have just spent the morning at the gastro clinic with DS2, he is back on senna (sad), and also been referred to psychologist....what can I expect????

[Psychomum5]

DS2 has suffered with bowel probs since birth....he has now finally had a 'formal' diagnosis (if you can call it that) of 'chronic constipation, bowel dismobility and IBS.

he spent 2wks last summer in hospital having to have strong amounts of senna and movicol to 'clear him out', which had a nasty effect on him and he became incontinent. he was also referred to a psychologist as he became scared of doctors, but nothing came of it and we heard nothing.

anyhoo.......by october he was a 'normal' 5yo, no bloating, no constipation, no diarrhoea, happy!!!

then, 4days later we had our car accident, and all went back again. the pressure on his belly from the seat belt during the crash made his belly go bad again, and 6mths later his bowel is back to how it was before the admittence last year....so......we are back on senna again, without the movicol this time, but still, senna has had such an awful effect on him before and I am worried and scared for him......I am tho going to start him ona very low dose to hold off the explosions (I hope).

also he has had another referral to the psych, as they are concerned about his ability to cope at school when his tumy is bad, plus he has had lots and lots of bad dreams and bad night since the crash so that isn;t helping his belly.

We also have concerns re-school, and his teacher has mentioned twice now about referring him for assessment for ADD and dyslexia....which his doctor is concerned about but hopes for the school ed. psych to look nto that....is that true/poss......would the medical psych not look into that all too????

what can I expect from the psychologists.....and will they look into the family as a whole or just DS2???

sorry for length, and TIA

Its nice I eat it with them too, you can always serve it with grilled chicken

sounds good

we all eat together too, altho it still doesn;t help DS2 eat

ahwell...not cured overnight is it!

Can but try - eh.

I understand that we all want to do what is best for them, but with medical stuff it is sometimes like groping in the dark.

Stick with your mummy instinct it is usually right

Hi Psychomum. Havent read all the thread so forgive me if I repeat others. Ds (now 8)has longstanding chronic constipation etc and has been on senna and lactulose every day since about age 3. Pears, juice, apples ( not bananas) all help. Continence was an issue at school too! He used to swing from one extreme to the other (IYKWIM). The best thing has been getting things stable and regular - to avoid the 'doesn't go-bunged up- running through -sore bum- goes eventually-blocks the loo-frightened to ever go again' cycle.
The most helpful advice I had was to set up a regular rewarded sitting habit. The only way I could encourage this was to read to ds on the loo (him not me!) I still do this ( Ds cannot read he has LD etc - sitting still is not his forte either) although now I sit just out of view in preparation for privacy. He gets an extra story at bed time for trying. (It used to have to be chocolate drops). Other kids might need different motivation!
It has taken a long time to get him regular and self motivated and rarely in pain. We still use medication - the paediatrician said he would have to grow into his capacity so its a long haul.
( ps we find calpol works well for frightened to go sore bums!) We work on the principal that it helps to try!

thanks for that magso

went to docs this morning re-script from the hospital and to tell him about the referral. also to ask his advice about school too, as they are faffing about whether or not to refer him now or leave it another year.

I reckon now, but school not happy, so asked doc if he could refer to ed psych over their heads IYGWIM.

he said no, but said to go to the school and explain that waiting a year, with DS2 probs now would be detrimental to him.....

anyhoo.....went back to the school and spoke again to the 'senco' lady (she isn;t actually senco, says she is until you get into it and then find she is just the one in charge of learing support, she has to get a senco in if she is in anyway confused.....!)((I digress))

well....she said that they are not planning on referring him now as they want to wait and see, and refer him to be assessed instead when he goes into junior school in yr3....well, he is yr1 now, they aren;t happy with his prgress, they say he has attention difficulties, he is throwing up glaring signs already that he has dyslexia (and this in a school that last year said DS1 DIDN'T in any way had dyslexia.....we were told recently that he DOES*!!!!), so forgive me if I am cross with the school attitude.

Oh, and she said that they are already teaching him as tho he does have these problems, so a DX would not change anything...

well........yes, it would actually.......if nothing else it would mean that the junior school will be able to sort out him having a one-to-one as soon as he starts, rather than wasting probably an entire year (which he will ill afford) while he waits for them to see a problem and THEN refer him!!!!

arghhhhhhhhhhhh

Oh, and the senna starts tonight, so have warned school and they said if he reacts the way he did before he will have to stay home ans they will send work home....now, how will that help his settling probs, and most importantly, how will that help me seeing as he refuses to work for me, and as I will be caring for him re his belly, I am not wanting to fight with him about school work IYGWIM...

((sorry.....ranting now.....))

Psychomum - I believe that you can ask for a statutory assessment yourself; you don't have to wait for school. Have a look at IPSEA

Sympathy on the constipation front. dd has been on and off movicol all her life and I suffer to some extent myself. Fybogel is vile BTW and I doubt you'd get your ds to drink it.

sagger.....that looks interesting....thankyou

I will read in full later (just done a quick scan and in the midst of cooking), but that may be my way forward!!!

I am also thinking fybergel isn;t the way for DS......I will be senna starting tonight and will see how we are going at the weekend. he will drink it easily enough (well, he did last summer), so no worries with that....I am going to look into powders tho to add into his youghurts tho may.

watch this space..........

have you tried massaging his tummy... but get a trained therapist to show you how to do so in such a way to help constipation.

just gentle massage with a gentle oil might help soothe a liitle bit and might be good for his overall calmness.

My DS loves his tummy being massaged when hes tired.

eve....I used to try that but he is etra tickly on his tummy and it always ended up in a gigglefest.....(which altho lovely, doesn;t have quite the same effect)

he loves his back being stroke however

Would second tummy massage - and we have to massage firmish over vest (no oil) to avoid the tickles! We still have setbacks every time there is a change in routine!
Also second looking at IPSEA. Some schools seem very poor at supporting children with additional needs! (Maybe poor is the word - if lack of money is the reason for not seeing the ED Psych). So its only the dcs with parents able to make a huge nuisance of themselves who get help! Is ds2 on school action or action + yet? Does he have an IEP? (If not why not). Waiting 2 years to start investigations is well (IMHO) too long if DS2 is struggling or there are concerns already.
Re: attentional difficulties. The Gp might be able to refer to the local developmental or community paediatrician with a view to exploring ADHD/ADD or other developmental conditions that affect education. Paed could then put (a little) pressure on the school. IMHE everyone seems to 'wait and see' or leave it to someone else. Constipation is a miserable painful condition, and DS2 (and you) have my sympathy. Its odd how things often occur together! Good luck!

magso....hadn't thought about massaging over clothes. will try that later (he has gone to school with tummy ache so we will see how he gets on today!).

re-school......yes, he has had IEP set up since this time last year in reception so he has been on 'wait and see' for a year already, and yet they still want to wait more.

he is on 'school action' too.....their reason's for not referring as yet is that it won;t chnage the way they teach him, as they already DO teach him as tho he has ADD and dyslexia. yes, ok, so they won;t do anything different if he is 'labeled', but never-the-less-, he is going to be going to a different school and the end of yr2, and their approach is different (I know this as my elder kiddies bar DD1 have all been to this school, 2 of them from this infant school......and the differences are obvious IYGWIM).

I am not wanitng to wait....I want referral's to get going now, especially as with him being referred medically will hoepfully mean the psych's 'marrying up' if you get me??

the 'senco' lady has agreed to write a letter to the ed psych now, as soon as I know where and to whom he is going, but still.....I am not sure what she will say or even whether she says they 'suspect' or if it will be that 'mum suspects' (and TBH....I have never ever thought this until this past 4mths since his TEACHER said something!!!! until then I thought it all to do with his tummy issues, the fact that he has had many times in hospital, and the fact that he is the youngest of 5...(ie, he has flitted between his siblings so never had to learn to concentrate, and I have done more for him for longer as he has had no younger siblings for me to fret over or for him to feel 'better than' IYGWIM)

arghhhhhhh

(sorry.....frustration coming thro now)

well....yesterday tummy wise wasn't great!

senna is started......he did complain of tummy ache a lot at school....they encouraged lots of drinking which culminated in him needing to wee every ten minutes!

now, he has always wee'd a lot, and we had this problem with the constant loo breaks when he was first in reception, but it started to get less frequent when he went full-time (he has always been like it at home too from toilet training).

anyhoo.....he started weeing less which I thought was him just getting better at recognising the signals.

nope, it seems he has been drinking less (which obviously has an impact on his bowel). well....he is drinking much more again, and back to the old pattern of consant needing to wee........

and.......wet beds are back

he has asked for pull-ups again already..what to do tho???

he is pooing ok, normal for him at the moment at least. seems the senna just makes the pressure on the bowel more obvious maybe and that creates pressure on the bladder (well, as they explained a couple years ago).

oh....and leg pain is also back with a vengence altho to be fair, he is only 2 days into senna.

arghhhhhh (not at DS2, more at the weeing more which means more disruption and washing and makes the incontinence more likely meaning that school won;t take him). poor little man...

Poor ds and you! (Have 2 duvets and padsheets on line and hoping for sunshine- and frankly the washing does get me down sometimes).
I found it helpful to get the school nurse involved when ds was excluded from school for toileting issues. She was very helpful - gave helpful info on setting up a loo sitting habit and the only one who understood the misery of it! She also explained it to the teachers and organised a change bag and changing support rather than sending home for wetting accidents.
It took me a long time to accept the need for the medication routine but eventually we settled into a regular routine and doses! Theres quite an art to getting it just right especially after a set back.
Have you tried EPA fish oil (eg eskimo kids) for the other worries?
Good luck!

Hi psychomum - slightly different point, but if you were in a car accident then you can get your child assessed for medico-legal report - this could be physical and/or psychological. I've done these psych reports and recently had a private patient who had pre-existing difficulties which were then made worse by an accident, so the insurance company paid for private therapy. Its worth a try as usually less of a wait, and in case you're not happy with public services. It sounds like there is evidence that just before the accident the problems were resolved, and the accident has prompted a re-emergence? Its just another option for you, though it may not be as helpful as using the integrated services you already have.

HTH

thanks Kay....

we have in fact been assessed as a whole family as we were all (bar DH) in the car at the time. the assessor guy (name??? argh) said that he had/has problems with nightmares etc apart from his medical probs and that is going into the damages report....so....hopefully all will stand together IYGWIM.

in fact the report on DS2 has come today and he said that he anticipated that 'psychological' symptoms should disperse about 8mths from the time of the 'index accident'. well......if the psychologist with the hospital says otherwise then I WILL re-imform my legal team and se if that does make a difference.

well......senna is kicking things off good and proper....

now havng the 'overflow' and explosions....and he poo'd himself a few mins ago.

oh, now am worrying about school!

There are lots of parental support groups on line if you google "encopresis". Sorry if you have already done all that. HTH