It’s strange how when something monumental is going on in your world, you feel like the entire world should stop and acknowledge it. I see famous actors sponsoring causes and I want to call them and explain that they should REALLY be talking about heart defects. They are the number one birth defect and no one is talking about them! My son’s surgery has been scheduled for November 30th. I’m currently immersed in the world of high end medicine. My days revolve around capillary refill rates and tachypnic breathing. But the world around me continues. I’m living in a world where I see friends’ babies die and can only stand silent witness and support as best I can. Even the people who come in to help us out can’t really understand because they go home and sleep and live a life outside of this world, we are never outside this world.
We have at least 1 doctor appointment every week. We have a pediatrician, cardiologist, a gastroenterologist and a urologist in addition to our pediatrician. Our insurance company has assigned us a special care coordinator who is also a nurse. Her job is to ensure C gets what he needs when he needs it and ensure we are not overwhelmed by bureaucracy. I always thought that you had to go to war with your insurance company for every procedure when you or your loved one was sick. The media fosters the idea that the insurance companies are out to find ways to let you die so they can keep more money. So far I have found that to be totally untrue. We have a home health nurse who comes weekly to check C's weight gain and make sure his O2 sats are still close to 100%.
I now know there are two kinds of pharmacies and that the big stores like CVS aren’t really equipped to meet all drug needs, I never knew that all pharmacies couldn’t dispense all drugs. We found out when we walked into the pharmacy and handed them a handful of prescriptions and they said it would take 4 days to fill it. The prescription in question was for salt water, very specifically formulated salt water, but salt water nonetheless. In case I’m not the only person who didn’t know, there are compounding pharmacies which can make drugs and non-compounding pharmacies (like CVS and Walgreens) who can only dispense what has already been created.
When you go into the hospital the world narrows to that room in that time. There are no days and nights, just 12 hour shifts and 4 hour vital checks. Monitors beep and leads fall off and you learn to be nonchalant about idiosyncrasies that can panic even seasoned nurses, because for your child it’s normal. My baby breathes two to four times faster than the average baby at all times. I’ve had fights with ER docs about it and watched nurses who take vitals, stiffen and start to quietly panic until I tell them it’s OK. It’s a relief to be at the cardiac clinic, because there, they don’t even blink when his respirations are in the 70s. He’s a cardiac baby and he’s awake. We get excited when his respirations are in the 50s because that’s amazingly low for him. It’s going to be very strange for me when I can’t check on my son by watching him breathe from across the room.
I’m constantly exhausted now, but I wonder what I’ll do with my time all this is over. This is not what my poor husband signed up for. He loves our son, but the amount of work and coordination boggles the mind. We should be able to get a solid block of sleep by now. We should be bummed the off days when the baby wakes up a couple of times in the night; instead we wake him up every night to feed him. I wonder if he’ll still be sleeping through the night once he’s not running a marathon all the time. My pediatrician looked at me and said “soon, you will have sleep”. I know that well babies are not this exhausting, but I’ve never had one, so I can’t imagine it.
But mostly, I’m scared, I know he’s sick in my head, but he looks fine to me. He’s getting more tired and this is getting to be more work for him every day. But the thought of handing him off for surgery is terribly frightening. My baby is going to have open heart surgery and right now that is the scariest thing in the world.
Monday, November 15, 2010
Thursday, November 11, 2010
The Longest Day Ever...
Sorry I haven't been posting, I think we are slowly wearing down a bit. I need to get back in the blogging habit so I can keep
I have been living the longest day ever. It started at 3am on 8/9/10 and continues through today. This day is broken up with naps that span at most 2-3 hours before I'm up for another hour to hour and a half doing "stuff" Pumping and feeding baby and giving medicine. But what I most certainly don't get is sleep.
On Monday, we went to the pediatrician and got a set of shots. Usually these shots are given at 4 months, but we'll be in that 6 month window where we can't have any vaccinations by the time he turns 4 months old. I started to wait until next week to do the shots because we're risking having to redo them if they are to close together. It ends up that we're lucky I did not do that. They wanted to do surgery closer to four months instead of six. They said December would be the month for surgery. So somehow, it knocked me for a loop when the surgery date was set for November 30th. I know its only one day, but I REALLY expected to have the word December in there somewhere. I was very disconcerted and I am very anxious.
Tomorrow we meet the surgeon and get another echo so he can get the pictures he wants to have for planning. I have lots of questions to ask and I hope getting those answers will help ease my anxiety. I'm back on heartburn meds, so I know I'm actually pretty anxious. I'll know more about the specific repair and how long we're expected to be in the hospital after tomorrow (which is actually later today since its 1:30 in the morning and I'm up expressing breastmilk for the 4am feeding).
I stuck C's rattle in his hand earlier today and he tends to hold onto it for a while if we can get a good grip on it. He's not really grabbing it on his own. He's a little behind on the tummy skills since we can't really get all the tummy time in that we are supposed to. Our goal is half an hour a day. Eating usually takes an hour and a half out of every three hours and exhausts us. Then our tummy is usually upset for another 40 minutes after that feeding and C must be held upright... so we're 2 hours and ten minutes in before anyone can do anything for themselves such as eat or go to the bathroom. Then 50 minutes later, we start all over again. Its nice when we dream feed because feeding him goes faster, but then he's asleep and we still can't do tummy time (plus we still need to hold him upright for half an hour). The pediatrician says not to worry about it, he's going to get pretty behind after surgery anyway, but he'll catch up quickly once he doesn't expend the energy of a marathon runner just to be awake.
I've posted a couple of videos on Youtube, but only one doesn't involve having to view it sideways. Its dorky, but I still enjoy watching C smile. I have no idea why he likes having his mouth tweaked but he REALLY does *grin* http://www.youtube.com/watch?v=LjQeTTDx6qA
I've been pumping for 40 minutes now, so I believe I shall be allowed to go back to sleep. I hope to finish another blog post I've been writing for a while soon and have it online by the end of the weekend.
I have been living the longest day ever. It started at 3am on 8/9/10 and continues through today. This day is broken up with naps that span at most 2-3 hours before I'm up for another hour to hour and a half doing "stuff" Pumping and feeding baby and giving medicine. But what I most certainly don't get is sleep.
On Monday, we went to the pediatrician and got a set of shots. Usually these shots are given at 4 months, but we'll be in that 6 month window where we can't have any vaccinations by the time he turns 4 months old. I started to wait until next week to do the shots because we're risking having to redo them if they are to close together. It ends up that we're lucky I did not do that. They wanted to do surgery closer to four months instead of six. They said December would be the month for surgery. So somehow, it knocked me for a loop when the surgery date was set for November 30th. I know its only one day, but I REALLY expected to have the word December in there somewhere. I was very disconcerted and I am very anxious.
Tomorrow we meet the surgeon and get another echo so he can get the pictures he wants to have for planning. I have lots of questions to ask and I hope getting those answers will help ease my anxiety. I'm back on heartburn meds, so I know I'm actually pretty anxious. I'll know more about the specific repair and how long we're expected to be in the hospital after tomorrow (which is actually later today since its 1:30 in the morning and I'm up expressing breastmilk for the 4am feeding).
I stuck C's rattle in his hand earlier today and he tends to hold onto it for a while if we can get a good grip on it. He's not really grabbing it on his own. He's a little behind on the tummy skills since we can't really get all the tummy time in that we are supposed to. Our goal is half an hour a day. Eating usually takes an hour and a half out of every three hours and exhausts us. Then our tummy is usually upset for another 40 minutes after that feeding and C must be held upright... so we're 2 hours and ten minutes in before anyone can do anything for themselves such as eat or go to the bathroom. Then 50 minutes later, we start all over again. Its nice when we dream feed because feeding him goes faster, but then he's asleep and we still can't do tummy time (plus we still need to hold him upright for half an hour). The pediatrician says not to worry about it, he's going to get pretty behind after surgery anyway, but he'll catch up quickly once he doesn't expend the energy of a marathon runner just to be awake.
I've posted a couple of videos on Youtube, but only one doesn't involve having to view it sideways. Its dorky, but I still enjoy watching C smile. I have no idea why he likes having his mouth tweaked but he REALLY does *grin* http://www.youtube.com/watch?v=LjQeTTDx6qA
I've been pumping for 40 minutes now, so I believe I shall be allowed to go back to sleep. I hope to finish another blog post I've been writing for a while soon and have it online by the end of the weekend.
Wednesday, October 27, 2010
Once more into the breach...
In the last month, C has started really fighting against eating. A couple of weeks ago on Friday, my mother cuddled C until he went to sleep and then handed said OOPS! and him off to me to feed him. I couldn’t get him to wake up and I was joking around and said my husband would pop the bottle in his mouth anyway… I illustrated by popping the bottle in his mouth and to my amazement he drank. We spent all weekend feeding him in his sleep and he doubled-tripled the amount he ate! We were very excited and we made our goal feeding all weekend long. On Monday we had an appointment with GI and she thought we’d figured out a pretty slick solution. She did find it very interesting that he quits eating at around 30 ml awake, but asleep we can easily feed 85-90 ml. She had no problem with the solution, gave us some adjusted meds for reflux and sent us on our way. Then on Thursday our home health nurse found out about it, said absolutely not and called the cardiac nurse practitioner. I explained that without the sleep method, C would only eat about an ounce before he started really fighting and feedings could take in excess of an hour and a half…. They said well maybe we need an NG tube then. I REALLY want to avoid that and everyone knows it… but I said whatever we need to keep C healthy. They called the on call cardiologist (thankfully it was Dr. Rajan who we had met before) and he said he’d bring us in for an evaluation.
After we got in, it was time to feed C, so we started feeding him, and forced him to stay awake through the process. Feeding him like this is kind of like going to war and kind of like making Foie Gras. Eventually he started screaming and fighting and gagging. I called the nurse in to see what I was experiencing and she agreed it appeared he was in pain. My husband went home and I asked the nurses to take the night feedings so all I had to do overnight was pump. In the morning they said they were unable to wake him for his overnight feedings, but were able to get him to eat while he was mostly asleep and it seemed to work very well… I was like “I know! That’s the point!!! So we went back to feeding him in his sleep. The cardiologists on the floor said they felt he couldn’t really be asleep if he was eating and they were also fine with the feeding solution we’d come up with.
The resident on the floor explained to me that as medical people they heard eating in his sleep and were afraid he wouldn’t protect his airway. I didn’t say it, but I thought perhaps they meant inexperienced medical people… because the attendings all seemed very clear that eating in his sleep was cool. However, from now on, just in case, I’ll be saying eating in a state that is so near to sleep it is indiscernible but still allows him to adequately protect his airway and coordinate his suck/swallow/breathe reflex. While a much longer phrase than in his sleep… it will hopefully prevent a return visit to the hospital.
Our non-fortified goal is 650 mL/day. I don’t think we actually need to eat 650 to gain however. We quit fortifying after this last trip to the hospital. Someone on one of the boards had talked about how their LO would throw up when drinking fortified breast milk. They later tested her breast milk unfortified and found it was 27 kCal without any fortification. I suspect my milk is also at least somewhat higher than the average 20. We weren’t making goal, but we were still gaining around 25 grams a day. So I quit fortifying… we still gain around 25 grams a day, C eats around 90 mL per feeding and he hasn’t thrown up in 2 days now (knock on wood). We’ll see how his weight gain looks at cardiology on Tuesday. Hopefully, we’ll be able to stick with just breast milk for a while longer. C's much more comfortable without the fortification and he’s able to poop much easier! (Its amazing how much of baby life revolves around the ability to poop). We no longer have the problems where he screams like he’s in pain. I think the fortified milk was just too rich. Hopefully we will continue to gain and won’t have to go back there. We did create something of an oral aversion through all this. It seems to be getting better as we continue to not fortify, so hopefully we can resolve this one and not gain another after surgery.
My fingers are crossed.
After we got in, it was time to feed C, so we started feeding him, and forced him to stay awake through the process. Feeding him like this is kind of like going to war and kind of like making Foie Gras. Eventually he started screaming and fighting and gagging. I called the nurse in to see what I was experiencing and she agreed it appeared he was in pain. My husband went home and I asked the nurses to take the night feedings so all I had to do overnight was pump. In the morning they said they were unable to wake him for his overnight feedings, but were able to get him to eat while he was mostly asleep and it seemed to work very well… I was like “I know! That’s the point!!! So we went back to feeding him in his sleep. The cardiologists on the floor said they felt he couldn’t really be asleep if he was eating and they were also fine with the feeding solution we’d come up with.
The resident on the floor explained to me that as medical people they heard eating in his sleep and were afraid he wouldn’t protect his airway. I didn’t say it, but I thought perhaps they meant inexperienced medical people… because the attendings all seemed very clear that eating in his sleep was cool. However, from now on, just in case, I’ll be saying eating in a state that is so near to sleep it is indiscernible but still allows him to adequately protect his airway and coordinate his suck/swallow/breathe reflex. While a much longer phrase than in his sleep… it will hopefully prevent a return visit to the hospital.
Our non-fortified goal is 650 mL/day. I don’t think we actually need to eat 650 to gain however. We quit fortifying after this last trip to the hospital. Someone on one of the boards had talked about how their LO would throw up when drinking fortified breast milk. They later tested her breast milk unfortified and found it was 27 kCal without any fortification. I suspect my milk is also at least somewhat higher than the average 20. We weren’t making goal, but we were still gaining around 25 grams a day. So I quit fortifying… we still gain around 25 grams a day, C eats around 90 mL per feeding and he hasn’t thrown up in 2 days now (knock on wood). We’ll see how his weight gain looks at cardiology on Tuesday. Hopefully, we’ll be able to stick with just breast milk for a while longer. C's much more comfortable without the fortification and he’s able to poop much easier! (Its amazing how much of baby life revolves around the ability to poop). We no longer have the problems where he screams like he’s in pain. I think the fortified milk was just too rich. Hopefully we will continue to gain and won’t have to go back there. We did create something of an oral aversion through all this. It seems to be getting better as we continue to not fortify, so hopefully we can resolve this one and not gain another after surgery.
My fingers are crossed.
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