7.27.2005

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.

9 Comments:

Blogger Kim said...

Okay, just in tears...of joy and amazement! Keep up the good work mom, dad and Frankie

9:03 PM  
Anonymous granpa frank said...

Well tonight he got to try his second bottle. It was only 5cc and he was not too interested in it so he only took about 1cc. He was more interested in sleeping than eating. I think Mom and Dad wore him out today. The rate of his continued development is amazing! Today he weighed 3 pounds 14 ounces and was more alert than ever.

10:28 PM  
Anonymous spencer said...

Thanks for all the good news. I think Frankie was just getting tired of posts using the phrase "not out of the woods yet" so he decided to accelerate things a little bit.

11:23 PM  
Anonymous Grandma Judy said...

Frank said on the day of Frankie's surgery, he moved himself from the middle to the top of the bassinette, TWICE. The nurse kept moving him back. He was less than 2 days old! A few days ago, he turned himself over and Dave said he raises his head to look around. We knew he was strong, listening to his heartbeat the long days in the hospital before birth. He's proving what he's made of every day and, yes, he certainly seems to have his mother's determination and guts. That might not be such a welcome trait when he's a teen ager, but right now, it's wonderful to hear about. Way to go Frankie!

5:19 AM  
Anonymous cousin carlee said...

wow, im so amazed with all of his progress that is great!. i can't wait until we finally get to see him.

6:14 AM  
Blogger dirtyweekender said...

I'm so happy for you three - soooo happy!!!

xo

8:10 AM  
Blogger MommaS said...

I'm so excited to hear/read all of this! He is an awesome little man, and I can't wait to meet him! I'm trying to convince Chris that he wouldn't miss me for a quick trip to Austin, but he seems to think I'm needed here. Selfish! Anyway, give him a poke for me. I always knew he'd be a good eater. All the Breshears' are!!

9:32 AM  
Anonymous aunt debbie said...

Well, if we're gonna start talkin' about good eaters, NOBODY holds a candle to the Cunninghams; and he's got some of that blood line in him, too. Never thought we'd be cheerleading for someone in this family to eat more, but here goes: WAY TO GO, FRANKIE, WAY TO GO! :)

Love and miss you all.

5:34 PM  
Blogger Silver Zephyr said...

the giuliani's ain't too shabby when it comes to appetite either...

10:45 PM  

Post a Comment

<< Home