seeking paediatrician in Perth

[pana]

Can anyone please recommend a good paediatrician in Perth for silent reflux? There seems to be this ridiculous assumption that reflux doesn't hurt babies so I'd like to not waste my or DS's time with someone that won't give us proper consideration.

After initially improving with losec things are going downhill again. I definitely give it correctly, half an hour before feeding on an empty belly twice a day. Might be due to teething but if thats the case we had a few days grace first. I don't want the horror to come back as DS is only just recovering in terms of the backward steps he made when he was in pain ALL of the time. Feeds are getting bad again and neither of us could handle the old fashioned feeds we had, or him being so miserable he stopped smiling, "talking" etc.

Any recommendations would be greatly appreciated

ETA DS is 4 months old.

[~Debbie~]

I see Dr Mark Parker. He is based at Mercy Hospital in Mt Lawley.
I didnt even realise Aiden had silent reflux, and he gave me a script immediatly for losec.
If you like, i can give you his number. He is difficult to see thou, i rang to get an appointment the other day, was told it would be 3weeks wait, so, i ended up chatting over the phone to him, as I had seen him previously.
Hugs, i hate that pain they go thru

[StrawberryMumma]

Pana, what area of perth are you?

[Mikenzees mum]

for a great general pead that isnt scared to refer on to a further specialist if needed, DR naidoo, at joondalup is great with reflux and wil also look into wheather food intoerance contributing toit

[pana]

Thanks for your replies.

I'm in the Morley area but I really don't mind travelling to see a good paediatrician. I'm pretty familiar with Joondalup so it doesn't phase me to see someone there. I've heard good things about Paul Porter and David Roberts but I don't know what they think about reflux.

Just re-read my original post - didn't mean to sound so negative . DS has had a bad few days so I guess its just getting me down again. Kind of been there, done that, don't want to do it again!

[StrawberryMumma]

Paul Porter is a lovely man.

[Mikenzees mum]

paul porter and, david roberts are both lovely i would see either of them, if need be

[scarlet121]

Well first off I am sorry to hear that your son has silent reflux, I can tell you from my expierience that it hurts them a lot and you are a really good mum to be wanting to find a doctor that will help him out.

The person I would recommend for reflux is the same as mikenzees mum, Dr Naidoo, from what she has told me about him he sounds like a wonderful reflux paed. My paed I wouldn't actually recommend for reflux.

You asked for suggestions and I would first like to ask what medicine is he on, what is the dose and how do you give it to him, like is it a tablet or compound.

If it is zantac, what is the weight of your baby, zantac is extremely weight sensitive and needs to go up with increaseing weight, I at some times was increasing it every week.

If you get back to me with any details, I will try and help you out with some suggestions.

[srv]

I was also going to suggest that he may be growing out of his dose as doses of meds in kids are weight based. We had to increase DS dose of losec at about 3 months of age because his reflux started to get bad again. Once the increased dose kicked in it was all good again. However I think doing this under the guidance of a good paed (some of whom have been recommended in this thread) would be the way to go. Reflux is awful. I hope you get things sorted out for your little one soon.

[pana]

Thanks for your replies.

I saw a GP today and he is sending us to Dr Christie in Midland who he assures me is very good. When I asked specifically about reflux he said that was everyday stuff for paediatricians and it wouldn't be a problem (!). Heres hoping he's right. I've managed to get a pretty prompt appointment so I'll go to that but ask for another referral to Dr Naidoo if I'm not happy.

DS is on 10mg losec twice a day, a dissolved tablet half an hour before feeding. I have a couple of fantastic references for doses for reflux meds that I tried to post in another thread, but they were removed by (?) the moderators. They veer to the high side for losec, up to 3-3.3mg/kg for severe cases. Scarlet121 are you a pharmacist? I'd be interested in what a local pharmacist thinks of that kind of dosing. It is from a very reputable source, but given that the link was removed I assume I'm not allowed to say where.

Thanks again for your replies. If things go well I'll let you know . If they don't then I'll try to be tactful given that I've named the doctor .

[Mikenzees mum]

Hi
im glad you got an apointment with a pead thats great, i really hope she wil help you,

the dosage of losec sounds normal to me its on the higher side of the cale but by no means to high or the highest i have seen kwim prety much average

good luck

[scarlet121]

I saw a GP today and he is sending us to Dr Christie in Midland who he assures me is very good. When I asked specifically about reflux he said that was everyday stuff for paediatricians and it wouldn't be a problem (!). Heres hoping he's right. I've managed to get a pretty prompt appointment so I'll go to that but ask for another referral to Dr Naidoo if I'm not happy.

I really shouldn't say this but Dr Christie is my paed, and he is the one I wouldn't recommend for reflux (LOL how is that for ironic). He is quite nice, but not at all sympathetic to our struggle and is very easy to dismiss things. ie, parkers last bought of chest infection, he told me to finish the antibiotics he would be OK, no follow up, but he knows Parker and his history, it turned into pneumonia again...kind of makes me mad KWIM?

In terms of initially how he treated us, he tested us for everything under the sun except reflux and by chance he did get us the referral to the paed gastro because he thought he had Chrons disease before reflux.

You are not allowed to post links here, the moderators will remove them which is a pity with something like this. Mikis mum and I met on an infant reflux website, that is how we know each other, it is very hard to get the right kind of answers from most people in Australia.

I am not a pharmacist (that is I can't dispense meds) I am a chemist, so I can make the meds there is a difference. WIth the dosing on a personal level, it sounds like you are doing the right thing with the dosing, the dose sounds good and he should probably be seeing a difference by now, it might be time to play around a bit. You could add in zantac, but I don't know if Dr Christie will allow this. How long has be been on the meds for? Does he get all the beads?

Have you thought about using a compound? Apart from having to get it made up every 2 weeks and keeping it in the fridge it is a really good way to give it. The beads are sometimes hard to get in.

I would really love to hear you go with the paed, even if it is just to see if I have just got him on a couple of off days lately.

[pana]

D'oh ! We are lucky and have the appointment with Dr Christie next week so we'll go anyway.

At least I think I'll have a few bases covered when we go to see him. He'll tell me to stop dairy and I'll be able to say that I did that a month ago, hidden stuff and all. He might tell me to stop eating wheat and I'll be able to tell him about the ridiculous total elimination diet I'm on that excludes just about everything. I've tried changing bottle teats and every simple suggestion for feeding that I can find (not that that accounts for the non-feeding misery), so if he can come up with something other than reflux for our problems then more power to him!

I don't understand why reflux is "believed in" by some doctors but not others.

I agree that information is limited on Australian sites. I was horrified to discover that some kids actually do require long term tube feeding , which is what I thought might be necessary on some of our darkest days. And I'm sure surgeons don't perform surgery on the really unlucky little ones for something that doesn't exist.

I am kicking myself that I didn't get around to taping a feed on the camera before the losec first kicked in. I should have done it, pyjamas and all (why is it you always remember to do these things only when its not convenient ).

I've heard on another site that teething, immunisations and being unwell with viruses etc can all stir reflux up again so I am really hoping thats the case with us and that things settle down again.

Caro, I've emailed you those links. I've found them very useful, especially the last one I gave you for general information.

Thank you all for putting up with my ranting . I'll try to go back to be a normal, rational person now...

[scarlet121]

Pana, if you email me the links too, it may be the site Amy and I are on? My email is
scarlet@iinet.net.au

Miki is tube fed full time, and we too have been very fortunate to not be tube fed, but everytime he is sick and he flares up, it is in the back of my mind.

The old adage a baby will always eat does not apply to refluxers.

[scarlet121]

Eeek Scarlett well I wont be going to him then !cant stand drs like that ! Gosh Scarlett why dont you go to a different one then ?

Because I don't have to go to him that often, I have a really good GP who knows Parker and his history, plus a back up GP, he also has a respiratory physician, gastroenterologist, neurologist and allergist, so if he is sick it generally falls into one of those categories KWIM? Last time I went was the first time in about 9 months and it was really only just a second opinion from the GP, but still...

If he needs a full time paed in the future, I think I will try Amys out.

I could be totally wrong about him, it is just how I feel. I hope Pana has a different expierience, who knows maybe he has learn't a thing or two since Parker. But he never once told me anything about diet, or his diet, eliminiating things, I asked to get him allergy tested and to an ENT, and he said he didn't need it (he does) but he did get his hearing tested which was really helpful when he was having ear infections etc...

He does beleive in reflux, in fact he suffers from it himself, so you would think him more sympathetic, but I think most doctors go on the 'they grow out of it anyway principle'

And Pana it isn't ranting, I am so happy to hear that you are researching it and becoming an advocate for your child, it is hard because we think doctors will fix everything, but in actual fact sometimes you have to do the hard work.

[pana]

I've emailed you those links, Scarlet.

Its true that most kids outgrow reflux but what about the meantime? DS is only 4 months but still is not "talking" as much or doing all the things he used to do before the reflux got really bad. I don't see how that or pain can ever be acceptable. Its hard enough for us, but others including yourself do it even harder! It frustrates me no end to hear of bad experiences with paediatricians as most of the GPs I have known have had fantastic attitudes. Not necessarily knowledgeable about reflux and its intricacies but definitely a "mother knows best" approach. Hitting a brick wall with the paediatrician is just something I don't want to happen.

I forgot to answer your questions earlier. DS has been on this dose of losec for a month, after 5mg once a day did nothing. He is surprisingly good at letting me give it now and he gets every last bead I can see! It really did seem to kick in at about 12 days and he began improving but everything went pear shaped again a few days into teething. That was a week or so ago. Things are still not as dreadful as they were but now that I've seen just how far the extent of his misery went (I knew it was bad but seeing it improve reminded me of just how bad) I don't want to risk going back.

He had a pretty good day today though and I am hoping the worst is over again. If I'm really lucky I'll have to justify why I am taking a well, happy child to a paediatrician!

Thanks for all of your support

[scarlet121]

There is a term called the reflux rollercoaster, basically it is as soon as things are going well, things sometimes go pear shape again, and it is generally cause of illness, immunisations or teething, anything that makes them feel crappy, makes them worse.

The dose is a good one, and I don't think Dr C will increase it though he may suggest to try something else, before doing that I would try the compound at the same dose, I think you will find that it works really well.

The compound works in two ways in that it has an antacid type reaction, because it will neutralise the acid on the way down, it is in this so that the crushed up losec doesn't get eaten by digestive acids before it gets to where it needs to be absorbed.

I just find that it works a lot better than the tablet with Parker. You can get it from St John of God Subi, the only problem is having to get it two weeks, if your bub needs that full dose then this is best as over time it starts to become unstable and I beleive doesn't work as well.

The other thing that happens by switching is that it will take another two weeks for the new one to work, so it can get pretty bad in between as one one gets out of the system quicker than the other takes to get into the system. If you have to switch, I would use zantac at the same time (spaced an hour)

Just something else, in terms of zegerid, you were talking about, these are the problems I have with MK, is that there they say you don't have to wait BUT in the actual prescibing leaflet, they say to wait 1 hour...so which one is it?

I will be honest and we don't wait with Parkers losec, but as a compound we don't necessarily have to, but I find that if we give it three times a day it doesn't matter if it is with food or without. I do keep an eye on it, and try to give it when I know he is more likely to be refluxy, hence have more acid for it to work.

[pana]

I'm going to see Dr Naidoo.