Sometimes this last week I had to take off my glasses. Then I squished my eyes shut took two deep breaths and opened them again. Nope. It didn't go away. The white bare walls, the white board that says Welcome to Henson Tower RN: Jai Lee. I sigh and lay my head back against the smooth vinyl chair. My eyes close of their own will. Then I'm awake and for the small second of time it takes before I open my eyes I've had a bad dream. But I open my eyes and it's back, not a dream at all. The vinyl tiled floor, the huge crib, and my sick little girl with wires and I.V. line sticking out of her.
The first night Izabelle was exhausted from the poking and prodding of all the nurses and doctors. We had been admitted for a "overnight stay" just to get IV fluids in her and get her re hydrated. She had blood taken for tests, three tries for the IV, deep suctioning through the nose, and a catheter to check urine content. She didn't sleep, just cried in exhaustion, too tired to sleep, too tired to eat. The I.V. was in one foot and the oxygen monitor was on the other. She kicked both feet vigorously, then she would give up and sleep, only to awake five minutes later and kick again. Two days later she succeeded. She had sweat and kicked enough and kicked the IV line out. Luckily by then we didn't need it, by then we should have been home, but the doctors wanted us to stay so that we could get a swallow study done faster. Out patient- 1-3 months. In Patient 1-2 days.
Even though we were admitted for dehydration, they had done an X-ray to check on her clinically diagnosed pneumonia. It was in her upper right lung and was therefore probably aspiration caused. Thus the swallow study.
Tuesday morning I make sure to time her feedings so that she will be hungry but not too hungry at 1:30. She sleeps all morning, I have to wake her to feed her, she is still recovering. At 11 am right before I am going to feed her the Transportation team shows up. We need to take her now or we might have to wait until tomorrow. So they put my sweet baby on a stretcher attach lead wires, buckle her in and wheel her out. She is OK and looks around at everything watching everything go by. When we get to the downtown hospital, she starts to fuss, by now it's been an hour past her time to eat, and she has been awake for longer then she has in a while. We transfer her into a blue chair leaning slightly backwards and I am told that They can't mix the barium in to my milk, they already have it ready as it's own "formula". Hmmm, this is going to be difficult. Izy, doesn't like bottles much, but if she tastes the milk in them she will usually try to get it out. I had been counting on this one familiar thing to help her. They had a normal bottle, but she won't suck on it, so they try a haberman feeder, where they can push it out into her mouth. She gives one weak suck then the chalky barium came out and she was more then a bit upset. She turns her head to get away from it, but she is tired and weak and they keep forcing her to look forward. They try to get her to suck, but she just doesn't want it. So they put some in her mouth. It flows down her throat as she weakly cries. It sits there and sits there. Finally she swallows. Penetration. I hear them say. Try the nectar consistency. Penetration. She isn't making a bolus in her mouth, she says, she needs to pull it together into one spot to swallow. But my little girl doesn't want it, she doesn't want to eat this strange chalky liquid they keep forcing down her throat. And without some effort at eating, some sucking and suction to help her it isn't happening. Later I realize what it reminds me of. It reminds me of trying to drink from a sports bottle without touching it with your lips. The water pools at the back of your throat and then you make a huge sometimes painful effort to swallow with out breathing it in.
I express that "this isn't a fair trial, she doesn't eat like that." Well the lady says, what side does she like to eat on? The Left I say. OK, lets lean her to that side. We talk about ways to make it closer to what she is used to. Finally I take the nipple shield and put it on my hand. I run the syringe under it and give it to her. Success! She is sucking. Something familiar she thinks. But then she tastes the chalk. Ugh, not in here too! And then she gives up. She tunes out the world, closes her eyes and does a very weak comfort suck. She doesn't want food, I can tell from the suck that she doesn't, but they are telling me. Mom, you need to give her some more she isn't getting any. So I give her some and I hear the rapid fire Penetration. Penetration. Aspiration! Stop! Try the Nectar thickened. It doesn't help. Nothing is going to make this little girl swallow right at this moment. As soon as they stop the test her eyes close and light snoring is heard. So the recommendation is a feeding tube with very limited-therapy-only-feeding by mouth for my sweet sick, exhausted, confused little girl who can't handle different.
After going over this in great detail for the doctors and reiterating that we don't feel the test was fair we were blessed immensely by an understanding doctor. She looked me in the eye and said- No one is going to tell you to stop feeding your baby. What you guys decide to do is up to you, we are all here to help you, but ultimately the choice is yours. I'm surprised I didn't float out of my seat so great was the weight that came off of my shoulders. Tears sprang to my eyes and I knew that the Lord had answered my prayer for a doctor that had the spirit. I had had several people tell me that many times doctors will report parents to DFS for not getting a feeding tube after a swallow study that showed aspiration. After she said that I was able to think more objectively. We told her that we would need to think about it.
After prayer Joseph and I both feel that she should get a G-tube when she is healthy enough for surgery. We think that if we give her the bulk of her nutrition over night then we can work with her on getting stronger muscles to eat during the day. Right now we have to give her the food, and we can't make her work for it or she will loose weight. It will also help when she is sick. I don't think she aspirates typically, but I do think she does when she is sick or tired. I don't know for sure that these are the only or even the best reasons, I only know that this is the decision that gives us peace. I know that our dear little girl is even dearer to our Father in Heaven and she is in His hands.