Pride & Joy

Frankie continues to meet each benchmark of progress ahead of schedule. When we first got to the NICU, I asked our surgeon for some kind of table table for Frankie's post-op recovery. He was reluctant to answer, explaining that it was basically impossible to reliably predict the course of his recovery, or to estimate the time it would take. "Each baby is unique." Doctors preface their prognoses with this trite truism in order to spare us the pain of shattered expectations. Instead of telling me what we could expect, Frankie's surgeon laid out the best case scenario. First, we had to make it through the surgery. If there was only one fistula, and it was high enough up on the trachea, the TEF (tracheosophageal fistula) repair wouldn't be a problem. If the the distal portion of the esophagus reached the esophageal atresia, that repair would be relatively simple. Then, there were the immediate post-surgical concerns: Would there be any complications from the anesthesia? Would the sutures hold? How long before he would breathe without the aid of a ventilator? How long would he require sedation? The big questions after that centered around Frankie's ability to hold down food and put on weight. It would be a while before he began breastfeeding, first moving from intravenous feedings to a mix of IV nutrition and tube-fed breastmilk, then graduating to gavage and bottle feedings. Offering a guidepost, he told me that most premature babies don't begin bottle feeding until the 34th week, even if they don't require surgery to fix their malformed esophagi. And of course, there could always be complications related to reflux, a fairly common side effect of this particular surgerical repair. He said we'd be lucky to bring Frankie home within a couple of weeks of his due date - after the due date.

They removed Frankie's chest tube last Friday, confirming that his sutures were holding fine, and exchanging his replogle for a Naso Jejunum tube. Since then, he's been receiving a continuous feeding of mother's milk through the NJ tube, steadily increasing from .5ml/hour to 6ml/hour this afternoon. Over the same period, they've been dialing back his intravenous nutrients; he may be completely off of them as early as tomorrow. We tried giving him a taste of milk from the bottle yesterday, and the nurse practically squealed when we got Frankie to swallow one mouthful. Today, they pulled the tube in Frankie's intestine up 14cm into his stomach, turning his NJ tube into an NG. His second go-round with the bottle was even more successful - he finished 5ml of breastmilk in less than 15 minutes, and swallowed almost all of it, with no sign of reflux. When we left him this afternoon, he was sleeping soundly and in the good care of his Grandpa Frank and Aunt Kristin. He'll be 34 weeks as of Friday, and if things continue progressing this smoothly, he'll start bottle feedings by the weekend, well ahead of schedule. Frankie's surgeon stopped by this morning to introduce himself to Anna and tell us that everything's going better than he'd hoped. Everyone tells us how much Frankie looks just like me, but after watching him handle all of this like a champ, I know what he got from his momma.