I took Ryan to an evaluation for autism (basically to confirm he is still autistic, where at on the spectrum “they” think he is, what services he’ll qualify for, etc.) on Thursday, and while we were there I brought up the fact that he likes to eat string (and paper, labels, stickers, pencil erasers, and occasionally small buttons and beads). After going over the history of this and how long it has been going on for (string: three months; everything else: the last two years), he was tentatively diagnosed with PICA (interestingly, PICA seems most prevalent in children and individuals with autism and other developmental disabilities).
Considering what I suspected yesterday and confirmed today, I am not surprised by the diagnosis. Right now I’m sitting by the phone, waiting for Ryan’s doctor to call back. I took him in this morning because I was concerned that he might have a bowel obstruction. Over the past several weeks his stools have become increasingly frequent and loose, but I attributed that to excessive consumption of juice and fruit snacks, and not being on a set schedule with meals until the week before preschool started. But beginning with this past week he has been stiffening up and acting as though he was in discomfort when going to the bathroom. And starting yesterday he has been SCREAMING and completely stiffening up and going rigid whenever Dan or I would change his diaper.
Ryan does indeed have a bowel obstruction. I took him to the doctor this morning, ignored the stupid nurse who suggested that Ryan’s bowel problems were simply a result of being autistic and not knowing how to go to the bathroom (so many kinds of WHAT?! right there, but I won’t get into them right now), and pounced on the very nice doctor who listened to me, checked out Ryan, ordered blood work (four tubes worth) and sent me over to the local hospital’s outpatient campus for x-rays.
And… the doctor just called. As I was easily able to see on the x-ray (his x-ray looks a lot like this one, though his impaction is on the other side), Ryan has a lower bowel obstruction — an impaction of feces in the mid- to upper part of his colon. Since nothing is showing up on the x-ray except the impacted feces, the guess as to the cause of the impaction is string, or drywall (Ryan’s excessive rocking and headbanging put a dent/crack in the wall behind his door, and unbeknownst to us he was digging behind the cracked part of the wall to get at the drywall. I discovered him doing this the other day; guess what Dan is going to be fixing today?).
The first method of removal is the least invasive one: prescription-strength Miralax AND prescription-strength suppositories. I’m waiting on the pharmacy to have them filled, which should be within the hour. As soon as they’re ready I’m going to go and pick them up, and then medicate Ryan from both ends. Then it’s the waiting game. If successful, we’ll have a craptabulous Sunday and Monday. If not… then we have to move on to the next option, which would be manual removal of the impacted feces. It sounds painful and traumatizing. 
I’m going to go through the house today with the vacuum and suck up any loose particles/papers/bits of this and that that might be under beds or furniture. Dan is going to fix the wall in Ryan’s room, and I’m going to go over his sheets, blankets and clothes to make sure there are no loose threads or fibers for him to get a hold of.
On Monday I’m going to call Ryan’s occupational therapist and let her know of this latest development (I had brought it up at the first evaluation on August 31st, and had mentioned it to her when I first met her, but she needs to understand just how bad it is), and I’m going to speak to his regular preschool teacher (Ryan’s occupational therapist can pass on the info to the developmental preschool he’ll be going to as of next week).
Gah… what a weekend this has turned out to be!
9 Comments
, on September 19 2009 at 3:22pm:
Wow I hope that the obstruction gets cleared! That has to be scary for both of you.
, on September 19 2009 at 5:08pm:
Aw hun sounds like you are busy! I hope that he feels better soon and I hope that it happens quickly his obstruction that is..
, on September 19 2009 at 5:38pm:
Ahhh poor Ryan … this makes my heart ache for him and you :(.
I’ve never heard of this before but I wonder what makes him eat this stuff?
All I have to say is that Ryan is sooo lucky to have such an awesome mom and dad. There are some people that should be parents and you are one of them.
, on September 19 2009 at 6:00pm:
aww poor ryan!. poor you. thats got to be so painful. i really hope for everyones sake that the meds work
, on September 19 2009 at 8:57pm:
Oh no! The poor thing! (And poor you!) I hope that Ryan feels better soon and everything gets cleared from his system. I can’t even imagine how hard it is for you guys to have to go through all of this. Ryan definitely is lucky to have you guys looking after him, though. That’s for sure.
, on September 20 2009 at 10:20am:
I hope Ryan begins feeling better. I read ahead and saw that he started to pass through some of the obstruction… let’s hope it continues!
, on September 20 2009 at 3:03pm:
PICA it sounds like something “cute” – but it is so not :). I’m glad that Ryan is doing better.
, on September 20 2009 at 6:16pm:
Poor Baby! I know that pain has to be excruciating, especially what you described as manual extraction.
I looked up PICA, I’m in amazement. God Bless you Jenn I don’t know how you do it, but you do and you do a good job at it. I don’t know if I could handle it!
As the domain name suggests, my name is Jenn, and I own this blog. I'm 26 years old and married to my one true ♥, Daniel. And while I have two kids (Alyssa is five, and Ryan is three), you won't find "mommy" in my username or email address, nor does my blog revolve around them. I'm a mother, but most importantly I am me, with a passion for love, blogging, reading, and photography. I'm also a busy freelance writer, web designer & SEO goddess.
You sure do have your hands full Jenn! I hope Ryan’s obstruction is easily cleared.. it must be hard on him. I have never heard of PICA before but after reading your tweets I have been reading about it. Hope everything goes well.