Post-Op (Again)

Hi Everone,
Today Alexandra is 20 weeks old.  She added five more holes to her list that now includes missing 1/2 of two different ribs, one long incision, and three small holes from her surgery a week ago.  All of the holes have a story to tell; below is the story of the newest...

What she had done
Alexandra was starting to suffer a lot more from really nasty reflux.  She was very uncomfortable much of the time and she was also vomiting a lot.  It's a real testament to her personality that she was smiling as much as she was during the other times.  So anyways, on Friday afternoon she had the Nissen fundoplication that I had written about previously.  Nissen is probably the guy's name who first performed the surgery.  Fundoplication literally means to fold (plicate) the top of the stomach (fundus).  Actually, it is folded around the esophagus, which closes off the esophagus as the stomach fills up.  This makes the reflux less likely.  

The procedure also includes the instalation of a feeding tube, which connects the stomach to a tube through a valve sticking out of the left side of the belly.  This is how she'll feed, burp, and puke for the months or years she'll live with the feeding tube.  This new feeding tube takes the place of the tubes in the mouth or nose that snake down into the stomach.  She has a pretty low threshold for gagging, so maybe this will help with some of the vomiting.  Either way, it's allowing us to see more of her face!!

The surgery was performed laprascopicly so we're hoping the recovery is quicker than a big incision.

How did she do?
In the first 48 hours or so she has been doing very well.  She actually came out of the operating room with the breathing tube already out.  This meant the world to Suhey and I because we were so worried about going back on CPAP again for a while.  The nurses didn't seem to expect her to be in much pain, but she's been in enough that we had to ask them to be more aggresive with the "as needed" pain medicine.  They did so happily and her pain has been pretty well contolled since then.  She's still not back to herself, but we see some subtle signs that she's "coming back".  She's been opening her eyes more often and for longer periods of time, and has only smiled once or twice since surgery.  We're not concerned, however... it's only been two days since we changed the shape of her stomach.

We are VERY proud of how she handled herself.  It's amazing to see her go through the things we do to her and still not be fussy or cranky... Except when that diaper has a drop of pee or a speck of poop in it.  When that happens, all bets are off, but hey, a girl has gotta have her standards, right?

So now what?
Alexandra started to get milk and formula trickled into her stomach early the morning after her surgery.  The amount of milk is gradually being increased with time.  She's being supplemented with IV nutrition as we give her stomach time to heal.  She's still on continuous feeding, so her stomach still isn't being challenged with a "bolus" feeding, the way most babies eat.  So instead of say 3 ounces all at once every 3 hours, she gets 1 once over the course of each hour.  It's still unclear as to when she'll gradually transition to bolus feeds.  She does NOT need to be on bolus feeds before going home.

Ok great, so what about her breathing?
Her breathing is doing remarkably well.  She's still not able to hold her own without help, but considering she had surgery two days ago, we're very proud of her.  She's still not liking the nasal cannula in her nose, so we have to CONSTANTLY supervise her to keep the oxygen flowing into her nose.  

Okay, okay... the pictures (as always, click to enlarge)

Day before surgery - GAME FACE ON!!!

Nice little reminder of some of the things Alexandra's late Great Uncle Bill (Nash) did for the Children's hospital.  He was always involved with kids.  I remember once that Santa Claus came to his house to chat with my cousins and I.  I noticed Santa was wearing the same watch that Uncle Bill wore.  I was really impressed that Uncle Bill had so much in common with Santa...  Who knew that 35 years later he'd be watching over a great niece like this?

Dad, Mom, and Suhey anxiously awaiting the surgery to end.  I was wolfing down chocolate chip cookies.  Not pictured: Abuela, who was probably getting some cafe con leche.

Post Op Day #2, just chillin.  Check out the LACK of a feeding tube going into the mouth or nose; just a simple nasal cannula for oxygen.