouldn't even notice but that's teens for you!
 
Grace also is sick in the morning now but she's 6.

However in her school plan it says under accommodations that;

Late arrivals or early dismissals for medical reasons should not count against the student academically.

Again she's 6 and private schoold, so no 504 plan is needed.
 
This was huge Jack's freshman year. He had Geometry and his counselor suggested we could switch to another class like others have suggested that would not be so affected by missed class time. Lucky for us he had a really small class (11 kids) and a great teacher who took the time to catch him up each time. I don't think it would have been possible if it wasn't such a small class. We work with his counselors on his schedule each year now. Morning tardies are not a problem anymore, but we still have "easier classes in the am. He has teacher's aide and student council 1st and 2nd period so we could schedule his infusions in the am as well and he doesn't miss out on the "harder classes" in the afternoon. It makes it easier to schedule and we don't have to worry about missing tests or important directions for assignments.
I think his 504 states that he not be penalized with tardies due to the unknown cyclical nature of his disease.
 
He has gym right now for first period so thats a good thing, aside from him being nauseous through it. Next semester he's supposed to have engineering, but that might be his easy class. We don't have study halls. Four core classes and two electives.

Just found out his 504 plan has been passed to the fourth person in two years. I have no idea who to contact anymore. And we can't seem to keep a school nurse longer than a year. We've gone through four in the last five years. It makes it hard to build relationships and every time I call, I feel like I have to start from scratch. No, he's not a faker; yes, he really does need to eat GF; no, he's not just tired; yes, you really do need to call me every time he shows up in the health office. Ugh.

Guess I'll just wait and see who calls me back, though more likely, they'll pull him out of class and skip me.

Sorry for the rant. Just frustrated and he stayed home today. Messed up my Christmas shopping plans. :(
 
Is he home because of nausea/vomiting? With my daughter (who also is nauseous in the morning) we waited till it settled and then would take her to school later in the day. Then you can do your shopping ;).

If it's any consolation, in college, my daughter arranged it such that her first class was at 10:30 or 11. So she got up at 9 at the earliest. She's found that when she wakes up at 9, she isn't so nauseous but used to get nauseous when she was waking up at 6 for high school (not sure why that's the case, but I'll take it).

So I know college is not for a few years, but tell him it'll get better!

Really hope you get to talk to someone - maybe when you put a call in, specify that you need someone to call you back and don't want them to give the message to your son.
 
I had a paper with all C's issues that I typed up. I signed and had the GI sign it (it was not the GI letter). It answered all the questions they typically asked. At the 504 meeting it was stated that they refer to this letter after going over accomadations.

When they had a question or I needed to bring up something I would ask that they read over the notes or have the sheet in front of them so we could find the best way to address the issue without dredging up every single thing.
 
Maya142 said:
Is he home because of nausea/vomiting?
Click to expand...

Yes. I thought he'd just go in late, but he's been in the bathroom a couple times now (no BM tho) and says he's really tired. He has the start of a cold, too.

I hope in a week I'm not looking back on this and saying, "Yup, that's when the flare started!"
 
Sorry but my kiddo doesn't get to stay home or go late for nausea or vomiting
Period
There is the nurses office to rest if he needs it otherwise he goes

He is nauseous every.single .day especially after eating or drinking anything ( working with Gi now on this one )
But unless he vomits more than once - he goes or has a really bad normal kid illness ( Cold Ear infection etc.))
That is our rule and he follows it .
Ds has to learn to function as an adult with ibd and calling off work due to morning nauseous isn't going to get him anywhere

He drinks shakes for breakfast and has for four years easier on his tummy.

If your son isn't willing to eat or find a shake to drink - he is olden enough at 15 to figure out how to eat at school
You gave him options ( talking to the school iir eating between classes ) its up to him .
As Clash said
You can remind him but part of this whole growing process happens whether they are chronically ill or not so ... He gets to choose

Same with my kiddo he gets to chose what to eat when to rest etc...
Going to school is not something he gets a choice on .

Good luck
 
^Depends on the kind of nausea. M has gastroparesis and very severe nausea - so bad that she could not concentrate at all and would keep leaving class to go to the bathroom. If she went to the nurse, the nurse would call wanting to send her home because she looked terrible.

M eventually stopped eating completely, so that she wouldn't have to deal with the nausea.

I agree that in general, nausea shouldn't be a reason to stay home. But M is now old enough to decide when she needs to stay home. With little kids, of course it is different, but with older ones, even in high school, they need to understand the consequences and then make the decision. At that age, it should be in their hands because they're the ones doing the make-up work.
 
I was also going to suggest shakes. S is another one who does not eat breakfast, never hungry (and, doing o/n feeds solidified his feelings of having no appetite in the morning - even tho o/n feeds ended years ago!). But, he drinks a shake on the way to school.

So that he's not trying to rush drinking the shake, which I think could make him more nauseated, can he try starting to sip at one as soon as he gets up and just keep sipping until he leaves? Even if he doesn't get through a whole shake, he'll have something and maybe you can work up to an entire shake before he leaves??
 
Oh, I don't usually let him stay home just for nausea. This all started at the beginning of the school year, so it's been going on awhile and he's only missed one other day. Today was just so bad, the worst to date, that he was afraid he was going to throw up at school. He even made it to the driveway before he turned around and said school wasn't going to be a good idea today.

Can you take Zofran daily? I do have an email in to his GI.
 
Tesscorm said:
I was also going to suggest shakes. S is another one who does not eat breakfast, never hungry (and, doing o/n feeds solidified his feelings of having no appetite in the morning - even tho o/n feeds ended years ago!). But, he drinks a shake on the way to school.

So that he's not trying to rush drinking the shake, which I think could make him more nauseated, can he try starting to sip at one as soon as he gets up and just keep sipping until he leaves? Even if he doesn't get through a whole shake, he'll have something and maybe you can work up to an entire shake before he leaves??
Click to expand...

It's worth a try. Today was two sips of Ensure and then it came back up.
 
M is allowed to take Zofran daily because of her gastroparesis.

The shake idea is great- just make sure he sips very slowly. He can even take the shake to school in a water bottle - no one would know and he can just sip slowly. If you get an insulated bottle, it'll keep the shake cold. We did this when M was trying to drink Neocate and had lost a lot of weight.
 
His GI wants him to try Prevacid or Prilosec before Zofran to rule out acid reflux. He has an appt on 12/29 so we'll re-evaluate then.

His guidance counselor also called and asked if he needs to go to a five period day instead of six. Hmmm. I hadn't thought of that. It's nice to know its an option and they're concerned.
 
From the sips of the shakes I've tried myself, I've found them all fairly thick/heavy. Maybe it would help if you diluted the shakes with milk?

Or maybe try the Boost fruit drinks - much lighter than the shakes and would still give him some nutrition. But, because they are 'lighter', not sure if they would alleviate hunger by mid-morning. They come in tetrapacks so looks like any typical juice pack.
 
He's a sophomore now right? Most schools pad the credits needed to graduate to allow for failed classes and to retake classes and still have enough credits to graduate. An open 1st period would probably be great for him allowing him extra time in the morning.
I think Jack's plan is to do this next year as he really only needs 3 required classes to graduate and would technically have the right amount of credits at the end of this year. He may even do 2 open in the morning and then would not have to miss any school for infusions. We do a 7 period day but they need 5 periods to walk the graduation line.
Whenever he has flared or had issues morning has always been the worst for him so thinking ahead if he does have any problems we're already prepped for it.
 
Another thought for missed credits (sorry, I think I'm repeating myself from another thread??) but my kids always did one credit over the summer. It was next to impossible for them to find jobs at that age so I insisted they take one credit (here, one summer credit means class runs for all of July). And, to compensate for their 'lost' summer and in place of a summer job paycheck, I paid them their final 'grade' per week, retroactively (ie, if they ended with a 75%, I paid them $75 per week). Just an option for him to make up an extra credit or two and give himself some wiggle room during the school year, make some money and keep busy for part of the summer.
 
I am the same way. I always wake up nauseous, skip breakfast, and sometimes skip lunch when it's really bad. This year I have study hall, so if it's really necessary, I can come in late, but it's highly frowned upon since the attendance ladies don't like having to deal with that kind of stuff. I usually just go to school anyways, then sleep during study hall. It helps! I have lunch around 1, but I'm not all that hungry then either... I bring something like a granola bar, or even a little bit of cereal. I started drinking protein shakes in the morning (the whey isolate stuff) and it really keeps you full all day, and it's easier to consume than food even through nausea. They whey isolate is great in the morning. For junior and senior year at my school, we have the choice of late arrival or early release in place of an elective. Im not sure if your school would allow that, but for us, they are actually considered to be electives. I've never come in late before though, but I can say that drinking a protein shake a few minutes after you get up then sleeping through a study hall if you have it early enough really helps with nausea- at least it helps me. I hope this helps, and I hope the nausea goes away; or at least begin to get better!
 
I also can't eat before 9am, I get very nauseas and have always been that way I hope the Prilosec helps! Keep us posted!
 
I give up. I'm so frustrated with him right now. Trying to stay positive though and glad he's going through the this stage while still living at home where I can at least observe versus being in college across the country somewhere.

We eat dinner around 6 or 7pm and then, with the nausea in the morning, he doesn't eat again until noon, by his choice. I've been packing snacks and cutting up protein bars for him to nibble between classes and he's not eating them. Says he forgets. His water bottle comes home full too. I'm guessing his calorie intake is way below where it should be. You can led a horse to water...

So, now my question is, if I let him continue this pattern he's in, what are the potential negatives?

My plan for now is to let it go until his appt on the 29th and then have his GI talk sense to him, maybe threaten overnight NG feedings or something too. That will catch his attention! In the meantime...
 
I wouldn't have the GI discuss the ng tube as a negative. If it is viewed in that light and then something does occur even if he is doing everything right that requires ng tube feedings you may get more push back from him.

When kids are small it's a lot easier to dictate their lives. But as teens their normal state is to seek independence and test the limits in order to form their own opinions and grow to be self sufficient.

Have you had an FC to determine if something is amiss or blood work? If that all pans out I would have the GI put the choices and possible consequences in black and white for him. Teens can be such visual learners, for instance C's GI laid out a graph on what his low calorie intake could be doing to his body and that brought C around quicker than my constant nagging.

Since C is now over 18 though, I do have to allow him to find his way. In some areas he has really picked up the reins in others I have to grit my teeth and let it go. Ultimately, C is going to have to see the consequences of his choices and make decisions based on that.
 
Clash said:
I wouldn't have the GI discuss the ng tube as a negative. If it is viewed in that light and then something does occur even if he is doing everything right that requires ng tube feedings you may get more push back from him.

Have you had an FC to determine if something is amiss or blood work?
Click to expand...

Good point on the NG, but he already hates them from the handful of experiences he's had. I just meant he'd do anything to avoid one if given a choice.

His labs on November 25 were all normal. He hasn't had a FC in a few years because his GI isn't big on them. He'd do one if I asked though. It's crossed my mind.
 
Have SO BEEN THERE! The advice given to me be counselor and child psychologist I worked for was to have him come up with a plan of what will work. I got the "I forgot" more times than I can count. I was told they are more likely to follow a plan if they come up with it. For example, "you must have x amount eaten by noon, how can I help you make that happen?"
As a teen, they just don't see the big picture and unless consequences are immediate they can overlook. While we can see what continued missed meals will eventually do to them they only look at I feel fine today and if I don't eat until noon I feel better.
I would personally ask for FC just one more piece to help rule out Crohn's being responsible.
 
Potential negatives are weight loss and malnutrition. I would also ask for an FC/bloodwork, just to make sure it's regular teen stubbornness and nothing else.

I wouldn't threaten with an NG tube, because should he ever need one, he'll be even more terrified. My daughter's GI always said if she couldn't eat, she'd have to get an NG tube. M always viewed it as a threat, even though I don't think it was meant that way.

Then when M was unable to drink enough Peptamen Jr, she had to get an NG tube and she terrified and distraught. Especially since she had been doing her part and drinking Peptamen, just not enough.

Tell him when you lose weight, the first thing you lose is muscle....;)
 
Our doctors say - "If you don't do X then you can't dance." They lay it out for her. It is up to her to make the choice. She always does X because dance means that much. Is there something that means that much to your son?
 
Ok. I'll ask for FC. I do feel like he has to give the Prilosec a chance and have it not work for his GI to be more open to a FC. Maybe I can work it so we have results by the time the appt rolls around.

Unfortunately, he has no activity that he's passionate about. Video games? Phone? He's very hard to discipline because he has nothing of value like that and is such a rule follower that it's never much of an issue. The one time we took video games away, he spent the time in his room reading and happy as a clam. And I can't take away what he loves - school and reading. He's super introverted and shy so friends have very little influence.

Would it be bad if we turned it into a reward thing? Have him come up with a plan like Jacqui suggested and then if he sticks to it, reward him? I have mixed emotions about this.
 
Didn't he play tennis? I guess that's seasonal though, so you can't really take that away.
How about extra chores?

Or having his GI talk to him about how important getting enough calories is. My kids always listen to their doctors when they don't listen to me!

Not sure about rewards in this situation.
 
I'll admit I've done the reward. Sometimes when they come up with their own plan you can discover more reasons why they are not doing it besides the "I forgot" with Jack it was everyone was asking him why he gets special permission to eat and he didn't want to call attention to himself. He came up with extra time at break, he would leave his 2nd period a little early and go eat and still have time at break to hang with friends and it was like he was going to take daily meds which lots of kids do as opposed to getting special privileges if that makes sense.
 
Make sure he comes up with the plan
Have him write it down as a checklist
Read it out loud to you and then check it off when it's done
If he doesn't do it have him explain why
No flimsy excuses he is accountable

As far as reward I know we have done that before
No biggie

Ng tube
We told Ds he gets to chose how the medicine ( shakes ) get in
Either he drinks them or ng tube
Showed him lots of pictures of kids with ng g nj and Gj tubes
Which is a good thing
He chose to drink it
And earned cash per week on EEN
Toys /video games per week second time on EEN

He has recently asked about ng tube
He drinks 8 shakes a day and has since April
Due to possible other Gi issues ( not crohns )

So glad it isn't a scary thing
Since he may need one sooner rather than later
 
We reward A for things that are difficult - multiple sticks, uncomfortable procedures, etc. She's only 10 and being a kid with a chronic illness is tough. Your son is a little older and is approaching adulthood. Rewards may be a good start but I would think he'd need to wean from that soon. Ultimately you have to do whatever you're comfortable with.
 
^Yeah that!!

As they get older, rewards have to get bigger to interest them.

When M was very sick and down to 82 lbs last summer (because of the gastroparesis), we were desperate to get her to try the NJ tube again. She'd already tried it once, and lasted only 10 days with it in, and so knew it was very uncomfortable and absolutely hated it.

We were so so desparate to get her to try it again, that my husband offered her a kitten (if I was planning on offering her a shopping trip:ybatty:). Eventually, M's weight got so low and she was so sick that her doctors became worried about her organs and she was readmitted and the NJ tube placed.

So right now, there is 6 month old kitten climbing on our dining table and trying to sit on the laptop keyboard:yrolleyes:.
 
Haha I love it maya142.

Me and my kids loves dogs, my husband not so much. There is really no reward system that C would put himself out for. He works, makes his own money and buys what he wants.

I was saying the other day to C that I wish we had a puppy. He was quick to say well use it as my reward then maybe Dad will go along with it. Hmmm...Wonder what C has pulled over on me using his CD since he didn't skip a beat about the puppy plan?!?!
 
I wouldn't have a problem with rewards. I'm not sure I used rewards with S as he was older but, I think I relaxed rules sometimes - given these kids are asked to go above and beyond the average kid, I'm good with them getting a bit more than the average. ;) Although, MLP is right in that bigger kids need bigger rewards! :eek:

But, as S was older, my conversations with him revolved mostly around the consequences of his actions. I explained that, at his age, all I could do was give him advice but the decision was his to make. I made it clear that, while my heart would break for him if he ended up struggling and suffering due to his actions, in the end, it would be he, not me, who would feel the consequences. In front of S, I did raise concerns with the GI (amidst his groaning and eye rolling!) and simply asked the GI to speak with him on matters. I then left the room so they could speak privately - there was no 'mom' conflict.

I've also found that, if you keep reminding, while it seems they aren't listening or taking heed of what you say... sometimes their actions do show they listen.

(Having said all this, S certainly 'forgets' alot of the time! S is still fighting a bit of stomach flu, calls me last night to say he's feeling sick and nauseated again, he'd just finished eating an apple... he was worried it might be crohns, I talked to him for a while, gradually it came out that before the apple, he had two pieces of pizza bread with lots of cheese and hot salami! :ybatty: 'Umm, no, I don't think the problem is the apple or crohns!' ...I just told him, 'I've given you all the advice I can and have suggested toast, broth, tea, banana, etc... never did I say pizza bread with spicy salami! So, go to sleep and start again tomorrow! :yfaint:)
 
IDK, if he really is a rule follower then he would be eating right? I think I am more concerned with why he isn't eating. If he truly isn't hungry there is nothing more disgusting to me than trying to shove food down your throat. Maybe the GI can help you get to the bottom of why he isn't hungry.

Maybe a little more exercise or activity will stimulate some appetite?

As for getting the kids to do what they should, sports is the motivation in our house. If you don't take care of your body then it simply won't perform for you.

He does play tennis right? maybe come up with a plan with the GI...if you fall below X weight then no tennis. This way it isn't an every day struggle and treat but rather a longer term goal.

Is he losing weight? I forget...
 
Two good things happened today since my rant this morning. One, his guidance counselor called him in and said they'd add the tardy allowance to his 504, asked how he's been feeling, and reminded him that health comes before school. Told him they'd find ways to make school work for him. And, two, he ate his protein bar during third period after the nausea went away. Praise is a big thing with him so I told him I was proud of him. I asked if he felt better after eating it and he admitted that he did. Progress!! Now I'm going to press my luck and see if I can get him to drink 1/2 an Ensure before bed every night.

CIC - He's not losing weight... but he's not gaining either. He's been at 113 for quite awhile now, though he is very slowly getting taller. I do believe he's not eating in the morning because he's so nauseous. What the cause of the nausea is, is the question, but even non-IBDer's seem to have trouble in the mornings as well. Unfortunately, in his mind, he has no time to eat after the nausea passes, but hopefully today he realized that's not true.

Spring sports don't start until April around these parts, so not really an option.

I hope we're not scaring the parents with younger kids! I'll just say I promise to be here for y'all when you get to this point in life. I really appreciate the advice coming from those of you with older kids who've gone through this.
 
Glad the school is working with him.
That is huge

How tall is he ?
I only ask since you said he only weighed 113 lbs.

Ds is 12 and weighs 102 lbs. but DH is tall and played football so ...
Assume the same for Ds
 
my little penguin said:
How tall is he ?
I only ask since you said he only weighed 113 lbs.

Ds is 12 and weighs 102 lbs. but DH is tall and played football so ...
Assume the same for Ds
Click to expand...

At 15 1/2, he's 113 and 5'4 - averaging 20th% for weight and 10th% for height. His bone density at 14 yrs 2 mo, marked him at 14 years.

His brother is 11 1/2 - 80 lbs and 4'11". Tall and skinny.
 
I think the younger the kid is dxed the easier it is to set the life style. It's like young kids dxed with diabetes by the time they hit high school they've made a habit of regularly checking their sugar, eating properly and medication regimen. Since it starts when the parents have full control of the child's habits. Of course, it doesn't always work out this way but it is a longer time to instill proper eating habits(lifestyle dietary habits), medication regimens and such.

I think if C had been dxed in elementary (when he had bouts of vomiting that was chalked up to various non concerning things) then he'd would be much further along at regimens with calorie intake, meds etc. Instead, he was dxed at 15 when kids are starting to explore their independence which even in non IBD kids can be challenging.

Hopefully, the kids that are dxed early reach teenage hood more adapted to the schedules and changes they need to make to control any blips with CD.

I agree with the nausea, like I stated earlier my non IBD daughter has always struggled with nausea in the morning with meals. Travel softball subsisted of a breakfast with team mates (usually fruits, oatmeal, granola or sometimes biscuits) followed by a vomiting before taking the field. The team started determining the outcome of the game on whether she got sick! That was the only time I think she felt pressured to eat, any other time she would skip breakfast.

It sounds like your son is on the right track now. I will say C was quicker to eat a banana then protein bar mid morning than the protein or other type bar alone. He said he feels like the banana coats his stomach. Just a thought.
 
I'm sorry ds is having a rough time and I hope you get to the bottom of it. A thought (that may not be necessary) for the school issue is looking into online classes. I work at a high school and we have a lot of kids with a blended virtual school/"regular" schedule.
 
Mehita said:
Ok. I'll ask for FC. I do feel like he has to give the Prilosec a chance and have it not work for his GI to be more open to a FC. Maybe I can work it so we have results by the time the appt rolls around.

Unfortunately, he has no activity that he's passionate about. Video games? Phone? He's very hard to discipline because he has nothing of value like that and is such a rule follower that it's never much of an issue. The one time we took video games away, he spent the time in his room reading and happy as a clam. And I can't take away what he loves - school and reading. He's super introverted and shy so friends have very little influence.

Would it be bad if we turned it into a reward thing? Have him come up with a plan like Jacqui suggested and then if he sticks to it, reward him? I have mixed emotions about this.
Click to expand...

I definitely find rewards for goals reached to be very effective. I've paid for weight goals reached and for daily ensure goals reached.
 
So... when do you freak out about weight loss? He's down four pounds, but that's our bathroom scale compared to the infusion center scale.

I think I'm in denial.
 
I'd probably be pretty concerned over a 4 lb weight loss, especially for a kid who's already small. Definitely time to talk to him/bribe him etc.

I like CarolinAlaska's goals idea - I think the daily Ensure goal might work well in this situation. I also like the checklist idea - could he make one on his phone, so that he always has it with him?

Also talking to him why he won't eat in class - is he embarrassed? Is he just not hungry? Does he actually forget?

We learned that 4 lbs can very quickly 8 lbs, which can become 12 lbs and so on. I'd weigh him weekly till his weight weight stabilizes.
 
I got concerned recently when both girls lost that much weight. They both had fc' scores over 500 and we tweaked meds and they stabilized and went back up

I would fyi the gi. Probably time to test a few things to make sure you aren't missing anything
 
Nausea woke him up around midnight last night. He was up for 45 minutes and asked for Zofran. It worked well and he felt mostly good this morning except for being really, really tired.

We bumped up his GI appt to this Friday. I'll ask for fecal cal like you all suggested. I'm guessing scopes and MRE will be on the agenda since last labs were normal.

I don't know about you guys, but when your teen asks to go to the GI... scary.
 
GI appointment - check.

His GI doesn't think the nausea is Crohn's related. Like me, he thinks it has more to do with DS going so long between meals and, something I wasn't expecting, anxiety. In retrospect, I suppose it does make some sense.

The plan for now is to stick with the Prilosec, use Zofran as needed, and also put DS on Lexapro for anxiety for two months. Does anyone have experience with Lexapro?

He also ran a Celiac panel, just to be sure it's not gluten sneaking in, and amalyase and lipase to rule out pancreatic issues.

If the Lexapro doesn't help decrease anxiety and, subsequently, nausea in six weeks, then he wants to do an MRE followed by scopes. I know nausea can be a side effect of Lexapro. Joy, oh, joy! And now that I'm thinking about it, I totally forgot to ask about fecal cal. Doh!

Oh, and we ruled out morning sickness from pregnancy. :)

DS is under very clear orders to eat at least four times a day and to give breakfast a chance again. Start with a nibble or sip of something and work his way up to a full meal (just like Maya suggested!). He was really good at explaining to DS about stomach acid and how not eating frequently enough can cause problems. DS also said sometimes it's hard to swallow or feels like he's swallowing something along with food, but this only happens in the mornings. The GI mentioned esophageal something or other, but wasn't too convinced. If/when we get to scopes, he'll look for abnormalities then.

The only thing his GI was a bit more concerned about was the nausea waking him up (twice now). He said if that keeps happening he wants a phone call.

I'm really hoping having someone who is not mom or dad talk to him about eating will have some effect on him. He seemed fairly receptive during the appointment and there was a lot of joking and banter, so... fingers crossed.
 
A would want a psychiatrist involved if they are prescribing lexapro
It is not a minor med.
Causes weight gain
Sexual disturbances
And mood /anger issues in some.
Lots of interactions on this drug
I thought ppi were out not sure

I would want organic issues ruled out first by the doc before psychiatric causes were cited.
Delayed gastric emptying
Gallbladder
Crohns
Celiac etc....

Does he see psych now ?
If not an eval would be a good place to start

My kiddos Neuro doesn't mess with gi stuff
And gi doesn't mess with joint stuff
You need the right captain steering the the right ship
 
Definitely see a psychiatrist before putting him on Lexapro. Not only is not an easy med to be on (interacts with everything!), it is a med that is hard to come of (has to be tapered, carefully). It also has a black box warning on it - I don't mean to scare you and that he shouldn't take it, just that it's not something you take lightly.

We ran into trouble with this kind of thing with Cymbalta, which is a slightly different kind of antidepressant (SNRI vs SSRI), also needs to be tapered. Our (ex) rheumatologist prescribed it to my older daughter for pain. When it didn't work, she told her just to stop it, so S did. Then she promptly got horrible dizzy and nauseous. We contacted the rheumatologist who dismissed it as anxiety.

She was in the first few weeks of her first semester of college and she could not go to class or eat. She was so miserable that she cried and cried about wanting to come home. Then about a week later we googled "Cymbalta withdrawal" and realized that was what had been going on. Put her back on Cymbalta and she was back to normal in 2 days. We then saw a psychiatrist who was completely horrified her rheumatologist had just stopped it, and helped her taper of it.

This is a very long way of saying, really, you want to see a psychiatrist!

My younger daughter is on Lexapro for anxiety and it works very well for her. It took about 6 weeks to work. When she went on it though, she had already been seeing a psychologist for more than a year. She was anxious and miserable ALL the time - could not sleep at all - and it was very clear to us that she needed to be on medications.

I can't remember, is he seeing a psychologist? I would try that first before jumping to meds. If he is seeing a psychologist, does the psych agree he needs meds?

Nausea certainly can be from anxiety but it can be from plenty of other things. Our GI did not pay attention to M's nausea - called it reflux (which she had) and later gastritis, which is what her scope showed. When it got really bad, she finally ordered a gastric emptying test - and guess what, gastroparesis!

I would want first Crohn's to be ruled out (when was his last FC?) and then other things for the nausea. I'd definitely work on eating breakfast too - it's not easy, but he can do it!

Good luck!
 
He doesn't see anyone now. He saw a therapist two summers ago about medical anxieties, fear of needles, etc, but she said he was good to go after three months and he hasn't been back. I'm going to share what you guys said with him and see if he'd be open to trying it again.

Psychiatrist or psychologist? Reading the bios at the place he used to see someone and I can't tell what they are. It just says therapist. Our hospital does have both, but the drive and hours won't work.

Maybe his ped would have a recommendation.

Orrrrrr... he could just try eating!
 
Psychologist does cognitive therapy which helps anxiety

Psychiatrist prescribe meds but work with therapist ( only have masters )
So you only see psychiatrist for 15 minutes tops every
The therapist is seen weekly

Be aware getting in to see a psychologist or psychiatrist takes months
 
I highly recommend cognitive behavioral therapy - it really helps with anxiety.

Definitely first psychologist and they will typically have a psychiatrist whom they can refer you to, if they think your son needs meds.

I agree with MLP^ our psychiatrist appts. are less than half an hour but M sees her psychologist every 10 days or so. Sometimes more frequently, sometimes less. In the beginning, M saw her weekly.

His pediatrician might have a recommendation. We went with the psych M's GI recommended, because we figured she would have a lot of experience with kids with chronic illnesses. M had already seen two other psychologists whom she didn't like because they didn't "get it." It's quite a drive for us too, but since we couldn't find anyone good locally, we figured it was worth it.

That said, you might find a great one who is next door to you.
 
Mehita

Chiming in support for finding a psychologist. Our GI recommended one who is experienced with teens with IBD. If you have to you could pay your son by the hour to go, or tell him to try it once with no strings attached.

He/she will know right away whether he needs a psychiatrist.

Good luck and hope he feels better physically soon too.
 
Not sure how I missed this whole thread - sorry. Nothing to add really, so much good advice from everyone else! I agree it's worth asking about psychology first before meds although I don't know what your waiting lists are like. My daughter was referred for chronic pain over 3 months ago and still waiting! Hope he manages to eat a little bit of breakfast, it is horrible trying to eat if you feel sick. That's great the school was so understanding
 
That's nice that the GI doesn't think it is Crohn's but I say test anyway. Are you with me JMRogers, Clash et all? At least a fecal cal test. He could appear just fine but something else could be going on.

Yeah I get anxiety But the point is he had been eating right? This is something new. Could be anxiety but could also be disease activity.

If I am covering all the bases by giving my kid anxiety meds I would also want to cover the Crohn's base.
 
Mother of the Year goes to...

DS is so mad at me right now. He was totally on board with the GI's plan yesterday and says I'm a hypocrite for changing the plan after all my preaching prior to the appt about how he needs to do what the GI says. Now I'm the one not doing what the GI said by holding off on the Lexapro. I tried to explain my reasons, but when the walls go up, well, it's like talking to a wall.

I'm mad at myself for not thinking more quickly on my feet at he appt.

To top off the night, little brother overheard my husband and I talking about bribing options to get DS to eat and see a therapist. Now he's upset with DS for being "stupid" about eating and says he won't go to school anymore unless we pay him.

Overall, a terrible, horrible, no good, very bad day. :(. I'm thisclose to just throwing in the towel, letting DS get sick by his own doing, and dealing with the clean up later.
 
Last edited:
What a difficult situation!
It's so hard when they're teens - they're so impossible sometimes. Sending hugs!
 
I would have been right with you at the GI's, don't be so hard on yourself it's difficult to think on your feet when you have no experience so really don't know the questions to ask you just assume the doc knows what he's talking about especially if you already have a level of trust with him.
So hard wroth the stubborn teenage boy, now mine would listen to me and then do precisely what he wants.
 
Definitely don't feel bad about the GI appt. It's impossible to think of everything during the appt, especially when something like the Lexapro comes up, which hadn't even been on your radar.

My daughter is on a low dose SSRI (Prozac) for anxiety, and she started it the week she was diagnosed. It was recommended to us by the attending GI during her first hospital admission, based on how much anxiety E was having during procedures like blood draws and the MRE. My husband and I e-mailed back and forth with E's pediatrician about it, read about it online, and then went ahead with it. We were also advised to schedule an appt with her ped a month after starting the Prozac, which we did. My daughter hasn't had any side effects from it, and it's made a huge positive difference in her ability to cope with her Crohn's.

We've also been looking for a psychologist or therapist for about 6 months, but haven't found anyone good yet, so we've been grateful for the Prozac in the meantime.

None of this is meant to disagree with the other advice you've gotten here. Certainly SSRI's shouldn't be taken without serious consideration, cognitive therapy can be very effective, and most importantly, you don't want to ignore symptoms that are due to a Crohn's flare rather than anxiety. But even if your son's symptoms are due mostly to Crohn's, that doesn't mean that he might not benefit from Lexapro, if he is also suffering from anxiety. If you can get an appt with a psychiatrist soon, then great. But if you can't, think about talking to your son's GP about it. They often have a lot of experience with SSRI's.

As for the siblings/rewards thing, I can totally sympathize. We do a lot of talking about how fair treatment doesn't mean equal treatment. And whenever possible, we try to make the rewards be something that my younger daughter wouldn't want, or that she can also enjoy. (The latest reward, for drinking a smoothie every night before bed for the past 3 months, was a bass clarinet rental. E has been dying to play bass clarinet, but it's not something that my younger daughter cares about. Another recent reward, for going to see the plastic surgeon, was a video game that both girls can play.)

Best of luck with all the decisions. It's not easy. :ghug:
 
I'm sorry, Mehita. Seems sometimes the harder we try, the worse things get messed up. They'll come around.
 
That is a bad day. I'm sorry it is piling on you.

I think you are doing a great job managing your way through this awful maze. You will get through it and to a better place and hope that time comes sooner than you think.

If you decide to throw in the towel, maybe I'll join you. We can let our sons and jealous siblings hang together and figure it out on their own. Meanwhile we can go to the beach. Kidding. Sort of.
 
One of the two Celiac tests came back positive, which I'm interpreting to mean that gluten is sneaking in somewhere. We're already fairly strict, so this is very frustrating, especially with the 20ppm labeling and the Cheerios fiasco. We can't trust food labels anymore and if you can't trust food labels, what are you supposed to do???

Since seeing the GI on December 18th, he's only been nauseous once. This leads me to believe that if there is gluten, it quite possibly was something he was eating then, but isn't now... maybe something I was putting in his school lunch every day, which he's not eating now since it's winter break.

The kitchen is getting a scrub down and the pantry is being analyzed today. If you guys have any other ideas, please post.

Also, if there are any Celiac experts out there... tTg w IgA was 0 = neg, but the tTg w IgG was 8.9 = weakly positive. I know IgA is the more accurate of the two, but still concerned about the IgG result. His IgA value alone was tested at 646 with normal at 70-380, so IgA is definitely not "low". He's a sensitive Celiac, so I do see how "weakly positive" could have been having an effect. Thoughts?
 
Well YAY! You have found the possible culprit!

No experience with gluten issues here but does he buy any food at school or a deli etc near school? Maybe that is more the issue than your home practices and yes, sadly food labels aren't always 100% correct:ymad:
 
When having food issues - food allergy or otherwise
It's best ( although annoying ) to go to basic whole foods
Only things that come in natures package for the majority of the diet ( fresh fruits /veggies /rice /lean meats )
And bake from scratch so less likely contamination
Are you calling the companies individually for cross contamination within the last few months asking explicitly about made in the same lines or same facility as ?
Do you avoid the same facility or only if it's labeled as such ?
I know we try to call at least once a year but the stakes are higher - traces equals anaphylaxis so has to be done
Sorry it looks like he is reacting but can be fixed
 
crohnsinct said:
Well YAY! You have found the possible culprit!

No experience with gluten issues here but does he buy any food at school or a deli etc near school? Maybe that is more the issue than your home practices and yes, sadly food labels aren't always 100% correct:ymad:
Click to expand...

Nope. He only eats what I pack. He doesn't even take $ to school or carry a wallet.

@MLP - Yup, I call all the time. I have a three inch binder with notes and chicken scratches with updates. He doesn't eat any "made in a facility with" items or even very many non-certified foods. It's to the point where I can even tell you that full size Snickers bars are ok, but the mini's are not because they are made in a different plant. Same ingredients, different facility. Fun stuff, huh?

We have a great local support group here so I'm bending their ears as well.

I did have plans to start a clean eating thing beginning January 1. Maybe DS will be more onboard now...
 
Ok so your following the rules but is he???
Teenagers tend to take more risks especially chronically ill ones.
Is he avoiding high risk items regardless of labeling
Case in point
Our allergist told Ds absolutely no chocolate , ice cream or bakery food items
Regardless of labeling
So all ice cream is made from scratch same with cakes muffins etc...
Chocolate only enjoy life otherwise not worth the risk
Due to tree nut cross contamination
 
Good that you have some progress. I'll check my son's two gluten tests bc I think they were similarly wonky.

The notebook is a great idea as well as info that Manufacturing and ingredients can change. Ty.

I'm sure you've covered this, but are there any other places where he might be around food? I've become hyper aware of how many events involve food since my son went on scd over a year ago. An occasional teacher offers candy for incentives, clubs bring in snacks, parents of friend's can push illegal things bc they don't know and are trying to be nice, practices, and school functions? Gluten items really are everywhere. It is really hard to tell a teen that unless we made it we can't be positive it is ok. we know this but I'm not sure a teen's brain is really always firing like ours. You know how they say a teen may seem like your peer physically and sometimes intellectually, but emotionally and for higher level reasoning they are not!

Says the mom who had to remind her son at a recent buffet that meatballs and crab cakes have breading. ???

Ps. He got sick after eating subway turkey meat only (at a practice a few days in a row) which is called gluten free but could he contaminated in a store?
 
This is going to sound kind of mean, but he really is a geeky, nerdy, home body. He rarely goes out ever and when he does, he always brings his own food. (I'm not saying he doesn't have any friends... they all just tend to come here (sometimes too often)).

After seeing the results this morning, he has decided he wants to track his food. His idea, not mine (I had to pick my jaw up off the floor), so again, I really don't think he's taking any risks. I actually think he's more freaked out than I am right now. And I still think it's something small. Something he was eating everyday for several months. Something not quite strong enough to make him vomit, his usual response, but just enough to bring on nausea. I'm making a list as I type this of things popping into my head... toothpaste, lip balm. The acne creme? Dog food and not washing hands after?

Very interested to hear about your son's tests, Optimisitc. I'm still confused as to why IgA could come back negative and IgG as positive.

I'm drafting an email to his GI with my questions. I'm going to have to let it simmer over night though. Hey, let's put him on Lexapro!! I'm a bit annoyed right now and very grateful to those of you who told me to wait.
 
I'm glad you some sort of answer - even if you have a lot of things to narrow down! Do you think it's something he eats or uses at night, given the nausea in the morning?

Great that he wants to track his food - since he is worried perhaps he will be more open to a healthier, cleaner diet.

Hope you figure it out and he feels better soon.
 

Similar threads

D
EEN & School
Replies
4
Views
1K
kiny
kiny
C
Your thoughts, please. 10 yr old.
Replies
12
Views
936
wenkren21
W
P
How long on EEN before your child had solid motions again
Replies
5
Views
691
padrach3
P
S
Two year old with symptoms
Replies
22
Views
3K
J100
J
M
7 year old in pain not diagnosed
Replies
4
Views
1K
my little penguin
my little penguin

Latest posts

Back
Top