Monday, 27 February 2012

Signs & Symptoms - back to the start

 Have you ever noticed these - on your shopping trolley?
Have you ever stopped to take in just how many signs there are around us? Looking for a sign to illustrate this post, I suddenly realised just how many there are - they are well everywhere; it's like an epidemic (just try counting them, next time you go out somewhere). But how many of these are completely necessary - of how many do we actually take notice or even understand? With Baby the signs were there, clear to read - if only I had known how!

Going over old ground
For those of you who have been following the 'story so far', some of what is written in this post will be familiar to you. Sorry if I bore you by 'going over old ground', but I have in mind those new to this blog, who might be wondering whether they or someone close to them might have a problem with milk - in which case this particular post (focussing on what alerted us to Baby's problem) could perhaps prove useful. So, for the purposes of this post, I'm going...

Back to the start
By the time I eventually saw our family doctor, the diagnosis of cow's milk protein intolerance had already been reached and clearly proved. In some ways, I wish I'd visited the family doctor first (rather than the two locums I actually saw) as, when he asked me about her symptoms and I rattled them off, he nodded and agreed that they were classic signs

Truth to tell, I'm not entirely sure when Baby first exhibited signs of having a problem, but as we were having other issues at the time (let alone the fact that we were trying to get our heads around having a new baby) maybe I just missed them to begin with. All I know is that I first became aware of soreness in her nappy area, around two weeks into her little life. 'Agh! Lie still!' I would yelp in frustration. Baby would writhe with an incredible show of strength in her tiny frame, and I would struggle to change her. 

As soon as it dawned on me that her resistance was due to soreness, I felt horrible rush of guilt for feeling so frustrated. Immediately resolving to be more gentle when cleaning her up, it took at least a few more days for me to realise that the writhing preceded, not just accompanied each nappy, and that the nappies were rather frequent. Were they too frequent? I didn't know/couldn't be sure however, the signs seemed to escalate - particularly at night. This was when the cycle of feed, cry, nappy, cry much more, feed again to comfort and soothe, seemed to be endless and I was lucky to get a few hours sleep. 

Seeking help
The Hub being back at work was sympathetic but, being able to do little about it (although he did turn to his favourite reference book - the Internet, searching for clues) managed to sleep through. I was exhausted. Quizzing the midwives got me nowhere, neither did two visits to the doctors. I was getting near to the end of my tether, and wondered whether it would do any good to go to A&E - I wasn't sure if it would fast track  us to being seen by a paediatrician or whether I would be dismissed as an over worried first time mum. And then came the decision to see someone about her tongue tie. To get a private referral. 

I sometimes wonder how things would have turned out, had we not 'gone private'. How long it would have taken to get the correct diagnosis - after all I'd already seen two doctors locally. I've met others for whom it has taken longer - although they had different symptoms such as reflux, vomit and eczema. All I know is that the time for which it lasted seemed unbearably long. Part of me felt it must be what having a new baby was like whilst another part of me knew it was wrong. 

Baby's Symptoms
Thankfully we did see the paediatrician, thankfully he enquired beyond the tongue-tie , thankfully he was a specialist childhood allergies, thankfully to him our case seemed pretty straightforward. Once I had described, in as much detail as I could, what had been happening, the paediatrician was able to make a fairly swift diagnosis; the diarrhoea, the writhing prior to a poo (presumably caused by tummy cramps), the frequent explosive blasts of yellowy brown watery poo, all taking place not long after a feed. These, in addition to the sore botty that wouldn't clear up (burning caused by acidic poo) all pointed to one thing as far as he was concerned - cow's milk protein allergy. 

'Testing' the diagnosis
Me, wanting to be sure that he knew what he was talking about (having had two misdiagnosis, I was understandably cautious) questioned how he could be so sure. Apparently, at the age Baby was then, (she was just a month old) the only two likely causes of all her discomfort and distress were an infection or cow's milk protein allergy. Due to fact she was being breastfed, and so young, the infection was the least likely but (to rule out the possibility) a sample was to be collected and tested. Meanwhile, I was to steer clear of all products containing the slightest amount of cow's milk. 

It was this latter course which was to prove the diagnosis. Sure enough, within about three days, the symptoms had vanished and I had a completely different baby. It felt like the miracle for which had been praying. The test results, which were to follow later, merely confirmed what we already knew - there was no sign of an infection.

Other symptoms
The symptoms I have described are common to many other food intolerances or allergies. There are, however, quite a number of other possible symptoms that can accompany the same condition, such as:

Feelings of nausea
Stomach rumbling
Runny nose
Weight loss (if left)
Malnutrition (if left)

Interestingly enough, it seems that individuals can exhibit a different set of symptoms at different times of their life. So a young child might begin by exhibiting symptoms affecting the gut, but later (when they're older) have the kind of reaction that affects breathing.

How can one know for sure?
If you are trying to work out whether you or someone else you know might have this problem, it can be quite tricky to find out. It's easier when they're a baby, as problems with cow's milk among babies are fairly common. It is possible, however, for symptoms to go unnoticed, or for people to develop symptoms later in life. Older sufferers have much more variety in their diets and so identifying the cause of a problem, can be like looking for a needle in a haystack. So what about diagnostic tests?

Quite a lot of people have heard of skin prick tests. Medical opinion is divided on how useful they are and blood tests don't always detect problems that do exist, as I found out following the tummy bug I had the other year. Part of the problem is that such tests work on detecting a response in the immune system, which might occur with an allergy but not with an intolerance.

A first step towards pin pointing a problem might be to keep a food diary - listing everything that is consumed, alongside any possible symptoms. Doing this can help to identify patterns and perhaps the cause. Following this, excluding 'suspects' from your diet  (one at a time) can help confirm what is triggering the symptoms, and therefore what is causing the problem. 

These so-called 'exclusion diets', such as the one that Baby and I have had to follow are most reliable way of confirming that a food is causing a problem but it is recommended that these are carried out under medical supervision, as are food challenges (where following an exclusion, a small amount of the 'problem' food is reintroduced back into the diet). This is because otherwise you could be missing out unnecessarily on important nutrients.

So how do I know?
Although the blood tests that I had (following my tummy bug) the other year proved that I wasn't coeliac, the fact that wheat along with other certain foods caused me intestinal pain and dihorrea, (accompanied by headaches when the reaction was particularly strong) was enough to convince the doctor that I was intolerant to some foods. Like with Baby's problem the unknown factor was and remains - whether the intolerance will be short lived or last for life.

No comments:

Post a Comment