Fundoplication Diagram

This is a little hard to read, but it at least gives an idea of what the fundo is. The highest part of the stomach (or fundus) is wrapped around the esophagus and stitched back to itself. The last picture also has a G-tube coming out of the stomach.

Andrew is doing great. He is the same kid as before except for 2 things. 1) He's hungry more frequently. Which makes sense because his stomach is smaller now. 2) The lack of reflux symptoms. He had slept with his mattress flat now. Before I always kept it inclined to help decrease reflux while we ran his pump at night. He used to reflux and choke on it if he cried too hard, or laughed hard. One day he drank some water, and then was crying over something, and the water came right back up with such force that it came out his nose! I laughed, but it was a good demostrate of the ease of his reflux. He was really mad about it.

Since the fundo, I haven't seen any sign of reflux. He still sleeps with his back arched, but I think it's because he's used to sleeping that way now.

We did do dilation on the 29th. His striture had narrowed some, but not nearly as bad as before. The surgeon said that the incisions look good. We are scheduled for another dilation and to get the tube changed to a button (the smaller version of the tube) on Aug 26.

We spent a few days after that at my mom's. We visited with my aunts and cousins on my dad's side, and also went to my Grandpa Noyes 90th birthday party.

When we got home Sunday, I was nearly out of diapers for Ty. I mentioned it to Ryan who replied, "Don't buy anymore." I'm not sure how serious he was, but I thought it was a good idea. We've had several potty training attempts, but something always stops me after a couple days. This time we were out of diapers, so there was no way out unless I went to the store. The first day wasn't great. Tuesday I had to go to Price, so I decided to buy a potty chair while I was there. I had told myself I would let him choose whichever seat he wanted, no matter the cost. I figured if he was excited about it we had a better chance. So what did he choose?

The PINK 'froggy potty seat'. They had a green one, but Ty wanted pink. To my joy, it was only $13. We got home, and he used it right away. He's only had 1 accident since. He has bargained to wear any diaper (including Andrew's diapers, which are way too small) to bed. He's found diapers even I didn't know I had. That's good enough for now. He wears his underwear the rest of the time. In previous attempts I would have him wear a diaper when we went places. This time I've just left him in underwear and he's done great! Even our 3 hour trip to Price, and 3 hours up the mountain. He just held it until we got home. I am sooooo excited!

Happy Again

Ty and I got a chance to relax in Grandma Nina's pool while Andrew was recovering.
Ty doesn't care much for actually swimming. He really likes to stay on the stairs and throw the toy torpedoes for others to gather.

Andrew did spend a few days fairly miserable after surgery. He wasn't allowed to eat or be tube fed until 5 days after surgery. He wasn't even interested in eating for that amount of time because he was just trying to sleep off the discomfort. This picture is from Sat 7/17. He was starting to be awake and grumpy by then.

We started feeding him by tube Sunday. What a difference! We started at 10 cc/hr, which is 2 tsp/hr. He had to prove he could tolerate that for 24 hours. Then they increased the rate by another 10 cc's every 6 hours until he got to 40/hr. That was enough for him to come home on Tues. By then he was also starting to want to eat by mouth. Now that we're home he eats anything and everything. He has completely given up his bottle since not having it in the hospital. Nothing wrong with that, I guess. It was a good way to get in extra calories by mouth, so I'll just have to tube feed that much until he starts eating more calories.

His wounds are still draining some and are red. I plan on trying to use oils to help lessen the scarring. I'm not sure if he'll think they're cool, or just be embarrassed by them when he's older. I hadn't realized until I was taking off steri-strips that they went through his belly-button for one of the holes! There's one more to the right that isn't shown in this picture. His pain has been lessening, and very managable since being home.

I'm not sure if it's being sore from surgery or just a growing up thing, but Andrew has also started walking EVERWHERE. No more crawling. It's still new to me to have him walk into the room or to walk when he wants to play with a toy across the room. It's great for him though. His newest trick is carrying things and talking while walking. Last night he was so proud of himself he did laps around Grandma Shell's living room for a lot of the evening.
We have a follow-up appointment with Dr. Barnhart next Friday. The results from the nissen seems to be optimal. I haven't noticed reflux symptoms. Andrew did gag and heave the first few days in the hospital, but since getting food again hasn't had any episodes.

As for the stricture it's just a wait-and-see deal. He's been able to eat great since we got home. Today he gagged up twice, but it may just be that he was shoving too much in his mouth too fast.

It's great to be home, and great to see Andrew doing so well. It was so hard to watch him go through surgery and the first few days after. I would sit in the rocking chair and cry for him. We trusted our answer from the Lord that this is what he needed next. Now that I can see that Andrew's healing and so happy again, I'm so glad that we made this choice. Thank you so much for the support and help from all of you.

Fundoplication Surgery

Well, after a lot of thought, research, discussion, and prayer, Ryan and I felt like it was time to go ahead with fundoplication surgery for Andrew. It's a surgery to stop reflux, where they wrap the upper part of the stomach around the esophagus, and then sew it back to the stomach.
We had known for a long time that this was a possibility because Andrew has such severe reflux, but were trying to avoid it. Now that he's had such problems with his stricture and his reflux has not improved as much as we had hoped, the surgeon recommended that we do the surgery to stop reflux from irritating the stricture.
We went in for the surgery Tuesday. Start time was expected to be 12:30 and it was going to be about a 3 hour surgery. Well, he didn't end up going in until 2:15 or so. Then they had a much harder time than they anticipated. The plan was to do the surgery with laparoscopy (5 little holes instead of an incision). Just after 8 pm the surgeon finally came out of the OR. We'd had updates throughout surgery, so we knew that Andrew was ok, but that things were not going as smooth as they had hoped.
They ended up making an incision after several hours of trying to do the surgery with the laparoscopy. They also ended up moving Andrew's G-tube sight. Which overall means they closed the old one and made a new one. Most of Andrew's small stomach was used for the surgery, so we'll have to stretch his stomach again. Overall he's doing fine. He's has decent pain control, and has been stable and healing fine. He is not interested in doing anything beyond being held and has slept 98% of the last 2 days, so far. The pain should decrease from here though. He has avoided coughing or clearing his throat at all, and did run a high fever Tues night, but an x-ray cleared him of any infection worry.
He got a PICC line placed today. Which is like a long IV that goes from the inside of the elbow, through the vein and ends just before entering the heart. He'll get IV nutrition, and all his medication through that until Sunday. Then he'll finally be able to start having G-tube feeds. He'll be starting all over, like he did in the NICU last year. They will start at a very slow rate, and use drip feedings to avoid having pressure build-up in his stomach. Then slowly increase the rate. When he gets to the full volume of feedings and tolerates it, then he can come home. The magic number is 36 cc's/hr, I think. That's just over 7 tsp/hr on a continuous feeding. We'll work on the rest at home.It's hard to see with all the tape, but you can probably tell what's what. The top bandage is the old G-tube site. The line below the tube is the incision site. The rest are the little holes used for laparoscopy. And, of course, the new tube. He'll have to have the long tube until the new site heals. This tube doesn't have a balloon on the inside because his stomach is so small again, that a balloon would possibly block to exit from the stomach to the intestine. Instead there is a plastic disc on the inside. I'm not sure how they get it in, or how they'll get it out, but that's how it was described to me. Ryan and Ty have been staying at my parents at night and visiting the hospital in the day. I stayed with Andrew the last two nights. Tonight Ryan and I will switch, and I'll stay with Ty while Ryan is with Andrew at the hospital. Man how we love those hospital pull-out couch beds! At least we get to stay with him.

Summer Fun

Like father like son. Ryan and Ty waiting candy at the Parade.
The boys at the 4th of July family party.

Ty loves getting into the dirt!

Andrew is walking now! He's been really close for a while. He started just taking a step or so, then three, then eight, and now he's anywhere he wants to be. Already he's getting pretty fast too! He really likes the independence.

We got Ty this little loader last week just for fun, and he loves it so much he even sleeps with it! He scoops anything he can find all day long. Andrew is a little jealous, but steals a turn when Ty is distracted. Usually we give Drew a dump truck and they play together with them.

Andrew is getting so close to walking on his own. He really likes to use one of these push toys to get around now, instead of crawling so much. He can turn them and get them to go just about anywhere he wants. He's getting pretty fast and loves to show off his new skills.

He has also started climbing some, and can get in and out of any little chair we have. You can tell he's pretty pleased with that new skills as well.

We passed on an old camera to Tyler, but both of the boys like to pretend to take pictures of us.

I walked into the front room and found Andrew like this one day! Like I said: enjoying climbing.

We went to the reservoir for a cookout last week with Grandma Shell and Papa Steve last week. Ty is definitely following in the tradition of his dad and Papa loving the outdoors.

With school out, I've been able to move all my piano lessons to the mornings and I only teach 2 days a week. I also take the boys for a walk on M-W-F in the morning. I love the new summer schedule. It does mean getting out of bed earlier, but I love having the rest of the day open for my plans or even just lounging around with the kids.

Ryan has been getting lots of hours at work the last few weeks. He always gets up early for work, but now he stays a little bit later. Nielson's is still waiting before they build the shop for the PRV testing, so Ryan is doing mostly welding still. He has been able to go help in the oil fields a little bit and to work on other projects for the company. I think he's enjoyed having a little variety to his work.

Last weekend we went up north and got to visit with Bonnie and Skip for a few days while they were here. We had a baby shower for Bonnie too. I'm so excited for her and Skip!

Ty has recently mastered counting 1-10. He counts all the time now. Even Andrew has picked up on the tones, and follows suit by trying to count as he plays. Ty still mixes up colors sometimes, but for the most part knows them. I love watching him learn.

Andrew has had a good month. He had a rough few days after the dilation at the end of last month. After about 3 calls to the surgeon, a trip to Riverton for an esophagram, and lots of discomfort for Andrew, we added a new medication for his reflux. I've felt like the Prevacid hasn't been enough for a few months, but after adding zantac Drew is doing much better. I still notice some discomfort, especially if I miss even one dose of either medication, but it's much better. He will usually grab at his chest, or pull at his throat when he's having what I suspect to be heartburn.

I also had an ah-hah moment this morning. Andrew hasn't been sleeping through the night for a while now. It's become part of life that I wake up and find Tyler's binks at least once, and wake up with Andrew at least once every night. I haven't really been able to say why Drew has been waking up though. I usually put his blanket back on and give him his bottle, then he'll go back to sleep. Last night he slept all through the night! I got up with Tyler and Andrew was still in the same position he had fallen asleep in, which never happens.

So what was the difference? I always have to check the formula pump in the morning, because lots of times it doesn't alarm when it's empty and will just pump air into Drew's stomach until I turn it off. So I went in to check the pump, and while the bag wasn't empty, I noticed that part of the tubing was clear. There is a port on part of the tube that popped open and I had "fed the bed". So my conclusion to this sleeping issue: Andrew's reflux is keeping him from sleeping well. His stomach stayed empty all night, so he slept! I love when I get to sleep too!

Happy Birthday Tyler!

Tyler turned 3 on the 15th. I am amazed that's time has gone so fast! For his big day we took a trip to the zoo. Grandma Nina and Grandpa Mel came with us. Along with Grandma Anderson, Aunt Joyce, Nicole, Reese, Amanda, and Peyton. We had a good time. The weather was just right: warm and sunny. Tyler really enjoyed looking at all the animals.

Afterwards, we went back to Hooper and had cake and ice cream. Tyler has now realized what presents means, and is very fond of receiving them.

The goal was a cookie monster cake. It didn't turn out quite like I'd hoped, but Tyler still liked it.

Tyler has been making us smile tonight. He’s such a character! He had a hefty dose of sugar this afternoon, so he’s been VERY energetic. He kept saying over and over, “I not a puppet. I a real boy!” He likes to watch Shrek, so that’s where he learned it.

We have been helping him to say prayers lately, and he was very excited about praying for dinner tonight. He had to wait until dinner was ready, and then Ryan helped him. It went something like this:
Ryan: Thank you for this day.
Tyler: Thank you for nursery.

Ryan: Thank you for this food.

Tyler: Thank you for church.

Ryan: Please bless this food.

Tyler: I like nursery. (still in prayer tone)

Andrew had a follow-up visit with the Genetics specialist this week. The doctor saw him playing and asked how he was doing and said he's confident that Andrew has VATER. Which is just the initials for a group of birth defects that group together often. Andrew has Tef, Esophageal atresia, and Renal deformities. That group is sometimes part of chromosome problems as well, so the doctor wanted to make sure that Andrew didn't have any other problems beyond that, but said he is confident that he doesn't have any genetic problems.

I learned from the doctor that Andrew's type of birth defect occurs when the embryo takes some sort of hit, sometime between conception and 20 days. He said it could be something like a minor illness, even a low fever that I didn't even realize I had. The experts really don't know what causes it, and because it happens so randomly and early in gestation they will probably never find out. The good news is that it's not likely that Ryan and I will have another child with EA/TEF and it's not likely that Andrew will have children with these problems either.

Andrew also had another dilation yesterday. Things went well for the procedure, but he's had a rough time since. I think he may have a virus that's upset his system. He's not been interested in eating, has been throwing up, his reflux has flared up, and tonight he has low fever. He was very uncomfortable, so Ryan gave him a blessing and he's been able to go to sleep now.

Otherwise Drew is doing great. He's making progress toward walking. He likes to walk with push toys, and has figured out how to turn them so he can go where he wants to now. He's also been practicing going up and down stairs. He gave the porch steps a try this week while I was planting flowers. He made it up and down once, but the second time he stood up against the house and ended up falling down the last two steps. He got a pretty nice scrape on his forehead and nose, but was fine otherwise.

He's also added some new words to his vocabulary including cookie and see-ya. He yabs a lot when he plays and certainly seems like he knows what he's saying. He definitely understands a lot a what we say. I like saying, "Andrew, you want a bath?" He'll take off crawling to the bathroom every time.

I love my boys!!

Redecorated!

I have been wanting to recover my couches and paint our front room for a long time. My mom had made slip covers a few years ago, and did an awesome job, but didn't like the fabric once we had it together and they faded pretty fast.

So with part of our tax return I bought myself new fabric. I used the old slip covers as patterns and put these together. I am pretty proud of my work! I learned a lot in the process and really like these. The fabric is like micro-suede.

I searched and searched for the fabric to do pillows. I found this and loved it, looked more, but came back to this one. So I taught myself how to make the covers for the throw pillows. Ryan helped me make cornice boxes to go about the windows, and then I recovered my cedar chest.

I got a really big mirror to put above my piano. I am planning on hanging family portraits above the love seat, but need to get some new pictures.

Our land lord paid for the paint. (My first time painting too.) So now we have a room that Ryan and I both really like.
Ryan and I saw this cute sand box a few months ago, and knew that we wanted it for the boys to play in this summer. We almost couldn't find it at the store, but they had just moved it and apparently the sales lady didn't know they had these. Today we drove out to the desert and got sand to put in it. The boys had a great time playing in it, until Ty got a little too excited and ended up throwing a shovel full of sand into Andrew's face and open mouth. Once Ty learns to not throw the sand, I'm sure they'll be spending a lot of the summer in the sand box.