Except for ten scary minutes, Julianna had a great weekend.
The good: J is getting good sleep, and her heart rate is normalizing. It was too fast before, a sign that she was uncomfortable and working hard to fight her latest battle. We were able to restart her feeds, albeit at a lower rate. She played and played.
The bad: A few hours into her full rate of feeding on Saturday, J threw up. Her feeds go into her small intestine, so there’s not much in her stomach to come up. A little bit can be devastating, though,so we were alarmed. On Sunday, we kept her feed rate down, and things were fine.
Julianna got her g-tube (feeding tube to the stomach) placed in June 2014. It was supposed to make feeding easier and safer, but for some still unknown reason, it didn’t work. J couldn’t tolerate g-tube feeds and we lived with the constant fear of her throwing up. We tried everything – different formulas, rates, body positions, medications. Nothing worked: she still threw up every single day. It was a difficult time. We knew that she was at high risk of aspiration but were helpless to stop it.
After four months, it happened and J ended up in the PICU again with aspiration pneumonia. The feeding issue was addressed with a G-J tube (a tube that lets us feed her through her small intestine, or jejunum). It’s not a permanent fix, and we were warned that it may not work at all — but it was really the only option. Fortunately, it has worked beautifully. Her G-J tube has been in for fifteen months now (I think that’s some sort of record), and until a few days ago, we had no problems with feeding.
I’ll admit, the thought of going through more feeding problems makes me nervous. It is scary when a vital act (feeding your child) is dangerous. We have to watch her even more carefully now, because these events occur suddenly and silently.
I learned a while ago that control is an illusion. Julianna’s care is highly regulated. We talk about BiPAP settings, heart rate, liters of oxygen, millimeters of water, how much saline to put in her nebulizer. We aim for perfection, but nothing in this world is perfect. We will never be enough – but we have to keep trying.
There’s a temptation when writing sometimes to shove things into a nice package and put a bow on it — Here. The stuff inside isn’t so pretty, but I wrapped it up for you. Does that make it OK?
Our reality is more complicated. The ugly and the beautiful are all mixed up. She fills my heart, but also breaks it. The status quo is tenuous, and I’m scared of change. On most days, the beautiful and the delightful are stronger than the ugly and the fear – and that has to be enough.
For the last few days, she has talked a lot about food – she wants to eat pretzels, biscuits, ice cream, salt, crunch: “Does anyone have some food here?? I LOVE pretzels.” She hasn’t gotten her usual volume of tube feeds recently, so I thought this explained all of the food talk. She told me in her matter-of-fact-without-any-self-pity way that she is always hungry. This is the strength that breaks my heart.
As always (thank GOD!), she wants to play. This is not really a pretty bow. It’s her world, and it has constant hunger mixed up with courage and magic. If I let her draw me in, it is enough.
On Friday, Julianna was an Asian princess with PJ’s from Singapore (Thank you, W!) and a silk fan blanket.
On Saturday, Julianna decided that her toys needed a spa day. Her unicorn and giraffe got pedicures. She insisted that they take naps afterwards, because she knows that spas are supposed to be relaxing. Afterwards, she defended them valiantly against the unicorn/giraffe “friends” who disapproved pink and blue hooves.