Rachael took Jimmie in to see his Pediatrician Dr. S this morning. Justin is on his 24 hour shift and Rachael is completely overwhelmed and feeling "crazy"! So she came to my house to feed Jimmie beforehand and I ended up going with her because she was afraid he would throw up in the car. He didn't throw up in the car, he did one better. He performed magnificently for Dr. S. and threw up at least 4 times in front of him. Two of which were the horrible ones where his eyes bugged out, his head turned red while the rest of him went white and his arms and legs flailed crazily. Then the puke spurted out of his nose and mouth and when he could finally breathe- he screamed.
Dr. S. looked him over and except for the horrible refluxing and puking he looks great! He weighs 8 pounds 10 ounces! Doing all bottles with fortifier has really given Jimmie a much needed boost in his weight gain. His lungs sounded fine and most importantly he was satting in the mid to upper 90's.
However Dr. S. is concerned. He said what he saw Jimmie doing was starting to get scary. He's not turning blue, but Dr. S. said if you had him on monitors you would see his heart rate drop way down. He's definitely vegeling. Also Dr. S. thinks that he may be "micro-aspirating" and that is what is causing the retractions Rachael has noticed off and on in his breathing. This is NOT a scenario that should continue.
Dr. S. is pretty conservative and does not typically like to treat reflux. However he agreed it is definitely time to get aggressive with Jimmie. Rachael did start him on the Zantac yesterday though he only held down one dose. The new plan is he'll be dosed with Zantac 3 times a day and Rachael may add another drug the Dr. prescribed called Bethanechol that is supposed to move the milk through his GI track to his stomach faster. The Dr. also prescribed Prevacid to replace the Zantac if we are not seeing good results with that. From what we understand Prevacid is a more expensive and a more aggressive antacid than Zantac. Ellie- (our pharmasist in the family) please feel free to share what you know about these drugs. (-:
The cause of Jimmie's reflux is his prematurity and more specifically an inmature valve that doesn't function as it should. The antacid doesn't treat the reflux it just takes the burn (acid) out of it. The Bethanechol is what is supposed to help keep the Reflux from happening.
Rachael's facebook status posted last night says, "Rachael is feeling crazy!" Let me elaborate: Crazy in a bad way-- like insane. She has been filled with anxiety and fear about Jimmie's health and especially his breathing. She dreads the horrible traumatic feeding times that come every three hours around the clock. She feels like she should never put Jimmie down because he's much less likely to puke if he's held upright all the time. She also has to pump milk for him every 4 hours. Justin has to work. He helps as much as he can and is also completely tired of the struggle. We are all gonna help them as much as we can, but the burden is pretty big for them right now. They both remind each other they are dealing with this because Jimmie did survive his extreme prematurity. They are both unspeakably thankful for that, but they still fear for his life and his prognosis at times. Rachael has said if she were not so vigilant with her symptoms at 20 weeks (they could have easily been written off as not serious) she would have lost Jimmie. So she feels like she has to be extremely vigilant about every little thing. Pray that she can relax and trust God to guide her.
The truth is Jimmie is doing great! He is breathing without support, neurologically he is on track, he does take his feeds by mouth. The big picture is very encouraging, but what Rachael and Justin are going through right now is extremely exhausting and difficult. Rachael broke down this morning and just sobbed for Jimmie. He is such a fighter and he works so hard to eat and then to see him struggling and in pain is so hard.
Please pray that these drugs work! Dr. S. is pretty confident they will. If they don't, much more serious and invasive measures would have to be discussed. Also pray that all of the TKM Rachael is doing will help the reflux and also help with any side effects from the drugs.
Thank you for fighting for Jimmie, Rachael and Justin.