Another reflux study

James made it in to Miami safe and sound a little after midnight. As soon as we woke up this morning we got ready to come and see our little girl.

The doctors still had no success with getting the ND tube in place. After my discussion with the surgeon yesterday they have decided to go ahead and do another reflux study. This one will be a GERD study and unlike the upper GI this one will be over a longer amount of time. The plan is still to try the g/j tube advancement at the end of next week. However if the test definitely still shows reflux then we have a possible backup plan with surgery.

Pyloric stenosis had been mentioned to us by family a while back. This is a condition where the valve at the bottom of the stomach does not function properly to empty food. This usually results in projectile vomiting, dehydration, and failure to gain weight. Teryn has not shown any of these symptoms. But over the past couple days I have been thinking....she wouldn't show dehydration because she is receiving IV fluids, she is gaining weight because food was being diverted past her pyloric valve and she is receiving supplement powder in her milk to help her grow. She may not show much projectile vomiting because of the previous Nissen fundoplication to tighten her esophageal sphincter (sometimes people who have had this procedure can no longer vomit.) I was just wondering if maybe there could possibly be a problem with her pyloric valve because they have trouble getting the feeding tube through it and also because yesterday the reflux that came out was fairly forceful. I mentioned this to the resident this morning and he said it is something to keep in mind.

I am thinking maybe we should have an ultrasound to check and see just to rule it out.