We saw Dr Charles today at Children's and he was really nearly horrified by the fact that she had gone through 5 cleanouts and 3 ER visits in one month. Of course it happened to be the month that he was out of the country lol.
He thinks that our current plan, no dairy, and 4, 1/2 caps of miralax is good since she's been doing better. He agrees that her getting sick in November was probably the trigger that set her on the down hill slide.
I asked him about several things today 1) her anterior anus and my findings about it requiring surgery, he doesn't feel that she does. 2)her reaction to enemas, he doesn't want her having them period 3)using senna and dulcolax, senna yes, but he doesn't want her using the dulcolax because it puts her anus out of her control 4)potty training, we will be getting into the GI therapy next month 5)urinary issues, he's still unsure if they are being caused by the constipation 6)gagging and spitting things out, still calling it rumination if it worsens she will need a scope to rule out esophigitis
So our current plan: follow up in 1 month. Use miralax daily, if no bm then we will do senna, if she goes more than 3 days without a true bm we will come back sooner and start therapy then. No fiber supplements. Keep and eye on her bowel habits and swallowing...and I think that pretty much covers it. We'll be back at Children's bright and early for urology with Dr Roth tomorrow.