The pump won the battle, but will I win the war?

I’m headed to bed. I have an arsenal of amazing pictures to sort and post of our weekend adventures. And yet, I’m stuck calorie counting and running the numbers again.

*UPDATE*

Prior to last week – Alexander took Trileptal and was completely lethargic. This medicine was making it so he would sleep almost 20 hours a week. He would eat maybe 1-2 oz a day orally. Maybe…. Then we had a seizure and things were re-evaluated.

Alexander was put on Depokate or Depokane or Valproic Acid.  Same drug – different name.  This drug does NOT make him tired and it has a side effect of increased appetite.  The combination of these two mean Alexander now eats: (drum roll please) around 8 oz of food a day.  This is stage 3 consistency baby food with some table food thrown in for practice.  Tonight he ate his entire piece of chocolate Ellaclare cake.  I mix duocal at a rate of 1 scoop per oz – so each ounce is about 50 calories..

We had also put Alexander on the pump overnight because of his total disinterest in suck/swallow.  Also – he needed the fluids and the calories.  He currently takes 12 oz in a 24 hour period.

Here is the FABULOUS conundrum…….

Before he was getting 100 cals from food + 400 cals from Ellacare + 50 cals from MCT oil (supplement) = 550 calories = 115 cal/kg  This is a great number for weight gain.

NOW…. he gets 400 cals from food + 400 cals from Elacare + 50 cals from MCT oil (supplement) = 850 calories = almost 200 cal/kg. This is extremely high.

How much liquid does he really need? should we try to get rid of the pump at night? we could bolus him some during the day to make a little up… and he could go back to sleeping through the night ….

The pump is just so…. *sigh* I hate that thing.  I hate to look at it. I hate to say we use it every night.  It is not what I want for my child.  However, it was a necessary evil.  I don’t want to push Alexander too fast and I don’t want to lose the ground we’ve gained by him being on the pump.  Also…. if this huge calorie intake makes him grow a little faster – then I will tolerate the pump for now.  BUT – it still comes down to – he is on a feeding pump every night.  As I type this, I find myself tapping the keys.  what to say – what to say?  Should I stop it?  Go back to bolusing during the day? How much actual formula liquid does he need if he is eating that much? Should we continue on with the pump and hope for a big payoff from these huge calorie intakes?

Thoughts?

The Best Mother’s Day Ever.

Yesterday was the best mother’s day ever.  I woke up happy.  Truly happy.  My best friend (in her pregnant glory) was sleeping on the couch, the twins were chattering away, and my sweet baby was a year old.

We woke and got ready for church.  Yesterday was my “presentation” for our church.  I’m in the middle of editing the video of it – so hopefully I can get it up later today.

During the service – I looked out.  My childhood friends were in the pews.  My childhood “second mother” who babysat me and instilled great values in me sat in a back pew.  The “second mother” to my children – their own babysitter sat with her family in a pew toward the front.  Our friends and family were there to support us.  We are beyond blessed by the amount of support we receive.

But a mini miracle happened last night.  I wish I had my camera with me to capture this moment… but I didn’t.  I wish I had a video camera to show everyone what Alexander did… but I didn’t.

Instead I have this silly photo.
Yes, you are looking at the picture of a banana.  Because the part of the banana that is missing Alexander ate.  ATE. not mashed up. I cut it into quarters by length.  And he ATE EACH PIECE.  He chewed the pieces up and swallowed them.  What a wonderful end to a beautiful day.
I had one more surprise when I went to go back to bed.  On my pillow Ray had placed this essay.  I like this one a million times better than the Welcome to Holland essay.  Not only was it a beautiful essay to read on Mother’s Day ~ it was such a kind gesture from my husband.  Sometimes I think it is easy for us to feel overlooked. (Isn’t that what Mother’s day is really all about anyway?)
It was the perfect gift for Mother’s day… Acknowledgement. 
 Here is a copy of the essay:

The Special Mother
by Erma Bombeck

Most women become mothers by accident, some by choice, a few by social pressures and a couple by habit.
This year nearly 100,000 women will become mothers of handicapped children. Did you ever wonder how mothers of handicapped children are chosen?
Somehow I visualize God hovering over earth selecting his instruments for propagation with great care and deliberation. As He observes, He instructs His angels to make notes in a giant ledger.
“Armstrong, Beth; son. Patron saint…give her Gerard. He’s used to profanity.”
“Forrest, Marjorie; daughter. Patron saint, Cecelia.”
“Rutledge, Carrie; twins. Patron saint, Matthew.”
Finally He passes a name to an angel and smiles, “Give her a handicapped child.”
The angel is curious. “Why this one God? She’s so happy.”
“Exactly,” smiles God, “Could I give a handicapped child to a mother who does not know laughter? That would be cruel.”
“But has she patience?” asks the angel.
“I don’t want her to have too much patience or she will drown in a sea of self-pity and despair. Once the shock and resentment wears off, she’ll handle it.”
“I watched her today. She has that feeling of self and independence that is so rare and so necessary in a mother. You see, the child I’m going to give her has her own world. She has to make her live in her world and that’s not going to be easy.”
“But, Lord, I don’t think she even believes in you.” God smiles, “No matter, I can fix that. This one is perfect – she has just enough selfishness.” The angel gasps – “selfishness? is that a virtue?”
God nods. “If she can’t separate herself from the child occasionally, she’ll never survive. Yes, here is a woman whom I will bless with a child less than perfect. She doesn’t realize it yet, but she is to be envied. She will never take for granted a ‘spoken word’”. She will never consider a “step” ordinary. When her child says ‘Momma’ for the first time, she will be present at a miracle, and will know it!”
“I will permit her to see clearly the things I see…ignorance, cruelty, prejudice….and allow her to rise above them. She will never be alone. I will be at her side every minute of every day of her life, because she is doing My work as surely as if she is here by My side”.
“And what about her Patron saint?” asks the angel, his pen poised in mid-air.
God smiles, “A mirror will suffice.”


Lamentations on a Long Day of Doctor Visits part 2

imageSo that last time we tried to cram 3 doctor visits in 1 day – I came home and was brutally honest about how terrible they were.  It is extremely stressful to go to a doctor for the first time.  How do I present Alexander? When I explain his diagnosis… do I tell them the things he might do? or the things he might not do? how much emphasis do I put on the right words to express the help we need and I know we need help without portraying Alexander in a light that no amount of help will help him.  This is, of course, my personal view of our interactions with doctors.  Some doctors refuse to even see us because they feel Alexander is out of “their range of comfort zone.”  Others see us and then say, “well, from what I know about WHS, he will never _______ insert any old word, so why bother.”  And, just as frustrating was our last visit with the geneticist who said, “why worry? You can’t do anything to change him, so just let him go. ex: Give him more diuretic and he will poop more.”  I do believe therapy and interventions work.  I do believe medications work. And -  I believe Alexander deserves these medications / therapies / interventions etc.  So – we only work with doctors that believe like I do.  You can call it whatever you like – but … this is our life and this is our son

So…. today’s visits were….. AWESOME!!!!

 

Visit 1 – Endocrinologist – really not necessary in my opinion – but we went.  When Alexander had his 45 + minute seizure – his blood sugar dropped very very low.  He is a “hard stick” so they never did get the right lab work to determine what was going on. The reason we stayed in Hershey so long a few weeks ago was to do a 24 hour fast to attempt to get Alexander’s blood sugars to drop again.  They never did drop again, and Ray and I believe his blood sugar drop was a result of a big seizure – not the cause of one.  Although blood sugar drops can cause seizures – so does Wolf Hirschhorn Syndrome – which we know he already has.  We’ve checked his blood sugar every morning and it hovers around 100 – after an 8 – 10 hour fast of overnight sleeping. Just like it should. So – a delightful visit that we can check hypoglycemia off our list! YAY Alexander – finally something you don’t have. 

 

Visit 2 – GI Doctor.  This was the visit. The doctor. The guy who had to help us.  This was the visit I needed to choose my words carefully and get Alexander the help I knew he needed.  Alexander cannot tolerate the volume of food/liquid he should be able to tolerate. He just can’t do it. Even if we put it in his tube – he will sometimes scream for 2 hours imagebecause his stomach contents have not moved.  And… it doesn’t have anything to do with pooping – he poops.  His stomach does not empty properly.  I have researched this topic. They used to put kids on Reglan for it (bad bad bad drug). There is a class action law suit now against Reglan and it can make kids have palsy like shakes, etc. bad drug.  The GI doctor I tried to see a few months ago was ticked that we could no longer use Reglan and he’s the one that said – even if he did help us – Alexander would never do anything – but just be fat.  When I say research.. I ask other WHS parents what their kids’ symptoms are / what the doctors say / and what meds/therapies they use.  Then, I spend hours going through medical journals, etc to see what I can learn on my own before we go to the doctor.  I understand this might be unorthodox…. but none of the doctors we saw today have ever seen a kid with Wolf Hirschhorn – so – in Alexander’s case – I need to be his expert and advocate.  Anyway – the newest “best solution” to slow gastric emptying is a small dose of an antibiotic called Erythromycin…. I’ve been after this drug for months.  We sat and talked to this doctor for an hour or so. You know what his first suggestion for helping Alexander was? Erythromycin. :)   It was like this huge wave of relief washed over me. Finally … he didn’t want to tell me Alexander wasn’t worth helping…. He had a nice, non – invasive solution. Did I mention that I LOVE our new GI doctor?

 

Finally – our Immunologist appointment.  By now it is 2pm and we are exhausted.  And she is wonderful.  She explains that she would like to run basic tests on Alexander’s blood to determine if his immune system is compromised and if it is – by how much. This is exactly what we wanted her to say.  No – there is nothing you can do to “fix” a compromised immune system – you are just more susceptible to illnesses … but … we can know if we should be paranoid about germs or not. (Right now we are just paranoid)

 

All in all – an awesome day. Totally different than our last day of 3 visits.  I was so nervous because all of these doctors were going to be new to Alexander.  I was afraid we would make a “misstep” and the doctors would not help Alexander. Instead…. it was a day like normal people have at the doctor. AWESOME.

 

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