Possilbe Breakthrough

We're still awaiting final word on whether Madeleine will be released from the hospital today. She's doing find-- the doctors just wanted to discuss amongst themselves and also wanted to review some data from her monitors before releasing us. They said there is a chance that they'll ask to keep her one more night-- just for observation.

Regardless, we think that we've learned a lot about Madeleine's health issues and are hopeful that we may have figured out a breakthrough solution. Here's our thinking:
- Madeleine's largest goal is still weight gain. As she gains weight all of her other issues should resolve themselves.
- The biggest inhibitor to weight gain is Madeleine's tachypnia (fast breathing) as this burns calories. Madeleine is always tachypnic and therefore, she isn't gaining weight as effectively as possible.
- There are three potential reasons for her tachypnia: heart problems, chronic lung problems, and other factors that affect the lungs. They don't think the heart is causing any problems as the surgery correction appears to be working great. It is possible that the lungs have some prematurity problems but alone, this doesn't seem to be enough to cause her constant tachypnia. Adding further credence to this belief is that Madeleine gets medical treatment for her breathing via a nebulizer every 4-6 hours. When the treatment is administered, it is reasonable to assume that the chronic lung symptoms would be relieved for at least a short amount of time. (If you're asthmatic and you use your inhaler, it calms your breathing down-- same line of thinking applies with Madeleine.) However, Madeleine doesn't appear to get much, if any, relief from her treatments. While we can't fully rule out chronic lung problems, it is increasingly likely to suspect other factors affecting the lungs. In Madeleine's case, it is entirely possible if not probable that her reflux is causing fluid to irritate the opening to her lungs. Additionally, the doctors believe that Madeleine has "micro-aspirations" that have leached into her lungs-- the likely culprits of her current bout with pneumonia.

So-- what does this all mean? Well, it means that it is possible that if we solve her reflux problems, her tachypnia will subside and she'll likely put on weight much faster. In other words, solving the reflux is potentially the way to break out of the vicious cycle of health issues she's fighting and could puth er on a fast track for growth.

Here's the current plan for solving the reflux:
- During the day, we are going to feed her three times: at 11AM, 2PM, and 5PM. We are going to give her a bottle for feeding and will let her take as much as she can for 30 minutes. At 8PM, we are going to add up the totals from the three feeds and then substract this amount from her full day amount of 490 cc's. We'll then add this remaining amount into a bag and will hook the bag up to a pump that will slowly feed Madeleine the remaining formula over a 12 hour period. By taking this approach and maintaining her dosages of prevasid and reglan, we're hoping to minimize the frequency and incidents of reflux. This is the approach we've taken for a day in the hospital and it already appears to be helping Madeleine's breathing relax. Its still too early to draw any significant conclusions but we're pretty hopeful.

In any case, that's pretty much everything for us. I'll report back once Madeleine gets released and will let you know how she's doing with this new feeding approach. We're going to have a low key weekend at home-- hoping that by taking it slower, Madeleine can benefit as well. Kirsten and I don't do a slow life pace very well-- we're hoping it isn't necessary for too long.

Take care,

Brent