Since they are weighing Jeremiah every day now, they discovered today that he has lost three more pounds since he first came to the hospital five days ago. Considering they flushed his system out with liquid Miralax for the first two days however, they are not surprised or worried. He is now 4'10" and 65 pounds.
Today we got a partial diagnosis! Finally, some answers. Superior mesenteric artery syndrome, or SMAS for short. It's a rare digestive system disorder. This artery provides blood to the small intestine, cecum, and colon. It crosses over the first part of the small intestine, called the duodenum.
In the lateral view of the picture below, on the left side, you see where this artery is in relation to the small intestine opening (duodenum). As you can see, separating the artery and small intestine is what is called a fat pad. And who knew, but this fat pad is necessary for healthy digestion! Now if only all of the bodies fat pads were considered healthy, I would be Olympian athlete status!
Now look at the right side of the lateral view picture above and you will see what happens when you lose so much weight that you lose that fat pad separating the artery and small intestine opening. The artery acts as a bowel instruction, blocking the duodenal (opening to the small intestine).
(That concludes the homeschool biology portion of this blog post!)
In short (lol), the artery's obstruction of the small intestine is why Jerry keeps vomiting when he eats. His food cannot get past his stomach. Of course, since the weight loss is what contributed to the SMAS, we still need to figure out what caused the drastic weight loss in the first place.
Today was endoscopy day.
Tissue samples were taken from his esophagus, small intestine opening, and stomach. She is checking his enzymes and for any digestive diseases of these organs, including lactose intolerance. Pretty amazing stuff really. The biopsies will be back Friday. If they all come back normal, the weight loss mystery remains just that, a mystery.
For now, the goal is to put weight back on Jerry so his fat pad gets built back up and separates the artery from obstructing his small intestine once again.
While he was still under anesthesia from the endoscopy, his NG (feeding tube that went through his nose and into his stomach) was removed and an NJ tube was inserted in its place (feeding tube that goes through his nose and bypasses his stomach to go right into the small intestine). Sorry, more biology. He will be fed supplemental nutrition through that tube daily.
They also inserted a PICC line in his arm today to deliver extra nutrients straight into his veins in his heart to then be pumped efficiently to where his body most needs them.
In a few days we can hopefully reintroduce solid foods by mouth. It'll have to be small increments at first because his stomach has not been able to retain food for some time now and has likely shrunk (another problem I could live with). As soon as he is tolerating eating by mouth and is able to digest those foods via his stomach and small and large intestines (like everyone else), he will finally be able to go home.
In short, we are here for a while! So if you have kids, bring them to visit. He is getting bored. But don't talk about food or even smell like you may have eaten in the last hour because, even though his stomach cannot tolerate food right now, he is still hungry. Come to think of it, don't even come in with a food stain on your shirt. And if you don't have kids, come anyway. We have board games and Jerry would love to tell you all about the playroom down the hall. You might even get a field trip.
I will leave you with one funny from today. The GI doctor told us about taking tissue from Jerry's throat before performing the endoscopy. She left the room then and Jerry looked at us and said, "No wonder I am throwing up. There is a tissue stuck in my throat!" In true Jerry fashion! Love him!
I am a Christian. I am a wife. I am a mom. I am an author. In that order.