Back at the Hospital

I know I've been a crappy blogger lately, and I'll try to fill you in on all kinds of goings on, but I wanted to go ahead and tell you what happened this week with the little Boo.  The Big Sister Boo, that is.  The formatting is weird because I'm copying and pasting from another webpage, but I'm sure you'll manage.  :)  I'll let you know what the docs decide to do next week.  (And briefly: me and baby boy (definitely a boy) are doing fine and go back to the doc this week.  So far, so good there!)

[Background: Becca has had 2 other seizures in her life. One was clearly hypoglycemic-related (blood sugar was 45 at the time), and the other was related to an illness, though not necessarily febrile, as by the time the ambulance arrived (I was driving down the interstate at the time - awesome), she didn't have a fever. That time, they kept her overnight, gave her antibiotics for the underlying illness (which we had been at the doc for that afternoon), and sent us home with a med in case she seized again. That was over a year ago and probably related to a tick-borne illness.]

Becca came home from school at noon on Thursday (normal time) and told the babysitter that her tummy hurt and she wanted to lie down. She felt feverish, so the babysitter gave her Tylenol (I told her not to bother with a temp b/c I trusted her judgement that she was feverish but not crazy hot), and they had a lazy afternoon sleeping and watching tv. 

I came home at 6:30, and she ran to the door, jumped up and down, etc to greet me. So she definitely had some energy. She still felt warm, but I planned on giving her Tylenol at bedtime (just an hour later). She still wasn't crazy hot or anything.

So by 7:30, I'm getting her bedtime stuff together while she's watching baby videos of herself (so cute). I'm assembling her feeding tube stuff in the kitchen and hear her making some whimpering-type noises from the couch. I check it out; she's seizing. I get her rectal Diastat kit prepped; we're supposed to give it to her if a seizure lasts longer than 5 minutes. It lasts for at least 4 minutes (assuming it wasn't going on TOO much longer before I noticed), and then she stopped shaking but was still out of it and not really responding for another few minutes. After about 15 minutes, she's responsive, but kind of drunk and -- this was the scary part -- unable to talk. She would answer questions by nodding or shaking her head, but couldn't get words out. If you've even seen someone who has had a stroke trying to talk, that is what it looked like - sticking her tongue out a lot, trying to form words with her mouth, but not being able to do so -- or even get any sounds out. Then she vomited - yellow, bilous-looking stuff. I took her temp after the seizure, and it was 104.3. Blood sugar was 173. Breathing was fine, didn't appear to desat at all.

The on-call ped said that she "absolutely needed to come in and be seen," so I got our stuff together (sad how quickly I can pack a hospital bag for me and her these days  ) and waited for DH to get home (5 minutes away). If John hadn't been close, the ped was going to have us call an ambulance so that I could watch her during the ride. 

So we drive 40 minutes to the kids' hospital, are immediately triaged (never given Tylenol because at that point she wasn't even feverish - at all). She started talking (slowly) on the ride in, which made me feel better. In fact, her first verbal response was her Simba "ROAR" when I prompted her with the line from "I Just Can't Wait to Be King." Pretty adorable. So - we go through triage, and they send us to the waiting room. For 3 hours. By the point, she's pretty much herself, though still her sick self, and she pretty much laid in a chair and slept. She's 3 hours behind on her tube feeds (not having had anything since lunchtime), so I start bugging the nurses to get us back to a room so we can start feeding her, or we are going to be looking at a hypoglycemic seizure on top of the first one. We even considered leaving because I felt like what she needed most was to sleep and get her feeds, but I was afraid insurance wouldn't pay if we left without being discharged.

Finally, we get back to an ER room. The nurse checks her out; vitals are fine. After about an hour, we see a resident. All is well. I'm lying on the cot with her, and John is miserable in a crappy chair. After we had been in the room for 3 hours - now it's 3 am - we still don't have her hooked up to feeds b/c the nurse needs the docs to order it, and we haven't even laid eyes on an attending yet. I mean, I'm glad we weren't in the trauma room keeping them all busy, but, really, 6 hours later, I would have thought an attending would have at least heard about us. So I go out to the nurses' station to remind them that we are here, and one of the nurses is quite surprised to hear that we've been waiting in a room for 3 hours. Yes, and 6 total, thank you. And at this point, John is "sleeping" on a sheet on the emergency room floor. Ew.

After that, things start moving; we see the attending, he orders a strep test. I remind them about tube feeds, and that *eventually* gets started as well. Becca was a super champ, of course, even "roaring" again so that the nurse could perform the strep test. The attending also wants us to get a urine sample. Right. Get the not-potty-trained 3-year-old away from home to pee in a cup. We give it a couple of tries, but give up, not wanting to traumatize her to the whole peeing on the potty thing, which is *finally* kind of getting the hang of. We ask if they have to have it (the only other option is to cath her - ugh), and the docs says that basically, he wasn't looking for anything in particular, so never mind. Phew. Feeding pump alarms every 2 minutes (literally), so John and I take turns sitting by it and restarting it every time. The nurse doesn't know how to use it - we had to teach her. (But really, she was wonderful...we have just dealt with a lot more pumps than she has.) Strep test comes back negative. Docs don't know what else to do; nurse suggests they send us home. Great idea. So we are out the door about 5 am (after arriving at 9 pm), with a *suggestion* to call neurology to set up an EEG and consult. 

We drive through Krispy Kreme (which just happened to open early on Friday mornings - thank you, Jesus  ) and get home about 6. We all sleep until 11 and proceed through a normal day and weekend, albeit on the lazy side. By the time we got home, she was COMPLETELY FINE. That's the oddest part to me, and kind of nerve-wracking. I mean, if the seizure were really related to the (brief) illness/fever, why/how could she bounce back so quickly? I mean, the fever was COMPLETELY gone by the time we got to the hospital, and she was herself the next day, even without sleeping much. So that concerns me that there might be some underlying seizure disorder that we are just now seeing. The good news is, though, that if there is an ongoing condition, it appears to be mild, since we've only seen 1 seizure a year (though who knows if others have happened during the night, etc - but still, if so, she bounced back quickly). I doubt that she'd have to go on full-throttle seizure meds, but it's another thing to watch for, I guess. 

Test Results & Bug Spray

Okay, the results from the blood tests came in, and they DIDN'T show ehrlichia.  The good doc did say that the titers can come back negative early in the illness, so if we wanted to be academic about it, we'd test again in 2 weeks.  Since she's pretty fully recovered now (still tiring quickly, but that's all), that would be cruel to put her through drawing all that blood again just to satisfy our curiosity.  So we'll never know for sure.  I asked him what he thought it was, and he didn't really have a guess.  Darn those doctors who are willing to say, "I don't know!"  (Just kidding, of course - that's actually a sign of a really good doctor.)


But since the whole incident instilled in me a phobia of ticks on my child, I asked him for recommendations on insect repellent, and he magically produced a wonderful handout on just such matters, and another one on sunscreen just for the heck of it.  This, of course, makes me want to break into the office to seize handouts on every possible pediatric topic, like my possessing a sheet of recommendations and warnings will somehow scare away anything that could possibly harm my baby girl.  While the handouts may not be that effective, I did learn a thing or two about the appropriate use of insect repellents, so consider this your Itty Bitty Hill  public service announcement: my paraphrase (or better yet, my "precis," or an homage to Sarah Bayrd) of the American Academy of Pediatrics handout on bug spray:

• Usually bug bites are just annoying, but sometimes they can make your kid stupid-sick.
• Don't bother with the non-chemical means of repelling bugs from your kids.  Most of them ain't gonna work.  If you don't want to put chemicals on your kids, that's okay...but they're gonna get bit.  I will admit that they say that repellents made from some essential oils do offer some protection but they are "much less effective repellents" and last less than 2 hours.
• DEET is no longer considered bad.  In fact, it's your best defense.  Just don't use a spray that is more than 30% DEET on your kids.  
• DEET levels work kind of like SPF - the more DEET in the spray, the longer the protection lasts.  To quote: "For example, products with amounts around 10% may repel pests for about 2 hours, while products with amounts of about 24% last an average of 5 hours."  But once you go over 30%, there's no additional benefit, so no need to go overboard on the chemicals.
• Even though I just put DEET and SPF in the same bullet point (did it again now!), don't use products that contain both - the DEET makes the SPF less effective and you may end up overdosing on DEET because you're likely to reapply it more often.
• If you are particularly concerned about ticks, you can treat your kids' clothes with permethrin, which kills ticks on contact.  Do not apply it to your kids' (or your) skin, just on their clothes, where it will last for several washings.  I'm considering doing this to a few pairs of B's pants and her jackets.  We don't like ticks 'round here, that's for damn sure.
• Something they recommend that I won't do: "Avoid dressing your child in clothing with bright colors or flowery prints because they seem to attract insects."  Um, too bad.
• Don't use anything on babes younger than 2 months. And don't spray kids in the face.  Spray your hands and then rub it in their face.  But not in their eyes.  'Cause that's just mean.
• And I love this one: "Remember, children need and love to be outdoors."  So now that we've made you paranoid, go play outside.  

Speaking of being paranoid...some of you have asked how we're doing after the whole hospital adventure.  I'll say that we are doing fine, for the most part, but I definitely think that Becca and I are a little jumpy still.  (John Hill continues to be impervious to worry, though I think he's really just delegated it to me.)  When we were listening to the president's speech on Libya on Monday and heard him say "hospital," Becca picked up on it and told me that we were going to the hospital.  (Interestingly, she wasn't upset about it at all.  Hospitals are just places you go every now and then.  And sometimes you get free blankets there.)  But she freaks out when I say that we need to do something quickly and says, "No tick!  No tick!" because quick=tick to her ears.  And I nearly had a panic attack after scheduling Becca's first date with a teenage babysitter as I immediately pictured everything that could go wrong.  (Logically, I can tell you that the far likeliest scenario is that everything will be absolutely fine and that the next likeliest scenario is that something will happen but the babysitter, a very responsible high school senior, will handle it beautifully.)  But I think the jumpiness is natural, so I'm trying to give myself grace about it.  And I'm saying "fast" instead of "quick" around Becca.  :)

Our First Ambulance Ride

Wohoo!  I first I was hoping would never come...

I have a migraine and it's been an awfully long week/end, so I'm going just the fact on you here.  Perhaps I'll add some reflection later. 

Last Friday, Becca had 2 ticks we pulled off of her.  Saturday, she had another.

Becca threw up on the way to therapy on Wednesday morning.  She'd started getting a little cough and threw up.  Not altogether odd, but a little unusual for it to happen in the car.  And really gross.  Big props to Miss Ashley for helping clean her up.  Probably not in her job description.

Thursday morning, we got Becca up for school and found that she had thrown up in the middle of the night and slept in it.  Ew.  Again, a little unusual, as she usually wakes up.  Just as we were walking out the door on Thursday morning, she threw up again.  A pain, but not unusual because she was coughing.  She went to school (this is so common for Becca that it doesn't keep her out of school), we went to work. 

I pick her up at school at 3.  Her teachers mention that she threw up her bolus feed (again, not unusual - but I'm noticing a pattern here) and that her eyes had just started to look a little red.  Almost everyone in her class (including both teachers) have had pinkeye in the past week, so they thought Becca was finally catching it, too.  As I held her, I noticed that she felt hot, so we took her temperature - 101.5.  I got the heck out of dodge and called the pediatrician so they would know we were on our way.

We get to the ped and thankfully our regular doctor was in.  (God bless Mark Rawls.)  Of course, they take her temp, and she doesn't have a fever, but she has lost 3 ounces since the day before.  I give him the story, he examines her, she throws up all over me, she acts SUPER puny, he gets concerned in that I'm-not-going-to-worry-the-anxious-mother pediatrician kind of way.  I didn't realize how concerned he was until I asked him about a general developmental thing and he saids, "Let's not worry about that right now and focus on the illness at hand,"even though he's always willing to discuss developmental stuff ad naseaum with me. 

He was particularly worried about the tick bites and went back and forth about whether we should do labs, start antibiotics or both.  We opted to start the meds and do the labs, which would not be definitive for tick-borne illness (hence the question in whether to both with them if we were going to treat anyway), but could show us some common indicators for ehrlichiosis.  (Google it and pick a reputable website.  I'm out of energy to do it for you.)  We had the blood drawn, which was miserable, and Becca cried for the next 45 minutes while we made our way over to the children's hospital to pick up the prescription b/c regular pharmacies wouldn't have it.  There's a problem with the insurance, etc., we can't get it until the next day unless we pay out of pocket, blah blah blah.  So I shell out the cash and get the heck out of dodge. 

Becca actually asked to eat (!!), so we stop for dinner and our friend Emily joins us.  Becca's actually happy for the first bit of dinner (she LOVES Emily), but then she gets super-fussy.  While we're eating, Dr. Rawls calls (that rhymes!) and says that he's glad we're doing the medicine because her labs are suspicious - platelets are low, one kind of white blood cell is high and another is low, liver enzymes are elevated (which she has a history of).  Of course, she hasn't actually started the antibiotics yet because I don't have the right syringe to fit into her Mic-Key button, and she's sure as heck not going to take it by mouth.  Oh, and even though she asks, Becca doesn't actually eat much of anything. 

We head to the car, and Becca perks up.  She's happy to be outside, says goodbye to Emily approximately 25 times, starts singing.  We're halfway home (from Green Hills for you Nashville folk), and she's still singing "Happy Birthday" to Emily (which we sang to Emily 3 weeks ago).  It's dark by now, after 7 pm, and at some point she stops singing.  At exit 65 (Hwy. 96), I notice that her right arm is sticking up at an odd angle, and I reach back to hold her hand, and it's rigid and shaking.  She won't answer me, and I can't really see what's going on.  I can't pull over because I'm in the middle of a major construction zone.  It's raining a little bit.  I know there's some places I could cross the median and head back towards the hospital but I can't see them.  I end up talking to her, trying to get her to respond, holding her hand and calling 911 while driving a.l.l. t.h.e. w.a.y. to the next exit, #61 (Peytonsville Rd./Goose Creek). 

I pull into the Shell parking lot.  I want the 911 dispatcher that my phone is about to die and have them have someone call John and tell him to meet us at the hospital.  My phone dies.  Becca has stopped seizing by now, but she's still non-responsive.  She's breathing fine and her color looks okay, as far as I can tell in the dark parking lot, but she won't answer me or look at me.  I panic slightly, trying to find somewhere to park the car that doesn't have a tow away sign (funny where my anxiety goes, isn't it?), park, and pull her out of her seat.  I start throwing things in bags (I carry a bunch of crap in my car), keep working with Becca, and wait for the ambulance, which arrives after just a couple of minutes. 

My new best friend, Amy, and her partner check Becca out, see that she's stable, send the firefighters away when they get there with their siren blaring.  Check her blood sugar - 95 - beautiful.  Check her O2 sats - fine.  Pulse - fine.  Responding some but definitely NOT acting like Becca.  They ask if I want to use our carseat or theirs, so I grab ours.  (How weird is that to think about?  They put her in her carseat and hooked the carseat to the gurney.  Makes sense, but odd.)  Nice EMT guy whose name I don't know tells the gas station guys not to tow my car.

We make our way to the hospital (25 miles or so?) without the sirens, which I learn you only get if you are dying.  No thanks.  I borrow dude's phone to call the pediatrician and almost yell at the answering service when they keep asking their usual inane questions ("what's her approximate weight?  R as in rabbit, e as in elephant, b as in boy..." etc.) and tell them just to page the damn doctor and tell him that we're on our way to the emergency room.  Becca is distraught at this point, but Amy and I finally get her to calm down a little bit to sing her favorite line - "aaaall true da town" in "Wheels on the Bus" in between tears.  Super pitiful.  As we pull in to the ambulance bay, Dr. Rawls calls the guy's cell, and I tell him the whole story in what turns out to be the first of about 1,400,032 renditions of it.  No, that's already the third because I've already told the dispatcher and the EMT's. 

John's out in the waiting room at this point and I ask the nurses to go get him but they keep asking me questions while he just waits out there.  Annoying.  He always makes Becca happy and I'd kind of like to see him at this point, too.  You've got about 15 people just standing around who could get him. 

Oh yeah, Becca threw up in the ambulance, too.  And another time while being checked in.  And another time.  And one more time, I think.  I'm still wearing my vomity clothes from earlier anyway.  She's had a slight fever when the EMT's got her, so they tried to give her Tylenol and she throws it up.  (Fever's only 99.9, so it doesn't seem like a febrile seizure, which are not caused by high temps but by quick spikes in temps, but with one that low it couldn't have "spiked" all that quickly.  And I think the kind of seizure looks different or something like that.)

But back to the hospital - we see a million doctors, but there's no mad rushing around or anything.  She's definitely stable at this point, though definitely not well.  The nurse tries to tell me that I can't hold her while they put an IV in, which I tell her (in more polite terms) is total bullshit and I will be holding her, thank you very much.  (Do I hear a cheer from my child life friends?) 

We get a Mic-Key button extension and give her the first dose of the antibiotic.  ER doc is also thinking that it could be ehrlichiosis.  It's rare to have such a serious reaction but it's certainly not unheard of; in fact, every year a few kids in Tennessee die from it.  (One of my dear reader's child had a very severe case of it last summer, in fact - Valerie, I've been thinking about you guys for days now!)  Even though she's stabilized now, they want to keep her for a while to observe her in case this is the beginning of things going very badly very quickly, as it's known to do with kids her age exposed to ehrlichiosis. 

Flashing back to the night that I spent in the ER in the CRIB with Becca last summer, I immediately start lobbying for a cot for me.  (The cots are awful but definitely better than the crib.)  Of course, the hospital is full, like it always is (build the darn expansion already, please!  Donors, do you hear me?) but they think they maaay be able to get us a room.  Such a tease.  I do try to make the case, though that after you've spent 150 nights in the hospital, you ought to get bumped to the top of the bed board.  We don't get a real room, but we do get bumped over to the observation area, which is much nicer than the ED - it's bigger, we share a bathroom with the folks next door instead of using the emergency bathroom in the hall that gets REALLY gross as the night wears on, and Dr. Rawls will be our attending instead of the ER doc (who is lovely but doesn't know my kid).  I get a cot, but I do end up spending a couple of hours in the crib b/c Becca keeps waking up thoroughly confused (of course). 

I've pushed for them to start her feeds or to give her the very strong sugar water IV fluids so as to avoid a repeat of the Emergency Department Blood Sugar Debacle of 2010, so they get her milk and get it going.  She doesn't have to be hooked up to any monitors or anything and the residents on duty assure me that I'll wake up if she has another seizure.  They just want her to be at the hospital in case anything does happen, which sounds like a good plan to me.  We deal with logistics: John swings by Mapco to get me some essentials and heads home to take care of the poor pups who have now been in their crate for 14 hours.  (Mental note: give housekey back to our key-keeping friend, KCC.)  Mark and Marne (from church) have brought John's car to the hospital (Carol dropped him off b/c they were all at a dinner together), and we send them to get my car from the gas station and take it to their house.

Becca and I have a blessedly uneventful (though definitely not restful) night.  I ask the residents if they can find a stuffed animal or soft blanket for her since we don't have any of her loveys with us - silly me thinking the docs would have any clue about this.  Eventually, I ask our Care Partner (m.a.), Princess, for one, and she finds a hot pink/zebra stripe supersoft fleece that will forever be known as Princess Blankey.  Rock star! 

In the morning, I keep expecting doctors to wake us up at 5, but we don't see any until close to 7:30, and Becca even slept until about 7.  They do their assessments; all clear.  Dr. Rawls comes by a little after 8, and the scene is much like the first time we met him after Becca's g-tube surgery- Becca and I are cuddled in the bed while she dozes and he sits in the rocking chair, which I remember because I liked that he didn't stand over us and talk at us.  Good doctor.  He wants us to stick around into the early afternoon to give the antibiotics more time to work (got the 2nd dose that morning) and make sure she's still improving.  By noon, Becca is almost totally herself again, and I'm begging the nurse to call the residents to discharge us.  (We'd already gone on a few hospital adventures and when John got back and took her on a walk, they even saw Miss Melissa!) 

The orders come through and we have the easiest discharge ever.  The nurse (Hope - who is awesome) encourages me to hold Becca while they remove the IV.  Becca's now covered in Dora Band-aids not because she is covered in boo boo's but because she loves Band-aids, and I had happened to buy a box at the pharmacy, so with every unpleasantness she got a new Band-aid.  She still won't let us take them off.  ("Leeb it oooooon ban-ai!") 

Becca falls asleep on the way home and climbs into bed as soon as she can.  She sleeps for 4 hours.  I get home little bit later (stopped to get my car and pick up some food) and also sleep for 4 hours.  She and I repeated the pattern this morning - the nap that is, not the hospital run.  She's been pretty pitiful and puny today; she obviously still doesn't feel very good.  She threw up last night (like normal) and after her bath this morning, she REALLY didn't want me to brush her hair - hiding it under a hat from me and everything - so I'm thinking her head was hurting. 

So - what did/does she have?  It could be a random virus.  It could be ehrlichiosis.  It could be both.  They drew blood to run tests for ehrlichiosis but they won't be back for a few days (that's why we didn't run those tests to begin with - you've GOT to start the antibiotics before the results come back anyway).  Will she be okay?  Should be, even if it is erhlichiosis.  The antibiotics are pretty awesome (doxycycline).  Will she have another seizure?  Maybe.  It could be the seizure activity is isolated to this particular illness.  It could be that she'll be prone to having seizures when she's sick.  If that's it, most kids grow out of us by the time they are about 5.  There's a very, very, very small chance (maybe 5%) that she has a form of epilepsy, but unless she has another seizure, we're not even going to see a neurologist.  We do have a prescription for an emergency medicine to give her if she has another seizure, but Dr. Rawls thinks that we won't need it - he wasn't even going to write it for us, but the residents did, and he agreed that it's a good thing to keep at home, though we don't have to mess with taking it to school, training all her caregivers, etc.  (Thank goodness - we're about to get so complicated that only nurses can take care of her!) 

Here's the bit that I find oddly encouraging: Dr. Rawls said that nothing they did for her was based on her history.  We may have acted more quickly because of her history, but they would have essentially done the same thing for any other 2.5 year old with the same issues and a recent tick bite.  So this was actually a regular old kid illness, not a preemie thing.  How 'bout that?!

Weekly Weigh-In (Kind Of)

Well, apparently the "Weekly" part isn't even accurate these days!

Here's a recap of the past few weeks:

November 17 (regular Wednesday weigh-in): 8.95 kg (19 pounds, 12 ounces), 31 inches

November 24 (regular Wednesday weigh-in): 9.05 kg (20 POUNDS! Wohoo!), 31 inches

By the time we arrived at Grandma and Granddaddy's house for Thanksgiving that Wednesday night, Becca was running a little fever. It got worse over the next few days, peaking at 103.8 that weekend. By Saturday, I was on the phone with the pediatrician. From Saturday afternoon to Sunday evening, she was fever-free. Sunday night, the fever came back, and on Monday we went to see good ole Dr. Rawls. As always, they weighed her when checking her in:

November 29 (sick visit): 8.90 kg (19 pounds, 10 ounces) (We didn't do height.)

That meant that she was down 6 ounces in 5 days. Yuck. (Perhaps I should note here that when Becca gets any kind of illness, even if it's not stomach-related, she stops "tolerating her feeds," meaning that she throws up every night or morning...hence the loss of weight.)

The good doc determined that Becca had a "non-specific viral illness" that we just had to wait out. She wasn't feeling horrible, just tired, extra whiney and a little pitiful. I decided that when 2-year-olds get sick, their threshold for 2-year-old behaviors gets lowered. Anything could set off a tantrum, and heaven forbid if I didn't "Hold you!" all day long. I can't blame her, though. When I'm sick my threshold for 2-year-old behaviors drops, too. We watched a lot of t.v. but muddled through mostly in one piece.

On Wednesday, she was still running the fever (on day 8!), so we couldn't go to therapy, so we skipped the weigh-in as well. (It's usually done all in one trip.) Her fever finally broke for good on Thursday, and now she's still tiring quickly but doing fine. We never saw any respiratory symptoms, and the only GI symptom was directly related to the tube feeds (which we ended up slowing waaaaaaay down and mixing with Pedialyte to help with her toleration). She's back up to full feeds now, and we're back to our regular routine, which brings us to today's measurements:

December 8 (regular Wednesday weigh-in): 8.85 kg (19 pounds, 9 ounces), 32.5 inches;*

Which leaves us with a grand total of 100 grams (3 ounces) lost since November 17.

And that puts our net change, exactly 5 months from the day her g-tube was placed and about 4 months from the time we started growth hormone injections, at a weight gain of 1150 grams/35 ounces and a height gain of 3.5 inches.*

Even with the up and down months like this one, I feel like putting the tube in was a good decision. And the growth hormones are DEFINITELY a good decision (especially since she seems to be experiencing very few side effects from them and usually doesn't even mind the shot.) She's moving through clothing sizes now (currently in 12 months, but bumping up to some 18 months for the length), whereas she spent an entire year in 3-6 month clothes. That may not be the most scientific measurement, but from a mommy's point of view, that's a very good sign! Developmentally, she's picked up a lot of steam, too, and while it's impossible to pinpoint the tube feeds as the cause, having more consistent nutrition has definitely helped. If I had it to do all over again, I would probably push to have the g-tube placed when we were considering it in the NICU, but we had no way of knowing what the next 2 years would look like. Still, I'm glad we got it when we did - almost in the nick of time from some serious nutritional deficients. All's well that ends well, I guess.

*I highly doubt this height measurement is accurate.

Back to the Hospital!

There is lots and lots to fill you in on regarding our past week: Becca turning 2, moving to our new house (the best present I've ever given a 2-year-old!), Becca physical therapy evaluation at Vandy, John's and my speaking - keynoting! - at a conference on prematurity, and Saturday's Elmopalooza, but, as I've just stopped in at Moe's in the midst of errands to use their free wifi (still not internet at the house!), all I've only got time to tell you about the upcoming week.

On Tuesday I managed to wrestle my way on to the nutritionist's (at the GI) schedule, and she snuck the doc in to have a looksey. I told him flat-out that we needed to do something because she's throwing up more and not gaining weight, and, frankly, I just can't take it anymore.

So we made a plan. I was caught completely off-guard, however, when he told me that the plan involves 3-7 days in the hospital and that he'd like them to be next week. Whoa! We'll go in tomorrow whenever a bed opens up (you wait at home until they call - nice system), and they will run some tests, procedures, etc. I know that Dr. Moulton is planning on doing a scope so that he can look down her esophagus (and up her other parts - oh my) and see if there are any signs of food allergies. (Apparently they don't all manifest themselves in commonly observable ways.) While she sedate for all that fun, he will place a pH probe in her stomach. It will stay in for 24 hours so that we can see if something is off that might be contributing to the reflux. Then they will feed her through an n-g tube (nasal-gastric tube: nose to stomach; the same tube she had in the NICU for so long) and control her calories precisely and then weigh her periodically to see if she does indeed gain weight when she is getting enough calories. If not, there's something else going on that we need to uncover. If so, they will put in a g-tube, which is a semi-permanent feeding tube straight into her stomach. I say it's semi-permanent because, while some kids and adults have them their entire lives and depend on them for their full nutritional needs, Becca would likely grow out of her need for it in a few years. For now, we would use it to supplement the food that she does take orally so that she can eat what she wants and I won't lie awake at night counting every calorie she took in today (minus the ones she vomited) and brainstorming ways to get that total up to 800. They may also perform a nissen fundoplication, which would keep her from throwing up as much (more on that later if it comes about). I imagine to get this all done we'll be there more on the 7 days side than the 3.

In some ways, it feels like a step back. I thought hospital stays - at least ones that lasted several days - were behind us, especially now that we have made it through 2 RSV seasons without incident. And it feels like we are sending to her an inpatient feeding rehab (which we are), but one like you send severely anorexic patients when they are severely malnourished and have to be force fed and physically rehabilitated before they can begin psychological treatment. Truth be told, I feel like I've let my 2-year-old become anorexic. If I can mess her up this badly this early, what does adolescence have in store for us?

Of course I know she's not actually anorexic. But I think I'm learning the same painful lesson that mother of kids who do struggle with eating disorders learn...and that all parents eventually need to learn, though I'm not sure they all do. I can't make my daughter eat. I just can't do it. In fact (and you would have thought with Becca's personality I would have learned this earlier), I can't make her do anything. Sure, I can forcefully do things to her - like wrestle her on the changing table when she doesn't want to lie down for a diaper change - but I can't make her do it on her own. The truth is that she is a separate person. She is an individual. Becca is Becca and I am me. As close as we are, as much as I love her, and as much as she depends on me (seriously, if I had a dollar for every time she stretched her arms out and said, "MAMA," this week, I'd be dictating this post to my servant), she is her own person, and she is in control of her own body and what goes in it. The odd thing is that this is a lesson that I really want her to learn, but it's not one I want to learn about her. I want her to be independent, confident, clear that she doesn't owe anybody anything with her body, and comfortable with that responsible self-control. But, wow, I want her to do things my way. I want her to gobble up her food and ask for more. I want her to make a mess with her food and smear spaghetti sauce all over her face as she shoves it in. I want her to eat a damn cookie. I want her to eat enough so that the doctors don't cut a hole in her stomach and pour it in. But she won't, or, in other words, because of her health and sensory issues, she can't bring herself to do it. And, in the end, I can take her to therapy 1,000 times a week, I can sing and dance, I can sneak, I can cajole, I can bribe, but I. Can't. Make. Her. Do. It.

Hello, parenthood. Nice to meet you (again).

p.s. The hospital has wifi, so I should be able to keep you updated. Since John or I have to be there all the time, we'd love visitors, but make sure to call my cell phone first in case we are off the floor for tests, etc. Even better if you come bearing some energy to entertain a toddler for a few minutes so we can take a break. I mean, I love her and all, but a mom can only dance for so long before she collapses. :)

Sick, Sick, Sick

Itty Bitty is sick.

Don't worry, it's nothing scary, but it's not very much fun for her. Actually, Becca being Becca, for the most part, she's acting completely fine. In fact, she's "organizing" the movies right now. But here's the scoop:

This weekend Becca stopped chewing. Could be weird eating issues, could be ear pain. She has tubes but has gotten several ear infections since they were placed. Sunday night she had a fever. Monday morning, the fever was gone, but she had a goopey ear. By Wednesday, it was goopey enough that I called the doctor, and they called in antibiotic ear drops. Wednesday evening, I checked her ear and it was full of blood, mostly dried. I gave her her drops, and they dislodged a big clot of blood, which had puss behind it. (Gross, I know. Welcome to parenthood.) Her ear continued to seep blood, but she want to sleep fine.

This morning, she woke up to diarrhea, which has continued throughout the day. We saw Dr. Collins this morning, and she (gingerly) peeked into the ear and decided that we needed to do oral antibiotics, too. We never really determined what was going on (because she didn't want to dig around in a tiny, painful ear), but basically, whatever the issue is (ear infection, dislodged tube, etc.), it would be treated with drops and oral antibiotics. So we've started those. (The oral one is the yummy bubble gum medicine that we had as kids - you know, they one that stays in the fridge?) The diarrhea - and the vomiting that woke her up from her nap this afternoon - are likely from a stomach bug on top of the ear issue. Good times. But, again, it's nothing scary, since it isn't lung-related.

More concerning, though, was the fact that she had lost 4 ounces in 2 weeks, even while growing 1/4 of an inch. Chances are that the weight loss is attributed to the fact that she has thrown up once a day every day for eight straight days. Apart from today's episode, it's always been at a meal, and it's always been way more than she has eaten at that particular meal. Her speech/feeding therapist, Caroline, is confident that she's not gagging or having trouble swallowing, so we (John and I, Caroline, and Dr. Collins) are figuring that it must be reflux-related, so we are going to go ahead and see a G-I specialists because, as Dr. Collins said, "You need more doctors." It's actually quite amazing that we've made it this far without a GI, even in the NICU. Hopefully s/he will be able to help with the reflux and figure out a way to get some meat on Becca's bones without a feeding tube. Or maybe we'll have to go ahead with the tube finally. It certainly wouldn't be the end of the world!

Okay, I hope I haven't grossed you out too much. Oh, and one of the dogs was sick today, too. And just to make sure that this post isn't birth control for you childless folks out there, here's a picture of the pretty, pretty princess - she's even cute when she is pitiful.

Here she is after she threw up at our picnic - all her other clothes were gross!

In the post-puke bath:

And here she is cuddling with daddy after getting her ear drops.

UPDATE 3-28!

Becca is much better, though she threw up in the middle of the night last night (4 a.m., in fact), and has had a couple of gross diapers today...but that's better than the 6 poopy (though there wasn't much actual poop, just liquid, poor girl!) she had in the 12 hours she was awake on Friday. I think the stomach bug may have passed, and we're left with the diarrhea caused by the antibiotics...which she hates, by the way. Hates the yummy pink amoxicillin. But it smells so good! I feel like I'm putting us way back on the progress we've made with feeding when I force the syringe into her mouth, so I'm going to call the doctor tomorrow and see if we really have to do the full 10-day course. (Yes, I know you are supposed to give all the antibiotics even if symptoms have disappeared, but we're going for the lesser of the evils at this point.) Let's hope we have a restful, puke-free and poop-free night!

Bye Bye, Virus!

I think she's kicked the virus. She was much happier this evening after another nap and some Saltines. I would whine all day, too, if I didn't get to eat anything. When she squealed and started babbling, I realized that I hadn't heard those happy sounds all day. Her temperature had popped back up to 99.9 just before her bath, so we gave her another dose of Tylenol, but I think she'll be okay tomorrow. Thanks for all your thoughts and prayers!

At supper on Saturday night, I finally made the connection that the wild flailing motion that Becca had learned was her version of waving. No silly hand twitching for Becca - it's got to be a full arm flail. It's pretty darn cute...but now that we're @ blogspot, you can judge for yourself without leaving the site! Let me know what you think!

Lazy Day

Still have a sick girl. Her fever is gone (97.4 temp this morning), but she threw up at breakfast (after just a few sips of Pediasure and a few Cheerios), and she's really lethargic. Really lethargic. And pitiful. I talked to the pediatrician's office, and they aren't worried. I've started Pedialyte, and she wants to chug it. (I'm not letting her.) But she's pitiful. Poor girl. I'll let you know how the day goes.

Ick - Queasy Alert

Pitiful Becca...

Just put Becca to bed after a long evening. She hasn't eaten much the past two days, and she was kind of dry heaving yesterday. She's had 3 mushy poops today, and she threw up at dinner. Yum. She's been acting a little funny, and her temperature just before her bath (but after watching the rain with me on the cool front porch for a few minutes) was 100.5. I think the wee one has a wee tummy virus! Of course, she was still happy as a lark in her bath today, even though she dry heaved a few more times and was off balance. I love my waterbug!

Don't worry; I'll keep you posted, but my hunch is that it's just a little bug. We've got Pedialyte on hand already. I'm not feeling so hot myself, so we may be sharing it (the bug, not the Pedialyte). Let's hope we're over it soon!