Back on the Horse

Contrary to all the previous pictures, she does wake up to cry. We're making some changes now. Kristin and I got a chance to talk with Dr. Downey for a while about our concerns with her spitting up her milk fortifier and the slow wean schedule. I mentioned to her that Elise has missed many doses of either morphine or ativan due to her vomiting. I pointed out that she didn't have any emesis until the milk fortifier was added to Kristin's milk and sodium was replaced. She really doesn't seem to especially like anything down her NG except for her mom's milk. So we discontinued the milk fortifier as it was supposed to be giving her more calories, but in effect it decreased her total calories by causing her to vomit. So we have increased her to 120 cc (4oz) every three hours with a one hour break. This will give her a better result of 120 kcal/kg, her goal amount of food for growth. Today we also taking a large stride in reducing her morphine. We are reducing the dose to 0.1 and increasing the interval to 12 hours, effectively decreasing her total morphine 75%. We will keep the ativan at 0.1 every six hours for now. So we are pretty content with the changes made today, many times in medicine the best treatment is to let nature take its course. That means letting physiology take place and keeping our hands off things. I feel much better with her getting off the sedation, allowing her to be more successful with breastfeeding attempts. We are off to Springfield tomorrow and will be updating you all on Wednesday. The process is going to be drawn out, so we will begin every-other-day updates. Love you all, Jason