I didn’t have too much to talk about with the pediatric gastro doc.
Eli’s tummy troubles — barfing up what he ate — appeared to be just normal infant reflux, us stuffing poor buddy in an attempt to fatten him and forgetting to give him his antacid due to our disorganization. All of that has been resolved.
I was sitting in the doctor’s office, and a video I had just taken for the social video sharing app Vine started playing in a loop. Loudly.
Dr. John Grunow, a pediatric gastroenterologist at OU Children’s, was a good sport.
“Sure, I like insanity,” was his response.
I had him explain to me why Eli’s pancreas doesn’t work right. How is it linked to CF? What are his body’s enzymes? Will he really starve without them?
Below are his answers and a quick overview of CF and the pancreas:
The problem is this: If you look at cystic fibrosis, the big problem is they do not have enough water in their sweat, and that’s because of that defect that they’re born with. There’s too much salt and there’s not enough water. When you have a system when things have flow through tiny tubes, then if you don’t have enough water, the material becomes thick, so it plugs up the tube.
JK: The thick and sticky mucus –it plugs up the tubes in the pancreas?
It does, just like it plugs up the tubes in the lungs. It plugs up these tubes that will be delivering the enzymes into the intestines.
JK: So the enzymes get stuck and can’t come out to do their job. What is the function of enzymes in the body when it comes to absorbing food?
There are three basic nutrients you have: Proteins, fats and carbohydrates. They come in as complex structures and have to be broken down into smaller pieces. The purpose behind enzymes is to break things into smaller pieces.
It so happens, for proteins, there are additional enzymes you get in the lining of the small intestines. You could do without a lot of the pancreatic enzymes and still do OK with the protein. Similarly, with carbohydrates, there are important enzymes that come from the pancreas for digestive starch, but there are still enzymes of the lining of the small intestine. So you could get by w/o that from the pancreas. For fats, however, there really is not a good substitute. If you aren’t able to deliver enzymes to digest fat into the small intestine, then you can’t digest fat well, and that’s a major source for nutrient intake. Because of that, then you just can’t grow.
As Dr. G explained, a child who doesn’t receive the right enzymes will simply stop growing. Being small would mean his body would be more vulnerable to a variety of assaults on his health.
That’s why every day, before Eli eats, I give him a dose of enzymes. I break the pills apart and deliver them in applesauce. He takes one before every meal unless it has been under an hour since he has last eaten. I haven’t counted recently, but he eats roughly every 3-4 hours, probably about 6-8 times per day. Once he has his pill, I give him whatever his baby heart desires, food-wise.
I’ll do a separate post where I show more about that process.
Here are more posts about Eli and his recent tum fun.
Until next time!