TL; DR: Dr. Fishbein brushed off my concerns about reflux (though luckily DID prescribe a PPI),…read moreinstead basing his medical opinion on a swallow study he never viewed and a single observation of me feeding my son. He told me that my son's reflux symptoms aren't that: instead, he's "uncomfortable," stating what my son really needs are Early Intervention, Speech/feeding therapy, and OT. After 2 appointments at each, it was clear we didn't need those services.
I was referred to CDH/Lurie's and, specifically Dr. Fishbein, by a Speech-Language Pathologist at St. Alexius who conducted (two) swallow studies on my infant son. The referral was a result of Laryngomalacia and his exhibiting reflux, as I was told was also observed on the swallow studies.
At my first appointment with Dr. Fishbein, he walked in as I was feeding my son. I explained how we were referred and went through all of his symptoms (grunting, arching, kicking legs, balling fists, flailing arms, chewing, sour face, gagging/sticking out tongue, red face, hyperventilating/fast breathing, screaming and vomiting [oftentimes projectile] after eating). I explained Zantac, prescribed by other doctors, didn't work for us and I'd like to try a different medication.
The SLP at St. Alexius said that there was marked improvement between the swallow studies. Without having seen the videos from the swallow studies, Dr. Fishbein proclaimed that there was no possible way for my son to show improvement in 2.5 weeks and stated that he would treat my son based on the results of the first swallow study.
He also told me, as he watched my son finish eating and squirm (right before he vomited, like he does) that he's "uncomfortable" and it's not reflux. ?! He told me in a rather alarming way that my son is developmentally delayed and what he REALLY needs is OT, Speech/feeding therapy, and Early Intervention services. He told me that my son should have been receiving these services MONTHS ago and that I'm behind. It freaked me out and, of course, made me question myself as a mother and also my pediatrician who had assured me my son was fine developmentally.
He did prescribe a new Rx (Prilosec) which has helped my son's symptoms significantly.
Meanwhile, I have gone to see OT and Speech at his insistence/referral. Neither Speech nor OT seemed to have glaring concerns: just look for cues indicating fatigue while eating, and work on Tummy Time.
After the first Speech and second OT appointment, we had a follow-up with Dr. Fishbein. He asked how Speech/OT went, and I relayed the above. He said, "That's not what the reports I received back say - both Speech and OT indicated there's work to be done!" I also brought in the swallow study videos/CD. He first told me he'd look at them and return. He left me in the room for 15+ minutes while he saw other patients, then came back and told me he didn't have time to view them, and would pass it off to the Speech Therapist, who would call me the following week. (She never did, and the OT had to facilitate the call. After attempting Phone Tag once, she never returned my call and waited 2.5 weeks until our follow-up.)
Dr. Fishbein also told me that he doesn't think my son has reflux at all, despite all of the symptoms he's presented. He told me that only 5% of infants legitimately have reflux, and said the only way to know for sure would be to sedate and scope my son.
Today we had our second appointment with the Speech Therapist. She watched my son eat and, by the end, told me she doesn't have any concerns and we don't need to follow up with her anymore. I relayed the conversation I had with Dr. Fishbein at the last appointment and the notes indicating "work needed to be done." She looked confused. I told her that we have an appointment with the Feeding Clinic in January (which includes Speech, OT, and GI/Dr. Fishbein). She told me she'd contact Dr. Fishbein's nurse, who will follow up with me. I'm thinking it's clear that we don't need this appointment.
The fact that Dr. Fishbein failed to examine the swallow studies and proclaimed he would base his treatment on the results of the first study (which was conducted poorly) show a huge err in judgement. Further, no one even looked at these swallow studies for a month - a long time considering the goal should be to ensure my son receives the appropriate medical care and intervention.
Further, the whole alarmist approach - telling me my son is developmentally delayed, and that he's in desperate need of OT, Speech/feeding therapy, and Early Intervention - really scared and upset me. Here I am trying to do what's best for my son, and I was told I missed the ball. I should have listened to my pediatrician AND my instincts: my son is just fine. I think Dr. Fishbein downplayed my concerns about reflux, and instead focused on referring my son for services he really doesn't need.
The only positive? Getting a Rx for a PPI (Prilosec). Oh, and the secretary is THE sweetest woman ever.
