|Renal ultrasound...I really wish they would get these types of TVs in Cardiology!|
|She does great with the renal ultrasound!|
First was the renal ultrasound. Not much change since the last one...this is good news. Her right kidney grew a little (really good news). Her left one did not. She has bilateral cystic kidney disease...meaning both of her kidneys have cysts and do not function at 100%.
Next was nephrology...late as always. I know it is probably hard to make an appointment at the scheduled time, but just once I would like to have one at the scheduled time. Anyway, we weren't there for very long because everything stayed the same. Dr. Kwon wanted blood work, so that would be done in cardiology...we don't let anyone but John (he can stick anyone, anytime...and he is the BEST phlebotomist EVER).
|Lots of heart bags for the parents in the Cardiac ICU.|
Off to lunch...nothing exciting.
Cardiology the rest of the afternoon. And I mean...the rest of the afternoon. We managed to get home at 6pm...UGHHHH!!! Height...yeah, she is getting taller (that I knew), Sats...86, which is still great. Blood Pressure....98/46, they tell me this is good. Finally...WEIGHT...17 pounds 5 ounces...OUCHHHHH. I was so hoping for a better number. Praying, feeding, carrying her around...anything to get a few pounds on her before this appointment.
So...what does that mean. We got to meet with our favorite dietitian ever...Christina. She is wonderful and caring and loves Hope. She stressed that Hope needs about 1200 calories per day. WOW...that is a lot for my little peanut. If she gets 500-700 on a typical day I would be surprised. This is going to be so hard for us because she likes all the healthy foods...especially watermelon which has about zero calories. We have tried everything. We finally found these juices from Nestle which she likes. I am going to try really hard to get her to drink 2 a day. She usually only drinks ones, so another challenge. That will be over 500 calories just in juice. We also add Benecalorie to everything. 1.5 ounces packs 330 calories, but it is hard to use the whole thing, so she only goes through one of those every 2-3 days. This is going to change. I need to get 1-2 of those in her a day. With the typical food she eats, that should get us around 800-1200 calories a day.
I must say that this is the hardest thing I have ever gone through in my life. I never in a million years would think I would have a child that could not gain weight. I have struggled with weight all my life. It is so much easier to not have junk food in the house and lose weight than it is to try and get a toddler that does not want to eat to actually eat high calorie food.
So...here's the plan. We feed her like crazy. She has to go to the cardiology department at Medina Hospital on the 10th for her weigh in. Then...feed like crazy, limit activity, get her to sleep as much as possible, and weigh in on the 17th. If she gains weight all is good and we know that it is just a calorie issue and we have to make sure she gets in enough calories to gain weight. If she doesn't gain weight we have to go back downtown and have another discussion with Dr. Prieto. She is suggesting that if she is not gaining at that time that we put her in the hospital for 3 days and determine if it really is a calorie issue or if there is something else happening. It would also mean another g-tube discussion. We surprisingly did not talk much about a g-tube with this appointment. My feeling about the g-tube is that if Dr. Prieto has a problem with getting her ears pierced because it is elective, I feel the same about the g-tube.
Overall...I think the appointments went a little better than I expected. I knew we would have hard discussions on her weight. I am glad Jerry came with me because I really needed to have him hear the stress they have about her gaining weight. He realizes the importance and I am hoping it will get him to really enforce the issue a lot more. I don't want Hope in the hospital for weight issues. The next time I want her in the hospital is when she has her Fontan.
And now that discussion...Dr. Prieto and the cardiologists at the Clinic believe the best time to have the Fontan is between 3-5. They know that many places are performing them at 18-24 months, but they feel like there is not enough data to prove whether or not that is a good idea. It has not been happening that long (maybe 2-5 years at some places) and there is just not enough data to support the theory that earlier is better. That gives me some breathing room to get Hope to the biggest weight possible. Low weight is a major risk factor for the Fontan. Bigger kids do much better than ones that are little. Dr. Prieto is going to send me research papers and their own data showing this...because I really need to see it in writing.
|View of Cleveland from the parking garage...on our way home (finally)!|
So, that was our day. Very long, very draining. I was happy, sad, scared, and relieved. I went through the whole roller coaster of emotions and now it is over. Back to real life and spending as much time as possible loving on my kids.