Mrs Wishy Washy

A little bedtime story:

OMG did I cut them off???

Her curls that is. About two weeks ago I decided that it was time to give Ellie's curls their first real trim. The curls were getting tangled all the time and they were getting stuck in the zipper of her backpack too, and that was not fun for any of us. So we gave her a sink bath, washed her hair and then I got started with the cutting. Now her hair doesn't get stuck in her backpack, is much easier to brush and wash and doesn't look as ratty. But the perfect ringlets are GONE!!! I always loved how her hair made perfect Shirley Temple curls that looked like I had spent hours perfecting, when in reality I did nothing. Oh well, hopefully they will come back in the humid weather this summer. Hopefully.

So back to a more serious topic, Ellie. She is still not gaining weight. She is basically stuck at 14 kilos. We think she has gotten taller and we know her shoe size is bigger, but the weight gain is not happening. We are also battling high output from her ostomy. Usually I can pin point the culprit when she has high output, (pork marinated in brown sugar and orange juice, Mac and cheese, too much Popsicle, beef with too much spice) but this time we are at a loss.

After her study she was pooping in her diaper 8-10 times a day . Sounds like normal short gut right? But we did the study because she wasn't pooping! Her ostomy output during this time was fantastic. It was around 300mls a day and her urine production was great too. Then she went back to her normal of pooping 2x a day but only with a suppository. And her output went up to 1000 a day. Not great.

We have been managing her hydration with extra D5 during her naps. Then we have been tracking everything she eats and looking for a reason. She also started oral vitamins right after her study, so we have been looking at those. Now we are mixing them into her milk bag at night so that she gets them over a slower period of time. But we are still seeing high output.

The next thing we are looking at is bacterial overgrowth. We haven't seen this since before her ostomy was created but, it is very common in the short gut world, so we knew it would come back. Her breath stinks and her output has taken on a almost yellow orange color, we think these might be due to bacterial overgrowth.

If we can get her output under control then I'm sure she will start gaining again. I'm ready for her cloths to look like they fit again.

Other than the high output and looking skinny she is doing great. She started gymnastics, ballet and Tap classes last week. Gymnastics are her wild time and she is amazing in ballet class.

We are spending today snowed in and very bummed that we didn't get to go to CT for K8's birthday party. But we did have fun playing in the 10 inches of snow that was supposed to be 1-3 inches. The sight of a snow angel with a enteral back pack impression in the middle is fantastic.

OMEGAVEN!! Welcome

With the article on the front page of the Globe last Friday we have a bunch of new readers. We went from having around 150-200 visits a day to over 900. So we decided to do an quick post to catch everyone up to date. I have linked key words in this post so if you don't know what something is, just click on it.

Ellie before the Omegaven

Ellie was born in with Jejunal Atresia, this left her with 30cm of grossly dilated small bowel coming down from her stomach that ended in a dead end, and then 70% of her colon, that was very small from disuse, coming up from below also ending in a dead end. What happened is that at about 10 weeks into gestation the bowel either got twisted or there was a blood clot, and the bowel lost blood supply and died. It was then reabsorbed into the body. We have been told by the geneticist at CHB that this was a just bad luck and not associated with any genetic disorder.

Ellie post Omegaven

She is was at Children's Hospital Boston for 8 months and now is doing very well. We have been back multiple times since then but not enough to get the name "frequent fliers." She was on Total Parental Nutrition (TPN) and Omegaven for IV nutrition through a central IV line in her chest for the first 32 months of her life. But as of December 1st, 2008 we were able to stop both with the hope that she would be able to sustain her needs from the small amount of bowl that she does have.
She eats 3 meals a day, and the only thing she drinks in Elecare formula. She also is on tube feeds 16 hours a day. This is what the is in the backpack that she wears. The backpack holds a pump and a bag of formula that is pumped into her belly 16 hours a day. Your intestine adapts as it has contact with food, so if it always has contact with food, then it is always adapting. And adaptation is the only way her bowel is going to be able to do the job that a normal child's would.
Ellie had very dilated small bowel that resulted in inability to tolerate food, bacterial overgrowth and a few line infections. So in November 2006 we opted to create an ostomy at the end of her small bowel to allow the back up of food to have a place to go, while keeping the colon attached. This has worked very well and we have seen little to no bacterial overgrowth since. And (knock on wood) no line infections. Click here to see a map of her bowel layout.
We are hoping that sometime this year we will be able to reconnect her bowels and remove the ostomy. Then she will have a central IV line for a short time and a G-tube for as long as she needs it.

If you are looking for information about short bowel syndrome or short gut, a very good site is the Short Gut Wiki, it was created by short gut parents and patients for anyone with short gut.

If you are looking for more info on Omegaven please look at the Short Bowel Wiki for more information. There are some great stories of some amazing kids on that site. Also you can contact Children's Hospital Boston to learn more about their Omegaven program. The lead surgeon for the program is Dr. Mark Puder he works along with pharmacist Kathy Gura to run the program.
We have met many amazing families through this blog. Please look at the column to the right to visit their blogs, get more info on short gut and our doctors. We also love to meet new short gut families, please feel free to email us (look in column to the right).


We can not say enough about Omegaven, or Dr. Puder, pharmacist Kathy Gura and Ellie's surgeon Dr. Russell Jennings. We give credit to all four for saving our daughter's life. She is an amazing child and we can't wait to see what she will do next.

Front Page!

Surprise, surprise, today's Globe has Ellie on the front page.

http://www.boston.com/news/local/massachusetts/articles/2009/01/09/old_fashioned_lifeline/

The front page:

The web video:





Thanks, Adam for putting this one in motion.

Maybe she is just getting longer

We are back from Maine and happy to be on home turf again. Traveling is much easier than it used to be but the home court advantage is always a good thing and not live out of a bag and a box of medical supplies.

It was great to see everyone and let Ellie play with her cousins, try skating on very big borrowed skates and go sledding again on a nice toddler sized hill.

See if you can spot the 'Oh, shit' moment in this video when I realized that I might have just flung my daughter into the woods....

'Daddy, do it again!'

We had a big relief Monday morning when we finally got home to the scale and had an Ellie weigh-in. Today she weighed in 14.18 kg (31.2 lbs) , more or less exactly what she was the day after Christmas and within a few grams of where she was when she went in for her study a few weeks ago and where she was when she came off TPN a little over a month ago. We were sure with the way that her pants were falling down around her ankles that she was shedding weight but apparently it is still there. Maybe just rearranged itself. Or maybe her body is following along with the growth of her feet and stretching out on a daily basis. But considering the current cold, the very active month that we have had and the other mysterious ills of her ut, holding her weight is a great thing.

So no call to Childrens to talk about getting on the TPN train again. The case of omegaven is in the cupboard but we'd rather leave it there if we can.

Speaking of which, we spent about 5 hours with folks from the Boston Globe Monday telling them the condensed version of the Ellie story and giving them a crash course on short gut, TPN and all things medical around here. It looks like they think the omegaven story is as great as we do and are working on a way to get it into the paper around here again.

we'll post a link if it runs.

Back to my favorite chair for some quality time while Ellie catches up on her sleep after four very busy weeks.