Giving Thanks

Thanksgiving has long been my absolute favorite holiday, and this year we have even more reasons to be thankful. Caroline's issues have settled down for the time being. The vomiting, diarrhea, and diaper rash have ceased, and her appetite is back so she's been eating well. The ear infection is still hanging on though, and if it hasn't gone away by Wednesday (3 weeks with the ear infection) our pediatrician is referring us to an ear/nose/throat specialist. I am thankful there haven't been any more trips to the ER, and that her appetite is good, and that throughout all the trials and tribulations my sweet little baby has been such a good trooper.

Winnie had doggie dental surgery last week (what is it with dental problems in this household??) and he came through just fine, despite having 5 teeth pulled. He's taking 3 different pills each day and eating mushy dog food but he too is cooperating like a champ. I am thankful that there were no problems with the surgery and he is his usual napping, baby-avoiding self.

Bill is still working out the details with the car insurance company and hopes to be buying a new Altima within the next few weeks. I am so very thankful that he wasn't hurt in the accident, because I can't imagine trying to navigate our daily routines without his help!

And I'm so very thankful for the wonderful relaxing holiday weekend we spent enjoying food and family. I woke up Thursday morning feeling like a kid on Christmas, so excited for a day full of stuffing ourselves silly on good food! I made sure to go on a nice 4 mile run that morning so I had 'earned' the privilege to indulge in gluttony, and spent the entire run reflecting on all the little things I'm thankful for. It was a fantastic run and made the anticipation of the feast even better! 

We had Thanksgiving at Jeff and Kristen's house this year. Jeff did a great job with the turkey, although I couldn't begin to explain how it was cooked (something about infrared, not fried. Laser beams? I have no clue.) As usual there was a copious amount of food, including lobster bisque, laser-zapped turkey, honey ham, shrimp mirlitions, dressing, mashed potatoes, green bean casserole, cheesey cauliflower, and rolls. And the best part was enjoying the leftovers for several days afterwards!! The gift that keeps on giving!

The spread took up the entire countertop!

I salivate just looking at these pics...

After stuffing ourselves on the feast we flopped on the floor and couch and teased Jeff mercilessly as he charred the apple pie with a nice smokey aroma. Luckily the smoke detectors did not go off and the pie tasted just fine, which is a good thing because my entire Thanksgiving's happiness rested on the fate of that pie. (I've been salivating in anticipation since last Thanksgiving.) We watched Caroline and her cousin Riley entertain themselves and pondered what sort of mischief they'll be getting in to together next year when they're both walking and talking up a storm. Sweet cousins.

The first of many many happy Thanksgivings together

Thursday night my mom and I made our usual holiday craft trip to Michael's and on a whim, decided to stop at Babies R Us to see about getting a walking toy for Caroline's Christmas. We pulled up 15 minutes prior to the store opening at 8 and my mom and I gasped at the length of the line. Holy holiday insanity. Luckily no one got trampled, injured, or tazed by police, and we were able to buy the item in pursuit, so I'd call that a successful initiation into the madness of holiday toy shopping.

Calm and orderly at Babies R Us.



Meanwhile, at Walmart....
http://video-embed.al.com/services/player/bcpid619299288001?bctid=1984834091001&bckey=AQ~~,AAAAQBxUMrk~,0PvcDEZHzy-ARvzSadmpH0dyfNemipBZ

Our shopping spree continued Friday, hitting up sales at Lowe's, Home Depot, another trip to Babies R Us (why can't they just put ALL things on sale for the entire weekend, instead of 'friday only' and 'saturday only' specials??) the Container Store, Staples, and Half Price Books. In my mother's eyes Black Friday is a national holiday unto itself, and the woman would literally shop for 12 hours straight if left to her own devices. By noon though I'm usually starving and needing a break, so thank goodness LSU always plays Arkansas in the afternoon and we must take a mandatory break! 

Nana's most excellent deal- the world's largest teddy bear!!

She'll get a lot of bewildered stares
driving back to Louisiana with this in
the passenger seat.

Aunty Em came over with her service dog Kline and Caroline was delighted to see him again. I think Kline was glad to have his portable kennel to retreat in to...otherwise Caroline would have 'loved' him all day long!!

We spent Saturday putting up Christmas decorations and watching college football and working on a craft project for Caroline. The Christmas tree looks decidedly different this year, with ornaments hung only waist-high and up, and tied to the stairway banister to prevent toppling. So far she hasn't tried to climb it....yet. 

Mom and I worked on creating some magnetic felt counting fish for Caroline, with a little magnet fishing pole to go 'fishing'. I think this will be a new tradition for us...I want to make sure that every year Caroline gets something home-made at Christmas. I sent the fish-in-progress home with Nana to finish...can't wait to see if Caroline enjoys them (or eats them)!

All in all, a wonderful Thanksgiving holiday that I will cherish throughout the year. Sometimes I wish we could just skip Christmas and have another Thanksgiving instead!!

9 months

Apologies for the delay in posting....we're still playing catch-up after last week's medical debacle. Spending all day Sunday and Monday in the ER was only half the battle. She continued to throw up until Thursday, with intermittent bouts of diarrhea, so we were constantly on guard watching for signs of dehydration and panicking over her lack of keeping anything down. She only ate about 6 ounces of formula and 4 ounces of juice/pedialyte each day. We saw a new pediatric GI specialist on Tuesday, Dr. Reid, who is the chief of pediatric gastroentology at Texas Children's Hospital. Dr. Reid explained that she was looking at the case as 2 sets of different problems: 1) the acute illness or condition that was causing the vomiting and 2) the big-picture problem of why she was not eating enough. Caroline's growth up to this point has always hovered right in the middle of the 50th-60th percentile. This past month she achieved no growth whatsoever (even lost a pound during the last week) and now her growth percentile is slipping, which makes the doctor concerned. She ordered some blood tests and a stool sample test and also a swallow study as a starting point for figuring out why Caroline isn't eating enough.

And above all else, she needs to be able to eat solid food! Currently Caroline is entirely off solid foods completely; it's been that way for about a month now. When I first took her off solids she seemed to do better (eating 24 ounces consistently) for about a week. Then we met with the nutritionist, who suggested starting back on solids one food at a time beginning with bananas. So she ate one 4 ounce serving of bananas for a few days, and then the problems came back...fussing, not pooping, only eating 13 ounces of formula. So whatever the problem is, eating solid foods makes it worse. Until they figure out what's going on I have no desire to bother with solids.

Last Thursday she went to her regular pediatrician for her 9 month well-baby checkup (haha) and good thing we went, because when he peeked into her ears he informed us she had a double ear infection and promptly put her on eardrops and antibiotics. I'm still not clear if the vomiting last week was due to the constipation, the ear infection, or a stomach bug....or all 3? After the ear infection diagnosis, there was also the blood in her diaper on Thursday afternoon, which was also pretty scary to see. She didn't have a diaper rash or any visible cuts or wounds on her bottom, so I have no idea what that was about. I called the doctor and she didn't have any ideas either. So far we haven't seen any more bloody diapers ....instead, we've had a whopping dose of diarrhea and terrible diaper rash this week from the antibiotics. We saw the doctor again yesterday and he switched her antibiotic and gave us a prescription diaper cream, so I'm waiting to see if that helps at all.

And in the midst of all these medical fiascos, Bill went to go vote on Tuesday morning and got in a wreck and his car was totaled. It wasn't his fault...he was just stopped at a stop sign when 2 other cars wrecked and one spun out and hit his car. Naturally the driver at fault did not have insurance so we're having to file claims with our insurance, get a rental car, and go new car shopping. All while the baby was in and out of doctors offices and testing labs. Good thing Nana came to the rescue! She flew in on Tuesday to help with the baby and it was such a relief to have another pair of eyes watching her and monitoring her symptoms and offering opinions and suggestions. We can't thank Nana enough for coming to the rescue!!

adios Altima....

So that's where we are today....now back to our regularly scheduled 9 month update! Aside from the medical issues, she seems to be a happy outgoing playful ball of energy! Her favorite toy right now is her music table; she loves to push all the buttons and hear the songs. She just learned how to 'dance' and it is tooo cute!!

She also still adores Winnie too, and he is slowly....very slowly...getting used to her approaching him. Now he'll withstand her for a few seconds before he runs away from her. The other night I even caught the 2 of them almost playing! He had his bunny and she was trying to grab it. For one bright shiny moment my far-flung fantasies of baby and pug playing together almost came true....and then she spotted the stairs and abandoned him in favor of pursuing the stairs.

She's pulling up on everything she can get her hands on and reaching for every object within arm's reach. She gets a big kick out of anything she hasn't seen or explored before...for instance, the egg crate foam mattress topper my mom had on the twin bed downstairs. Such a funny interesting texture she of course had to try to get it in her mouth. Everything goes in the mouth! Step 1: grab it with hands and turn it over. Step 2: try to put it in the mouth.

She is babbling a lot and says 'dada', but I still haven't heard 'mama' yet. We practice that every day....so far no luck.

In addition to her achievements, we have some challenges to work on as well. She has a very limited capacity for self-soothing. Once she gets upset and worked up, she wants someone to come pick her up and soothe her. I know this is partly my fault because she was in pain and cried so much for the first few months of her life that my goal was to hold her, rock her, soothe her as best I could and do whatever it took to calm her down. Well she's 9 months old now and we've got to catch up on the self-soothing skills. Parent-teacher conferences at her school were last week (which we missed due to all the illness craziness), but her teachers sent home the standard report on 'how your child is progressing this year.' The first item stated "We are working with Caroline to learn how to self-soothe." Read: your kid is a crybaby who needs a lot of coddling. At least we have one failsafe item though...the magic tshirt! I send one of my tshirts to school with her, and the teachers swear that if she's crying and just won't calm down, all they have to do is give her the tshirt and she calms down. Now we must work on learning how to calm down without the tshirt...

And the other big challenge is still separation anxiety. She still wants to be with me almost all the time. She doesn't want Daddy to give her a bath, or Nana to give her a bottle, or anyone else to put her to sleep...she wants ME to do all those things. She is making slow progress at school though...she started taking a decent nap and taking a bottle from her teachers. We just need to keep practicing.

Last but not least, a little picture lagniappe from all the family and friends we've visited within the last month!

reading with Aunty Em

Granny and Grandpa and their 2 girls

Uncle Tina! 

Aunt Maggie drove all the way in from Florida
to BR to visit with us!

Playing with Aunt Precious and Nana

Cousin Riley decided crawling was cool.

Big girls playing together. Riley was very
gentle with her little cousin!

the feces fiasco

November is my month of gratitude, and I take time every day to recognize the small things I'm grateful for. So I'll preface this post by saying I am enormously grateful that I don't have a child with a chronic life-threatening illness. That we don't spend time in the emergency room on a regular basis. That I'm not fighting with insurance to cover treatments that are life-saving. I know Caroline's problems seem small in comparison to those parents and my heart goes out to them.

Saturday night Caroline refused her 7 pm bottle, like she has been doing for months and months now. At this point we hardly even try to get her to eat it...it's a lost cause. So we usually have to put her to sleep and then wake her up a few hours later, around 10 pm, to make her eat the bottle. We put her to bed and she didn't fuss or object too much. When I went in to get her at 10 pm I noticed that there was a large wet spot on her sheet, so she must have vomited but I didn't know when. I never heard any commotion on the baby monitor while she was sleeping.

I gave her the bottle and she drank about 2 ounces and then forcibly vomited it all back up...all over herself, me, the couch. I woke Bill up to clean the couch and then she and I hopped in the tub to rinse off the puke. I had to rock her for about an hour before she fell back asleep.

She woke up fussing around 2 am, which is also the new norm these days. We're guessing she's either waking up out of pain or hunger every night, and given that she had not eaten a single thing in 12 hours, we guessed maybe she was hungry. Bill gave her a bottle...same results. Puke all over her, Bill, the couch. We went through the routine all over again, and I rocked her back to sleep for an hour.

By Sunday morning I was pretty worried and started consulting baby health books and my favorite resource, the interwebz. We determined that she needed some Pedialtye in small quantities to keep her from getting dehydrated. We gave her 1 tsp of Pedialyte and it was promptly vomited back up. With that we called the on-call nurse at her pediatrician's office to find out what to do next. She didn't have a fever, and her mood was pretty much normal, so I was absolutely convinced this was just another symptom of her ongoing unresolved digestive problem. Bill was sure it was just a stomach virus, but I was absolutely convinced it was connected to her other problems. Bill talked to the on-call nurse and she advised us to head to the emergency room since Caroline couldn't keep anything down and there was concern about dehydration. I was blatantly relieved that we were hopefully finally going to get to the bottom of this problem. Perhaps the situation was finally dire enough that the doctors would listen to me and see that there is a 'bigger picture' issue at work here!!

We went to the emergency room at Texas Children's Hospital. We got there around 9 am and filled out some forms and were promptly seen by the triage doctor. Waited for about 20 minutes and then they had a room ready for her. We talked to her assigned nurse and doctor and I explained that the immediate concern was dehydration due to vomiting, but I was also concerned that this vomiting was connected to a larger unresolved issue that has been plaguing us for months, with not eating and not sleeping and suspected pain. I mentioned things I had been obsessively googling, like impacted colon and stomach ulcers and small bowel obstructions. The doctor agreed that an xray would be helpful, and later confirmed that poor little Caroline's system was completely backed up with poop. She was not impacted per se, and there was no evidence of looped intestines or other physical problems, but she was severely constipated which was causing the vomiting.

I asked the doctor if this constipation was the possible source for all her problems the last few months, and she said yes. I asked why did this happen, and how do we avoid it? She said the compounded prevacid can cause constipation as a side effect, but it didn't make sense to me...if she's been on the prevacid since April, why would the constipation only be showing up now? She recommended taking Miralax for a few weeks to help clear out her system, and giving her apple juice or prune juice in conjunction with solids to help her keep pooping.

In the meantime, they wanted to perform an enema to clean out her pipes and then offer her juice and make sure she was able to keep something down before she was sent home. They performed the enema while Bill and I tried to distract poor Caroline...she was such a trooper. Not happy about it, but not screaming her guts out or anything. 10 minutes after the enema she had the most foul-smelling bowel movement that has ever wafted through my nostrils. Bill and I were gasping for air in her hospital room, and begged for face masks. There were a lot of poop jokes exchanged. What else can you do?

Preparing for the poop-a-thon. We sang songs
to keep her entertained, including a rousing
rendition of "Tutti Frutti Baby Got a Stinky Booty."

She only had 1 poop and then fell asleep. I really expected her to be a pooping machine, with feces flying everywhere, but there was just the 1 poop. I thought the nurse would not be satisfied with the results and we'd have to do more work to get the poop going, but she said it was good enough. Then they gave her some anti-nausea meds and 2 ounces of apple juice. She kept it down, so the doctor decided to discharge us. She said Caroline should continue pooping on her own, and we should return to the ER if the vomiting came back. We finally left around 2:30.

She got a does of Lactalose and a dose of Miralax when we got home, but despite those 2 medicines AND an enema, she didn't have another poop. I was worried and had this nagging feeling that this wasn't over yet. She took about 5 ounces of formula at 7 pm and kept it down, so I tried to be optimistic.

This morning she got up around 7:15 and I gave her a bottle at 8. She took about 4 ounces and then promptly projectile vomited it all back up. Every single ounce. In between trying to console the crying baby and stripping off vomit-covered clothes and scrubbing the couch, I called Bill to tell him we needed to go back to the ER.

We got to the ER at 9:15 am and it was a lot crazier than yesterday. We waited 45 minutes just to see the triage nurse, and then waited another hour and a half just to get a room. We waited 30 minutes and saw a nurse. Then waited 30 minutes and saw the attending physician. Then waited 30 minutes and saw the attending's supervisor. The whole day seemed like nothing but waiting and waiting and more waiting. The attending physician finally called our GI and conferred with him and agreed to do a lower GI contrast study, where they insert barium into her lower intestines and watch it move around to check for obstructions. The test itself was not actually painful per se, but I know it was not comfortable for the poor baby to have a tube and fluids stuck up her butt and then held down unable to move. She screamed and cried for the entire procedure. It was not fun for either of us, and I just prayed that we would finally get some definitive answers.

We waited another hour until the attending physician came in and said the test results were normal, everything looked fine, so they were sending us home. My heart just sank. Not that I WANT my daughter to be sick or have some physical abnormality, but I was hoping that if this test didn't give any answers that they would keep probing. When we entered the ER this morning, I was determined to get some answers. But I left with nothing more than another prescription to treat constipation, and not a single clue as to what was causing her to be so severely constipated to begin with.

As I told some of my friends on Facebook, My frustration is that between the GI and her pediatrician, they have just been treating each symptom in isolation without looking at the bigger picture and digging deeper for answers. The bottom line is, somewhere between the time the food enters her mouth and exits her butt, something is not working right! I don't know what it's going to take for the doctors to get to the bottom of this. But at various points throughout  her 9 months of life, she's had: gagging, choking, vomiting, spitting up, pain, fussing and crying, hard/bloated abdomen, refusing bottles, refusing solid foods, constipation, and diarrhea. Her growth up until now had been on-track, but within the last month or so it has flatlined. If this keeps up she will start to plummet off the growth chart. Maybe then the doctors will be satisfied that she's 'sick' enough to warrant concern and aggressive testing and treatment. 

tricks and treats

We have both tricks and treats to report from Caroline's first Halloween. First the treats...she looked absolutely precious in her little lamb costume and I took about a million photos. Here are a few of my favorites.

Winnie was less than thrilled with his matching lamb headgear and only cooperated for a few photos. But it was still cute.

However it was pretty warm when it was time for trick-or-treating so I decided the lamb costume might be too hot. We had to go with a backup costume...ballerina! Still cute!

We went trick or treating with Bill's friend/coworker and his kids in our neighborhood. It was a  great night for strolling and collecting candy! Somehow the candy just magically fell into her stroller as we went past each house. I wasn't complaining or objecting. Bill harassed me for collecting candy for a baby, but hey, she was cute. I couldn't help it if people wanted to throw candy at her. 

She was cooperative for about an hour and then it was getting to be bedtime so we headed home. Pretty good for her first Halloween.

And now, for the tricks of Halloween. She is still having eating and sleeping issues and I'm racking my brain and harassing doctors until we get this figured out. Per the GI's advice, we tried increasing her acid reflux meds but that did not produce any improvements at all. After extensive googling I decided there must be some issue with the solid foods, so I took her completely off solids for 2 weeks. She seemed to do much better...went back to sleeping through the night, eating her bottles without objecting.

I then contacted a nutritionist because I figured she must have some kind of food intolerance. We made an appointment on Halloween, but in the meantime the nutritionist recommended giving her just one serving a day of bananas, b/c that's a pretty safe food. So we started with bananas last Tuesday. For the first 4 days there didn't seem to be any problems, but by Saturday there was a return of the symptoms. Fussing and refusing bottles, not pooping, not eating. She only took 13 ounces of formula!! So I thought, aha! Bananas are the culprit. And promptly stopped giving them to her.

But when we met with the dietician yesterday, she was puzzled by Caroline's behavior. She reviewed the list of solid foods Caroline had been eating and said that they were all pretty 'safe' foods that don't usually cause problems. I mentioned that the bananas seemed to cause problems...even with only one small 3 ounce serving per day of bananas for a few days, she became extremely constipated and didn't poop for 4 days afterwards! I told her I'd even given Caroline 2 doses per day on Sunday and Monday of Lactalose to help her poop, and she still didn't poop until Tuesday! Bad bananas! But the dietician said bananas don't cause constipation like that, and that it was concerning that 4 doses of Lactalose still didn't produce a good bowel movement. Most people will have loose stools/diarrhea when given Lactalose.

She said Caroline should be eating 32 ounces per day of formula, IN ADDITION to the solid foods. I scoffed and said on a good day we're lucky if she'll take 24 ounces. Sometimes, like Saturday, she'll only take 13 or 15. Clearly this is not acceptable...she should be eating more, and we need answers as to why she's not eating. She advised me to keep pressing our GI to get to the bottom of this issue and told me to keep trusting my mommy instincts. I'm losing faith in our GI...I feel like he's never really paid attention to Caroline's milk allergy and is always quick to focus on the reflux. His methodology is incredibly slow and frustrating...it's always 'try this and and I'll see you in 4 weeks.' We went through this slow process for 2 months last spring before I finally got aggravated and tired of waiting and took matters into my own hands and put her on Elecare, at which point she got better. So I'm not willing to wait for another painstakingly slow process of trial-and-error while this drags on for several more months. It's already been almost 3 months of this now.

So we're still muddling through, and if I don't get answers soon I will consider switching GI's. The dietician went through a very similar situation with her own son who was not eating, and the doctors just wanted to put him on tube feeding...totally treating the symptom, not the cause. She had to keep yelling and screaming until they found a doctor who got to the root of the problem and helped her son. I took her GI's name and will contact him soon if this isn't resolved quickly!