B was for Barf (at least initially)

Patience is a virtue as they say and that couldn't be more true around here.  Our big plans for bolus feeds two weeks ago got interrupted by a brief bout with the flu.  The day of my last post - the day we were going to try bolus feeds - Finley wound up vomiting all day and thus instead of bolus feeds had a nice apple juice and Pedialyte cocktail instead.  She bounced back well and was back to herself the following Sunday but when we were going to try the bolus feeds the next day - her blood sugar was running a little low from being on the apple juice/Pedialyte for more than 24 hours so we decided to delay things.  That said - this past Saturday turned out to be the big day - we ran Finley's feed over the course of an hour and then gave her an hour off the pump and...SHE DID AWESOME!.  The only thing was - she didn't realize that she was off the pump when she was (perhaps because she was annoyed with me sticking her every 15 minutes) but I think that she will enjoy it as we do it more and more.  It felt like a huge victory for us though and I really can't wait until we can work her up to a longer period off - like 2 hours - that will really make a difference for her.  I've also been reading more and more about Blenderized Feedings - this is the concept of blending up a mixture of fresh foods to create a nutritious mixture of fresh foods that can be pushed through the g-tube in lieu of the Pediasure she gets now.  When she was on breast milk and formula I felt a lot more comfortable with that being her main source of nutrition but the Pediasure is just loaded with corn syrup and its not something I want her to be on long term.  My ultimate goal is to replace as much of the formula with fresh foods through her g-tube and orally as we can and use the formula minimally.  I've joined a Blenderized Feeding forum on Yahoo (who knew right?) and and reading more and more.  Our particular problem is her blood sugar and making sure that whatever nutritious blends we create have the appropriate amount of carbs in them to keep her blood sugar up.  I am going to be meeting with a dietitian from Children's in February (its the appointment that took 4 months to get in to!) and I am hoping that we can start her on a plan.  In the meantime, I think I might just try doing some of the calculating on my own and try a test run with something simple.  More to come on this....

Also - you will see throughout this post that I've included a boat load of pictures - I was too lazy to upload any for my last post and had a lot  of good ones to share - ENJOY!



In just two shorts weeks (well 13 days but who is counting) - my friend Gina and I are participating in the Kohl's Step Up for Kids.  We are going to be climbing 80 flights of stairs at the Aon Center in this event that benefits Children's Memorial Hospital.  Gina and I participated in this event MANY years ago - when I was pre-kids and in way better shape - but it was a lot of fun!  Clearly, these days my reasons for participating are much different - while the physical activity part of it is important - the most important aspect of this year's climb is doing it for the hospital that took such great care of our princess and has made it possible for her to someday climb 80 flights of stairs (if she so chooses).  That said, please check out my personal fundraising page: http://tinyurl.com/2czx94a - I am in desperate need of a little support - $5, whatever.  Every little bit makes a difference.


Which brings me to the next thing I want to say.  This past Thursday I had to go to Richmond, VA for the day for a client meeting.  I got home around 8:30 pm and was in the kitchen opening mail.  Much to my surprise was a letter from Gina's (my fellow stair climber in crime) Aunt Ann.  First of all - let me say that it was a handwritten letter - who doesn't LOVE a handwritten letter?  I always feel so privileged to get a handwritten letter, thank you, etc because it means a lot to me that someone would take time to do that for me.  So not only was this letter unexpected, but it was so sweet (she reads my blog) and it included a donation for the Step up for Kids!  Not only was the letter unexpected but the donation was even more so - it was all so thoughtful and kind and - Ann - I just can't thank you enough!! 







Overall, the week was definitely eventful - aside from doing bolus feeds over the weekend - Finley had her cochlear implant consultation on Wednesday.  While we liked the doctor, we had been warned that she wasn't the warm and fuzzy type (and she definitely wasn't) and the appointment was what I would characterize as slightly uneventful.  We spent much of the appointment talking about Finley's medical history and her CHARGE diagnosis - and one slight pet peeve I have is the doctor's who seem to know nothing about my child when I walk in the door - in spite of having ALL of Finley's medical records in the computer that is sitting in front of them!  It would seem to me that the purpose of e-medical records is to make the access to that information easy and readily available, but I digress...What we learned what that this would be a bit of a process and there are a lot of things that will need to take place before it is determined that Finley is or isn't a candidate for an implant.  Fortunately, we have a lot of that data already since she just had an ABR (hearing test) and she has had a CT scan of her temporal bones and we have great therapists that Dr. Young knows (one of which has a daughter that has two cochlear implants and is a patient of Dr. Young's!).  So Dr. Young explained some things to us - like about how ultimately they could decide to implant Finley's good ear (the right) instead of the bad one (the left) because it might be more beneficial to do the good ear and the result might be better.  We are going to begin with seeing one of the Children's implant audiologists who is going to give us a set of loaner hearing aids that are stronger than the ones Finley has and we are going to see if there is a noticeable difference in how Finley responds and interacts.  She will also need an MRI at some point so the doctor can look at her cranial nerves, the structure of her head, etc.  Our therapist told us that the process from start to implantation normally takes around 7-8 months.  Geesh!  Perhaps the most bizarre thing about the appointment, aside from it being less informative than we were hoping, is that at the end of the appointment (although we didn't realize it was the end) the doctor just got up and walked out - without talking about next steps, saying goodbye, etc.  We thought maybe she was stepping out for a minute - but I called to her as she was walking away and I said,  "um....so...What are our our next steps?" To which she replied, "Someone from my office will call you."  And then it was over.  Just like that.  Weird huh?  So, I am hoping and praying that someone actually does call this week so this doesn't wind up being yet another doctor that I need to follow up with!


This one is a particular favorite - Finley rolled completely off her lily pad and was UNDER the Christmas tree!

Off the pad again - we can't keep her on it!

Nate before going out to play in the snow.  He did eventually put some clothes on too.



Finley was wearing this hat to try to block her from looking up at the light during her vision therapy - GO SOX!

This hat wasn't as effective (Nate wanted her to try this one) because the underside of the bill was green - and so all Finley wanted to do was look at it!



This is Finley pre-bath - rolling around naked in her crib - she definitely takes after her brother - she LOVES to be naked!


We have a busy week ahead - endocrine on Wednesday and our first gastro appointment on Thursday.  I hope you all have a great week!

2 comments:

Sylvia said...

Wow - a lot happened since I saw you last Wednesday! Our little cherrleader helped the Bears win on Sunday!

Unknown said...

how rude utterly rude jsut getting up and walking otu what happend to bye see u later or soemthing like that think u mite need a new dr xxx

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Finley's Medical History

Born on 8/8/2009 - Finley is taken to Children's Memorial Hospital via the transport team 12 hours after she is born.  She is having trouble breathing and is turning blue.  She is immediately admitted to the NICU.

8/9/2009 - Finley is diagnosed with Tetralogy of Fallot, a congenital heart defect and laryngomalacia, a condition that causes her to aspirate whatever she swallows in to her lungs.

8/21/2009 - Finley has open heart surgery to place a Blalock Taussig shunt to help facilitate proper blood flow.  When she is older, she will require a full repair of her heart.

9/10/2009 - Finley is released from the NICU.  Because of her laryngomalacia and reflux, she is fed 100% through a nasal gastric tube.

9/14/2009 - Finley is re-admitted to the hospital for an infection in her surgical wound.  Finley's genetic test comes back - she is diagnosed with CHARGE Syndrome.

9/15/2009 - During a CT scan to assess the infection, the doctors notice something strange on her CT.  It appears Finley has a malrotated bowel and will require surgery.

9/23/2009 - Finley is examined by the opthalmologist and she is found to have colobomas, a condition common with CHARGE Syndrome, in both eyes.  The degree of her visual impairment is unknown.

9/30/2009 - Finley has the Ladd's Procedure to correct the malrotation and also has a g-tube placed.  

10/7/2009 - Finley has a sedated ABR to check her hearing.  She has a mild hearing loss in her right ear and a moderate to severe loss in her left.  Her loss can be at least partially corrected with hearing aids.

10/8/2009 - Finley is supposed to be released from the hospital today but she has been having low blood sugars.  The endocrinology is called in to evaluate her.

10/29/2009 - Finley is finally released from the hospital with a unconfirmed diagnosis of hyperinsulinism.  Actual diagnosis requires fasting blood tests - because of her heart condition, it is not safe for her to fast.  She needs to have her blood sugar tested every three hours and we are taught how to administer an emergency glucagon injection in case her blood sugar gets to low.

11/1/2009 - Finley requires emergency injection because she cannot sustain her blood sugar.  She is taken to the local ER and transported via the transport team to Childrens Memorial.

11/10/2009 - Finley is discharged from the hospital on a 24 hour continuous feed.  We add polycose to her milk to help her keep her blood sugar at an acceptable level.

11/22/2009 - Finley is taken to the local emergency room with a bad cold - she is having trouble breathing and her oxygen saturations are low.   She is transported via the transport team up to Children's Memorial.

11/25/2009 - Finley is released from the hospital - just in time for Thanksgiving.

12/8/2009 - Finley is taken to the local emergency room for observation - she has a bad cold.

12/21/2009 - Nate is chasing the dog and the dog runs in to Finley's IV pole, knocks it down and pulls out her g-tube.  She is taken to the ER at Childrens to have it put back in.

2/10/2010 - Finley is admitted through the ER at Childrens - she has a bad cold again.  Oxygen saturations are low and breathing is labored.

2/13/2010 - Finley is released from the hospital.

4/17/2010 - Finley is taken to the ER at Childrens - she has pus draining from her belly button.  They suspect a urachal cyst - they send us home with orders to return on  Tuesday (during our scheduled visit) for an abdominal ultrasound.

4/20/2010 - Finley is admitted to Childrens for an overnight stay.  She will have a swallow study and abdominal ultrasound on Tuesday and a CT and sedated echocardiogram on Wednesday which will require anesthesia.

4/21/2010 - The anesthesiologists have trouble intubating Finley, so they call in her ENT to have a look at her.  He observes that her airway is 75% closed off - partially due to scar tissue from previous intubation and partially due to an infection.  The diagnosis is subglottic stenosis and may require her to have surgery on her airway.  She is immediately admitted to the PICU and put on a 24/7 breathing treatment and antibiotics and steroids to help reduce the inflammation.

4/26/2010 - Finley is well enough to be taken off of all oxygen.  Immunology and Infectious Disease are called in to examine Finley because the culture of her throat are growing staph and strep.  Infectious Disease is trying to figure out what could have caused her infection.  Immunology labs will be drawn to determine if Finley has an immune problem which sometime occurs with children with CHARGE.  This is the second significant infection she has had since she was born.

4/27/2010 - The lab calls to say that they mis-read Finley's airway culture.  It's not growing staph - its only growing strep.

4/28/2010 - Immunology labs are back and don't show anything significant.  Finley's lymphocyte counts are low but that isn't unusual for a child who is fighting an infection.  The doctor wants to re-examine her before her first birthday.  In the meantime she cannot have any live vaccines.

4/29/2010 - Finley is discharged from the hospital.  The ENT will do a bronchoscopy before her heart repair surgery to determine next steps on her airway issue.

5/11/2010 - Finley has open heart surgery to repair her heart.

5/17/2010 - Finley begins to show signs of infection which is later identified as a urinary tract infection.

5/25/2010 - Finley is discharged from the hospital.

5/30/2010 - Finley goes to the ER at Childrens because of fussiness, sweating, heavy breathing.  And echo later identifies that the pressure gradient around Finley's pulmonary valve is an astounding 90%.

6/1/2010 - Finley is admitted to Childrens to try a medication called Propranolol to help ease the pressure in her heart.

6/2/2010 - The Propranolol brings the pressure in Finley's heart down from 90% to 50%.  Finley has a positive test for C. difficile which will require antibiotic treatment.

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