Hope Moriki knew that newborns often spit up, but her mother's intuition told her that Zenichi, her two-day-old son, was spitting up too much, too often. "He couldn't keep anything down, and he wasn't spitting up so much as violently vomiting every time I attempted to feed him." After ten days with no reprieve, she took Zenichi back to the hospital where he was admitted immediately and, with medication, was able to keep milk down. For the next two years, Zenichi continued on medication, but he was still vomiting at least twice a day and he was chronically underweight. Mrs. Moriki decided to consult another doctor. "The new doctor performed an endoscopy, and finally, we had a diagnosis-eosinophilic esophagitis (EE), an allergic inflammatory disease in which the wall of the esophagus is filled with large numbers of eosinophils, a type of white blood cell." she recalls.
"His health was at the point that with even the smallest provocation, like a common cold, Zenichi would start throwing up until he needed to be hospitalized. We were spending most of our time in the hospital," Mrs. Moriki remembers. "One night, Zenichi was so sick, and I knew that he would have to be admitted and I just couldn't make it to his doctor's hospital in Manhattan. It was the middle of the night, Zenichi was in awful shape, I had his toddler brother and we had to take the subway. I said, 'forget it, we're going to New York Methodist. It's ten minutes away.' From the moment he was in the pediatric emergency room, I knew that NYM was going to be our hospital from then on. The doctors and nurses inspired such a feeling of confidence in me-they knew what was going on and how to handle it. We had a GI consultation in record time. That sealed it for me; I had switched to NYM."
"Because EE is an allergic condition, the doctor recommended a panel of skin-prick allergy tests. Zenichi tested positive for a number of allergens, such as nuts and wheat. So we completely overhauled what he ate, eliminating foods that he was allergic to, and placed him on a diet for people with EE, which also eliminates dairy foods, soy, gluten, eggs, fish and shellfish-but he was still throwing up. I didn't feel as if his condition was actually being managed at all."
As she had predicted, Zenichi had to be admitted, and he was seen by Yvonne McFarlane-Ferreira, M.D., chief of pediatric gastroenterology at NYM. "I immediately felt at ease with Dr. McFarlane-Ferreira," Mrs. Moriki recalls. "She sat with me, and listened to everything Zenichi had been through over the past six years. It was clear that her goal was to make Zenichi feel better and not just to fit him into the box of his diagnosis. My son was an actual person to her, not just a set of symptoms. She said that although the allergy tests can be revealing-the best way for me to learn his reaction to certain foods was by watching him closely. I had always had a hunch that his main allergies were to dairy foods and nightshades, but when I mentioned this to the other doctors, they dismissed the observation. Dr. McFarlane-Ferreira suggested that we see what happened if we eliminated these foods entirely."
"It turns out that while Zenichi does indeed have some food allergies, they are not as critical as was assumed earlier-and as I suspected, dairy foods and nightshades were the real culprits. When those items were completely removed, Zenichi began to get much better. For the first time, I felt like a doctor cared about what I had to say," says Mrs. Moriki.
"I always tell parents that the most effective way of determining what a child is allergic to is likely to be through close observation. I never underestimate the contributions of the parents in the treatment of a child-listening is the best diagnostic tool. Their children may have seen a number of doctors, but no one knows their children as well as the parents," says Dr. McFarlane-Ferreira. "Based on Mrs. Moriki's observations, we were able to slowly reintroduce a number of foods into Zenichi's diet and he began gaining weight. After cutting out dairy foods and nightshades, he was able to enjoy a more varied diet without the vomiting, and participate more fully in everyday activities."
"Since our first visit to NYM, we haven't gone anywhere else. After six years of taking Zenichi to doctors and hospitals all over New York City, I came to NYM and finally exhaled. The staff on the pediatric inpatient unit was wonderful-it seemed like no one there ever had a bad day. The doctors, the nurses, the volunteers-they just made it so easy. Zenichi can now keep his food down and his weight up. He is finally on the road to recovery.
Read more real life patient stories in the 2011 NYM Annual Report.