We had started the formula feeding pretty soon after Beckett was drained Wednesday afternoon. The first time we tried feeding him, he only drank 1 oz. He did not like it. The next time he was starving and we made it pretty warm. He drank 4 oz. I was feeling optimistic. Then we decided to go to slow flow nipples so that in a month when we can go back to nursing, he will be more willing to nurse. After we made that change though, he would only drink an ounce at a time. I was not feeling optimistic.
Morning came. He still was only drinking an ounce every few hours and we were just waiting to figure out the game plan and hopefully get home later on. Dr. Book came in pretty much first thing in the morning and we started to discuss things. She felt Beckett’s tummy and wasn’t happy. It was already getting tight again. So she decided that we would proceed to get him drained again but this time we would leave the drain in and watch it. That meant we would be admitted for at least 3-4 days. Another disappointment. She also reemphasized to us that it was critical that he take the formula. If he didn’t then he would be put on a feeding tube. She did say though that if he will take the formula well, that I could have one nursing session a day.
After she finished speaking with us, it dawned on me. Addie’s birthday is on Sunday. We are celebrating on Saturday. And now we will be at the hospital. I broke down. Is this my life now? Will we be constantly missing important life events or rescheduling things? I needed to leave. I needed to breathe. I stepped out to make some phone calls to make arrangements for Addie and Raemee for the next couple days and to figure out what to do about Addie’s birthday. Thankfully, we are so blessed with wonderful friends and family who stepped in to help us take care of everything so we can balance our two lives. We can take care of Beckett and also make Addie’s birthday the day that she deserves.
While I was out, Dr. Book came back and spoke to Shawn. She was very frank with him and told him that she was fairly confident that Beckett would need a feeding tube based on everything so far. She wanted us to be prepared. When I found that out, I was so resolved to keep trying. I wanted to go back to the regular nipples to see if that made a difference. We had to have Beckett fast until he went for his procedure at 1:00pm to get drained again. So I just kept hoping that once we could start the feedings again, that he would do it. That morning was so long waiting for them to come get us. Finally at 1:30, they were ready for us. We headed back to the Jazz room and were told again what to expect. The only difference is this time we would leave the room with a drain out of his belly.
Once Becks was situated, we headed up to the room that we would call home for the next few days. We just hung out until the nurses came to get me to head down to get him. Another long wait even though in reality it was only 30 minutes or so. I walked with the nurses back down and saw my little warrior. He was pretty out of it. The doctors came to talk to me about everything. They said it went well. They drained another 400 mL. That’s 13.5 oz. I couldn’t believe it. They then showed me how to open and close the drain, signs to look for and then repeatedly told me to be super careful that we don’t pull the drain out. Each new conversation I have with doctors makes me more overwhelmed and scared and yet at the same time strangely empowered.
The nurses and I headed back upstairs and got him situated. We did his vitals and weighed him. When he was weighed initially Wednesday morning, he was 13 lbs 6 oz. When we weighed him Thursday after his second drain, he was 11 lbs 8 oz. Just by taking out that fluid he lost almost 2 lbs. But he looked amazing. After vitals were done, Dr. Marty came in. She is a resident with the GI team and she is awesome. She explains things so clearly and answers every question I have. She told me the game plan. We would watch the draining. They would empty his bag every couple hours and measure it. Because he is losing so much fluid, we have to replace it with protein rich fluid called Albumin. We also had to administer IVIG (immune Globulin) to make up for all that he was losing. We would also keep an eye on how much formula he would take. And we got the green light to start feeds again. I had them get us 2 oz. We warmed it up and put a regular nipple on. Beckett sucked it down so fast. We had them get another 2-3 oz. He drank that also. I was slightly optimistic that it was just a nipple issue and not the formula but he was starving so we would have to wait a few feeds to figure out whether or not it truly was that nipple issue.
We continued to feed him throughout the day and he still did great. He would consistently eat about 4 oz. I was pretty happy about how well he was accepting it. He didn’t seem to care about the taste. He cared a lot about the nipple and also the temperature. Later that evening, the GI doctors came around to talk to us. We met Dr. Jackson and Dr. Marty came in with him. He explained to us in great detail exactly how the liver works and just how biliary atresia affects everything. He helped us understand it in a way that was very visual and gave me a different and better view of what was going on inside our little man cub. He also had me feel for Beckett’s liver and spleen. It was fascinating having him tell me exactly what I was feeling for. Beck’s liver is HUGE!! It takes up most of his chest cavity.
We went to bed feeling fairly ok with the events of the day. We felt like we were moving in a good direction. We slept pretty well and woke up around 7 am Friday morning. Beckett did great all night, slept well and ate well. As we were getting ready for the day, the GI doctors cam around again. Dr. Jackson looked at the fluid and felt like it was looking pretty good so he wanted to consult with Dr. Book about how long to keep the drain in. I found out that Beckett had drained 400 more mL overnight. So much fluid!! But the amount coming out was at a much slower rate which was another reason he wanted to talk to Dr. Book.
He then asked me if I understood why we were giving him this special formula. I gave him what I thought was the reason and oops I was wrong. He then went on to clearly explain it to me. I thought the formula was a low fat, which was why he couldn’t have my breastmilk because it’s too fatty. But that’s not the case. It’s all about the type of fat. The type of fat in breastmilk goes through the lymphatic system. This is why he can’t nurse. Because his lymphatic system needs to heal. The kind of fat in this formula actually goes straight into the blood. It never goes through the lymphatic system. I felt so much more knowledgeable about exactly what was going on.
Later on in the morning, Dr. Book came in with her whole liver team. There was her nurse, Holly, the liver coordinator, Brook and the social worker, Barbie. It was awesome having our whole team with us to talk to us. Dr Book looked at Beckett and then started telling me how glad she was that we had the drain in so that he didn’t have to go in and be put under again to get that additional 400 mL out that had accumulated throughout the night. She also looked at the color and was really happy about it. It wasn’t milky anymore which means the fats weren’t in it! So we will need to get it retested at some point to be sure but that is looking good! She even suggested that we might take the drain out and treat the rest of the fluid build up with diuretics, which will help him just pee out the extra fluid. Then she asked about his feeding and was really happy with how he’s doing.
I started feeling like things were going to be ok! Finally a visit with doctors that wasn’t bearing bad news! I was feeling happy about things. I started thinking, “I can do this!” Beckett got hungry and so I pulled him out of bed by myself, wires and all. I fed him. He took in about 3.5 oz and then I burped him. He did great. He started looking sleepy so I put him down for a nap. Then he got this look in his eye and spit up a little. I helped him sit up and that’s when it happened. He started vomiting. Not just spit up. Full on vomiting. I was so scared and Shawn was working so I was alone. I ran out of the room to get a nurse but no one was there. I came back in to help clean him up and he threw up a couple more times. I ran back out and found a nurse to come to help me. His puke was curdled and gross.
So here I sit. Now I feel like I’m back to square one. Is he not tolerating the formula as well as we thought? Or was it a fluke? Will this keep us in the hospital longer? Will he need a feeding tube? I hate the roller coaster. I’m hoping as the afternoon passes that we will get some answers. That I can get some reassurance. It may have been a fleeting thought, but the “I got this” feeling was wonderful. I want it back.