You may - or may not - know that our almost-two-year-old has been having medical issues for quite a while. A detailed description will take hours to write down, and will bore everyone but the most dedicated medical student to tears. Suffice it to say that he has chronic diarrhea (since February!), accompanied by a host of other strange symptoms that range from tongue ulcers to gross motor control issues to extreme irritability. Throw in very dry skin and skin eczema, loss of appetite, gradual delay in language development...
We've been testing for celiac disease, amoeba, giardia - the usual suspects. All negative. Since he's adorable and wonderful, it's hard to believe he's sick just by looking at him. Which is ultimately what the doctors did in the German hospital when we were evacuated this summer. All the tests were negative, EEG normal, neurophysical exam normal, stool normal, blood normal.... all but a diagnosis of anemia remained normal. They labeled me hysterical and sent me home.
And things did not get better. Now we are at the point where we are ready to point guns at doctors if they would just keep at it and find a REASON.
Truth be told, in the summer when we were in the German hospital, Jacob did show relatively few symptoms, and he did not exhibit those tongue ulcers that squick me so. But he did yesterday (as he did last week, and the week before, and the week before that...). So genius struck my husband and we took a picture, sent it to our health insurance - and it really is true that a picture says more than a thousand words. We got an answer within the hour, and now we have the task of finding a "competent pediatric gastroenterologist in an academic setting with experience in developing countries".
That's easier said than done. Any ideas?
You may look at the picture of the ulcers under the fold, if you are not squeamish and think you can help us identify the cause of all the misery. Or if you are not squeamish and just curious.
Ruled out are: Celiac disease, giardia, amoebiasis, various food allergies including nuts, soy, wheat, egg, and milk.
UPDATE: We actually solved the puzzle only a few days later in September 2007. On my own blog I have a sidebar with links to valuable articles about Chronic Diarrhea of Childhood (which is what this is called).
Also, the tongue "ulcers" are no ulcers and the syndrome is indeed called "geographic tongue" like so many helpful commenters have suggested. Thank you all for your continuing interest and support.
These days (2010), Jacob is a big hulking kid who has the occasional loose stool but has been toilet trained successfully almost a year ago. He's never had any accidents, no matter how bad the diarrhea was on any given day. He still has the funny tongue and very dry skin, but other than that, all is well. It surely isn't something I would want to revisit and the stress and the fear from those days are still with me. We still read all the comments, so if you have questions, write on. You can also leave a comment over at Expatria at the post entitled "Enigma" which is a re-post of the first link I mentioned. Best wishes to all parents who are going through the same as we did.