Sleep Time

Karsie got a PICC line in.  Dr. Suttner called us tonight and asked if she could try to put in a line in a deeper vein.  The vein she had to use was in her jugular, which is on the side of her neck.  In order to do this Karsie had to be sedated, which also meant she had to be intubated during the procedure.  It only took about 30 minutes and they got it in.  When we left Karsie still hadn't woken up, but she was breathing over the machine, so as soon as she wakes up tonight she will be extubated.  She had a long night so hopefully she is getting some needed sleep.  

On to day 2 filled with barium and GI studies.  We will probably be getting a call in the morning, since Dr. Saenz seems to like to work in the morning, about the study or the results.  From there we don't know where we go.  

Results Part I

Dr. Saenz just called.  The good news is that it still doesn't appear to be an obstruction, so surgery for that is probably not in the picture.  However, it did show lots of air/gas all the way through and the lining is thickened. So something is keeping it in there, but we're not sure why and they're trying to find out.  

The long term prognosis is unclear but tomorrow the studies continue.  Karsie will have an upper GI and the goal is to see what the anatomy is like.  Saenz thinks the problem is mechanical, so this may lead to some kind of tube going directly into the stomach.  It may be a lot of things, but until it gets fixed none of those things are good.  

Post CT Scan

Karsie is out of the scan.  We are out of the NICU now as they are doing a sterile procedure on her (PICC line).  Hopefully they can find a good vein and get it in.  

Good news:  They didn't have to intubate her.  That saves her poor little throat from having to deal with more issues other than the acid that has been hurting it by throwing up for so long.  

We should be getting a call at some point in the next couple hours to tell us that we can come back (in other words they either got the PICC line in or another line) and information on the CT scan.

CT Scan Underway

Karsie is getting her first test done now. The goal is to not have to intubate her, but they are giving her just enough medicine to put her asleep, so if she doesn't handle it they will have to intubate. The pictures will be ready within minutes, but when they get read is anyone's guess.

The next test may come later if the CT is inconclusive. That would be an upper GI where they put barium in her bowels and watch the flow.

Finally, they are going to put a central line in after the CT scan. If they can get a PICC line in they will do that, but if not they will call the PICU and have them do one.

More updates later...

Update

Just a quick update...
Last night around midnight Karsie had a tube (larger than her feeding tube) placed from her nose into her stomach to try to deflate the bowel and empty the stomach. That tube produced some pretty icky stuff. It was a yellow/brown fluid that looked like poop... possibly backing up into her stomach as a result of a blockage. Since the initial stuff came out, nothing else has come out of the tube.  Not good news.

 
Another concern last night was that her blood cell count was lower than normal.  Because it looks like she will be going through tests and many more pokes, she received a unit of blood which helped bring her red blood cell count up. She is also getting IV antibiotics. Last night her CRP (test that shows infection) was about 12 which is high and this morning it was down to about 8. This means she is reacting well to the antibiotics. Her white blood cell count came up (another sign of possible infection).

This afternoon she will be getting a CT scan to try to get some pictures of her abdomen.  This seems to be our best shot at determining whether she has an obstruction or not. Unfortunately, she will have to be sedated for this. She might also have to be intubated (put back on the ventilator). The intubation would only last as long as she is sedated. While sedated, she will also have a PICC line placed so it will hopefully be still enough for them to put in the line without blowing a vein. If the CT results are inconclusive, then she will have the GI study (a barium swallow and a barium enema) that tracks fluid through a series of x-rays to see if they can see any kind of blockage.  

Again we're torn on how to feel.  On one hand we hope that they find nothing and she is not obstructed.  However, that means there is something else wrong and this guessing is not fun. On the other hand if they find that it's a blockage, it's at least an answer to why this is happening, but it's a scary answer.  There's no real way to hope here other than wait and see and then hope for the best outcome from whatever is determined.  

You are loved Karsie.  Show us your fighting spirit yet again... 

Tests

It has been an incredibly stressful couple of days for us.  Karsie seemed to be doing fine on the formula mix.  Then she started to throw up.  Today she threw up literally every feeding.  All of it. She's not keeping anything down.  She lost a ton of weight and her white blood cell count skyrocketed which could be infection or just a sign of swelling.  So, again the scare of a bowel obstruction is in the picture.  

Tomorrow (today by the time anyone reads this) Karsie will undergo a series of tests.  We're not sure what tests they will run but they will be to determine if she has an obstruction.  The real kicker was when she threw up the final time before they cut her feeds entirely and it smelled awful.  Kevin thought it smelled like sulfur while Michelle and the nurses thought it smelled like poop.  That's a bad sign.  

She's being put on antibiotics again and probably going to get a blood transfusion.  She had an IV put into her head and probably going to get a PICC line (or try to put one in) put in sometime tonight or tomorrow.  This seems to be a much longer stay in the NICU than we anticipated.  We know it sounds redundant, but we are so emotionally beat up right now we're not sure how or what to feel.  It always seems to be something.  

Crying Over My Spilled Milk

The newest development in Karsie's care came about yesterday when the GI doctors came to visit. They had seen her once while she was out of the hospital and will continue to follow her. They decided to put her back on the erythromycin to help improve her bowel motility. They also talked about the possibility that Karsie might be having allergies to something in my breast milk. Babies aren't allergic to breast milk, but can have allergies to things the mother eats and passes into the breast milk. Since I have been pumping since July, and we use the oldest breast milk first, Karsie has been drinking milk from August/September. There is no way of knowing what is in the milk that might be causing her to spit up. If she was home and breast feeding, we would be able to play with the foods I eat and try to rule some things out. However, even if we were to take in fresh milk, the delay in feeding at the hospital as well as the charting burden this would create, we would be hard pressed to be able to play with the breast milk in the same way. Therefore, Karsie will be placed on Elecare formula (hypo-allergenic, lactose free). She tolerated this formula when it was added to the breast milk, so it was the logical place to start. If she tolerates this without spitting up, then we can assume that she is allergic to something in my milk. If she continues to spit up, there are several other formula varieties to try. If she continues to spit up on all the different varieties, then we can assume that she is just a spitty baby and possibly return her to breast milk. Another option to be played with at some point is if Karsie needs higher calories in less volume. This can be done with either formula or a breast milk/formula combo.

All of this is a bit controversial. I have worked VERY hard to keep my milk supply up in hopes that someday Karsie might exclusively breastfeed. I also feel VERY strong about the benefits of breast milk, especially to a "gut" baby. However, I realize that the reality of Karsie's situation is there might be something that is better for her at this time. Don't get me wrong... I know that formula babies are just as happy and healthy as breastfed babies... and that in the long run, everything will work out... but this is the one thing I had complete control over. I read books about nursing and pumping and I was prepared for this. When Karsie was so sick and we couldn't do anything for her... I could pump and save my milk to heal her when she could take it. I have been blessed by a good supply of milk. I haven't had problems with pumping or storing my milk. Albeit, I hate pumping, but I have control over that.

I will continue to pump to keep up my supply in hopes that someday Karsie will be able to nurse again... I might spend some time staring into the giant freezer full of milk and crying... I might be "that" mother, the one that nurses her kid until she is old enough to ask for it, because I felt like I missed out on nursing in the beginning... I might end up having a giant freezer full of hard work to donate to someone else's sick baby... I might retire my rental pump sooner rather than later...

In the mean time... I am going to enjoy holding my baby and feeding her bottles of stinky formula.

Quick Update

Karsie's PICC failed again last night.  Her veins just keep blowing.  We hope that with the volumes she is on today and later that the PICC will not be as necessary, but it was the hope that the nutrition would help her make up for lost weight/nutrition.  We're pretty certain that when her peripheral IV goes then we're done with the IV's which actually could be a bad thing as she may need fluids and has no veins left (easy ones) to accept it. Let's hope she does not need any for a long time.

We should have another update later today when we come back from the hospital. 

Congratulations to our friends Ryan and Kerri for getting married today.  We are so sorry we are stuck here and cannot make it. We'll dress Karsie up fancy for you guys today.   

Poked

If there was a word to sum up Karsie's day today... it would be "poked."

Let me rewind and start from yesterday afternoon.
When we left in the afternoon, Karsie needed to get another IV (this makes #6 since being readmitted). We came back in the evening and she had the IV and was getting a really low dose of TPN and lipids. We felt pretty good about the extra fluids and calories. Karsie ate like a champ yesterday and last night and today. She has handled her feeds fairly well with her usual occasional sit-ups. Today the doctor called and wanted to put in a PICC line (an IV that goes into a central vein). This way Karsie wouldn't have to have a new IV every other day. A PICC line is also ideal for TPN because the TPN itself can cause tissue damage if it leaks out of the IV, therefore a central line is better. Getting a PICC is a sterile procedure, so we stayed until the ladies found some good veins to try for the PICC and then we said goodbye. A little later, we got a call saying that after 4 tries, the ladies couldn't place a PICC and were not going to try any more. We got in to see Karsie this evening and she has a new little bald spot on her head and 4 different bruises from the attempts... and no PICC. While we were visiting, the nurse was concerned about the IV that she had in her arm, and so the nurse practitioner was going to try for another PICC line in her leg. We are hopeful that this one will work as Karsie is running out of good veins for IV's and we don't want her to be poked anymore than really necessary.
Tonight at midnight, her volume goes up to 60mL every three hours and we are hoping she will continue to handle her feeds with minimal spit-ups.

The TPN has given Karsie a little boost in energy and the nurses would agree that her personality is back to her normal NICU-self (still different than her home-self).

We Have a Plan

Kudos go to Tammy, our nurse practitioner today.  We understand that everyone tries to keep us involved with planning, but Tammy really sat down and took a good chunk of time to hash out a plan for Karsie and for that we are incredibly appreciative.  The key now is that this plan is either kept or we are involved in changes as they need to be made.

Problems:  Karsie is now not handling her full feedings as she has been off of it for so long.  Dr. Saenz continues to be doubtful that it is an obstruction, so now our goal is to work on feeding and growing.  However, Karsie is not doing as well as she was doing at home.  She is tired and defeated.  Also, she is not gaining weight and is, in fact, losing quite a bit of weight.  This problem is a downward spiral.  She needs to eat to gain weight, but she can't eat because she can't tolerate her feeds, which makes her tired and then causes her to lose weight.  

Solutions:  Our plan is to start her taking 50 mL of breast milk every 3 hours.  She did not eat enough when she was able to take it on her own, so we are going to have to use her feeding tube, which hopefully will increase her weight/stamina and cause her to eat more orally which will get her to eventually take the tube out.  We have a little leeway to play with during her 3 hours.  If she is hungry the nurses (or we) will feed her orally until she is done as long as she gets at least 50 within the 3 hour time limit.  We also are slowing down the rate that she is fed by tube since she tends to throw up on the tube.  The plan is to give her a chance to feed orally every feed.  What she doesn't take will be given to her by the tube.  If she takes over half they will give her a small break and tube feed the rest over the hour's time.  If she takes less than half they will immediately put her on tube feeding over the hour.  This way she is not overworked during that time and her body has time to digest without getting pummeled with food.  This hopefully will get her to a point where she tolerates bigger volumes.  Finally, the plan is to increase her volume by 5 mL every 24 hours.  With no hiccups this will take approximately 4 days to get to full feedings again.  We then will start to think about adding in the extra fortifiers as she needs extra calories to continue growing that skin of hers on her belly.  We could be in for a while longer, but this definitely beats surgery.  

The final part of the plan that we really like is that it is written in the orders to contact us before any huge changes are made.  We're not sure how this will be delivered and followed through on, but we feel our opinion is at least being taken seriously for the time being.  That's all we ask.  Thank you Tammy...

Update

When we left the NICU yesterday, we were fairly convinced Karsie had/has a bowel obstruction. This morning, we spoke with the Nurse Practitioner and she said Dr. Saenz still doesn't think it's a bowel obstruction as she is pooping still and other signs are not pointing to it.  However, they are still not ruling it out.  After a lot of discussion today among the doctors and nurses (none of which included us) we have yet a new "plan" that we actually like but we are a little nervous as to how it will be run.

Today Karsie has been put on an "ad lib" plan for feeding. She is allowed to take as much as she likes every 2-3 hours as long as she meets a minimum for her weight.  The nurses and doctors are convinced (and so are we) that Karsie self-regulates her need for food.  In other words, when she stops wanting food, she lets us know and forcing her to eat much more than that could make her throw up.  The hope is that she will self regulate and get to a volume that allows her to grow but doesn't overfill her little belly. So they put her on a system where Karsie calls the shots.  When she is hungry, within 2-3 hours of her last feed, they will feed her until she doesn't want food anymore.  It's very similar to what normal babies do, just keeping very close tabs on it.  This doesn't yet solve any problems if it's an obstruction, so we believe they are treating it as if it is not and calling the emesis (throwing up) Karsie not being able to handle full feeds the way we were giving it to her.  Thus the switch in plans.  So far today, she has done very well with this new plan. Her feeding has gone as follows:
12pm- 38mL
2pm- 32mL
4pm- 31mL
6pm- 55mL
8:30pm- 37mL

She has to get to 180mL every 12 hours. She has met the goal for the first 12 hours already (she is one feeding away from her first 12 hours and already hit the quota).  They give her this "minimum" quota to meet as anything less would dehydrate her. We are a little nervous about the night shift as she is a good sleeper, and if she isn't sufficiently awake, she likely will not eat as much. However, the last time she was on 1/2 feeds (35mL) she ate every 3 hours by mouth just fine.

 
She is not on TPN yet (the nutrition that is good for her but hurts her liver after a while), and as of right now she doesn't have an IV. She had an infiltration on this one (which makes #5 IV that she has lost since last Sunday).  This is where basically the small vein can't handle the pressure of the IV and it starts to go elsewhere causing it to puff up the skin.  She also doesn't have her NG feeding tube, so she cannot be lazy about eating! We are hopeful the doctors will give her a couple days on this plan so she realizes she has to eat by mouth and cannot rely on the tube.  We don't want them to go with this plan and then freak out over a little setback when they have been changing the plan so much lately.

 
Her belly x-ray was less gassy today than yesterdays, but still semi-gassy. Which basically tells us nil. She always has had some gas but because everything is all jumbled together in her belly, there is no telling how it should be normally. 

We are hopeful that this plan will allow Karsie to eat like a normal baby and she will get as much as she needs at a pace that is good for her. And we are hopeful that this will work and she will get to come home without a tube and eating everything by mouth (which would mean more sleep for us)!!

The Pendulum Swing is Killing Us!

We were less than 24 hours from taking Karsie home and then she took a pretty big step back. Kevin was holding her and she started to throw up.  While she is a pretty spitty baby, this spit up was pretty dark yellow, a sign of possible obstruction.  They did another x-ray and it came back a little worse than the other x-rays taken.  

At this point she has been backed off to 50% feeds, an order by Dr. Saenz, and they are going to give her a chance to fix it on her own.  Dr. Saenz is coming in tomorrow to take a good look at her and write out a plan.  We're sure that they are going to exhaust every option before surgery, but to be honest, we're thinking that surgery is on the horizon for Karsie.  

They are going to be putting her back on the TPN and fat tomorrow because it's been a long time since she has gotten her full feeding, so she's not growing.  They are probably going to be doing some extra tests to see what exactly is going on.  

This is very upsetting to us as she was doing so well lately and it is very possible that we are going to have to start all over again.  We hope that she can correct it on her own, but we're not counting on it.  We're so exhausted with all of this and feel like we're being pulled in so many emotional directions that it's starting to take a toll on us.  So again we return to the prayer well and ask for more.

Catching Up!

Sorry we've been out of commission for a few days.  It's been an incredibly busy time for us. We had a fun time with Karsie on Halloween.  But she was one angry cow during picture time in the NICU.  We had to shove her arm into one of her sleeves as her IV was in the way (we made it work).  She is pretty grumpy not being at home, which we kind of enjoy.  However, she was REALLY grumpy Halloween.  Many nurses came by to look at her costume, and even though we didn't get a good picture of her being happy, she did have a long time where she was content.  

Yesterday we celebrated Michelle's birthday by taking a day off and going to Disneyland.  We visited Karsie at 6 a.m. and returned to the NICU at 10 p.m. just in time to see her sleep both times.  Since Michelle gets a free day at Disneyland on her birthday, we took advantage; plus with our friend Dave having the same birthday, it led to a good day of everyone in the park saying "Happy Birthday" every 5 minutes.  It was exhausting, but very fun.  So, we didn't get to update you guys for a while, but we're back now.

Karsie:  She has been doing fantastic!  The plan is still to be out of there sometime Tuesday, but incredibly we're still not sure what the plan is even though we've asked.  There are some details that are a little confusing.  She has not thrown up at all as of 5:30 this morning.  We're not sure about after that.  She has been on 100% of her feeding since midnight last night, so we assume that midnight tonight they will increase her calories to 22 with rice cereal.  That should get us finished by Tuesday at noon; unless they want to observe her for 12 more hours, which would put us at midnight, which would mean they would extend our fun little stay until Wednesday. The other thing Karsie has been doing is eating orally almost all of her feeds.  She is pretty tired from midnight to 6 a.m. (who isn't) so she usually has to be fed through a tube at that point, but every other feeding she has been eating all of it.  Hopefully this continues with her 100% feedings so we can get that tube out soon.  We should have a vision of how she is doing and how she will do later on tonight.  We hope to have some pictures of her coming home....again.

Same Ol' Same ol'

Not much is happening with Karsie except being in the NICU longer and longer and longer.  They changed her plan to go slower with her increased feeding.  She will be on a full day of pedialyte, a full day with 18 mL of breast milk, a full day of 35 mL of breast milk, a full day of 53 mL of breast milk, and finally a full day of 70 mL of breast milk.  This is a full day of 25, 50, 75 and 100% of her total feeding respectively.  

We're kind of puzzled as to why this plan is all of a sudden slower than the other plan because the only thing that has happened between the two plans was her brown residual, which they have told us is not a concern at this point.  So we're not sure how going slower is going to help them decide what problem that brown stuff could be a sign of especially if they are no longer checking for it. And if they do think it's a problem we're not sure why they are not telling us and not looking for it anymore.  I think we're just a little frustrated that we're going back to having the same issues we were having before with communication.

If you're keeping score this new plan will keep her there until at least Tuesday.

Afternoon Update (10-29)

No one seems to terribly concerned with the brown residual but it did keep Karsie from coming home tomorrow. They started her back up on pedialyte and we will start this process all over. It was good that they stopped it, but the surgeon said that she needs to keep her bowel functioning. Unless she throws up more than her normal she will come home when they get her to full feeds, which at this point looks like Sunday or Monday. The brown residual was probably dried blood which may have come from putting in her ng tube that night or from something else, but she continues to poop which means things are going through. I guess we just wait and see...

NICU Stay Extended

We were about a day away from bringing Karsie home when we got a call from one of her nurse practitioners saying that they were pulling up brown residuals from her stomach.  We're not sure what this means and what the residuals are, but they stopped the feeding.  We're not sure if they have a plan, but we will have to go through the introducing food to Karsie all over again once they figure out what's going on.  We of course understand the need to stop feeding, but we were so close to having her back and, to be honest, this is really starting to wear on us.  We are going to wait for our surgeon who may or may not be in today to talk to us about the plan, but for now we just have to be patient which is not something we are good at in such an uncomfortable environment.  We should know more later on today.  

Tuesday News

This morning Karsie had another abdominal x-ray taken and the results were similar to the last 2. She still has gas in her bowels, but there is nothing that jumps out at the doctors as a concern.
Her labs from yesterday looked good. The labs that were pointing towards infection are coming down and if they continue to come down today the antibiotics will be stopped tomorrow.
Today Karsie got started back on feeds. She was at 70mL feeds at home... so to ease her back into it, she is starting with 18mL of pedialyte. Then if she tolerates that for 24 hours, she will go to 35mL of breastmilk. If she tolerates that for 24 hours then she will go back to full feeds. This puts us at Friday afternoon as the earliest discharge. We were hoping for sooner, but we want Karsie to be eating well when she comes home again. At 12pm today, Karsie ate all 18mL of the pedialyte and was ready to keep going. Maybe this will be the boost she needed to get her eating by mouth?!?!?
Another test that was run upon admission to Children's, was the liver function tests (to check her biliruben levels). The good news is that she was bringing those down too. Hopefully after a bit more of the medicine for that, her numbers will be all the way down!
So now, we are waiting for her to eat and digest everything... praying for no spit-ups and good poops and a big eater! Hopefully this stay will come to an end very soon!

Quick Update

Still a lot of unknowns but Karsie is still doing well. She is being treated for a possible infection as some of her lab work is suspicious for that, but they won't be sure until about a day or so when the cultures have been grown.

Dr. Saenz came by and looked at her. He said everything by sight still looks real good. She had an xray done to see more but they couldn't find anything conclusive on that so they sheduled another one tomorrow morning without her dressing on to see if they could see more. She still had a poop today which is still very good news.

The plan is to continue draining her bowel and start her on feeds tomorrow at some time. The feeling from everyone, assuming she doesn't have an obstruction, is that she had a bug (or small infection) and she should be out in a few days. That's our hope too.

Karsie is still acting like Karsie. Mad as heck she is not eating, but still consolable and happy.

Our Family Minus One

Kevin and Michelle are now home following an exhausting day at the NICU.  Like good ol' NICU fashion the current plan is "we'll watch her and go from there."  Well, we've been told more than that, but that quote did come from someone tonight.  

At this point there is reason to be optimistic.  She had been pooping, which still could mean an obstruction if it occurs in the upper part of the intestines and she is just cleaning out the lower part.  She is not producing the green bile, which means food is passing through.  Also, she is not continuing to vomit after we stopped feeding her.  There is still a good possibility that there is an obstruction, but it seems that if there is it is small and we caught it right away.  

Dr. Saenz wants her there for at least 12 hours to monitor her.  They are deflating her stomach and bowels to give them a rest.  Hopefully during that time (tonight) the bowels will work out the problem on their own.  After that the goal is to "wake up" the bowels again by introducing the feeding.  We were told by one doctor that this process will not be nearly as long as before and hopefully she will be eating and out of there within a couple of days.  

Pinky note:  There is a considerable change in the shape of Karsie's omphalocele.  The best way we can describe it is Mt. St. Helens.  Think of the mountain before it blew up verses after. Pinky looks like the top of the mountain blew off and there's kind of a crater now.  When she breaths it goes up and down like loose skin.  This very well could be the sign that her intestines are moving back into her abdomen, which could be the "kink" in the bowels.  

We miss you Bug...

Surgeon Report

Dr. Saenz came by and asked a few questions and looked at her. He said that the bowel still feels real soft and her pooping is a real good sign, so there's hope for good news. However, as he would with any patient that had once had an abdominal defect, he is going to keep her for 12 hours or so and evaluate her. They are going to stick a bigger tube into her stomach and deflating everything. They will watch it for this time to see what's happening.

We're hoping that she just caught a small stomach virus that they will catch and clear up, which is a possibility Dr. Saenz brought up.

NICU Again

All signs are pointing to a possible bowel obstruction. The x-ray showed enough to be concerned with but we were told that the x-ray is one of the lower levels of sight, so it's possible it's not an obstruction.

However, Dr. Saenz, who happens to be on call, is seeing us and he's in surgery so we are being admitted to the NICU until they solve the problem and are able to fully evaluate her.

Waiting

Luckily we didn't have to wait in the waiting room with all the sick, flu-infested kids. They all seem to be interested in keeping Karsie away from possible germs. That being said we are still waiting.

We were called in to triage and then let back out. We then were called back and given an observation room (temporary room) and they ordered an x-ray. The first order of business is to rule out a bowel obstruction. Other than the throwing up there have been no signs of this, but nevertheless we are worried about that. That was the reason we went in today and didn't wait until tomorrow.

We're not sure what the next step is, but we figure there will be blood work involved (assuming there is no obstruction).

Back to the Hospital

Once again we covet prayers.  Karsie has not stopped spitting up today.  We don't think she has taken much if any of her feeds.  All of which have been by feeding tube today as she has been refusing any oral feeding.  She is starting to throw up without much in her stomach which causes the heaving.  She is very uncomfortable.  Normally we would feel real bad and wait it out, but since she has Pinky to deal with we are going into the Children's Hospital emergency room to check her out.  Hopefully we will have some answers soon.  She's just not right...

Long Days

It has been a rough couple of days for Karsie.  She has been spitting up more frequently and is a bit more uncomfortable than we have seen her.  We think her schedule changed a bit yesterday (Saturday) as she was completely zonked until the afternoon.  Then she behaved a bit like she usually does in the morning.  She also was awake much later last night than she usually is.  We're not sure why that is after having such a good day the day before, but we are trying to fix the schedule issue.

We have also noticed that her spitting up is more frequent when we feed her by the tube.  When she is hungry she eats quite well and she hardly ever spits up.  However, if she is not hungry then she does not take the food orally, which means we give her the rest by tube, and she frequently spits up.  We are on the cusp of calling the doctor just to play it safe.  We're not concerned with an obstruction yet as there are not many indicators other than the spit up, but we are pretty sure there is movement in the bowel/stomach area as the shape has changed just slightly.  It could also be moving back into her body which would create some discomfort.  

Hopefully Karsie will pull through this soon so she can get back to improving her eating so she doesn't have to be tube fed.   

Fat Update

Sorry it's taken a while to get this up.  It's been a long day.  A good day, but a long day.  

Karsie is still gaining.  She is now up to 7 lbs. 12 oz.  That's up almost 5 oz. in a week.  It's great growth for Karsie, but about average for a normal newborn.  Her skin is still taking her calories away, but we're thinking Pinky will be complete before too long now, so that should speed up the process.  The rest of the doctor's appointment went well.  We go back in two weeks.

Eating is still going well.  We have noticed that she is eating much better by mouth at night. She had averaged in the 30's orally until her 6:00 p.m. feeding today.  She ate 72 and 60 at 6 and 9. She also loves eating by breast much more than the bottle.  She took 54 and 72 during her two breast feedings today.  We would do them all by breast but she needs the extra calories until her skin heals and she grows with only the breast.  

Not an area of concern, but an area to watch.  Her poop has slowed down a bit.  Yesterday she had 2 stools and today she has only had one.  Granted, that one was a doozy, but it's below her average.  This is probably not a big deal and might even be good as it shows she is using her calories and not flushing them out, but it's just a change we're watching.