Fistula increases again

Peter's fistula continues to go up in volume. He is putting out a little over a liter a day from his fistula.  His output is almost as high as it was before the surgery. The docs are discussing how to handle it and may try a new medication to see if that will slow it down, but ultimately he needs more surgery and it is a question of how best to surgically correct it and when. He is still eating, but he is limited in what he is taking in still, as there is some suggestion that there is a correlation between the volume he ingests and the volume put out the fistula. There is not a connection to the fistula and the GI tract anymore, the surgery fixed that, but as there is still a good deal of intestinal tissue connected to the fistula, that intestinal tissue still thinks it needs to secrete liquid when Peter eats. That is my understading of the reason for so much output, anyway. That, and the chyle leak that continues alongside this problem.

I must say that it is very difficult to find low-fat foods that are not high in sugar or fiber.  We have about 5 boxes of cereal for him to eat, baby foods which he is beginning to tire of since he has been eating them for years, and some meltable Gerber Puffs which he likes but have no caloric value.  He has enjoyed dipping pretzels into ketchup and mustard, and baked chips this way as well.  He won't eat noodles or bread, though they would be good for him.  He did eat a few nibbles of pizza today though.  It wasn't low fat, so the fistula output became more milky after that snack, but how do you say no to a kid who is finally trying another new food that any other time would be a milestone?  Dr. Kamin is OK with an occasional fattier snack, as he has reminded us of the importance of considering quality of life as well.  I wonder if there is pizza-flavored baked chips?!