James and I began this blog at the very beginning of our pregnancy with Wyatt to share and update our new adventures as we became pregnant and start the new season of parenthood. Sixteen weeks into pregnancy, I had to go into surgery to ensure our son would not come too early and shortly after, we found out Wyatt has Congenital Diaphragmatic Hernia (CDH). This is our humble attempt at being transparent and hopefully sharing the joys and love of Christ through this roller coaster ride we're on. And now to share even more with the new miracle on the way.

Tuesday, April 16, 2013

Coffee Ground Vomit and I Don't Get Along...

Wyatt is ready to go golfing with Daddy!

So yesterday I put this status update on Facebook:

If you think about it, please pray for Wyatt tonight. This afternoon he had an empty stomach but managed to throw up a measurable amount of the brown coffee grounds (blood). It hasn't happened since but GI wants us to come in first thing in the morning. We've had almost 3 months of almost never throwing up but we've had to up his formula intake because I stopped pumping this week and his body is having a hard time getting used to processing the increase in formula. (I've got a stock pile so the mixture is about 2/3 30 calorie breast milk and 1/3 full 30 calorie formula) and the total daily volume has gone up to. I'm scared to go out with him bc of the puking. So sad for him, he hates it so much! And (last one, I promise) tonight he is sleeping with a special pulsox machine that records his heart rate and oxygen levels and if he does "good" according to his pulmonology doctor, he will no longer "need" oxygen and we can have the medical supply company pick up ALL the tanks! Yea! Thank you for keeping us in your prayers. We praise God for Wyatt's growth and progress every single day! :) 

Here is our update:

Wyatt had a good night.  No more throwing up and no more blood.  Praise God.  Thank you for praying.  The mere fact that we go in to see our GI doc this morning first thing is a miracle.  She doesn't usually have open appointments let a lone first thing in the morning, they usually add them to the end of her day.  She said we must be special.  I agreed of course.  We love our GI doc and she loves us!  If you're in the Dallas area and need one, let me know- I recommend her!  Anyway- she said Wyatt coffee ground vomit could have been any one of several things.  i introduced butternut squash yesterday for the first time (she said this was an unlikely reason but maybe and to try again in a few days and for 3 days in a row and see).  It could be the increase in volume and formula.  His body needs to get used to processing and breaking it all down.  So, Dr. A increased two out of three of his reflux meds.  She didn't do this last week at our appointment because at that time he didn't need them increased (I agreed, things were good- very minimal vomiting at that time) and she was going to let him wean himself off by outgrowing the dosage.  I'm all for that happening if he can do it but with the increase in formula/volume, he is just not ready yet.  The third possible reason for this episode could be g-button irritation.  She is his GI doctor but she is not a surgeon so she can look at it and say it's a possibility but the surgeon is the one that needs to really make that call.  She did tell me somethings to look for.

She also called the dietitian in to go over Wyatt's plan of action for his feeds.  We did have on major miscommunication, totally my fault but we still needed to fix it because of his vomiting.  We went from literally little to no vomiting to throwing up almost every feed and at night.  It sucked and I was already adjusting my frame of mind to not going anywhere with Wyatt because I didn't want him puking all over me, himself and the floor of some public place.  BUT with these adjustments, this should not happen.  Praise God!  I am so thankful for getting to go back in.

So, the original plan of action called for Wyatt daily intake of milk/formula to go from 690mls / day to 810.  That is a lot in our little world.  :-)  To break it down a little more (wish I could insert an excel chart here...) at night Wyatt was getting 385mLs over 9 hours (a rate of 43/hour) and 3 day time feeds of 100mLs (I had pushed the rate to 101mLs/hour putting the feed right at an hour).  He was not just tolerating it but able to play, bounce, jump and lay flat without throwing any of it up.  Life felt good and somewhat normal.  I was not complaining.  And with the new volumes it put the night feed at 450mLs at night over 9 hours (a rate of 50) and the three daytime feeds to 120mLs pushing the rate to 120mLs/hour as well.  This is an aggressive plan.  I am a fan of aggressive as long as Wyatt can tolerate it comfortably and we don't know what he can handle until we try, right!?!  :-)

With those 2 changes, I also requested how to transition Wyatt from my breast milk (fortified to 30 calorie with formula) to formula only.  This was a really hard decision for me to make but it is time for several reasons.  We put our house on the market on the 30th of this month and there is a lot to do in preparation (we have painters  and landscapers here as I type...) then to have showings where we (Wyatt myself and our 100 lb doberman) will have to be out of the house off and on who knows when or how often, packing, keeping the house in perfect order and looking for an apartment and a new house all at the same time.  Oh, and let's not forget Speech Therapy, Occupational Therapy, other doctors appointments and playing and taking care of Wyatt in general... Wyatt's gotten 9 full months of breast milk and I still have more in the freezer to continue using.  He has the milk allergy and as hard as I try, I can never truly know if something has the milk protein or not.  Yes, I could eat at home 100% of the time and know but let's be real, James and I like to eat out and waiters don't know all the time.  They try but you'd be surprised at some of the things that have milk.  It's more than ridiculous!  I felt so much guilt when Wyatt started throwing up, questioning my decision but I know ultimately it's what is right for him and us as a family.  I have to remind myself of this and just rest in the peace of knowing this really is what is best.  :-)

Day one I went all out and did it all.  450 mLs at night with the rate of 50 / hour.  During the day Wyatt received 120 mLs at a rate of 100 / hour all half fortified breast milk half full 30 calorie formula mixed together.  Whew- lots of throw up.  His little body did not like all those changes.  So, I immediately pulled back some before today.  The next night I mixed 2/3s fortified breast milk and 1/3 formula and only gave him 400 mLs but still at the rate of 50 / hour.  I've increased each night by 5 mL (last night Wyatt received 420mLs total and did great).  The dietitian wants me to slow him down there and instead of a 5Ml increase a night go to a 10mL increase over a weeks time.  For the three day feeds we will slowly work our way back up to 120mLs total volume and a rate of 120/hour.  Today I'll start Wyatt at 102 mLs total volume and increase his feed by 2mLs each day as tolerated and once we get to 120, I'll then increase his rate slowly as tolerated.

I give all these tedious details for all the tubie mommies out there.  You never know who is going to have the same problem and it's interesting, to me at least, to know what other kids are capable of tolerating and learning from them too.

Wyatt is doing great and I don't think he ever even felt bad.  I'll post his 9 month pictures and milestone updates very soon!  Just wanted to update everyone and THANK YOU so much for all your prayers.  They've been answered and we hope he continues to accept this new feeding regimen.

I won't know the results of his possible removal oxygen removal at home "sleep study" until they pick up the pulsox and send the data over to his doctor.

Doing laundry wore out Daddy and Wyatt! 


Thanks for praying for Wyatt!!!

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