Tuesday, January 6, 2009

Finally...Cyclic Vomiting Syndrome (CVS)

I finally know what happend to my husband. After doing research on the internet and some of the journals, I finally got the most similar symptoms that showed by my husband's condition compared to the diagnosis that have been told by our previous doctors these past 7 years. Cyclic Vomiting Syndrome (CVS) is an uncommon, unexplained disorder of children and some adults that was first described by Dr. S. Gee in 1882. The condition is characterized by recurrent, prolonged attacks of sever nausea, vomiting and prostration with no apparent cause. Vomiting occurs at frequent intervals (5-10 times an hour at the peak) for hours to 10 days (1-4 most commonly). The episodes tend to be similar to each other in symptoms and duration and they are self-limited. The child is generally well between episodes.  

The onset of CVS occurs in infancy through adulthood but most commonly between age 3-7. It can persist for months to decades. The episode may recur several times a year or several times a month. Females are affected slightly more than males. The child may be prone to motion sickness, and there is often a family history of migraine.

Episodes may begin at any time, but typically start during the night or early morning.There is relentless nausea with repeated bouts of vomiting or retching. The child is very pale and resists talking. They often drool or spit and have an intense thirst.There is often intense abdominal pain and less often headache, low-grade fever and diarrhea. Prolonged vomiting may cause mild bleeding from irritation of the esophagus. Patients often describe being 'possessed', out of control and stuporous.The symptoms are frightening to the child and family and can be life-threatening due to dehydration and electrolyte imbalance.

CVS has been difficult to diagnose because it is infrequently seen in clinical practice and because vomiting may be caused by a large number of common disorders other than CVS. There are as yet no blood tests, x-rays or other specific procedures used to diagnose the disorder. The diagnosis is made by careful review of the patient's history, physical examination and studies to rule out other diseases that may cause vomiting similar to that seen in children with CVS.

Although some patients know of nothing that triggers attacks, many can identify specific circumstances that seem to bring on their episodes. Emotional stress, intense excitement (birthdays, holidays, vacations), and colds or flus (some journals says chronic sinusitis - which I think related to my husband, basically in my opinion, the infection in the sinus triggered the migraine and then the vomiting syndrome) are the most frequently reported triggers. Specific foods or anesthetics may also play a role.

Treatment is generally supportive with early intervention in a dark quiet environment for sleep and I.V. fluids when needed. Medication trials sometimes succeed in finding something to prevent, shorten or abort the episodes. An essential component of treatment is the doctor-patient-family relationship. It involves a physician who does his/her best to understand CVS, is supportive and willing to coordinate the care in collaboration with all involved. A family/professional network, such as CVSA(Cyclic Vomiting Syndrome Association), can help heal a family that has been in doubt and despair for years.

After this I'm gonna bring my husband to the hospital and ask the doctor to prescibe the sinusitis or migraine medication for him. I'm not saying that Malaysian doctors arent smart enough, but sometime from my past experiances with the them, when we tried to tell them our opinion, they tend to treat us like a bunch of ignorants who try to act like smart alecks, as if we dont even know a thing about health. So, anybody, who know about this thing please dont be shy to share it with me. I really appreciate it.

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