Surgery Day!

Short version:  Bonnie's surgery went well, and she is now the proud owner of a G tube.  She is also sporting a Nissen fundoplication (not sure if this is something one can "sport", but whatever).  

Long version:  At 3:00 a.m. today, I noted with glee that this would be Bonnie's last feeding via NG tube.  At 7:00 a.m., she got some Pedialyte through her NG, but since it wasn't formula, I'm sticking with my glee from 3 a.m.

We got to the hospital at 10:00 a.m. for surgery scheduled at noon.  They gave Bonnie a baby-sized yellow hospital gown to wear.  It was really cute, but it came off about five minutes later because the pre-op area was about 86 degrees, and chick gets hot really easily.

Bonnie and the yellow gown.  And maybe a gang sign.  We'll have to have a chat about that. 

Dr. Surgeon came to talk to us about his plans.  He said he'd been doing a lot of thinking today about what would be best for Bonnie.  Asked if her reflux seemed to still be bothering her (yes) and if she was still throwing up (yes--averaging 7-8 times/day lately, which is actually an improvement).  He said it's a little difficult to justify doing a Nissen (the anti-reflux procedure) when the baby is gaining weight, but that he believed it would make Bonnie feel a lot better and improve her quality of life.  The plan was to for sure do the G tube, and try to do it laparoscopically.  He would try to do the Nissen laparoscopically as well.  If he had to open her up to do the G tube, he'd go ahead and do the Nissen that way, but he wasn't going to open her up *just* to do the Nissen (though he offered to).  Got all that?

Right at noon, Mr. Anesthesia Guy came and toted Bonnie off.  He was a nice guy, and she seemed happy to go with him, so this part actually wasn't as traumatic as it could have been.

The first update was about an hour into the procedure.  All is going well.

Another hour later.  All is going well, still working on the Nissen.  We are "awhile" from being done.

Two hours after that.  The Nissen is done!  Now working on the G tube.

Half an hour later.  Dr. Surgeon comes out.  He looks exhausted.  Like perhaps my four month old daughter beat him up.  (He actually has what I believe to be a good healthy fear of Bonnie, from back in her NICU days when you better not mess with her too much or she'll pull some crazy stunt.  Prior to surgery today he said something about "treating her with respect."  Thaaaat's right.)  Anyway, I give him a lot of credit because he was not going to let her screwy anatomy defeat him.  The phrase, "it took me an hour to find her stomach" was uttered.  This wasn't a straightforward procedure.  Bonnie didn't make it easy on him (wouldn't have expected any less), but I'm grateful for a skilled surgeon who knew what to do with her.

After some serious miscommunication--which I would continue to be upset about it if would accomplish anything--we were finally (*finally*) reunited with Bonnie in the PICU (pediatric ICU).  She was asleep-ish, but squirmy and grimace-y and not very comfortable.  That's what happens when your guts are shuffled around for five hours, I guess.  She got a dose of morphine to help with the pain, which seemed to help quite a bit.  Despite all the tubes and wires, she looked beautiful.  See below for photographic evidence :)  We left a couple hours later, since we can't spend the night in the PICU.

Assuming no drama tonight, she'll move to a regular room tomorrow.  There's a possibility of going home on Thursday (in two days), but we shall see.

Thanks everybody for your prayers.  This surgery was at least as nerve-wracking as her hernia repair, maybe more so--probably because it took three times as long.  We are so grateful to God for giving us this precious baby and for continuing to hold her in His hand.  We love you, Bonnie.

And now, picture time!  These first few are from the night before surgery.

Here's one from this morning after her bath.  I was so excited to get that NG tube off her face!

And now, pictures from PICU (after surgery).

Pretty girl.

Snuggling with her blanket

Heading back to Charleston!

Just a quick update to let y'all know we're heading back to Charleston tomorrow for Bonnie's G tube surgery.  This will replace (what I've come to know as) that super annoying NG tube.  We had really high hopes that she would miraculously learn to eat by mouth once we left the NICU, but alas, that has not happened.  I'm convinced that at least part of the problem is that her formula tastes like poison.  She's on Neocate, which is what's known as an "elemental" formula because it's super super broken down.  Really.  If you read the ingredients, it goes like this: some form of carbohydrate, some form of fat, (then the biochemistry lesson begins) arginine, alanine, isoleucine, valine, etc etc etc.  Yeah.  Individual amino acids.  How could that possibly taste good?  Turns out it doesn't. (And if you remember this post about how I licked my child to find out if she was salty, it shouldn't surprise you that I tasted it.)  I feel sorry for Bonnie that that's her option of something to eat.  Poor gal.  So yeah, in addition to her gagging and weak suck, she is absolutely not a fan of Neocate.  All that to say, the G tube has become a necessity.  Much safer, more stable, less obvious.  The downside is that it requires surgery, which is what's happening on Tuesday.  

We would love it if you would pray with us for a safe and successful surgery.  Now that Bonnie's been home for a month, the thought of her going back to the hospital and having all the hospital "stuff" going on again (IV, pain meds, monitors) doesn't excite me.  

Here are a couple recent pictures :)

My sweet little nugget.

Heading to school on a rainy day.

Henry giving Bonnie a kiss.  They love each other.

Update from the home front.

Many apologies for not updating sooner to let you all know that we did indeed make it home (two weeks ago!?).  It is seriously crazy with two kids at home. I don't know how people do it.  Anyway.  Bonnie got discharged from the hospital two weeks ago today (still with the Thursday theme), just one day shy of her 3 month birthday.  I'd love to tell you that it was a great and magical day, and it was, but it was also really stressful and overwhelming--we had been living away from home for 3 months, so in addition to bringing a new baby home, we were essentially moving across the state.  It was a wild day.

So. Since we've been home, we've been getting to know Bonnie and her schedule.  Turns out she's a really good sleeper.  I have to get up 4-6 times a night (to turn her feeding pump on and then off an hour later, every three hours), but she sleeps pretty well through the night.

Except when her belly hurts.  Which seems to be quite a bit.  On her third day home I started keeping a log of her spitting up/vomiting and how it related to her feeding times, calorie content of her formula, etc. (I never claimed I wasn't a nerd.) After a couple days of feeling like we were torturing her every time we started one of her feedings (via NG tube), Jonathan and I pretty well lost our minds and called the surgeon to ask for an earlier appointment.  The original plan had been to work on feeding by mouth for the month of September, and then get a G tube if she couldn't kick the NG habit by then.  Well.  She's throwing up so much, and so gaggy and refluxy in general, that we're hardly able to work on oral feeding.  She's pretty unlikely to make her deadline, so we want to go ahead and get the surgery over with.

We bumped up her consult with the surgeon and had that appointment today.  In addition to talking about getting a G tube, we discussed an anti-reflux procedure called a Nissen fundoplication.  Reflux is annoying at best, but for Bonnie, it could be really dangerous.  With her paralyzed vocal cord (which is probably-but-possibly-not mostly better since her cry is decently loud), she's more likely to aspirate formula into her lungs, which could cause pneumonia.  Since her lungs aren't the best, pneumonia could easily land her in the hospital.  Also, since she's throwing up so much, she's not getting all the calories she needs.  For a girl who has spent a good chunk of her life not gaining weight, she has some catching up to do and needs all the calories she can get.  (The good news is that she's up a full pound since she was discharged two weeks ago. Yay Bonnie!)

For anyone interested, she's already on a couple reflux medications.  She's been on Prilosec for a few weeks now, which helps with her stomach pH (i.e. acidity).  I feel like the Prilosec is doing what it's supposed to do, so when she refluxes it doesn't *hurt*.  But she still feels it come up and it bothers her.  Once we got home, her pediatrician decided to try her on Reglan, which helps the stomach empty faster so that there's less to throw up.  That actually seemed to help for about two days, but then the throwing up came back in full force. Sad.

So.  Surgery is scheduled for October 9th.  She will for sure get a G tube, but the Nissen is questionable.  The surgeon feels that it might be too difficult to do since Bonnie is still so little.  He said ideally, she'd be about 20+ pounds, and she's currently not quite 11 pounds.  Please pray that the surgery will go exactly as God would have it.  There are some potential complications to the Nissen which make me nervous, but potential complications of the constant throwing up aren't so great either.

Here are some pictures of Bonnie's last day in the NICU, as well as a few from our first days at home.

Our favorite neonatologist (Dr. Jenkins!).  She took care of Bonnie while she was on ECMO, and she was back on service for Bonnie's last two weeks.

Bonnie and Karlayne, one of her wonderful primary nurses. We love her! 

Bonnie and Joan--ECMO nurse extraordinaire.  We love her too!

Bonnie and Courtenay, another one of her awesome primaries.

Not so sure about her carseat.

Loading her up in the car.  As soon as we took her outside (for the first time ever in her life) she fell asleep.  We were holding up traffic here getting this shot, but whatever.  Your baby only comes home from the NICU once.

Stopped at a gas station on the way home and took a little break from the carseat.

Henry is the sweetest big brother.  We've had a lot of this sort of thing since we got home.  He's leaning in to kiss her.

At home in her swing.

Big brother Henry on game day.  Seriously, could he be any cuter??

Last night in Charleston

As of now, we're still on for going home tomorrow.  Bonnie still isn't gaining weight very well, but we're going to let her pediatrician (in *Greenville*, i.e. home) worry about that.  She's currently getting fed over an hour, every three hours.  They wanted her feeds compressed to 30 minutes before we left, but we're going to work on that at home too.  Bonnie's going home with an apnea and heart monitor to be used just while her feeding is going in, in case her NG tube misfires (i.e. ends up in her lungs instead of her stomach).  We're also taking home a feeding pump, which looks like this.  I got trained on the new equipment (monitor and pump) today, and it hit me how much stuff we're bringing into the house, and how much of a production it's going to be to feed her. Holy cow.  We'll get a routine down pretty quickly I'm sure, but I think the first few days are going to be a little insane.

Also, I'm trying to remember that when Bonnie's home, I am her *mother*, not her *nurse*.  The Helms house isn't turning into a hospital.  I plan on enjoying having my child home and not letting her medical needs overwhelm us.  And really, she's not *that* medically complex.  She doesn't eat, and she's on three medications.  That's totally manageable.

Bonnie had another echo yesterday, because they discontinued her sildenafil (Viagra!), which was started back in the dark days of ECMO to help with her pulmonary hypertension.  They wanted to see how her heart looked without the medicine.  Turns out, it looks *great*.  No evidence of pulmonary hypertension.  Miracle.  Pulmonary hypertension was her ticket to ECMO back in the day.  It's a beast.  And it is *gone*.  Praise God.  Also, they checked her urine yesterday and found that it had blood and protein in it.  This is likely a lingering effect of when she was in kidney failure, but we'll follow up with the pediatric nephrologist to keep an eye on it.

Things are likely to be kind of crazy for the next few days, but I will update with homecoming pictures when I can.  Until then, here are some cute pictures of Bonnie enjoying her pacifier (formerly a rare event, but becoming more common--which is a good sign for future eating endeavors!).  Please pray for an uneventful (3+ hour) trip home tomorrow and a smooth first night back on the home front.

Time to go.

Big news today. Big. Ready for it?  We. Are. Going. Home.  Next week! On Thursday!  (This is, of course, barring any major disasters such as failure to gain weight between now and then.)  

Here's how this all came to pass.  A couple days ago, we found out there was an opening in the Level 2 nursery (in Sick Baby Land, a Level 2 nursery is between the newborn nursery and the NICU, which is Level 3).  Bonnie's been a Level 2 baby for awhile now, even though she's been in the NICU the whole time.  She's not critically ill and doesn't even have an IV anymore.  Just learning to eat and get off some drugs.  Anyway, a space came open in Level 2 and there was some discussion about whether it would be a good idea to move Bonnie there.  I've never been there to see for myself, but I hear it's quieter and more roomy.  Indeed, there has been a lot of hustle and bustle in Bonnie's little corner of the unit lately, and the prospect of a quieter space was appealing.

So. That day we had a discussion with Dr. J (love her) about whether moving to Level 2 would be a good plan.  The sticking point was that if Bonnie ends up needing a G tube, she would likely have to go back to the NICU following that surgery (might still be on the ventilator for awhile post-op).  Going to Level 2, only to go back to NICU a few days later, didn't seem worth it.

So *then* we had a very long talk about going home with a G tube (requires surgery but more stable) versus an NG tube (no surgery but somewhat more risky).  I won't get into all of it, but Jonathan and I have pretty strong feelings about giving Bonnie a chance to learn to eat before we offer her up to the surgeon yet again.  Everyone agrees that babies do better at home than in the hospital, especially when they get to be a little older (like Bonnie) and are aware of everything going on around them.  It's overstimulating.  All kinds of alarms going off, people bustling all around, getting woken up and messed with *all day long*.  Anyway, we want to give her a fair shot at learning to eat, and we want her to do it in an optimal environment.

Dr. J called up the surgeon, and she must have caught him in a charitable mood, because he said that he'd be willing to send her home with either an NG or a G tube.  So what *that* meant was that if we went the NG route, the only thing standing between Bonnie and sweet sweet freedom was getting off her Ativan.  Well.  She's on track to have her last dose of Ativan tomorrow (Sunday) night.  Then they want to watch her for a couple days to make sure she does okay without it.  They also want to make sure she's gaining weight.

The long-term plan is to go home with the NG and give her the month of September to learn to eat by mouth.  If that doesn't happen, we'll come back to Charleston for a G tube.  Obviously I hope it doesn't come to that, but if it does, at least I'll know we gave her a chance.

The Bonnie update is that she's still not interested in eating by mouth really at all.  In fact, the past couple times we've tried, she gets *really* ticked off about it.  We're giving her a break for a couple days to reset and will try again on Monday.  She had another swallow study yesterday, which showed that she has gotten better about protecting her airway when she swallows.  Hopefully we'll be able to stop thickening her milk, because her speech therapists feels like that little bit of extra texture is contributing to her gagging, which then contributes to her not wanting to suck from a bottle.

I think I'm still in shock about going home in a few days.  I'm thrilled, but there is a *lot* to do between now and then.  We've been living three hours from home for close to three months now, so we have a lot to pack up.  Also a lot of follow up appointments to set up, training to receive, equipment to learn, etc.  Please pray for what's left of my mental and emotional faculties to get through these next few days.  And please pray that everything goes according to plan and that we can take our sweet girl home on Thursday.

Some pictures, of course:

I love this picture.  That's my dad holding her. 

Cuteness.

Yet more cuteness.

Sleepy girl rocking the leggings.

Up to no good.

Here's one for the occupational therapists in the crowd--she's figured out how to get her hands to her mouth.  Big deal for her future eating endeavors (desensitizing her gag reflex).

And a couple funny (to me) things, to be filed under "Time to Go."  Apart from my subjective feeling of losing my mind, here are two incidents which illustrate that we have been here long enough.  First, one of the unit secretaries had some sort of foot surgery when Bonnie was a few weeks old.  She's been out of work for quite awhile.  I saw her yesterday in the NICU and she said, "Why are you guys back?"  My response: "We're not *back*. We never left."  

Second, Jonathan and I were talking about maybe painting our TV room at home and were going back and forth on whether to paint the brick fireplace.  I'm going on and on about how once you paint over brick you can never go back (you know, because now there's paint on it).  He gives me a funny look and says, "Les. It's already painted. It's the same color as the walls."  

Me: "No it's not."  

Him: "It is. It's white."  

Me: "Noooo it's not."  

Him: <produces a picture of said brick fireplace which is indeed the same color as the walls, and has been since we moved in three years ago>  

Me: "Oh."  

Him: "You need to go home."

Time to eat, baby.

I haven't updated in the past few days because I've been pretty frustrated with the way things have been going with Bonnie.  I'm at the point where I feel like she's being held hostage in the hospital, and various random events and medical decisions are conspiring to keep her here forever. Like, "We want her to wake up and learn to eat, but *first* we're going to increase the dose of this medicine that makes her sleepy! Muahaha!"  Or, "We don't want her to gag because then she can't eat, but *first* we're going to take away one of her reflux medicines that was keeping her from gagging! HaHA!"  And the ever popular, "She needs to be hungry to eat, but we're going to keep her on continuous feeds for awhile so that her belly's never empty!"  I'm sure there is sound medical reasoning behind these decisions, I'm just not privy to it.  And from my perspective, it sometimes seems like a giant mess.

There's been lots of talk lately about possibly getting a g-tube if Bonnie can't learn to eat by mouth in the next couple weeks.  Honestly, it shouldn't be that big of a deal, but it's a big deal to me.  I don't want her to have another surgery.  I don't want some foreign object semi-permanently attached to her.  I want her to eat, and I want her to come home.  The other option for kids who can't or won't eat by mouth is a nasogastric tube (NG tube).  That's what she's got right now--just a teeny little tube that goes in through her nose and down to her stomach.  The problem with those is that they don't stay put very well.  If you're not careful, the tube ends up in a lung--dumping a bunch of milk or formula into a lung would clearly lead to disaster. Especially if you've only got one good(ish) lung to start with.  The powers that be don't like sending kids home with those because bad things can happen.  I do not want these bad things to happen, and I also don't want Bonnie to have a g-tube.  Therefore, she needs to learn to eat.

This learning to eat business is really tricky.  If you've never tried to feed a baby with an oral aversion, then lucky you.  Here's how it usually goes.  If she's awake and in a good mood, we start with a pacifier.  But you can't just pop it in her mouth like you could with a regular baby.  You have to rub it on her lip first to get her used to the idea.  You can try to put it in her mouth, but she has a pretty uncoordinated suck most of the time, so her tongue is all over the place.  If the pacifier hits the back of her tongue, she'll probably gag.  If she's having an especially gaggy day, she might spit up.  But lets say we get the pacifier going successfully.  We'll give her a minute or two to get the idea of sucking on something in her head.  Oh but wait, the goal here is actually to *consume* milk.  So then we need to get a bottle nipple in her mouth.  No matter how stealthily you switch out the pacifier for the bottle, she notices and doesn't appreciate it.  The bottle nipple is softer than the pacifier, for one thing.  Also, if you suck on the bottle, *milk* comes out.  That's all well and good, except that now there's liquid hitting the back of her throat.  Gag.  (And this is only if she actually decides to suck on the bottle.  Half the time she either chomps on it or rolls her tongue around it or just flat out refuses.)  If all the stars align, she'll take 10 cc of milk.  That's a third of an ounce.  That's the best she's ever done, and that was over three weeks ago.  For reference, "full feeds" would be about 80cc eight times a day.  So you see what we're up against. 

There are a few encouraging things on the eating front in the past day or so.  First, I think they've finally gotten her reflux medicine straightened out.  She's on Prilosec twice a day, and is a *much* happier baby now that that's on board.  She's also been less gaggy lately, probably partly because she's not so refluxy (technically she does still have reflux, it just doesn't burn and hurt as much).  Also, today I noticed she's really been interested in putting her hands in her mouth.  That's good because it will help her desensitize herself to oral stimulation.  Also good for self-soothing and whatnot.  Last, I got her to take 9cc of milk via the paci trainer today.  This is huge!  She hasn't done that in weeks!  The pacifier trainer is this cool little gadget that the occupational therapists rigged up for us.  On one end is a syringe with milk in it.  On the other end is a pacifier.  These are connected by a thin tube (same tube they use for NG tubes).  When using this device, Bonnie's got the pacifier in her mouth and I've got control of the syringe of milk.  I don't actually squirt milk into her mouth, but wait for her to suck hard enough to make the syringe move.  It's basically a really really slow flow nipple, and it helps her control the flow of milk better.  Anyway, I was so super proud of my girl that she caught on to this (for the third time...see this post and this one for why that is) today!

The paci trainer.  Cute, eh?

So, despite the above frustrations, I'm trying to remind myself to be grateful for where we are.  For one thing, I have a living, breathing (without oxygen!) baby girl that I will get to take home with me.  I pray that I never take that for granted.  Bonnie's hellish ECMO days seem like a lifetime ago, but we are so very blessed to have her still with us after all that.  Also, Bonnie's nurses are great and they love her.  I think the best gift you can give a parent is to love their child.  She often has visitors stopping by her bed to say hi and love on her.  

Please continue to pray for Bonnie's eating skills.  I know she'll figure it out eventually, but if "eventually" means 6 months from now, she'll probably go home with a g-tube.  Not the end of the world, but I'd rather not if we can help it.  

If you've read this far, I owe you some cute Bonnie (and bonus Henry) pictures.  Here you go!

Happy girl :)

What's so funny??
(Those shaved spots on the side of her head are where they were looking for a place to start an IV the other day.)

Onesie tie-dyed by aunt Ellen. So stylish.

I love this girl.

And this guy.

My handsome little buddy.

Various bits of drama.

Things got interesting after my last blog update.  And by "interesting" I mean Bonnie started throwing up again.  It only lasted a night, but her feeds were stopped (again), and they started her on TPN and lipids for nutrition.  Meanwhile, it got to be really hard to keep an IV in her.  Two nights ago her IV went bad and she ended up missing a dose of morphine because of it.  (She's still on morphine because she's *still* weaning off all her pain meds/sedation from when she was on ECMO.)  Because she's physically dependent on morphine, this did not go well.  Major freak out.  To keep that from happening again, the decision was made to put in a PICC line, which is an IV that goes in further and is more stable than a peripheral IV.  That was yesterday.

Since the second round of vomiting, they've been going up very slowly on her feeds.  Right now she's getting continuous feeds at 17cc/hour.  That's about 2/3 the total volume of milk she was getting before this recent craziness.  We also haven't been able to work on taking a bottle for about a week. Lost time. Super frustrating.

In other news, it has become apparent that Bonnie is having a lot of pain from acid reflux.  She'll be fast asleep and then start crying and get all sad-faced like she's hurting. They checked her gastric (stomach) pH several days ago and ended up increasing her dose of Zantac (which she's been on from day 1).  That may have helped some, but they checked her pH again today because she still seemed to be in pain.  It was around 2 and they like it to be at 5 (lower numbers=higher acidity=ouch), so they added some Prilosec.  Hopefully that'll help.

Also, with all the IV fluids and whatnot, Bonnie has gotten puffy over the last several days.  She's been gaining weight too quickly for it not to be water weight, and her lungs sounded wet.  Soooo to remedy this, she got a dose of Lasix today.  Over the next couple hours, she peed off almost 8 ounces of fluid.  I can't think of a clever analogy to illustrate how much that is, but trust me when I say it's a lot when you only weigh 9 pounds.

Here are some pictures from the past few days.

Henry in a tree.  He was looking at me and doing his "surprised face".

My little monkey.

I love this guy.

Please note the legwarmers.  This is Bonnie's Jane Fonda look.

Hmmm, does something look different?  Something missing, perhaps?

That's right!  No oxygen!

Chillin on an exercise ball with no oxygen.  Occupational therapy is cray-zay.

Zzz...

Please continue to pray for little Bonnie Bee.  She does seem to be feeling better the past couple days, but we really need to get going again on the eating and weaning.  She'll be eleven weeks old in two days.  Time to get on outta here.

Itsy bitsy update.

Just a quick update to let everybody know that Bonnie had a much better day today.  All her various tests yesterday came back normal and they started feeding her again through her NG tube today.  They stopped fortifying her milk (they'd been adding powdered formula to the breastmilk to increase calories so she'd gain weight), in case it was the formula making her sick.  Henry was allergic to milk protein as a baby so that's very possible.  Anyway, so far so good today with Bonnie--no throwing up, and she got some good rest.  Onward to bigger and better things.

#378 in the "Bonnie sleeping" series

And in other news, Bonnie's CDH buddy Parker got to go home today!  So excited for this little guy and his family.  God is good.

Belly issues.

CDH babies are notorious for having reflux.  Along with this often comes spitting up or throwing up, which Bonnie has had sporadically since they started feeding her (via NG tube).  It would be a little spit here and there, usually when she was upset about something.  She'd also get more spitty when her drugs were weaned because that can be a symptom of drug withdrawal.  Well, over the past 36 hours or so, the throwing up kicked into high gear.

Without getting too graphic about my child's GI issues, the summary is that overnight last night, she threw up after every feeding, in a projectile-ish fashion.  This was really not the news I wanted when we arrived at the NICU this morning.  She'd had a pretty dramatic throw-up event yesterday afternoon, after which she screamed hysterically until she finally conked out.  When we arrived this morning, they had just taken an x-ray to look for possible reherniation (and whatever else an x-ray might reveal) which could be causing this sudden onset of vomiting.  Good news=diaphragm is still intact.  Praise God.

So this morning I was holding my peacefully sleeping baby girl when out of *nowhere* she starts throwing up.  Again, in a borderline projectile fashion.  It was really pitiful, and it made her really upset.  Screaming, flailing...screaming.  I finally got her cleaned up and calmed down again, when The Surgery Resident came walking up.  (Apologies to any surgeons, future surgeons, and friends or relatives of surgeons in the crowd, but the surgery residents, as a rule, drive me nuts. Wait til your baby's in the hospital and you'll find out why.)  She was nice enough and asked lots of questions about what's been going on with Bonnie, trying to determine, I guess, if this was a problem that might require surgical intervention.  And/or to determine if it might be related to her previous hernia repair.  After the questioning came, "Do you mind if I look at her belly?"  Fine. So Bonnie got her belly poked and mashed, which woke her up and ticked her off.  Not two minutes later, Surgery Resident #2 (who Jonathan refers to alternately as "Jethro" and "The Man in Black"...because he was wearing all black, not because he bears any resemblance to Johnny Cash) walks up.  Again wants to poke her belly.  *Fine*.  Again with the screaming, ticked off baby.  Strong consideration given to answering, "Do you mind if I examine her belly?" with, "I'd rather you not, thanks."

After all the throwing up, little gal was getting dehydrated and needed to have an IV started to get some fluids.  There were also orders in place for an abdominal ultrasound to look for pyloric stenosis, and an upper GI to look for an obstruction.  And oh yeah, on top of (or because of) the throwing up, there are drug weaning and withdrawal issues going on. If you throw up your morphine or ativan, you're going to experience withdrawal symptoms because your body didn't absorb the drug...which is going to make you throw up (because vomiting can be a sign of withdrawal), which is going to make the withdrawal worse. And on and on.

At this point in the day, I was on the verge of losing it.  Watching my child scream in pain while there might be something very bad wrong with her was, frankly, terrible.  (For comparison, it was also terrible and scary having her on ECMO, but at least then she didn't appear to be *suffering*.)  To avert a nervous breakdown--because I'm not sure my insurance covers inpatient psychiatric care--Jonathan and I got the heck out of Dodge and went to lunch and ran some errands.  By the time we got back a couple hours later, the clouds had parted and all was right with the world.

Bonnie was peacefully sleeping, receiving refreshing fluids through her shiny new IV.  She had already had her abdominal ultrasound and upper GI, and preliminary results of those looked good.  It's still pretty unclear why she suddenly started vomiting every single feeding, but at least it doesn't appear to be anything anatomical that would require surgical correction.

Please pray for Bonnie's belly troubles and that she can start tolerating her milk.  They're going to try to resume her feeds tomorrow and see how she does.

Some pictures!  First one is from a couple days ago, but it's here because she's so flippin cute.

A couple days ago--hanging out with Momma.

Sleeping peacefully after this morning's ordeal.  By the way, look at those cheeks!

IV in her sweet little hand.

Ye Olde IV Pump.

Jonathan took Henry to the beach yesterday and they had a big ol' time:

Surveying his kingdom.

Playing in the sand.

Tasting the ocean. Mmmm, sanitary.

Artsy shot with the three Henrys.  Real Henry, Shadow Henry, and Reflection Henry.