Yes, after a 2.5-month wait we finally got in to see the GI specialist. Here is what she said (straight from her very own notes):
Super thin, lousy appetite, BUT lots of good nutritional parameters:
(1) Energy--development, (2) infection fighting, (3) has skeletal maturation (teeth and closed fontanel).
Worse lately! Now what?: Start with safe/easy methods to boost appetite. #1 cyproheptidine, #2 zinc => zinc deficiency leads to dysgeusia (not taste).
Very interesting, isn't it? Overall, Caleb looked very good. Once again I heard, "we almost never see a 27-weeker who looks this good." Physically, you would never know he had a problem (other than being "super thin"). However, we both agreed that if Caleb continues on his most recent weight trends, he's en route to very bad things. [He used to gain one pound per month. Then he gained one ounce per week. Then he gained one ounce in three weeks. Yes, very bad.]
So, now is the perfect time to take more drastic measures. The simplest and most obvious is cyproheptidine, an appetite stimulant. He's been on it since Wednesday and so far consumes an average of three ounces more per day, while his solids consumption has remained the same. It's helpful, but not great.
After a two-week trial we're supposed to call the GI doc to let her know how it's been going. If it's not working well enough by then, we're supposed to give him prescription zinc. Did you know that people with zinc deficiencies (very common in preemies) can't taste as well? Yep. Weird, I know. But I don't think Caleb has this problem. He's picky when it comes to taste. He won't eat French toast unless it has syrup on it. But the zinc is worth a try. (It also boosts one's immune system.)
If neither of these medicines work, she'll probably order some tests.
And that's where we're at. It's nice to be able to do something about it all. Even if we're just ruling things out, we're making progress. Finally.