Ellie

Ellie

Sunday, November 28, 2010

Jinx

It appears I have jinxed myself. Ellie was doing so well, eating 6 ozs at every feeding with minimal spit up; in fact, we had no spit up at all for about 2 days in a row. So, when, on Friday, I announced my love for Enfamil AR and the joys of the new concoction we call formula+ I should have known it would be down hill. The vomit is back and frequent. She's back down to about 3 ozs a feeding. She's still hitting the overall target of what she needs (about 14-18 ozs) but its not as rigid, structured, and, well frankly, enjoyable as it was the first 5 or 6 days. I am now back to being worried about her weigh in next Tuesday.

Friday, November 26, 2010

Thanksgiving

Yes, I realize its the morning AFTER Thanksgiving. So Im thinking Thanksgiving may be my favorite holiday. I found out last year Thanksgiving morning I was pregnant, and this year my giggly girl watched the parade with me in my bed. I was so happy most of the day I was teary-eyed (btw, what up with that? I was NEVER a crier before I had her, now I cry all the time!). I had to make a quick store run (was painless, really) to pick up milk and so I also bought non-toxic paint and we painted her hands and placed them on a piece of paper for "hand turkeys." She was not amused, but we were. And I think a lot of her family will be as well. Its pretty freaking adorable. Also, I got a TON of things done while the daddy-daughter bonding was occurring. I have to say, I dont remember the last time the living room looked this clean! I dusted, I vacuumed, I made a dozen bottles. Im still trying to organize some things (baby stuff, of course like magazines on the shelf and spoons, bowls and sippy cups in the kitchen) but I have to say between me and my lovely hubby we got so much done!

As for an update, Im on here because I believe its no longer a fluke- Ellie really is eating better! I was so worried the first day she was starving and the next day or so that she was just enjoying something new but we're up to Friday and she is wolfing these bottles DOWN. Not only that, there has been almost no spit up at all! Its amazing! Its damn near miraculous. Im considering calling the Vatican. She eats 6 ounces at nearly every feeding (doubling her usual 3 ounce intake), skyrocketing past her normal daily intake. She's averaging 18 ounces a day, when the GI Dr said she only needed 14, and I had calculated closer to 15 (14.5 to be exact) for hydration. Im really trying to be cautious and remain optimistic. All signs point to one fat, happy baby though!

On a related note, I love my mother in law. I know, Im one of the few. Yesterday she reminded me why I love her so much (although to be honest, I think about what an amazing person she is all the time). The minute she read the email I had sent to the family about the disappointing GI appnmnt, she called us. She started out with Happy Thanksgiving, asked if I was in the middle of something (so polite) and when I responded no I could hear her sigh in relief that we could talk about the situation. She sounded so worried and sad about what had happened, and then tried to cheer me up by expressing how wonderful she thought I was doing with Ellie, how she knew we were trying so hard and doing everything we can, and we were doing such a great job and fighting so hard. It was really sweet. My mother in law used to work in nursing homes, and her generous heart knows no bounds. She bends over backwards repeatedly to make everyone happy. I dont think she's had a hot meal in her life- the minute your glass is empty or food looks low she jumps right up. She often gets trampled in the process, because she allows herself to be kind to a fault (read: doormat) but I really dont know anyone who really gives until it hurts. I have no doubt there is a special place in heaven for my mother in law.

Tuesday, November 23, 2010

GI Dr

First, I love him, I think he's brilliant. He and I are on the exact same wavelength. I dont think Ive had an easier discussion with a doctor. He was very, very helpful and I can't thank him enough. He gave us a very important prescription- TIME. Ellie is running short on time to gain weight before her surgery. If she cannot gain enough weight, not only will her surgery be postponed, but she will acquire a lovely NG tube. I have expressed my desire to avoid the NG tube at all costs from day one, but we're running out of time. She needs to fatten up and she needs to do it NOW. Although he said the NG tube would only be used at night, she would have to wear it all day every day. So she'll look... well... not unattractive... but like a baby with a tube hanging out of her nose. No more Gerber photo shoots for her, ha ha. He tried to explain how it would ease my stress, because instead of begging, pleading, wishing and praying she would take more in, she would. And I wouldn't have to do it, it would just be done. I appreciate him trying to put a nice spin on it but the reality is my daughter will have a tube running down the back of her throat pouring food into her stomach all night. He did say he would help me stall against time, offered me more ways to fatten her up (polycose and oil- as in canola or olive). He also asked about the distraction surgery, I explained with any luck Dr Williams (her plastic surgeon) will continue his advice against it, but just in case I have an appointment with him Jan 13th. I also mentioned her teething and that teeth help pull the jaw forward. My follow up with the GI doctor is the next day, Jan 14th. So it may be a moot point if Dr Williams postpones palate to do distraction.

I have 2 weeks to help her get up to 10 lbs. This will be the scariest two weeks of my life. I realize that in the world of PRS (and sometimes the world in general) an NG tube is pretty low on the things that often happen. Its not a trache, its not a regular G tube- theres no surgery. And I know my angel comes with some serious battles I have to fight. I just hope this is one I can win.

Monday, November 22, 2010

4 month pedi appnmnt

Ellie had her 4 month wellness check up. She was laughing and cooing and carrying on in the waiting room but silent as a charlie chaplin film by the time we got back to an exam room. This actually worked to our advantage as you'll read in a second. I need to skip ahead so this will not be chronological. Long story short, she's doing great. She is still way ahead in her motor skills- she sat up to a 45 degree angle while we were there (I am convinced she'll be pulling up to sitting before 6 months), exhibited excellent head control, watched everyone move around and talk. I told him we let her drink like a big girl (from a tiny bottle without a nipple- only 10 ml) and when we put her in the high chair she sits like a big girl, and when we fed her cereal from the spoon she gladly grabbed it to help me guide it into her mouth. The doctor decided he wanted to hear her cry because she had never done so at our previous appointments, so her previous giggles that had been stifled worked to our advantage. Of course after she began to cry (it was her, "this is annoying please stop" cry) he decided he liked it better when she cooed and giggled. Well, duh. She took her shots like a champ- she screamed at first (which in my opinion she has every right on earth to do) but after I held her and kissed her we were all back to normal. Even cooing a bit.

Here's where it gets out of order- her weight. Usually they do this in the very beginning but in my story its got a life of its own and deserves a separate paragraph at the least lol. At 4 months of age my dainty darling weighed in at 9 pounds, 6.5 ozs. I was heartbroken. I was hoping for at least 10 lbs. I felt guilty. Logically and rationally I realize I did indeed do all I could- I added rice cereal thinking it would plump her up. I was in constant contact with our feeding and nutrition team at CHOA. I fed her a bit more than she probably would have liked to consume in hopes of stretching her stomach. I tried to feed her every 3 hours. I often did not take "no" for an answer when offering her a bottle. We tried polycose even tho it didnt work. When she had a bad case of vomiting last week (I assumed it was reflux since she had no other symptoms of anything else, unless it was teething but it seemed more formula than spit) I immediately called the pediatrician (who told me to wait until our appnmnt today). But being a mom, I was consumed with a mother's guilt. Especially when he said take the rice cereal out as it wasnt helping. I was devastated. I thought I was helping. I honestly did. And now to hear that I wasn't... like a punch to the gut. So she COULD have weighed more if I had just not been retarded and added rice cereal... at least in theory. She probably lost a bit in all the vomit last week but probably not half a pound. At any rate, he wants out of the loop, so to speak, on her feeding and diet. We already have CHOA and tomorrow we'll have the GI doctor so he feels that's too many cooks. He did give us Enfamil AR to hopefully help control her currently out of control reflux. He gave me 2 samples, I thanked him and put them away. I got home and made her 4 bottles with it, fed her one of them to see her reaction. She seemed fine with it. I read the label: dairy based. Now, it seems to me we were fairly certain that Ellie had issues with milk and thats why we switched to soy. Although to be honest, her first few months on formula she was on soooo many it was hard to keep track of which made her happy, which didnt, whether it was reflux or bad formula, etc. Her vomit this evening did seem to be a lesser amount, but maybe that's because its more like cottage cheese than formula. In which, by the way, I am covered. Anyway, I emailed the nutritionist at CHOA asking her if we need to change our ration of formula to water (its 3 scoops to 5 ozs right now). Another special needs mommy said she's on the same formula and was told to keep the same ratio *Shrugs*.

Saturday, November 20, 2010

Nerves

So we went on our second date night, nothing exciting- red lobster. For some reason tho my anxiety about leaving the baby skyrocketed. The first time - no issues. Second time- terrified. Maybe I was in denial at first lol.

Monday is her 4 Month Appointment, Tuesday is her appointment with the GI. I was originally going to cancel it but it seems her reflux has gotten completely out of control. The last 2 days have been nothing but vomit. It could be her teething but I dont think it is because its not always clear. BTW, got great info from my babysitter's mom about teething. My babysitter works with her mother at a daycare center and that brings me much relief. She is a great, smart, reliable girl who is very responsible. The fact that she and her mother are devoting their lives to helping raise other people's children makes me feel good. So anyway, my babysitter's mom said that (1) the low grade fever hits about 24-48 before the tooth breaks through so we'll keep an eye out for that- so far no fever. (2) The gums will look like someone beat the crap out of her- very red and swollen. (3) The first two teeth are the hardest, its all good after that. (4) She'll probably like the ice and/or frozen washcloth the closer the tooth gets to breaking through. Right now she acts like Im feeding her razorblades.

Anyway, back to vomit lol. Its been pretty nonstop but the pedi said if she has no fever, no pain, and she keeps peeing then it can wait til Monday. My concern though is all the weight loss that may have occurred so far. If our goal, and by "our" I mean the team at CHOA that call me all the freaking time about how she's not eating enough, is to beef her up, a lot of vomiting for a few days can't possibly be helping that goal.

The real issue with teething is about her jaw. She doesnt have a lot of room on her lower jaw for many more teeth than 2. This makes me think she may end up with distraction after all. Maybe Ill post on the PRN board to see if anyone else has had no distraction and teething before the surgery.

Thursday, November 18, 2010

PS to UGH

I belong to a support group for PRS. Its a fantastic group, can't say enough good things about the Peirre Robin Network. There is a link to it on the side of my blog. A new member with a 4 week old son was concerned that he had failed the hearing test, as is frequently the case with PRS babies- the condition causes narrow canals and sometimes flatten faces so the amniotic fluid cannot drain from the ears. Often tubes drain the fluid and things return to normal. Today, however, I saw this response from another member of the PRS network:

My son has PRS, and is now nearly 11 years old. He didn't have any hearing issues until he was 8 years old, when he failed a hearing test at school. He had fluid in his ears which didn't clear up, so his ENT recommended PET, but also recommended a CT of his middle ears to look into the hearing loss further. The PET didn't improve his hearing, but what the CT showed was a bony fusion of his incus and stapes (the tiny bones that conduct sound waves) in both ears, with the left being worse than the right. According to our ENT, this is common in PRS children. He currently wears hearing aids. He will be a candidate to have surgery to "unfuse" these bones when he is older, and bigger.

So, while the fluid issues for Joshua may clear up as he gets older, there are other issues that can develop.


Really?!?!?! I mean CMON REALLY?!?!?! Maybe because they didnt catch the fluid early enough it didn't help, but since its a bone issue maybe the fluid is a moot point. I can't even type the anger and sadness I feel right now. First and foremost, I was really hoping Ellie would be one of those babies that "outgrows" her PRS. Maybe she still will be. Second, you tell this to a father of a 4 week old?!?!? Way to scare the SNAP out of him. Look Im all for giving the heads up with this condition but good Lord. Let the man come off the wave of confusion and depression that accompanies this before you start slamming with all the "Great" things that happen as the PRS babies age. Her son is 8, why not let this baby get to age 8 and have a question before warning him of a possible bridge ahead? Let him get there, ask about i, and THEN cross it!?!?

Ugh

Yesterday was a pain- Ellie hadn't slept all night and didnt want to nap during the day. This meant I could get little to nothing done. I can accept that, Im a mom. Of course after 2 days on P90x I was sore as crap and really had no muscle strength so I couldnt hold her all day so there was a lot jumping from swing to bumbo to papasan. Husband was a jerk. I was really hoping today would be better. Honestly. Unfortunately all the saliva Ellie is making from teething has caused her to vomit repeatedly- she's currently in her 4th outfit and she's only been awake for 5 hours. So here are the good things that happened to me today- I found a nice uplifting quote. My in-laws sent me a Tday card, and Ellie a Tday card. I was able to get my work out in, albeit with many pauses and holding baby. Still need to do my sit ups. Middle ground- I am re-reading The 7 Principles for Making Marriage work because my patience is thin and hubby is about to get smothered in his sleep at this rate. The Bad- obviously, teething and vomit. We got denied Katie Beckett/TEFRA. I have some paperwork to take back to the pedi's on Monday regarding the denial. Still not ok with the pre-op paperwork staring at me from the coffee table. I also have to fill out her paperwork for the GI Dr on Tues this weekend (another appnmnt which will likely ruin my day). Could be worse. I dont want to know how, but Im sure it could be worse. Wish I could stay in bed. Guess I'll just try not to cry and wake the baby. She always looks at me funny when I cry, like "Ummm mom...? whats going on??" Which makes me feel even worse... not that I dont want her to see me cry, I just know she doesn't understand that sometimes mommy is emotional. And I can't explain to her that sometimes singing Christmas Carols makes me cry LOL. I can't help it, Ive never made it through all 4 verses of "Silent Night" since I was 12. LOL. Ah well. Buck up little camper as my friend Margaret says.

Wednesday, November 17, 2010

Stupid Mail

Llewellyn's pre-op paperwork came in today. It doesnt say anything we dont already know- like when to show up and a little bit about what will happen when we get there but I just held her and cried. My poor, beautiful, smart little baby girl has to have surgery. 2, in fact. I hope Im not this bad when it really is surgery day.

Tuesday, November 16, 2010

Countdown

A bit worried about her appointments next week. I dont care about the pedi one, frankly, she's doing great as far as he's concerned. I wanted to cancel the GI appnmnt but she's been so weird with her eating lately I guess I wont. Her appetite has been up and down up and down. Today I keep focusing on her surgery. 2 months, 21 days to go.

Wednesday, November 10, 2010

Neuro Appnmnt

The neurologist was a lovely older lady. And thankfully Llewellyn was her usual ham-self. She smiled, cooed, sat up, enjoyed being on her tummy (first time for everything). The best news, however, is that the neurologist found absolutely no reason for concern. She said Ellie does tend to alternate sides when moving her mouth, but when she full on smiles or full on cries, the left side comes alive. The neurologist further said it should only improve over time, and we have no reason for alarm. Phew! My concern, however, is that the neurologist asked about distraction. At the present time the answer has been no, but now Im wondering if they're going to delay the surgery in Feb and do distraction instead. Time to ask some questions on the PRS network. (I also want to know if she's physically capable of blowing raspberries)

Tuesday, November 9, 2010

Rice Cereal and Hearing Test, Dr Stickler

The rice cereal experiment is going much better than I had previously anticipated. She wolfs down every bottle with rice in it, and only drinks moderately from bottles which are straight up formula. No bad constipation, no diarrhea, no excess vomiting. This is only day 2, however, and Ive heard day 3 is when things will go south if they will. *fingers crossed*

We went to the ENT and had an audiologist perform the exact same tests Llewellyn had in the hospital. The first confirmed fluid behind the ears, the second said she failed the hearing test. I was told that while they can't be 100% positive, it is likely that it is the fluid in her ears causing her to fail. It should not cause her any problems unless she goes deaf or gets an infection. In either case there is little they can do until her surgery for the tubes in February of 2011. Something like 2 months and 28 days left. Her hearing is considered muffled, like listening under water. After the tubes are put in and the fluid drains they will redo the test and only then if she fails will there be considered a problem.

Dr. Gunnar Stickler passed away today. Stickler's Syndrome was named after him. I never met him personally but another mom on the PRS network said she and her son had met him and he was a wonderful human being. Evidently he ate pizza poolside with her son in Denver, here is her post:

I had the pleasure of meeting him and spending time with him at several
Stickler conferences. He was such a wonderful intelligent man. My son
got to spend time with him in Denver when he was 12. They hung out one
evening at the pool and ordered pizza. We had many long visits about
PRS and the lack of research being done.

He will be greatly missed.

Nancy


And here is his Obit:

ROCHESTER — Gunnar B. Stickler, M.D., 85, passed away at his home in Wayzata, Minn.

He is survived by his wife, Duci, of 54 years and his children, Kati Lovaas and George Stickler. A native of Southern Bavaria, Germany, he was a retired physician who practiced at Mayo Clinic for 32 years. Gunnar Stickler was chairman of Pediatrics at Mayo Clinic from 1969 to 1980. He was a member of the editorial board of Clinical Pediatrics for almost 25 years. Gunnar also served on the editorial boards of Pediatrics (6 years) and the European Journal of Pediatrics (8 years). Throughout his life he contributed over 200 articles to medical publications. His achievements include the discovery and description of hereditary progressive arthro-opthalmopathy, named "Stickler Syndrome."

The world lost an energetic, charismatic, talented, challenging, witty, and sophisticated man who cared deeply about his patients and who practiced the true art of medicine every day. In the words of his former resident, Douglas S. Moodie, M.D., "Gunnar created an excitement about clinical scholarship that was unmatched. He was a superb teacher. He challenged and compelled one to do clinical research and infected one with his enthusiasm for life and medicine and his quest for the truth."

Gunnar was an active sportsman who loved competitive sailing, skiing, cross-country skiing, tennis, and iceboating.

Gunnar is very much missed by his daughter, Kati Lovaas and son-in-law Mark Lovaas of Wayzata, and their children Kristina, Alexandra and Karl. Gunnar lived next door to the Lovaas family and found great joy in the daily involvement in his grandchildren's lives. Gunnar is missed by his son, George Stickler and daughter-in-law Diana and their children, Elsie and Kurt; along with his sister, Karin Ensmann of Truchtlaching, Germany.

In lieu of flowers, memorials may be directed to: Stickler Involved People (SIP), 15 Angelina, Augusta, KS 57010. Stickler Involved People is a 501(c)(3) organization whose mission is to educate and give support to the people affected by Stickler Syndrome.

A Bavarian "Leichenschmaus" memorial supper celebrating Gunnar's life will be held on Nov. 14, 2010, at 3 p.m. at the home of Mark and Kati Lovaas, 17840 Breezy Point Rd., Wayzata, MN 55391.

Monday, November 8, 2010

Hearing Test Pt II, Rice Cereal

So the feeding team, specifically the nutritionist at CHOA, has been on me to have Ellie gain weight. Like I'm withholding food or something. Anyway, she got with my pediatrician to refer us to a gastroenterologist. I call, they tell me the one closest to my house has no availability until Dec 6th. Helpful. The one in Atlanta has an opening November 23. Great. So we schedule for Nov 23 even tho she'll be seeing her pedi for her 4 month check up the day before. I feel this appointment is going to be a waste of time. Her surgery is only a few months away, and we can't see the GE for another few weeks. Plus we get to add rice cereal soon so I think that will help beef her up, in addition to helping fighting her reflux to help her eat more. I gave her a touch of rice cereal today, she wolfed down the entire bottle in no time.

We went to have a second hearing test b/c Ellie puts her ear to my mouth which I assumed meant she wants to hear better. They confirmed fluid in her ear and accordingly she failed the hearing test. They said nothing to be concerned about, just need to wait to get tubes in the ear to drain the fluid. If she fails a hearing test at that point, THEN we can have some concern and justified worry. So unless she goes deaf or gets an infection there's nothing to do but sit and wait for the surgery. So I guess its good news, there's no actual hearing loss, they're fairly certain its just the fluid but I still don't like that she hears muffled.