Sat 01/03/09 - - Feeding Fuss Day #2

Ava slept pretty much all night and made bottle feeding impossible.

The morning x-ray showed that Ava's stomach was distended with air, even without the NG tube.

During the morning rounds, the doctors weighed the pros and cons for re-inserting the NG tube.
Pros

• Ava's stomach can be manually decompressed, mitigating the risk of aspiration or increased pressure on her heart
• Assurance that Ava is getting all the nutrients necessary to grow and fight the infection

Cons

• Misplacement of the NG tube can cause discomfort
  
• Ava just came off of the NG tube and it was nice to bottle feed her again
  

Because the pros outweighed the cons, the NG tube was reinserted and again another 100-plus cc's of air was expelled from her stomach.

She was started on a new medication called reglan to help speed up the gastrointestinal functions and help Ava digest her feeds.

Teresa and I are keeping our spirits high that Ava will resume normal GI function and start tolerating her feeds.

There was no echo performed today (or tomorrow) due to the weekend.

Blood cultures remain negative since 12/27, so the staff continues to maintain the current levels of antibiotics (vancomycin and gentamicin) through IV.

There was a discussion with the infectious disease doctor and it looks like we have around four or so more weeks of IV antibiotic treatments left. Because of Ava's size and the aggressive nature of the infection it also is looking like the remainder of the treatment will be carried out at the Cleveland Clinic. While this is frustrating to Teresa and I (we have been at the Clinic with Ava since 12/16), we are keeping positive and taking things one day at a time.

On a light note - - on the morning x-ray we can see Ava's teeth coming in.