Today we found out the results of the all-important stomach emptying test. Danielle, our favorite nurse, peeked at the record early this morning. Although the doctor is the one who is supposed to interpret and communicate the results, she peeked anyway and gave us the good news. After the two hours had passed, Jonathan's stomach had emptied down to 47%. He only slightly passed the 50% mark necessary to be considered normal. As suspected, his system is a bit slow/on the high end of normal, but it is still considered normal.
It was our normal pediatrician's turn on the floor, so I was able to talk to him about the results when he stopped by our room. He said the same thing...slow but normal...normal just like every other test we have run. Although not the expert, his recommendation was to only get the G Tube put in so that we can feed him. The other procedures discussed (surgery) seemed excessive in this situation. We always have the option of surgery in the coming weeks and months if things don't work out at home. More and more this is looking like a behavioral/poor eater situation. Our approach to get things checked out while we here appears to be working itself out. We've had to stay a few days longer because of all of the tests done, but in the end it means peace of mind about his GI system.
The opinion that mattered most was Doctor Yasdi's. I didn't get to talk with him until mid afternoon. He confirmed the test results and basically said that everything he's looked at appears to be normal. The G Tube is a no-brainer in this situation, so we mainly discussed what the options were in terms of surgery to tighten the upper stomach (keeps the vomiting down, etc). I asked him how he felt about taking this one step at a time instead of jumping right to the knife to tighten the stomach. He had no problem doing a trial run to see if Jonathan could keep formula down over the next few days. It is my opinion after talking to him that he perceived Jonathan to be more of a vomit comet then he really is - hence the surgery to help prevent that. I maintain that the sickness really interfered with our stay more/longer then realized. It's not difficult to see why he would think that...the little guy has been vomiting most of the time we've been here.
The result was that he increased the formula amount to five ounces from four, and then will increase from five to six tomorrow for each feeding. If Jonathan can keep 6 ounces down at a time then we're "golden". This is a trial run...but if successful, might prevent a permanent surgery from happening. At 4 p.m. this afternoon he took five full ounces through his NG tube like a champ. He didn't even flinch - in fact, the opposite happened. He played hard and was quite happy (presumably because he had a full belly). If he can keep it down here, there's no reason he can't keep it down at home since it's essentially going happen in the same manner.
In the late afternoon, the surgeon came by to introduce himself. He told us that he had a time slot available at 12:30 p.m. on Monday for the G Tube "install". Assuming everything goes well between now and then with the feedings, we'll be headed home shortly. We'll have a way to feed him enough yet can manage it more on our own terms. If things don't work out, we can always address that at a later time. Keeping fingers crossed...
The best part about today was that Jonathan was completely back to his old self. He was smiling and laughing at everyone. Because he will be getting enough fluids from his feeding tube right now, we were able to stop his IV. That meant that in between feedings we could disconnect him completely from all of the tubes. It was nice to finally hold him without having to drag anything else around.