Outpatient Endoscopy: A smooth process with a surprise ending

Outpatient Endoscopy: A smooth process with a surprise ending

Posted by Celiac Disease Family

Off to see the Peds G.I. for our daughters first endoscopy.  But, before I explain the surprise ending, let me take a moment to talk about the methodical pre-procedure experience as I believe it deserves some merit--and reflection.

A few days prior, I received a call from the outpatient clinic's office asking me to surrender my insurance information so they could verify my daughter's insurance benefits.  The following day, another person from the same office called me, letting me know my insurance was fine--but that I had not met my deductible and that I owed a sizeable amount which must be paid now over the phone or the procedure could not be confirmed.  She was ready for my credit card faster than I could whip it out.

I chose my preferred Amex card (waiting for them to say they do not accept it) and proudly stated it's the only card I carry.  I thought to myself: what if a family could not pay via credit card?  Why wouldn't they have shared this important payment information during this initial consult?   In short, they worked really hard to make sure I was a qualified, paying customer.  And had paid--in advance--the day before.  I'm sure the doctor was VERY focused on these important details.

Nonetheless, the day of the procedure arrived.  Our daughter was understandably nervous.  My wife and I explained what the procedure entailed and that it would go smoothly.  We chose sedation through the mask therapy and we went her off.

After 40 or so minutes, the doctor called us in and explained that it was, in his opinion, celiac.  He put her on a gluten free diet and told us that we would need to see him in his office after the results came back to ensure that it was in fact, celiac.  He took the time to explain a little more about the disease and answer some of our preliminary questions.  And we were off to pick up our daughter from the recovery area.

And this is where it gets shocking.

As my wife and I approached our groggy -- but still smiling daughter -- a nurse came over with a glass of juice and some crackers for her.  We asked her how she was feeling, each gave her a huge hug and a kiss and she started to munch on the crackers and drink her juice.  As she started to happily munch on her second cracker, I asked the nurse in my sarcastic manner, "those are gluten free crackers, correct?"

Her eyes lit up, I grabbed the crackers from my daughter and the nurse's face turned white.  She didn't know what to say.  When I asked her how she could serve wheat crackers to a recently confirmed patient with Stage IV celiac disease, she simply replied, "The doctor didn't mention anything about eating gluten free."  Are you kidding me?

And that is what is simply so disappointing.

We had "process" where, on a quest to identify whether my daughter has celiac: his office

• takes my money quickly and efficiently for the initial consult
• takes my money quickly and efficiently for the follow-up consult
• swiftly calls me to verify my insurance before the procedure to make sure I am qualified to pay
• makes me pay quickly and efficiently the DAY BEFORE the procedure

And then minutes after the doc confirms a positive celiac diagnosis, our daughter:

• is sloppily and carelessly given wheat crackers as her first meal!

I am still baffled at how a physician with 10+ years of medical training and years of experience treating pediatric GI patients--specializing in celiac disease--can let this happen on his watch.

I am certainly aware of and have sympathy for the more consequential medical errors occurring to others, but this one seems so easy to manage.

It's just unacceptable to me.  I feel badly (embarrassed) for Dr. Enrique Hernandez...but more so for my daughter since this should have been preventable.  And she can't do anything about it...she's only 5.

My daughter is about to get checked for Celiac Disease

My daughter is about to get checked for Celiac Disease

Posted by Celiac Disease Family

I've been lucky so far.  I've been blessed with a beautiful wife and two great kids--one girl and one boy.  They sleep well, eat a healthy diet, perform well in school and are respectful to others.  We have our fair share of end-of-day overtired meltdowns and occasional public tantrums.  But overall, I couldn't be happier with how our "babies" (now aged 5 and 6) have developed into young kids.

About nine months ago, our daughter had been complaining of stomach cramps after eating.  We encouraged her to simply "go to the bathroom" and the pain (or so we thought) often went away after a while.  But then invariably, it would return a few days later.  My wife then started isolating certain foods,  such as Kelloggs Special K Strawberry cereal, then Danimals Yogurt -- both favorites of hers.  But the pain never stopped completely.

I drink Almond milk normally, but we buy our kids organic whole milk--and we thought she might have a lactose intolerance.  So we stopped dairy for a while.  No luck there either.  We were stumped and continued to be concerned.

During her routine annual physical, we spoke with our pediatrician and explained the situation in detail.  He noticed that her height chart had been increasing at the normal trajectory for someone of her age...but her weight was not following the same growth pattern.  He ordered a complete metabolic / blood panel and told us he'd have the results in several days.

That next week, one his his nurses called and asked us to meet with her pediatrician--and our daughter-- personally.  The nurse noted nothing was "urgent", but in today's healthcare environment where most doctors have an incentive to spend LESS time with the patient--we both knew something was not normal.  My wife and I speculated on several conditions but reminded ourselves it was senseless, negative energy and waited eagerly for that appointment the following week.

When we arrived that Monday with our daughter, her pediatrician, (Dr, Enrique Hernandez of Pediatric GI of the Palm Beaches) explained that her IgA and igE levels were "positive" and abnormally high.  Not knowing what this really meant, he explained that this is likely a sign of celiac disease. However, further testing needed to be done to confirm his diagnosis.

There is no history of celiac disease in either of our families..and neither of us really know what this disease is all about.  He answered our preliminary questions about celiac disease and how her recurring symtoms seemed to suggest it. But, he insisted we make sure she kept her regular eating habits so the upcoming tests would not be biased.

So, our daughter is set for an endoscopy next week with Dr. Enrique Hernandez. We have started to read a lot more about this disease and educate her about it as well.  I think we're ready for this....