In the mean time....

Ava is an intelligent little girl with an incredible memory. She remembers every doctor she sees by name or first initial. Also she can remember why she goes to them and why she has to take each medication. This comes in handy when she's having a not so cooperative day. March 12 we had a follow up visit with Dr. T and to meet Ava's nutritionist. Ava only put on a few ounces in 4 weeks but it was a start. Has she been taken the acid reflux medicine? No, she refuses. I pick my battles. (We don't think she has acid reflux, so I don't push this one.) How about the Lactulose (stool softener)? Yes but every 2-3 days.* Good. Her intestines feel empty, which means the Lactulose is working. Lately there wasn't as many complaints of being to full to eat or her belly  hurting. Finally one thing going right.

*Ava despises the taste of the Lactulose. The first couple days on it she gave a fight about taken it and also it gave her the runs. We went to every other day and cut the dose but it still wasn't easy to get it in her. After about a week of this Ava came to me one day and said "Mommy my poop comes out so much quicker and easier now!!" This is how we came to the compromise of every 2-3 days. She still doesn't like the taste but there are days that she'll ask to take her "poop medicine." She always says "Dr. T says I have to take my poop medicine to empty my belly so I can eat more healthy food so I can grow."

3 ounces was a good start but Dr. T wanted to see a higher gain in our next visit. She decided to prescribe an appetites stimulant. She prescribed Cyprohedtadine, an antihistamine that happen to have the side effect of stimulating the appetite Okay we'll try it. It was to giving a bedtime because it had may cause drowsiness. If she  is still drowsy in the morning then give it 1 hour before bed. (I'll come back to that story.) See you in 4-5 weeks. Next we met with Mitch, the nutritionist. We go over what Ava eats regularly and her portion sizes. Ava's eating habit is something David and I never agree on. I always say she eats but in small portions and not consistently. He says she never eats. at this point we pretty much have let Ava eat what she wants whenever she wants just to get calories in her. Mitch is glad to hear Ava is eating a variety of healthy food. her portions are correct. She's eating the portion a 2 year old would eat. She's eating for her size not her age. Hmmmm, makes sense.

Her suggestion includes a regular eating schedule. 3 meals and 3 snacks a day. If she wants to skip a meal then fine but don't let her eat again til the next meal time. (If she skips lunch then her next meal is a snack. She can only have a snack at that time. Don't try to make up for a missed lunch because then she won't eat her next meal either.) All makes sense. Also try to add in extra calories whenever we can. Extra butter, whole milk, instant breakfast shakes at bedtime. No drinks in between so she won't fill up on liquid. A portion of protein is the size of her palm, a portion of carbs is the size of her fist. try to give a well rounded meal. Got it! Weight Watchers with fattening food. We're good to go.

We gave Ava Cypro. at bedtime the first night. Boy did it knock her out. She looked comatose the next morning. David dropped her off at school and he felt bad because she looked like a zombie. the next night we started giving it to her at 7 pm. In a few days we noticed she was eating better. By day 5 she was waiting for Jack to fall asleep and coming downstairs to eat at 9pm at night. It was like she was famished! By the end of the first week she was eating like crazy. What did you do with our kid?? It was crazy the amount of food she was eating. This went on for another week or so then it slowed down a little. She is still eating better but not with the same gusto she did that first 2 weeks. Tomorrow (4/16) she goes back to Dr. T for her weigh in. I'll keep you posted....