Jonathan did really well with the feeding changes. He took four ounces of formula twice - once at 4 p.m. and again at 7 p.m. During the night he was still on a constant drip, but the small volume didn't bother him. Interestingly enough, the volume he kept down last night was the same amount he was vomiting up during previous attempts. Sounds to me like the virus/infection was complicating things and now that he is over it he can tolerate food.
Today was extremely uneventful for me. I had to go home in the morning and prepare for my interview at 11 a.m., so I missed the gastric emptying study. They basically tossed in some isotopes into his feeding tube and measured the rate at which the radioactive material moved its way through Jonathan's system. In a very anti-climatic finish, we never did get the final results of this big study. I think we will find out the complete results sometime tomorrow morning when we talk to the doctor. From what I hear, the preliminary results seemed to indicate that his system was slow...how slow is key to understanding his condition (if he has one). Gastroparesis is defined as after two hours, 50% or more of the food ate is still in the stomach. I'm not sure the test even went that long, in all honesty. We think that's the issue we're dealing with, but we need more information to confirm that. Gastroparesis has no known cause. The offender is the vagus nerve - the nerve responsible for the contraction (and thus movement of food through) the stomach.
To me, the degree to which his system is slow is important. It's important because we're now facing a decision to make about surgery. If his system is slow but not severely, do we try and manage this first and foremost with other options and leave surgery as a last resort? What damage can be done if we take him home and feed him through a tube for a few weeks to see what happens? We'd all have time to decompress, regroup, and explore all options before just going straight for the knife. In this sense I don't feel like we've done our due diligence. The doctor has been great but we haven't had this discussion yet...probably because it was too early to have it. So many questions right now. I think the doctor might be trying to assist us on the assumption we just want it taken care of. The more I think about it, the more I'd like to take it all one step at a time. That is, get a diagnosis, talk alternatives and treatment (another consultation after our hospital stay at his office perhaps), and then go from there. If the best course of action is surgery, then so be it. I don't want to have surgery done without really thinking and talking through all of our options. I'm not sure after this stint in the hospital we're in the best shape right now to make decisions of this nature if we don't have to. This, of course, all assumes that we can keep him fed enough with a simple outpatient procedure (giving him a new belly button for syringe feedings) in the meantime.
However, if things work out where staying in the hospital and having surgery is the best option, it looks like we could be here through the weekend and all next week for recovery time. Brutal. I can't take another day like today - coffee for breakfast, peanut butter and jelly sandwich for a snack, McDonald's sausage breakfast burrito on the way to the interview, a slice of pizza and soda for a late lunch, then a trip to Taco Bell for dinner. We just don't have any food left in the house and can't be bothered to cook anything when we get home. I need to make better choices otherwise we WILL be having a surgery discussion...about me.