A field trip?

I just got back from the hospital this afternoon. Although I was only there for a few hours this time, it was quite stressful. At first I was able to just sit and hold her, but then after I put her down, she started spitting up a lot (which she has been doing a lot the past few days). I was trying to pump at the time, and her nurse was with another baby, so I was hovering over her, suctioning out her mouth and nose (because she couldn't breathe), all while trying to hold the pump (I had forgotten my hands free system at home!). The danger with her spitting up is that she doesn't swallow correctly, and instead of it either coming out of her mouth or her swallowing it back down, she aspirates it as well. This had led to her choking, turning a little blue a few times, and getting junk in her lungs (which can be very dangerous and lead to pneumonia). The doctor has been trying some different reflux medication with her to try to control the reflux issue, but it hasn't seemed to help much, and he's afraid that if we wait too long, she will indeed develop pneumonia and that could be very bad for her. So, we are talking about a second surgery on her called a nissen fundoplication in which part of the stomach is wrapped around the esophagus to prevent reflux (and then aspiration, in her case). We have been asking about this procedure since before her g-tube surgery, but the docs wanted to wait and make her prove that she needed it instead of just doing it as a precautionary, largely because it is a more major surgery than just the g-tube itself. However, given the past several days, he feels she is moving us in that direction.

The field trip part comes in to play because the pediatric surgeons are gone this week, and if they determine that she needs it sooner rather than later, they will have to send her elsewhere to do it (they mentioned UVA or Wake Forest). They took an x-ray of her lungs today, and will take another one tomorrow, and compare and study for signs of aspiration, and then we should know the plan. Please pray that the docs would see what they need to and make the right decision. Although thinking about transporting her so far and her having such a major surgery, as well as the logistics of me/us being there with her, are so great, we want her to have the procedure if that will make her that much closer to coming home (and doing so safely!). I've had the feeling all along that she would need this second procedure, so it's not a surprise to me, but not something I'm looking forward to for her either.

In the meantime, they are cutting her feed volume in half and restarted an IV for fluids for her.