So we've been home for over a week now. Gabe has his NG tube still. We are offering him 70ml in his bottle every three hours and whatever he doesn't take, we put down the tube. We went to the Cardiologist on Wed. His weight was up slightly, but they told us to up his feeds to 75ml per feeding b/c they want him to gain a little faster. They also made some medication adjustments. On Thursday, we went the the Ped. office. She thought he looked good. She reiterrated how sick he was and agreed with me that it would be a good idea not to take him out in really public areas b/c he CANNOT get sick. She also did not know why he got so sick so fast, but told me to go with my gut and if I'm ever worried, go to the ED. When we were at the pediatrician's office, Gabe threw up all over me which was odd for him. Throughout the day on Thurs., I also noticed he wasn't eating as well. Justin also changed a diaper that day that he thought had some blood in it. I didn't see it, but he thought it was definitely noticeable. Around dinner time, Gabe was not eating well. He seemed like he was in pain when I was giving his tube feed. He started refulxing some. When he does this, he kind of bears down and holds his breath to fight it. His face turned really red and he was crying unconsolably. When he finally stopped, he looked pale and kinda out of it. I called the pediatrician who we had just seen earlier that day and told her I was worried and she agreed with me that we should go to the ED. I called the Cardiologist on the way and he met us in the ED at Children's. Because we had made some medication changes the previous day, I was kinda worried about his potassium level and blood pressure. Of course when we get there, Gabe looked great and wanted to play and flirt with all the lovely nurses. I felt kinda silly, but I was glad that I knew he was all right. The Cardiologist didn't really have any good answers for the blood in his stool. He said if it happens again to let the Ped. know and it hasn't. Maybe he was just straining or something. As far as not tolerating the feedings well, he just said to cut the Lasix dose if we think he's getting dehydrated and continue to use refulx precautions and give the tube feeds very slowly. He also hinted at the idea that b/c Gabe is a pretty fragile little guy who leaves everyone scratching their head, they want to watch him closely and may be leaning towards surgery earlier than later. He also told me that he "misspoke" on Wed. when he told me the ECHO showed his vertricles were back to normal...they were actually the same as when we were discharged which is still not totally up to par. I was pretty upset at the doc for that. So, Gabe has still spit up from time to time. You can hear him refluxing with his feeds and you just hope he doesn't get sick. We're feeding him very slowly and then holding him upright afterwards. The whole process is taking about 60-90 minutes to ensure he keeps everything down. I know all babies spit up, but this is just new for him and he seems uncomfortable after feeds when he use to go into a food coma sleep. The dietitian is going to call me back tomorrow. Part of me wonders if he's Lactose sensitive, but it seems like we would have noticed something before now. Poor little guy. I hope so much his ventricles get back to baseline so he can be as strong as possible for this surgery. I'm starting to get really worried about the surgery. I feel like this last hospitalization was just a preview of what is to come. I need to stay more positive though. So, here are the positives: Gabe wants to smile so bad...he's so close...it's going to be so cute. Gabe is also sleeping much better at night. We are the one's waking him up to feed him. Katie's wedding was fun. I'm so glad I got to be a bridesmaid. I was worried I wouldn't be able to with everything going on with the baby. It was nice to feel like a girl again. Yay for Grandparents being able to help with Gabe and learning how to feed him and give him his medicines.
Sunday, August 23, 2009
long and overdue
So we've been home for over a week now. Gabe has his NG tube still. We are offering him 70ml in his bottle every three hours and whatever he doesn't take, we put down the tube. We went to the Cardiologist on Wed. His weight was up slightly, but they told us to up his feeds to 75ml per feeding b/c they want him to gain a little faster. They also made some medication adjustments. On Thursday, we went the the Ped. office. She thought he looked good. She reiterrated how sick he was and agreed with me that it would be a good idea not to take him out in really public areas b/c he CANNOT get sick. She also did not know why he got so sick so fast, but told me to go with my gut and if I'm ever worried, go to the ED. When we were at the pediatrician's office, Gabe threw up all over me which was odd for him. Throughout the day on Thurs., I also noticed he wasn't eating as well. Justin also changed a diaper that day that he thought had some blood in it. I didn't see it, but he thought it was definitely noticeable. Around dinner time, Gabe was not eating well. He seemed like he was in pain when I was giving his tube feed. He started refulxing some. When he does this, he kind of bears down and holds his breath to fight it. His face turned really red and he was crying unconsolably. When he finally stopped, he looked pale and kinda out of it. I called the pediatrician who we had just seen earlier that day and told her I was worried and she agreed with me that we should go to the ED. I called the Cardiologist on the way and he met us in the ED at Children's. Because we had made some medication changes the previous day, I was kinda worried about his potassium level and blood pressure. Of course when we get there, Gabe looked great and wanted to play and flirt with all the lovely nurses. I felt kinda silly, but I was glad that I knew he was all right. The Cardiologist didn't really have any good answers for the blood in his stool. He said if it happens again to let the Ped. know and it hasn't. Maybe he was just straining or something. As far as not tolerating the feedings well, he just said to cut the Lasix dose if we think he's getting dehydrated and continue to use refulx precautions and give the tube feeds very slowly. He also hinted at the idea that b/c Gabe is a pretty fragile little guy who leaves everyone scratching their head, they want to watch him closely and may be leaning towards surgery earlier than later. He also told me that he "misspoke" on Wed. when he told me the ECHO showed his vertricles were back to normal...they were actually the same as when we were discharged which is still not totally up to par. I was pretty upset at the doc for that. So, Gabe has still spit up from time to time. You can hear him refluxing with his feeds and you just hope he doesn't get sick. We're feeding him very slowly and then holding him upright afterwards. The whole process is taking about 60-90 minutes to ensure he keeps everything down. I know all babies spit up, but this is just new for him and he seems uncomfortable after feeds when he use to go into a food coma sleep. The dietitian is going to call me back tomorrow. Part of me wonders if he's Lactose sensitive, but it seems like we would have noticed something before now. Poor little guy. I hope so much his ventricles get back to baseline so he can be as strong as possible for this surgery. I'm starting to get really worried about the surgery. I feel like this last hospitalization was just a preview of what is to come. I need to stay more positive though. So, here are the positives: Gabe wants to smile so bad...he's so close...it's going to be so cute. Gabe is also sleeping much better at night. We are the one's waking him up to feed him. Katie's wedding was fun. I'm so glad I got to be a bridesmaid. I was worried I wouldn't be able to with everything going on with the baby. It was nice to feel like a girl again. Yay for Grandparents being able to help with Gabe and learning how to feed him and give him his medicines.
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Glad that he is holding his own for now. I am not sure how long he has had the ng..but the reflux does come with the ng. My son has had the ng from birth and he vomits quite a bit through out the day. I am told it is from the ng. Also could be from extra fortified feeds that he could be adjusting to. Before surgery they used to make me stuff Wysdom to put on weight. We also do feeds over an hour to help combat the reflux. You could vent the tube to help with any gas.
ReplyDeleteKeep up the good work. :)
I am glad to hear that Gabe is doing a little better. I remember the constant tube feedings. It feels like you JUST finish one and it is time to feed again. I don't know if your ped or cardiologist have mentioned but both of ours agreed, on Gabriel, that we should just tube feed him at night and let him sleep instead of waking him up. They hoped this would gain him strength and get him some calories without the work. Just something to ask next time you see one of them. If you are able to I know that it helped us to get a Velcro wrap and hook his tube on the crib with him sleeping on an upright angle for the feeding. This way I could sit in the rocking chair instead of constantly holding the tube during the feeding. I know how nights can become long! I wish you two and Gabe the best of luck. We are following along with your journey and praying for Gabe to be strong.
ReplyDeleteGo with your gut! According to Micah's GI doc, dairy intolerance shows up around 8 weeks of age. And a symptom is often blood in the stool. If Gabe isn't already seeing a pediatric gastroenterologist, you might want to ask his pediatrician for a referral. Just mention that kids with Down syndrome often have motility issues and you'd like to have him checked out by a specialist. They'll want to run a stool culture to check for the intolerance.
ReplyDeleteMicah had lots of feeding intolerance issues between NICU and heart surgery. The docs wanted to blame it on the slow motility of Down syndrome. Also, the weak heart can cause things to slow down significantly.
I agree with Gabriel's mom about the night feedings, except that the night feedings were the only time that Micah would take a significant volume by bottle (he was hungrier) and it was important for him to keep his sucking strength up so he needed that time to feed orally. But, you should ask your doc to order a pump so that you're not spending so much time with a syringe to finish off the feedings (especially if it's taking so long). Micah's home health nurse suggested it when Micah had been home from the NICU just 2 weeks and she saw how long it was taking me to feed him. That way, you're not distracted with the manual feeding part and you can just hold him without regard to a syringe, etc.
Micah didn't have as many scares early on as your Gabe had (related to heart), but we've been through the ringer on the feeding stuff. Micah is still on Neocate, but most of his digestive issues are still related to his duodenal atresia. Feel free to email me: jenniemsu at gmail dot com.
Praying for Gabe...