Rachel's Journal - Month 3

Week 14	November 3, 2003 to November 3, 2003
Nov 3	Rachel was good today...no reflux or spit up until the 9PM feed, right after the tube insertion. She was fidgety through her feeds and mylicon didn't seem to help. She'd continued to fidget for a half hour after the feeds and then fell asleep. Getting 55-65cc/3-4hrs. 0.5cc Zantac/twice daily. 30-60cc pedialyte daily. Mylicon as needed.

Week 13	October 27, 2003 to November 2, 2003
Nov 2	Rachel was very good today...sleeping at pretty good at night and very well during the day. Maybe she'll be keeping Mommy up later.
Nov 1	Rachel was a good baby today. She was a little fidgety during and after her 4:30AM feed. Mommy stayed up with Rachel until 6:30AM when she drifted off to sleep. She was up again at 8:30AM and stayed awake for 4 hours until after her next feed. She slept rest of day and probably did not even realize Mommy and Daddy took her out :-) Mommy and Daddy are messing with Rachel's formula again! She's getting the Similac ready feed. Rachel continues to have refluxes and spit ups so it's probably something Mommy and Daddy has to live with for awhile. Rachel's been having drawbacks prior to alot of her feeds for the past couple days. Mommy will have to give her a little less formula, but is quite worry Rachel is not getting enough to grow. Going back to Neosure is just not an option as Mommy does not want a constipated baby! Perhaps a little olive oil will do the trick!
Oct 31	Happy Halloween! Rachel is 3 months old in the lunar calendar! Rachel kept Daddy up until 3AM with lots of straining. By the time Mommy took over Rachel had calmed down and was content to lie on Mommy for the hour prior to her feed. She took the feed well, but had reflux with no spit up before and after the feed. She continue to have these episodes throughout the day.
Oct 30	Rachel did pretty well today. She spit up (5-10cc) at 5:30AM and again at 9AM (<5cc). No reflux or spit ups for the rest of the day! The doctors have managed to stop Grandma's seizures. They are waiting for her to wake up...hope she does very soon!
Oct 29	Rachel continued to have reflux and spit ups throughout the day, so the DHA/ARA is probably not the problem. What is then??? Daddy measured Rachel today and she's grown an inch at 20. She can fit some of her newborn outfits :-)
Oct 28	Rachel weighed 6lbs 3oz on Daddy's scale...only gained 2oz since last week.
Oct 27	Another good day for Rachel. She slept all day again. Still spitting up sometimes, but is comfortable most of the day. Getting 60-65cc/3-4hrs. 0.5cc Zantac/twice daily. 30-60cc pedialyte daily. Mylicon as needed. Time to change formula again! Mommy read on the GERD forum that DHA/ARA additives found in Similac Advance may cause reflux. Will start on the Similac without the DHA/ARA. Hope they are right.

Week 12	October 20, 2003 to October 26, 2003
Oct 26	Just a typical day for Rachel. Rachel has been putting her fists (covered so she can't pull out the NG-tube) to her mouth lately. It's rather cute! Mommy and Daddy are very worry over Grandma's condition. Grandma was in the hospital having a catheter put in for hemo-dialysis. The surgery was successful and everything was going good until Thursday evening when she suddenly became non-responsive. The doctors ran various tests and determined Grandma is having brain seizures. The doctors administered some seizure medications yesterday. It has helped a little but Grandma is still non-responsive. They increased the dosage today. Everybody is very concern and hopes Grandma can snap out of it soon.
Oct 25	Rachel has been needing tummy massages to get bm since the powder switch! She's still pretty regular, going twice a day. She continues to have small spit ups, sometimes reflux with no spit up throughout the day.
Oct 24	Rachel was very fidgety after her bm at 5AM (Mommy had to massage her belly). She had reflux with no spit up probably because there's nothing in her stomach. Mommy gave her Mylicon, but she was still fidgety at her 6AM feed and took only 35cc. Daddy took over at 8AM. Rachel continued to be fussy at the 9AM feed and spit up a small amount afterwards. She was very good for the rest of the day.
Oct 23	Rachel was good until 4AM at night when she spit up. She was fidgety and wide awake afterwards. She was still fidgety after Mommy gave her some Mylicon. She would not even let Mommy sit down, calms only when Mommy rocks her standing up. She started to drift off at 6AM when Mommy was feeding her, but woke up every time Mommy tried to put her down. Finally at 7:30AM, Mommy was able to put Rachel down and went to sleep herself. Rachel spit up again at the 12PM feed :-(
Oct 22	Another good day for Rachel. Still spit up sometimes, but was comfortable most of the day. She likes to look around now when she's awake. She went over the 6 pound mark on Daddy's scale, weighing 6lb 1oz! Another small milestone achieved :-) Mommy and Daddy are very proud. Started to use the powder form of Similac Advance instead of the ready feed.
Oct 21	Rachel did very well over night. She took all her feeds without any fuss and slept soon afterwards. She was pretty much the same during the day. There were still some small spit ups.
Oct 20	Rachel was one fussy baby at night! She was very fidgety from 1AM to 7AM. She took only 30cc at 3AM. She was still fidgety during the day, but managed to take some naps in between feeds. She spit up again a bit after her evening pedialyte. 55-60cc/3-4 hrs. 0.5cc Zantac twice daily. 15cc pedialyte twice daily. Mylicon as needed.

Week 11	October 13, 2003 to October 19, 2003
Oct 19	Rachel was a bit fidgety between 2AM and 5AM. Mommy and Daddy have no idea what's bothering her. She had a bm earlier so it wasn't that. She was given Mylicon, so it wasn't gas. She got fed at 2:30 and was still fidgety afterwards. She finally tired out at 5AM after some reflux action. She slept all day...it's going to another sleepless night :-o
Oct 18	Mommy stayed up to 2:30AM with Rachel. She was not fussy or cranky, just wanted to be held. She was fine for rest of the night. She had 2 bm today...looks like the constipation problem has been resolved! She's still 5lb 14oz on Daddy's scale, no gain from Monday. Her spits ups and formula change must be effecting her weight gain.
Oct 17	Rachel was almost finished when she pushed back 30cc into the syringe at her 12AM feed. She very fidgety afterwards and kept Daddy up until 2:30AM when Mommy took over, gave her Mylicon and fed her. She seemed quite gassy and took her feeds very slowly. She had 3 bm today...is it going to the other extreme now??? She pushed back another 15cc into the syringe at her 9PM feed. She seems to be having a bit of trouble with her feeds (pushing back out and taking it really slow) lately. Is this the beginning of another problem???
Oct 16	Rachel was fidgety and did not finish her night feeds. She was able to relax and sleep after some Mylicon. She spit up alot right after her 5PM feed. On the brighter note, she had two bm today...very encouraging in that respect. Rachel went to stores with Mommy and Daddy today. It was rather chilly out, but Rachel didn't seem to mind it a bit. She did not like being in the car seat at first, but adjusted to it nicely. Maybe Mommy feels comfortable enough to take her out more often now.
Oct 15	Rachel woke up suddenly with a loud cry at 12AM...like she was in pain. Mommy thought she had a belly ache because her belly was very tense and she cried louder when Mommy touch there. She relaxed and settled down after Daddy gave her some Mylicon. Mommy decided to scratch the juice idea and try changing her formula to the Similac Advanced 20cal/oz instead. Mommy happened to have some samples on hand from registering in Similac's Welcome Addition Club before Rachel was born. It's now put to good use. Rachel only took 35cc during the whole night. She needed Mylicon to manage her gas. Rachel was much better during the day. She took her all feeds without much fuss. She had a major bm in the evening without any spit up this time! She pushed out 5cc of feed into the syringe during her pedialyte, but was able to take it all back in.
Oct 14	Rachel had a bm @12:30AM after another spit up. She spit up again in the afternoon. She had another very small bm at 10:00PM after much straining and grunting. Stopped giving her the mineral oil today since the stool consistancy is back to normal. Rachel was awake for her physical therapy today. She was able to lift her head a bit and focus and follow an object for a little while. Rachel will miss two weeks of PT as her therapist is taking off to get married. Congratulations to her! Mommy will have to work with Rachel in the meantime.
Oct 13	Rachel pooped at 1AM...after/while she spit up some of her 12:30AM feed. That's 50hrs since the last bm. Taking her temperature rectally 3 hours earlier may have help her cause :-D Hope she will be more regular from now on! Rachel is 5lb 14ozon Daddy's scale...gained only 3oz in 10 days. Still taking 55cc/3-4hrs...formula intake was not increased due to continued reflux. 30cc pedialyte/twice daily. 0.5cc Zantac/twice daily. 0.25cc mineral oil once daily. Mommy will start mixing 1oz of apple juice with 7oz water in the formula to get some juice in Rachel without having to increase volume intake. The juice will replace the mineral oil as the treatment for constipation.

Week 10	October 6, 2003 to October 12, 2003
Oct 12	Rachel was very fussy with Daddy at the 12AM feed. She was busy trying to poop and did not finish her feed leaving 15cc. She strained really hard but nothing comes out. She finally fell asleep at 2:30AM. Mommy had no trouble with her the rest of the night. She's gone another 48+ hours without a bowel movement! Looks like the mineral oil is not working. She also spit up a couple of times after her 6PM feed. Looks like the Zantac is not working either.
Oct 11	Rachel was very good at night. She was a bit fussy during the 4AM feed and left 5cc in the syringe, but went to sleep soon after the feed. Rachel went out for a nice drive to BJ's with Mommy and Daddy. It was a gorgeous autumn day and some of the leaves are at their peak colors. Rachel missed it all as she was sleeping most of the time :-) She had a couple reflux moments with no spit up today. Zantac not working? No bowel movement either. Mineral oil not working? Only time will tell.
Oct 10	Rachel was fussy during the night. Daddy stayed up with her until 4AM when Mommy took over. She was squirmy and gassy. Daddy gave her mylicon and she settled down for about an hour. She finally settled down after Mommy fed her at 4AM and slept decently afterwards. Appointment with the pediatrician today. Went over the results of the pediatric cardiologist visit. He agreed that Rachel is not in heart failure. He recommended .25 tsp of mineral oil mixed with 10cc formula per day for Rachel's constipation. He did not want to add fluid intake because of her heart condition. He prescribed .5cc Zantac/twice daily for her reflux. He also referred Rachel to a Gastroenterologist to evaluate the possibilty of a G-tube. The apointment was made for Nov 18. Pediatrician follow up in 4 weeks. She weighed 6lbs, gained another 10oz from two weeks ago. Rachel slept most of the afternoon. She had a few reflux attacks today including one in front of her pediatrician. Gave her the mineral oil at 6PM and she pooped at 10:30PM. Coincidence?! Whatever, Mommy and Daddy were relieved. Rachel continued to strain, so her bowels may still be a bit backed up. Started Zantac at night.
Oct 9	Rachel was really good at night. She had to be waken for all her feeds and went back to sleep soon afterwards. She finally had a bowel movement in the afternoon, 70 hours after the previous one. Mommy and Daddy were relieved. However, it seemed she did no empty her bowels as she continued to strain and was still uncomfortable for the rest of day. She had a few reflux episodes today, once spitting up a mouthful of formula (when the hospice nurse was here). These are quite scary as her face turns all red, then blue because she does not breath.
Oct 8	The poor baby was still constipated. She has not pooped since Monday. She gets exhausted trying while awake and the rest of the time sleeping rather soundly. Mommy and Daddy tried giving her a bath, hoping it'll help her along like it did on Monday, but it failed :-( It has not been a fun day for Mommy and Daddy watching her. She was not interested in her PT nor any oral feed today. Her speech therapist agreed that since Rachel has lost interest in oral feeding, it's best not to force it. We will continue with the weekly PT, but cut speech therapies to once a month. Rachel spit up another couple of mouthfuls after her 9PM feed during one of her attempts to poop.
Oct 7	Rachel saw her pediatric cardiologist today. A very nice man! She had an EKG as well as an echocardiography. Her EKG had abnormality as expected due to her VSD. The echo showed a 7mm VSD, large enough that it will not close on its own. However, the doctor saw no other holes...another small VSD, an ASD, as well as the PDA...as described in the report of the test done the day after her birth...which means they have all closed. The doctor felt her liver was a little low and her breathing was a little fast (in the high 50s at rest) which can be an indication of congestive heart failure. He offered to start Rachel on medication but said she may not need it yet as she looked quite comfortable. Mommy rejected the medication for now and scheduled a followup in 4 weeks. The doctor now has a baseline of her condition and should be able to monitor her better. Rachel and Mommy both slept through the rest of the afternoon...the doctor's appointment wore them both out ;-) Rachel's getting too big for the carbed. Daddy will have to install the carseat soon. Daddy had no problem with the tube today as Rachel was quite drowsy at the time...just have to make sure she's always sleepy when the tube goes in.
Oct 6	Rachel is still very gaseous...needing mylicon at most of her feeds. She was much better after she pooped during her bath...quite nasty but Mommy and Daddy were just glad she finally got it out! She gave Daddy a hard time with the NG-tube insertion...she knew tube was coming and blocked it with her cries. Daddy was finally successful after Mommy's unsuccessful attempts with the bottle. She's getting 55cc/3-4 hrs. 15cc pedialyte/twice a day. Mylicon as needed.

Week 9	October 4, 2003 to October 5, 2003
Oct 5	Rachel still has difficulties with her bowel movements...going every other day and trying real hard all her wakeful moments in between...even turned purple sometimes. She spit up a few mouthfuls after her 6PM feed.
Oct 4	Rachel is 2 months old today! Happy Birthday, baby girl! She had a little party with some of her cousins, uncles, aunts, and grandpa. Everyone had a blast while Rachel snoozed through the day. She weighed 5lb 11oz on Daddy's scale.