Healthy, High Calorie Eating and Sweating

--We spent the morning at Vanderbilt Children's Hospital (VCH). Daniel had 2 scheduled appointments. The first appointment was with a nutritionist to discuss Daniel's diet and what/if anything needs to be changed. The second appointment was a sweat chloride test to check for cystic fibrosis.
--The appointment with the nutritionist went well, a lot of our questions were answered and concerns addressed. Daniel was weighed and measured. Daniel weighed in at 16 pounds, 7 ounces and was roughly 27 inches long. (It is hard to get an accurate measurement on a wiggly 16 month old.) Daniel gained 1 ounce since his last appointment (October 18), his height stayed teh same. The nutritionist was concerned about Daniel's growth (or lack there of) as Daniel has been on a high calorie diet the past 4 weeks. Daniel consumes about 1, 360 calories a day. The average calorie requirement dor a 1 to 3 year old is 1300 (that's on the high end). The nutritionist was very pleased with the variety and well-balanced meals and snacks that Daniel eats. (We are good parents :) ) There is a concern that Daniel is getting the higher end of the recommended calories but is still growing s-l-o-w-l-y. The nutritionist said that many kids, especially preemies born so tiny (Daniel was a 2 pounder.) requires more calories to grow. She recommended that we increase Daniel's calorie intake to 1500 per day. We will do this by cooking food in oils and using butter, mayo and gravies as much as possible. We will also start mixing Duocal in some of Daniel's food. Duocal is an unflavored powder that can be mixed in liquids, puddings, yogurts, etc., 1 tablespoon adds 42 calories. The goal is to use 3 - 4 tablespoons throughout the day. Daniel will also drink Vital Jr., a high calorie milk drink in place of milk. The goal is to have Daniel drink 3 to 4 - 8 oz. cans a day. We will start keeping a detailed food journal (for 3 days) and send it via e-mail the the nutritionist, the nutritionist will break down the calorie, vitamins, etc. to determine if there are any changes that need to be made. Daniel will return to the nutritionist in 4 weeks, the goal weight for our return visit is 17 pounds, 4 ounces.
--The sweat chloride test went much better then we were expecting. We were fearful of what would have to be done to make Daniel sweat. A technique call iontophoresis is used to produce sweat. This technique requires the application of a painless electrical current that allows the penetration of a medication into the skin which maximizes sweat stimulation. The respiratory specialist placed 2 small square type thingys that were attached to a machine thingy to each of Daniel's forearms. These were left on for about 5 minutes, the square thingys and the machine thingy was providing the electrical current. The specialist then placed gauze on each of Daniel's forearms, wrapped each arm in a thick plastic and then wrapped 2 mini heating pads around each arm. We put Daniel's fleeced lined jacket on, zipped it up, put Daniel into his stroller and wrapped Richard's jacket around him. We were told to wait 30 minutes so we headed to the food court and got a cup of coffee and prayed for sweat. We returned to the doctor's office after 30 minutes, Daniel was unwrapped, the sweat-filled gauze removed and placed in a tube and we were finished. We were told to call the doctor around 3 p.m. to get the results.
--We headed home and tried to keep busy until 3 p.m. We called the Pediatrician's office around 3:30 p.m. and were told that a nurse would call us back with the results. We waited....The Pediatrician called around 6:30. I knew when it was the doctor that called and not the nurse that something had to be wrong. The normal sweat chloride level is 10 to 35, a level greater then 60 indicates cystic fibrosis, levels between 35 and 60 are considered abnormal. Daniel's sweat chloride level was 59. This was concerning to the Pediatrician due to other symptoms Daniel has as well. The Pediatrician consulted with the Pulmonologist and GI and they were concerned as well. Daniel is right now "diagnoised" with borderline CF (cystic fibrosis), he will have a repeat sweat test ASAP before the doctors determine a plan of care.
--Please keep Daniel in your prayers. We had prepared ourselves for the worst but we had not prepared ourselves for the unkown.