Long Awaited

Great news -- James is no longer on IV fluids! (Goodbye to the TPN!) He's up to 69 ml on his feedings (or 23 ml/hour), which is not quite up to the goal yet (75 ml or 25/hour), but is close enough that he's getting adequate nutrition and hydration with it.

This is wonderful news for two reasons. First, being off the TPN will allow his liver to recover, and second, they have taken out his PICC line, the IV used to deliver the fluid. Although James has had a PICC line for a long time, they always worry about them as a possible portal for infection, so getting rid of it removes a possible risk for him. (Of course, if needed they can always put in another one, but we're hoping that doesn't become necessary.) Getting rid of the PICC line will also make him a lot easier to pick up and move around. Hooray!!

It seems like we should throw a PICC burning party or something like that, but I imagine the plastic would smell pretty nasty if we tried to burn it.

We continued our educational activities today. We met with a nurse to learn how to use the home feeding pump that goes along with James's G-tube. Of course, the goal is to get him to be taking all his food by mouth, but it will probably take some time to get there, so the pump will allow us to make sure he's getting all his nutrition even when he's not fully transitioned to a bottle.

And we had another session with the ostomy care nurse; it was my turn to change the bag. James didn't seem to mind too much. :)

He had a little bit of spitup with blood in it while we were there, which was unsettling, but the doctors think it was just a little stomach irritation (which sometimes happens with the g-tube). He hasn't had any more since then, so that's a good sign. (If they had been worried, I suspect the PICC line would still be in.)

So, altogether a good day! (And after a terrible night of gas and fussiness, Matthew also seems to be feeling better today.)