Yesterday was a big day. It was Liliana’s 1st birthday and our visit to her surgeon. Before I get into the details of the appointment, we’re receiving the special formula now! WIC has Peptamen Jr in their warehouse and they managed to ship us a few cases. It was extremely fast; we went to WIC on Tuesday and got the formula Wednesday.

Wednesday morning, Sean and I went to an ultrasound for Damien. His anatomy is still good, his head is down, and they approximate his current weight to be 4 pounds, 13 ounces. If his growth continues on the correct curve, he will most likely be 7.5 pounds at 40 weeks, which is a whole pound heavier than Liliana when she was born. I think we’ll be opting for a C-section; Liliana was a tight fit and I did get a tear when she was born. Who knows what a bigger baby would do if I tried to deliver the “natural” way.

I have been feeling contractions recently though and I’m only at 33 weeks. Hopefully these contractions aren’t opening my cervix at all, else Damien might be making an early entrance like Liliana did.

Yesterday, Sean, Liliana and I went to CHOP to meet with the surgeon who fixed Liliana’s CDH. He agreed to do the surgery, which he said would consist of the following:

  1. Nissen Fundoplication: where they take the top of the stomach and wrap it around the esophagus like a nipple button.
  2. Fixing the slight malrotation of her stomach and any kinks/irregularities with the intestines.
  3. Insertion of the G-tube, which at this point would be a tube. It will be replaced with a button 3-4 weeks later.
  4. Removal of the gallbladder. He thinks it’s not affecting her reflux now, but since she has them, they will be a problem to her later.

He said that eventually the fundoplication may develop complications. One is that it may break down, causing recurrent reflux. Another is that it may move up into the chest. Both of these would require surgery to fix. The other complications he mentioned to us would be more likely to happen if Liliana was prone to seizures, and were temporary things. One of the complications was something about the stomach or intestines emptying too quickly and another involved wretching.

With the G-tube button, various parts of it may begin to leak at around 6 months. If there are any leaks, the button would have to be replaced. The button may also become too small for the abdominal wall as Liliana grows, at which point they would have to replace it with a larger button. I don’t think replacement requires surgery (the hole is already there), but may require us to go to the hospital to get the replacement done.

We’ve scheduled the surgery to be on November 12 and the surgeon said it would take 3 hours. She would stay in the hospital for 4-5 days, depending on how her feedings go.

Okay, time for the pictures!

Liliana on her birthday

She sticks out her tongue to lick the edge of the tape

Hello, Grover!

Your nose looks mighty tasty...

I hope this isn't a nose-licking fetish starting to develop.

Ew, mommy kisses.

(From previous picture) Teeth are starting to pop out! Two at a time!

Hmm.

Standing up using Mommy's chair...

Mommy's chair spun and Liliana couldn't stay up! The obligatory "It's my birthday and I'll cry if I want to" picture

So yes, she’s getting her two bottom middle teeth at the same time, and they look a bit crooked. I’m sure that these upcoming months of Liliana getting her teeth will be delightful.