I had emailed the nurse practitioner at our rheumies office last Monday, in preparation of our visit that Thursday and Friday. She spoke to the doctor, and we all agree that she needed a new swallow study done. Emily had told me that she feels like there is a bubble in her throat when she tries to swallow. Hmmm. Since she had started to get stuffed up again (on antibiotic number 2 for the month), I mentioned that, as well as the headaches she has been having. I assume they are either from the sinus infection from hell or maybe from the growth hormones.
I wasn't going to tell her about the upper GI until right before. I asked for Xanax for her. She never uses that stuff except for medical testing. She just freaks out. It's bad. I guess that everyone thought I was overreacting. Nope! It was supposed to be outpatient at 11, but knowing how difficult it would be to get us out on time, they made it inpatient at 11:30. She woke up on Friday morning to the nurse telling her it was time to go downstairs for the test. She got herself so worked up that she almost hyperventilated. She cried for a good hour. She didn't calm down until someone finally got her a 1/2 a Xanax, but it was too late by then. She was rescheduled for 3:30, though no one told the scheduler downstairs. We were discharged at 1:30, so we had time to kill. We couldn't really leave, and since she couldn't eat, we tried to avoid all of the food places.
They told me to give her another 1/2 Xanax around 3. Despite having one full Xanax in her, when they took her back she still had another hour meltdown. I can't blame her. She has no control, no say in any of this. It sucks. If I didn't suspect it was bad, I never would have pushed.
After she finally calmed down, she worked with them to help herself. She asked to be slightly elevated. I watched the barium start to go down, then back up, several times. At one point, I thought the camera was showing something else, or glitching. Nope. What it basically showed is that she has, as the nurse practitioner emailed it, "Her study showed severe reflux and little motility of her esophagus." Hmmm. I suspected as much, but it still hurts to see it. At the moment, that is really all that I know. This is in conjunction with her patulous esophagus, which if you missed it, means that the muscles at the base of her esophagus have dilated and spread away from her stomach.
At the same time, she has spent 30 days on Augmentin and 10 days now on Clindamyacin, and she is still sick. She had an x-ray last week that showed she is still gunked up, so the ENT is working on getting an authorization from rheumie to get this expedited so they can culture her and suck out the junk up there. I really, really think she needs to be on a prophylactic antibiotic. Then maybe we could stop IViG, and maybe not have to sleep over the hospital every month.
But, wait! There's more. I have noticed for the past couple of months that her ALT (muscle enzyme) has been a tad elevated. I'm no longer the one to panic at the first sign of trouble, so I've just been keeping an eye on it. However, Monday her thighs hurt badly- like a 6-7 on the pain scale. That could mean that her dermatomyositis is also coming back, which would mean adding Prednisone back in. We really, REALLY don't want to do that. It makes me so sad.
If all of that wasn't enough, they ran her cortisol levels on Thursday morning before she had any of her hydrocortisone. A normally functioning adrenal system will have a count of 10 or higher. She was only at 1.3, so the hydrocortisone stays for now. And the final kicker was the email from camp that she is on the wait list for both sessions. At least we had a few good months. Hopefully this will all pass quickly. I guess we need to find a set Gastroenterologist now. We've seen a couple before, but mostly as favors to our rheumies. We don't really have anyone set. Hopefully endo will be able to help her more with the cortisol, and ENT will see her fast to help her sinuses. Please pray that all of this comes together just right. Thank you.