Thursday, November 12, 2009

Poor Little Bug

Surgery is in Karsie's future. We had a bedside conference and with our surgeon, a neonatologist, a nurse practitioner, a nurse, and a social worker. Here is the basic outline of our conference:

Problems: Reflux... The doctors have decided that the problems with the emesis has to do with her reflux. When they took the barium pictures they saw an unusually large amount of reflux, which was more than they originally thought. The NICU often sees reflux get worse the older the child gets, so Karsie is losing lots of nutrition and could be losing more if nothing is done. Thickened bowel... This could be something as simple as her bowels are recovering from a virus, could be that she is just gassy, or could be something else that we don't know yet.

Solution: What was proposed to us was a procedure called fundoplication and a G-Tube. The surgery is where Dr. Saenz goes in and wraps Karsie's esophagus around the tear-shaped portion of the stomach creating a sphincter that basically makes it next to impossible for Karsie to throw up. They would then insert a G-Tube into her stomach which has an outlet sticking out for us to feed which bypasses the esophagus and goes directly into her stomach. If she had to throw up for other reasons other than reflux it would be released into the G-Tube somehow (we're not all sure how this all works yet). This would allow us to feed her continuously (instead of 70 mL every three hours we would feed her around 23 mL every hour). She used to throw up more when we did this, but we think this is due to the reflux as she was getting food continuously.

We feel like this could be a solution, but we're not thrilled about another surgery to stress through especially when the surgeon admits that this is a tricky surgery based on her anatomy. However, we are confident in our surgeon. We do not have a time yet because Dr. Saenz is looking at his schedule and will let us know when there is an opening.