Who takes the lead

So for anyone who has been following Addysons journey it is always a debate on who is taking the lead on her care (gi or gps). Seems like it should be a framed approach but that just doesn’t seem to happen between these two departments.

Anyway gi, gps and wound team all consulted on Addyson while we were inpatient for the eeg. Wound care was not needed but came anyway. Gps came by and suggested we irrigate through the stoma twice a day and scope her stoma at some point to see if maybe the stoma isn’t large enough causing blockages. They said they were good with that but wanted gi to take the lead. Gi came by and pretty much said he didn’t know what was causing the stoma to swell and why she’s having pain but to try solids again and see what happens and to increase her NG fluids daily from 800 to 1200. She gets 3liters or 3000ml per day. Usually around 2200 by mouth and the other 800 by NG. He suggested upping so we don’t start having more pots issues. Which honestly we have been good with since placing The NG. He said he would go consult with her motility team And they would get back to us. However that has not yet happened.

Usually when this happens it is ruled a sibo flare or a gi bug. She did leave a sample from the ostomy so they can test for a gi bug. If truly a sibo flare then we need to know why since she’s on the flagyl protocol of two weeks on two weeks off (repeating every two weeks).

It’s so frustrating the gi and gps and motility can’t seem to get together and develop one plan. One unified plan that they all agree on. Her stoma is even more swollen today than yesterday. So we will continue to push fluids and Monitor the stoma for blood flow issues.

This kid never sleeps during the day. She said her stomach hurt so bad

When I went to sleep she was facing the right way

she was hiding from the team

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