When we arrived at the hospital today we were pleasantly surprised to hear that Kinley didn't throw up at all last night. Yea!! So far today she has only thrown up once at 6:00 am and it was around 15 ccs.
Kevin and I notice that Kinley is a lot less fussy today and more sleepy than she has been for the past couple of days. There are a couple of reasons for this. First of all, since Kinley had her 2 month shots yesterday, she is still getting Tylenol and will continue to get Tylenol for 24 hours after she received her shots. Secondly, her methadone dose was changed so that Kinley got her full 0.8mg dose all at 8:00 am this morning. Previously she had been getting 0.4mg twice daily. Dr. O told me yesterday that this is not really a weaning step, but 0.4mg is getting to be too small of a dose to measure correctly. We will have to see how Kinley handles not getting a second dose of methadone at 8:00 pm today. I like the idea of giving the dose in the morning though because that is typically when she is more irritable. Kinley has been doing a pretty good job at sleeping at night.
At 1:30 pm Nancy, the OT, came by to do some tummy time with Kinley and observe her 2:00 pm bottle. Kinley did really well with tummy time. She was able to hold her head up for a while and did some rolling. Before Kinley's 2:00 pm bottle Anita, Kinley's nurse for today, checks Kinley's residual and it was only 2ccs. Way to go Kinley, keep chowing down that milk! According to Anita, Kinley has not been too excited about her bottles today, and we see that when I tried to feed her. With some coaxing, Kinley takes about 17 ccs of her bottle and then throws up a good portion of it, probably around 10ccs. Kinley was not really into taking her bottle and was spitting out her milk before she started to swallow some of it. I just don't think she wanted to eat at the time and would have rather slept through the feeding. After her bottle I read to Kinley to try and help her relax and sleep a little.
Later on the the afternoon Delores, Kinley NNP, stops by to talk with us. Delores is not sure Kinley has a hiatal hernia. She is going to e-mail Dr. S, the surgeon who did Kinley's repair surgery, some x-ray pics to see what he thinks. The reason for the e-mail is because Dr. S is in Bolivia for a medical mission trip. Delores can see why other doctors might think Kinley has a hiatal hernia based on her x-ray. She explains that when Kinley had her repair surgery and her intestines were brought back down into her abdomen, her stomach was shifted a little to make room for the intestines. Kinley's stomach is more midline than normal. Delores also explains that this is one of the reasons that Kinley has reflux. Basically, food has a straight shot (going up and down) from her esophagus to her stomach. To keep an eye on her reflux and how it is affecting Kinley, she will now get weighed every night to monitor her weight gain. As long as Kinley is gaining weight we may just have to put up with a little vomit and spitting up until Kinley will hopefully outgrow some of her reflux.
It is now time for Kinley's 5:00 pm bottle and Kevin is up to feed her this time. Before the feeding, Anita checks Kinley's residual and again it was only 2 ccs! Kinley takes all of her 5:00 pm bottle for Kevin (she is still only getting 20ccs by bottle and 70cc via her NG tube for each feeding) and then fills her diaper with poop. We have to change her outfit because her poo overfilled her diaper, but we would rather have it come out that end than the other, so we are happy. Kevin holds Kinley for a while and then puts her in her crib with her boppy for a nap.
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