Three Months

This wasn't exactly how we wanted to celebrate the boys' three month birthday.

We went in to the hospital in the afternoon, and James was not very happy. They had restarted his feeds at 9 ml/hour, and he was grimacing and crying a lot, and spitting up a bit as well. The doctor thought that his discomfort might be due to reflux, since he'd been getting reflux meds in his IV fluids, and those had been steadily decreasing as the formula volumes increased -- so they added the reflux meds to his formula, and she thought that continuing to feed him would start to make him feel better. But then when she was in talking to us, he had an episode where his oxygen saturation dropped, so that made her decide to stop his feedings again. Within just a few minutes, James seemed to be feeling much better; he opened his eyes and was looking around, with only the occasional expression of discomfort. I don't really know what this means for helping to identify the cause of the problems, but it suggests to me that it's something more than just reflux.

They're pausing the feedings for six hours and then are going to try again. If he has problems again, they'll do a contrast study to see if he has any additional blockages or narrow areas in his intestines. (The surgeons didn't think he did, but it's possible something may have developed in the meantime.) The contrast study would also help "clear the pipes" in case it is some kind of other difficulty with the poop getting through (not necessarily constipation per se, but something like that). Also, his morning X-ray also didn't show clear evidence of any obstruction -- it just showed a slight dilation of the bowels, which is probably contributing to him being uncomfortable but isn't something that was cause for concern among the doctors. So that's good, but an X-ray isn't really definitive for ruling out obstructions.

They also took him off Lasix and put him on hydralazine for his high blood pressure, and are giving him a drug that might help intestinal motility (Reglan, I think). Motility drugs don't have a great track record of effectiveness, but it's probably worth a try.

So, we don't really know what's going on with him. Maybe we'll be lucky and he'll do well when they restart this evening, but we're not wildly optimistic about that.

In better news, Matthew slept in his crib for a few hours last night! (He sleeps like an angel when someone is holding him, but squirms and fusses in the crib.) The winning combination seemed to be 1) swaddling, including wrapping up his arms, 2) noise machine set to "rain", 3) a little light in the room, 4) a pacifier, 5) mobile turned on, and 6) motion monitor (this one is for me, so I don't have to keep checking to see if he's breathing). Oh, and letting enough time go by after feeding him so that he doesn't spit up. So, hopefully this will continue to work.