Sunday, March 29, 2009

Long Winter

Mallorie's had a rough winter season, with some respiratory stuff, and now some gastrointestinal thing, but she seems to be coming out of it.

I probably definitely bring her too late to be seen by her pediatrician when she gets sick. Believe me, this is NOT because I think I know how to handle everything, but more like I think I'm supposed to know. When I call the office for an appt, and they ask, "What's wrong?" (to write down the purpose for the visit), I stumble for words, wondering, if this is a time when I'm being silly. I should and do know how to handle diarrhea and vomiting, by now. Clear liquids awhile. Slowly advance to more foods. Avoid lactose for a little while. Right? So I figure I will get to the office and hear, "Well, you know what to do."

Monday, when Mal got her last RSV immunization for the season, I wasn't surprised to learn her wt was down. It was 20.5 lbs, her usual low. I'd do a not-me and say I didn't start giving her soy protein, since about a week prior, I triggered some diarrhea and vomiting and diaper rash by giving some whey protein, but I'll just admit I did. Gave her whey, and yes, I know it's dairy and that she is allergic or something to dairy. And gave her soy protein because I was in a panic and realized she needed more calories than she was getting and more protein. Matthew had sat down with me one evening, and using the blenderized diet book and reading labels on jars of baby food, unintentionally made me see just how little she was getting each day, while I was appropriately giving her pedialyte when she wasn't tolerating milks.

Yes, I remember Dr. B's comment that she didn't necessarily have to gain weight, but she just didn't want her losing weight, because then she was moving in the wrong direction. Well, I swallowed all the responsibility for the weight-loss, and drew the straight line between Pedialyte (at 100 calories per liter vs milk at 100-ish calories per 5 oz) to weight loss, and decided to start adding things again. You don't even want to know all that Matthew and I decided she should have, but I bought a bunch of canned meats, Dinty Moore beef stew, and soy protein powder, and went a little hog wild with her diet, plus olive oil.

Took me a day to realize she was also running a fever, and since her tummy didn't take so well to the new diet, maybe the combination was that she had what Matthew and Jacob had had? Or maybe just moving too fast, again!

Took me another couple of days to realize that she look weak. And really felt pretty light. And when she got extra sleepy about mid-week, I called the pediatrician's office. Know this first: Dr. B is pretty popular, and you probably want to call the day before or early in the morning if you want to beat the throngs making their way to sit at her feet. So are her colleagues. So calling at 1:30pm is silly, but I was lucky enough to get an appt with one of them. Here's what I learned:

Her weight was down to 20 lbs, with her clothes on, and a big granny diaper. Poor baby can't have a working mom and wear all cloth diapers when she's having diarrhea, sorry. Especially when her mommy and daddy are up all night dealing with babies vomiting and having the kind of diarrhea diapers that cause rashes.

I lose the forest for looking at all the trees. Yes, I even knew this before, but apparently, knowing it doesn't prevent it! Dr. W smiled, and told me to step back a bit, look away from the trees, so I could see the forest. Then he walked me through the steps which I already knew, but had to shut my mouth and listen to ... because I really wasn't following the rules! She probably has some sort of stomach virus, so clear liquids till she can go 8 hours without vomiting (and he gave us fluid rates, since she was probably somewhat dehydrated, I loves me some numbers!). After 8 hours of no vomiting, we could drop the rate, and see if she could take some soy milk (doesn't have the lactose that breastmilk has), and work slowly, slowly moving beyond with the diet. He assured me that Mallorie, like any other baby, can go a little while without "proper nutrition." I cannot tell you how very badly I needed to hear someone tell me this. Another couple of trees for me .... I worry about protein intake whenever Mallorie gets her diaper rash and it won't heal, and about calories whenever I actually do a calorie count. I worry about her heart's VSD not closing, ever, because of inadequate nutrition. Heck, I worry a lot.

After all we've learned about Mallorie and soluble fiber, you probably won't believe I had already given her a whopping dose of oatmeal plus rice cereal the night before we brought her to see Dr. W. Thank God, she barfed the first time we tried that. And it's also good that when I spoke to Dr. B the next night, she told me giving her cereal when her gut was still messed up was rushing her too fast, because that meant she only got cereal the one time. Because last night she was screaming the cry we recognize from when I've done this before. We gave her lactulose and 2 enemas, and I've asked all the kids to remind me to put the cereal down the next time I get a bright idea that she can "take it" if she has watery poop. She can't.

Some things I've learned:

I don't need to wait till Mallorie is quite sick to bring her in to be seen by a pediatrician. Even if they do actually look at me funny, and tell us she's fine, it's OK.

I can't remember one other thing when I try to figure out calories, or protein, or some other detail. Pediatricians are good about helping someone like me with the whole picture.

I love Dr. W. And who knew he'd be so good at calming me down, considering Mallorie weighed in at 20 lbs, and mommy guilt oozed out of me in that moment of truth.

But I missed having Dr. B lay her gorgeous brown eyes on our baby.

Dr. B says it is always OK for me to bring Mallorie in for even minor illness. That it's what she's there for. And when I spilled out some of my crazy (how I worry over her VSD/protein intake/calories/what-have-you), she told me I could let her worry about her. And when I said, "So, OK, it's on you," she agreed. And here is a rough quote: "Yes, you are absolved of all responsibility, if you let me handle it." Apparently, by how light I felt at the end of that conversation, I was in need of a dose of absolution!

Dr. B is the queen.

And her colleagues also rock.

Mallorie is in some very competent hands.
Ignore the dates. These are from today. I couldn't figure it out in time to fix this, and am NOT going to try moving them from the camera to the computer, again. This was already over my head!

What Jacob says it takes to make Mallorie smile. As if he needed an excuse! :)


Cathy said...

I love the pictures. She looks great. I am glad you ditched the "not me" things. My learning disability can't take it. I hope things will be better.
Glad you found the time to share a post and a pic.

Tamara said...

So happy to hear she's feeling better. Love the flowers, although they aren't as cute as those little toesies peeking out from under her dress! Glad to see some of the stress lifted off your shoulders, I was worried about you.


May said...

hey there sweetie. Love looking at your big beautiful eyes again. hope your bum gets better.

Connie would a fundoplication help with Mal's puking? Seems to have worked wonders for Vera.

Finding Normal said...

Beautiful springy! Send that weather and some blooms my way, please!
Good for you for putting in on Dr. B. That's a lot to navigate alone, and as I like to say...that's why she gets paid the big bucks! Our ped tends to defer to our specialists, and I would like him to take a more active role. I know he reads the notes he receives about her care, but he also knows we have about 13 specialists to choose from when it comes to problems, and I don't think he wants to step on toes at the big bad Children's Hospital. Or something.
Anyway. Hope things are on the up-swing and that Mal will gain some weight. Addison lost a couple of weeks ago too when she was sick. Not that I know that officially, but her pants won't stay up, which isn't a good sign! :)

my3sons said...

She is just precious! Thanks for sharing the photos....

Laurie in Ca. said...

Here's my sweetie. She has really grown Connie and I just love that dress she is in. Too cute!! I am sorry winter has been so darned long for everyone with sick babies. I hope it is over and she can just enjoy spring and summer carefree. It is good to see you post. I have missed you a lot. I love you girl.

Love and Hugs, Laurie

The VW's said...

What cute pictures!!! Love them!

The responsibility of caring for our special little ones can be overwhelming! It can drive a momma mad! Try not to worry! She is in great hands!

Jessica mommy to Alex/ RTS said...

I love good doctors, and the picture of her holding Mallories hand is precious! Frame it!

Yes, Alex bolus feeds are just his peptamin, everything that is table food is by mouth, anytime I tried to put food in the tube, I clogged it. Im glad I dont have to worry about it, maybe you jsut cant with the mic-key????

Anonymous said...

Glad to hear she is doing better. Glad to hear that you are also learning to balance the "Mommy hat" and the "nurse hat"!

ANewKindOfPerfect said...

It is such a hard thing to balance the mommy and nurse business! I hope that you will take their advice and let them make these decisions for you. It's hard enough being the mom, without trying to be the doctor too.

We have a very specific diet that my Peanut gets through her g-tube. It's baby food, baby cereal, pedialyte, etc. It's all measured and the recipe is from her dietician.

Do you guys meet with a dietician? If not, can you?

I love giving my Peanut food through her tube. I love buying baby food jars. It just makes me feel more like a REAL mom. :)

And off that topic, I love love LOVE these pictures of Mallorie! Look at that beautiful smile and her pretty dress!! :) Thanks for sharing them.

Kim ( said...

I love the new pictures of your sweet angel Mallorie. She is precious! I pray for your forest sweet friend. You are such a wonderful Mommy to your family.
With love,

Anonymous said...

I love the pictures, she looks so pretty in pink.


brownblog said...

Thank you for your comment on my blog. Upon checking yours out I learned that we both have Mallories and Hannahs and my little one's middle name is Rose. Plus how sweet is the name Mallorie, I absolutely love it. Your kiddos are so sweet & you are such a strong Momma, hope everything is well with you and you have a wonderful Easter Weekend.

Anonymous said...

Cutest nose ever!