Sugar and Spice, and Rectal Dilations

A couple of days ago Rory started on feeds of Alimentum formula. They started at 5 milliliters every three hours, then ratcheted up by 3 ml every 12 hours. She's currently at 14 ml. She'll max out at 66 ml and hold there. Math says that's another eight and a half days of this. Another eight and a half days here, at the very least. Math is honest, that must be why nobody likes him.

Her stomach girth has been looking good, and shows no sign of increase. The last x-ray I heard about showed a hint of distention, but nothing too worrisome yet. They're performing enemas again, every 12 hours. At least twice, she had tiny stools after the enemas. This morning, they dilated her rectum and she stooled. It doesn't sound like there's much technology or science behind the dilation process, so the image your mind conjures is probably accurate.

Still no word from the pathologists, maybe they can't find anything wrong. I'm okay with that. We have pretty much run out of 'good' diseases anyway. So maybe it's just a case of a lazy bowel, you know these kids today have no work ethic.

The Quiet Times

It's quiet tonight. Lights are turned down low. Babies are all asleep. So is Rory, resting confidently in her fathers arms. His back is to the large, sliding glass door that represents all she knows about the outside world. Occasionally he hears a short-lived whimper down the hall, or the faint, but constant cluck of a monitor needing to be hushed. Nurses shuffle about behind him. His focus turns to her breathing...baby breathing. The sound brings peace as he feels the rhythmic rise and fall of her chest. Her toes flinch and curl in unison. The child has been in the NICU for 5 full weeks, with no firm answers in sight.

His mind wanders and he dares to consider the situation. He thinks about the present. He worries about her future. He wonders whether she will leave this building unscathed. He doubts that he will.

What Luck!

I can't believe my luck! The timing of this windfall is unbelievably fortunate, as I can certainly use $850,000 right now (I could use $850,000 anytime!). Don't get any ideas, I've blacked out the email address to prevent anyone from trying to steal away my opportunity. Ha Ha, too bad for you!

Modern Day Florence Nightingale's

If I say Kleenex, you'll think of 'tissue'. If I say Ajax, you'll think of 'scouring powder'. If I say Victaulic, you'll think of 'stainless steel pipe couplings' (well, maybe a small portion of you will). But if I say Florence Nightingale, you'll definitely think of Nurses! So who was this woman whose brand name has become synonymous with nurses everywhere?

Florence Nightingale was the pioneer of modern nursing. Normally I would recap what I just read on Wikipedia (I have a triple major in Wikimedicine, Wikihistory, and Wikiplagiarism), but I'm currently holding Rory with one arm and typing with my left thumb. So here's a link to this amazing lady.
http://en.wikipedia.org/wiki/Florence_Nightingale

My guess is that we've had about three dozen nurses since we've been in the NICU. And here are just a few of the modern day Florence Nightingale's we've had the distinct pleasure of meeting while in the NICU.

Nurse McLinda! You've already met her, she was Rory's day nurse on the day of her surgery.

Nurse Alex - She was Rory's night nurse the night before and after surgery.

Nurse Caitlyn - She has had many adventures with Rory (or misadventures, remember the bounce seat with Christine?) She also braided Rory a cute little head band.

Sisterhood of the Traveling Samples

I know my kids are going places in life (me and every other parent, right?). But our little Rory is already on her way! Pieces of our little starlet have apparently traveled all over the country for pathology tests by various specialists. At least one report suggests a sample has gone as far as Seattle, Washington! Can you imagine – Seattle, Washington?!?! Talk about living the cellular dream!

I’ve always wondered what the cells are like in Seattle, Washington. Do they look like ours do? Do they function like ours do? Dare I ask, do they multiply like our cells do? Maybe they wear flannel shirts and listen to grunge rock.

We’ll have no final report until our sisterhood of traveling samples return with results.

Like sands through the hourglass...

So are the Days of Our Lives. Our personal soap opera continues, with all the ups and downs, dramatic pauses, and ridiculous cliffhangers that monopolized daytime television during the summers of my youth.

Season 1: "Our heroine was admitted to the intensive care unit for a mysterious ailment. Doctors struggle to find a diagnosis, but are stymied at every turn. Nurse Caitlin is playing matchmaker between Rory and the patient next door, but Rory's overbearing father will have none of it. Rory's loving mother, consoled only by the handsomeness of her youthful husband, waits patiently for an answer. In the season finale, Rory anxiously awaits the results of multiple biopsies. The once kindly RMH threatens to toss her family out into the cold, cruel world because of policy changes. An overworked doctor rushes into the room to announce..." Dramatic pause, fade to black, and cut. That's a wrap people.

Season 2: "The overworked doctor rushes into the room to announce...[dramatic pause] 'oh, we're still waiting on those results, probably get them tomorrow, maybe the next day. Could even be by Friday. ' "

In the meantime, the docs have Rory starting feeds again, this time starting with 5ml of pediolyte, and then moving to small amounts of a special formula, the name of which eludes me right now. Babymakepoopyilac or something like that. And then monitor. Supposedly, THIS time they will proceed more slowly with the progression of the feeds, AND this approach won't impact the path forward once the biopsy results are available.

Pardon me if I appear skeptical, but I feel like I've seen this episode before, and I grow weary of the entire show.

Eric "Likes This"

If you didn't know already, or haven't figured it out by the tone and content of this blog, I'm a man. I'm an old-fashioned guy that adheres pretty strictly to Rev. 0 of the guy code. That's Rev. 0, the original version, not that touchy-feely, emotional stuff that 'men' use to define themselves today. As a result, I understand and appreciate the pat on the shoulder, followed by the awkward silence when words fail to express the obvious concern and care.

But I am amazed by what I have observed since Rory was born, and especially during this time. My family has been the recipient of an unimaginable outpouring of love and support. An outpouring so overwhelming that I literally have difficulty processing it in its entirety.

To all of you that have thought of us, prayed for us, stopped by to see us, provided meals, or otherwise supported us in our time of need: thank-you so very much. Thank you to the management at SPI for your understanding during this time. An additional thank-you is extended to the Ramaha's and the Brandon's for watching our home front while we've been camped out at the RMH all these weeks. And a very special thank-you to the Davis' and the Knudsen's, who have been caring for Reese and Riley so often and for so long, allowing us to focus on Rory and her needs. These debts can never be repaid, and we are truly appreciative. I am truly appreciative.

Nothing New

No news related to the biopsy results just yet. Christine and I are heading home to Temecula tonight to spend time with Reese and Riley, and they will all return to RMH and the NICU in the morning. Perhaps tomorrow...

Day 29

Today is the 29th day Rory will be in the NICU, or as I like to call it, the start of Week 5. This week promises to be filled with answers. Of course, each week prior has also promised answers, but everybody knows Weeks 1-4 are dirty liars.

Just waiting for the Pathologist to finalize her report, provide it to the doctors, and then have them tell us about it. Preliminary results suggested that Rory does not have ultrashort Hirschsprung's disease, but she could still perhaps have an even rarer form of Hirschsprung's disease. We're three tiers deep on the 'Rare' scale, so things aren't going so good. Hirschsprung's disease is rare. Ultrashort Hirschsprung's disease is rarER. This next one is rarEST? If I ever see Dr. Herald Hirschsprung on the street, I'm going to give him a piece of my mind (but that probably won't happen since he died in 1916).

So, we're still waiting to hear about the other things too. Meanwhile, other than all the tubes sticking out of her, Rory gives no hint that she's sick, uncomfortable, or that she has any issues at all.

The Faces of Rory

Yoda - "Use the force, you must, hmmm"

Cognitive - "Let me consider your argument"

Sneaky - "Shhhh, I have a secret."

Dramatic - "Oh my stars, I'm getting the vapors"

Baby Dreamers

Do babies dream? And if they do, what do they dream about? These are questions I've asked myself with each of my children. When you hold a baby, even a brand new baby, you'll note that they twitch, and wince, and roll their eyes under their lids. Their brains are clearly firing, but is it a dream, as you and I know dreams? Or is it the same level of limited cognitive thought they experience when they are awake - "I'm hungry"?

Maybe they dream of the future. Maybe they dream of that day when they will finally turn one year old and be able to get out from under the oppressive thumb of their parents. Maybe they dream of the day when they can rely on their own two feet to shuttle them where ever they want to go. Maybe they dream of all the foreign objects they could shove in their mouth if they were only a little bit closer and within reach.

Maybe they dream about being WWII paratroopers.

The Beaut is a Brute!

Doctors indicated it can take 24 hours for babies to wake up from their slumber after surgery. Our little beaut Rory is proving to be quite the brute, powering through anaesthesia, opening her eyes, being pretty alert and mellow, all within just a few hours. This little girl is like a freight train. Nothing's going to get in her way or slow her down as she barrels ahead on the tracks of life.

Papa & Nana visit

Papa and Nana were waiting outside during the surgery. They'll miss out on holding Rory so she can recover (nurse McLinda's orders!), but they were in the room when the docs pulled the breathing tube (with a little help from Rory). Rory's back to breathing on her own, almost awake now.

She's Out!

Rory's out of surgery, and still 'out' from the anesthesia. She's intubated for the time being, allowing technology to breathe for her until she's detoxed off the drugs.

Col. Hannibal Smith (aka Dr. Tim Fairbanks) went in rectally and pulled a 2 cm oval sliver from her rectum to biopsy for ultrashort Hirschsprung's disease.

He also performed a laparoscopic procedure consisting of three small incisions - one in the belly button, and two on either side of that. Through these holes, he was able to look around with a camera to see that everything looked very normal. He also collected two more samples for biopsy. These will be tested for one other disease specifically, as well as a grab-bag category of 'other'.

Hannibal removed Rory's appendix, because that's what docs do now if they have a reason to be inside the belly of a kid.

All in all, a very successful procedure. Rory is already starting to come around. No obvious answers were found, so we're back to our waiting game, this time waiting for biopsy results.

Two weeks ago, we were hoping it would NOT be Hirschsprung's disease. Today we are praying that it IS.

Waiting...

"Parents, party of two, your daughter is ready"

The only link we have to Rory right now.

She's In.

"If you have a problem, if no one else can help, and if you can find them, maybe you can hire the A-Team."

Rory is in the operating room. The A-team has taken our case.

Nurse McLinda is on the job!

Nurse McLinda (or just Linda if you prefer) is on the job today. She's seeing us off this morning, and will be waiting to take care of Rory when she gets back to the NICU. Thank you Linda. And thank you to all the lovely ladies of the NICU (and Brian) that have helped us this far.

She's Mobile!

T minus 1.5 hours

Daybreak has crested Rady Children's Hospital. It's six AM, and Christine and I are heading over to the NICU in a moment to see our newborn baby prepped for surgery. Six weeks and two days old, our little Rory will shortly have experienced more medical procedures than I have in all my thirty seven years.

The surgery itself should be fairly routine and straight forward. These are investigative tools that get applied quite often, so the Docs are well practiced and at the top of their game. Its not the surgery itself, but the findings, that weigh on my mind this morning.

Comfort and Style

Christine's first contribution to the blog, relaying the drama for mother and nurse as they fight to ensure the comfort of an ailing child. The narrative is a heart pounding tale of struggle, perseverance, and victory!

"How many people does it take to change a battery in a bounce seat? Well, two. We [Christine and the nurse] took the whole thing apart, only to find out that there was a simple door to replace the battery. No worries, we were able to put it back together, but realized that we put the old battery back in. We just agreed to leave it, as it is working and we have a spare battery when needed. Where is an engineer when you need one?"

He was at work.

Gamps and Ganny

Gamps and Ganny came to visit yesterday. They got to see all three kids together at once, what a treat! Reese and Riley decorated Rory's room too. She's a lucky little girl to have such doting grandparents and siblings.

T minus 24 Hours

Surgery still set for tomorrow morning. Not time to start worrying yet...but maybe soon.

Waiting for the weight

Rory has achieved the 8 pound mark, six weeks after birth. A milestone I suppose, considering most babies are born around this weight. At birth she weighed in at a respectable featherweight ranking of 6 lbs. 15 ounces (that's 3.15 kg for our metric friends). She was still bigger than her big brother when he was born, and that kids getting huge. Seems like he eats everything in sight, but thats a story for another blog.

Depending on the resource, newborn babies are expected to gain about an ounce a day, or just about a half pound per week. So Rory's weight gain is obviously on the low side, but no surprise there since she's only been allowed to eat for a sum total of maybe four weeks during her short life. The electrolytes and lipids the docs pulse through her veins are sufficient nutrition to keep her healthy I guess, but they don't do much for packing on the pounds.

Blood is thicker than water...

Rory had some blood test results come back this morning that showed she was a little bit low in hemoglobin, Red Blood Cells (RBCs) and some other stuff. Doctor says it normally would not be a big issue, but because she's going into surgery on Thursday, they gave her a transfusion to 'beef her up a bit'.

I dont like the fact that my daughter needs a blood transfusion. I realize they have lots of screening methods and tests to ensure the blood supply is safe, but I don't like the thought of a stranger's blood coursing through our baby's veins. I don't know anything about this 'volunteer donor' - Who are they? Where have they been? What's in their blood? I'm sure it will be perfectly safe, and I appreciate people that donate blood, but I don't have to like it.

[UPDATE: We had asked about blood donations from family. Even that process takes a few weeks for testing to make sure the donor blood is safe. They originally didn't anticipate her needing a transfusion, but here we are.]

No News is...

They say no news is good news, but in this case no news is just no news. Just a quick update and reminder here. Rory is still scheduled for surgery on July 21 (this Thursday) at 7:30 AM. She's decompressed pretty well over the weekend, and her spirits are high. So there really isnt much to expect out of the next three days except waiting for Thursday's surgery.

Surgery will include a long segment biopsy of the large intestine near the rectum. This is intended to investigate the ultrashort Hirschsprungs disease. They'll also go in through small incisions in her belly button to scope around with a camera, grap some material for biopsy elsewhere, and even remove here appendix. Can't say how long the procedure will take, as its very dependent on what they find once they're in there. My guess is if they only do what's described above, it'll be a couple of hours. If they do more than that...?

Rory Loves Cuddles

[EDIT: After seeing the title and picture together, I think Grandpa may have a new nickname!]

Today, Grandpa and Grandma came for a visit and a cuddle (as Nurse McLinda says - because she's Scottish). Despite her obvious discomfort at times, and constant hunger, Rory is a very easy going and mild baby. She's very expressive and interested in the sights and sounds around her. Her expression here seems to suggest "pull me in closer so I can give that mustache a tug!"

Big Trouble at McDonalds this Sunday AM

Given the circumstances, the title may have mislead you. Fear not, the trouble is at the onsite McDonalds restaurant this Sunday morning. The cash registers are down and the teenage staff has resorted to pen, paper, and calculator to keep the profits flowing for this McD's franchise.

Despite what these kids have been told by their public school teachers, they WILL have to use math in their future careers. It makes me proud to be an American, when I see that our youth still heed the call of honor and duty, and are willing to step up to face any challenge placed in front of them. In this day and age, asking these kids to apply the commutative, associative, and distributive properties of addition and subtraction by freehand is the same as asking our American boys to storm the beaches of Normandy almost seven decades ago.

Carry on brave souls, carry on. America needs you now more than ever.

Rory, Live!

That will be the name of Rory's variety show, up in neon lights on the marquee. Most of the nurses have become so enamored with Rory because of her easy going nature and good looks, we're thinking about kicking off a 32 city US tour when we get past this. Instead of the boring and typical singing, dancing and sketch comedy routines of standard variety show's, Rory's show will consist of cooing and smiling. The big finale will include grunting, leading into a successful poop! It will be a huge hit.

Saturday Morning in the NICU

At this stage in life, most of our Saturday mornings revolve around getting breakfast for the kids, TV or playing, and if I'm real ambitious, I might even mow the lawn before noon!

The past few Saturdays have been a little different. But that's what babies do to you. They force you out of your norm, and require you to give more of yourself than you even thought you had.

Wikidoctor

I'm not a doctor, but I play one on the internet. I'm just a few credits shy of obtaining my MD from the University of Wikipedia. If you're like me, then you've already googled the various medical terminologies and procedures that you've heard described, or perhaps read about in the various emails, texts, facebook posts, and now blog postings associated with Rory's condition.

But be careful. Don't forget that there is much lunacy out there. There are also well meaning and good intentioned, but inaccurate sources of information available on the internet. Don't assume that because a website was listed near the top of the Google search results that it must be the most valid and knowledgeable. Don't assume that because you read three or four paragraphs on a particular subject that you're knowledge is now tantamount to the doctor that went to school for a decade and has been practicing medicine for twice as long. I wish it were that easy, but it' not. As an example, if you google Hirschsprung's disease, you may eventually find this very blog within the results. And I certainly don't have any idea what I'm talking about. I'd be lucky if 50% of the information I've tried to capture here is accurate.

I encourage everyone that is interested to learn more about what's going on with Rory. Like anything, just remember the source of your information. Knowledge and information is available at unimaginable speeds these days. So fast in fact, that proper vetting and confirming is often overlooked or simply neglected. So be careful, don't read into the worst case scenarios and think that's what Rory has in store for her. And most importantly, don't ask us about it.

Date for Surgery

We have been slotted for surgery on Thursday, July 21 at 7:30 AM. We'll see if that schedule holds til then...

July 14, 2011 - update

Newborns have tiny veins, no surprises there. These veins are not designed for catheters. Catheters can fall out over the course of just a few days, especially if you have a squirmy, stretchy, kicking newborn. Over the last two weeks in the NICU, Rory has had at least 10 catheters or attempted catheters (did I mention newborns have tiny veins?). They've placed these, at various times, in both hands and both feet in order to supply the dextrose, TPN, and lipids required to supplement her when not feeding. If they know a baby will be here a while, they'll do a PICC line, or a peripherally inserted central catheter. But otherwise, if they can avoid it they'll manage with the normal IV line.

PICC lines travel the vein all the way to near the heart, where they can deliver their load more efficiently, without threat of falling out, or being yanked out by a flailing baby. I imagine its like threading a needle, except it's more like 100 needles, randomly stuck in a pin cushion about a foot long. While blindfolded. The procedure is long, 2-3 hours, without any anaesthesia.

Rory got a PICC line this evening.

Ronald McDonald House

I can't say enough about the organization, or the good people that work and volunteer at the Ronald McDonald House Charities. They organize meals and provide a place to stay for families of ailing kids, as well as much much more. They lift such a huge burden from the shoulders of people that are already straining under pressures of thier specific situation. Thanks Ronald.

RMH even has a salon where you can get your hair done (true story). Only problem is, they only offer one hairstyle.

[UPDATE: the kids were mortified when they saw this pic, which makes it all the funnier, right? Despite popular assumption, these aren't wigs, just a quick photoshop job.]

July 14, 2011

"Life moves pretty fast. If you don't stop and look around once in a while, you could miss it." -Ferric Bueller, 1986

The same could be said about diagnoses made in the NICU. In the last 24 hours the path ahead has changed at least a couple of times, shifting quickly from possibly being discharged to exploratory surgery scheduled for this afternoon. Now, the path ahead has changed yet again.

Our little Rory is proving to be a medical mystery of sorts, defying all textbook expectations and thumbing her nose at the doctors' combined knowledge and experience. The x-ray they took yesterday suggested the distention of her bowels was getting worse, prompting the reinsertion of the tube down her nose to decompress her, the return of the IV, and the complete removal of feeds (again). Additionally, they added enemas every six hours to clean her out and decompress her faster, ultimately prepping her for the intended surgery today. But things move pretty fast in the NICU...

As of right now, the plan is to delay surgical exploration until next week, giving Rory's bowels time to decompress and perhaps more importantly, relax. Try to keep up here, because this is where you might get lost, or you may think you're reading a previous entry. They are thinking her situation could be...wait for it...Hirschsprungs disease. More specifically, an even more rare form called Ultrashort Hirschsprungs disease. This is where the problem effects such a small piece of the large intestine that it gets missed in the typical biopsy. To check for this, they'll perform another biopsy, but rather than random, circular snips of the bowel, they'll cut a long piece for the testing. This allows them to see exactly where the ganglion cells stop, if in fact that's the issue. In some cases, this biopsy procedure even resolves the issue.

They will also perfom laproscopic surgery at the same time, making a few small incisions in the abdomen to insert cameras and look around, remove her appendix because its not necessary in humans anymore, and snip out another piece from higher up on the intestines that will be used to biopsy for another, even rarer disease. But I won't post the name of that so you can't go google it. It won't do anybody any good.

Planning on 5-7 days for the biopsy results. So we have AT LEAST two more weeks in the NICU, pending further developments and results. All the while, little Rory will continue her residency at Rady Children's hospital. And we will stay on at the RMH, as long as they'll continue to have us.

Thanks to everyone, friends, family, coworkers, and complete strangers for thier thoughts and prayers. Keep them coming.

July 12, 2011

Well, disregard previous. Based on Rory's x-ray from this morning, they want to hold her at least until tomorrow. Doc showed us x-rays from previous period when her swelling was reduced, compared with this morning's. Could clearly see bowels were enlarged with gas and and air. They're going to reduce feeds again, maybe develop a regimen for metered feeds we can follow at home. No need for IV or nose tube at this point, so that's good news.

July 12, 2011

They've told us that Rory is being discharged today! We're very happy, but they kind of sprung it on us, especially after talking about monitoring her for several more days. Maybe they need the room.

But she is seemingly back to normal. No real answer except that her bowel just takes a long time to move things through. The slow fill with gradually increasing volumes of feeds seems to have done the trick. We'll continue to give her prune juice at home and monitor her progress, but at least we'll be at home!

Goodbye Ronald...goodbye Grimace...goodbye Mayor McCheese...I'm going to miss you most of all Hamburglar!

July 6, 2011

Rory had her upper GI contrast yesterday. This time they fed the barium liquid straight down her nosetube into her stomach. We don’t have any results yet because the doctors wanted to see the barium travel through her entire system. This meant collecting X-rays throughout the day/night, with the last one this morning. So far nothing has come out the back end, so maybe they’ll be able to pinpoint where it’s being hung up. Another possibility is that she may simply have an immature bowel (like preemies) that moves really slowly. Corrective surgery for obstructions or twisted intestines, medication and patience for immature bowels. I like the latter at this point.

July 5, 2011

Over the weekend Rory started bloating again following feeding. X-ray suggests a dilation of the small intestine (probably expanding and swollen due to downstream blockage). They took her off of feeds and put the IV and suction tube back in. They're going to do an upper GI contrast today (this time she drinks the barium). Its likely this issue will require corrective surgery similar to the Hirschsrungs.

June 30, 2011

For those that haven't heard the details, here's a synopsis. We took Rory to urgent care on Monday because her stomach was distended and she wasn't eating or passing anything. We had been cautioned by the pediatrician to monitor such things when we left the hospital because Rory was a little slow in taking her first poop. While rare, they were concerned she showed a couple of signs of Hirschsprungs disease (I'll let you google that).

From urgent care she went to the ER, and from the ER to the NICU. They stuck a tube down her nose all the way to her stomach to siphon out everything and to relieve the bloating. They've had her on an IV of sugar water (dextrose) and she hasn't eaten since Monday. Today, they started supplementing her IV with nutritional fluids of some sort.

Tuesday she got a barium enema and x-ray to look for a blockage, but that didn't show anything obvious. Today, they took a biopsy of her large intestine to conclusively determine Hirschsprungs or not. We should get results tomorrow. If it is Hirschsprungs, then it's correctible via surgery, the severity of which is dependent on the location of the problem on the large intestine. If it's not Hirschsprungs, then we are back to square-one in trying to understand the problem. Meanwhile, Rory's stomach is returning to normal and she currently appears fine except for being really, really hungry. But we don't know if she'll just bloat up again once we start feeding her, so she'll likely be in the hospital for several more days regardless of the biopsy result.

Reese and Riley are well and having fun at their grandparents house for now. Christine and I are staying at our new best friends house - you know him too, he's the world famous Ronald McDonald! The RMH organization must be one of the most well known, but under-appreciated charities out there. Based on what I've seen, they provide a tremendous amount of support to relieve many burdens, big and small, from the families of sick kids. Kids that are in a lot more trouble than our Rory. So next time you're at Micky Dee's (you know you eat there!), toss your change in the box next to the register because it really is a worthy cause.

June 28, 2011

We had to admit Rory to Rady's NICU tonight. They're going to run some tests in in the AM for a possible blockage preventing her from pooping and not eating sufficiently. That will likely lead to a biopsy and more tests.

The beginning

Rory's story starts out like any other...she was born. Rory was born into a family that loves her, with a mother and father that very much wanted her, and an older brother and sister that were eagerly anticipating her arrival. From there her story deviates a bit from the preferred path of life. So much so, that in her first five weeks of life, she spent more time in a hospital than at home with the family that loves her so.

After an uneventful birth and fairly typical hospital stay for mom and daughter, Rory went home where she was doted on by family, as all newborns should be. About two weeks after she arrived home, her bowel movements became less and less frequent, and her feeding started to drop off. She became very lethargic, and would simply fall asleep while feeding.

Christine grew concerned quickly, and took her to the pediatricians after-hours urgent care. They recommended that she take her over to the Emergency Room at Rady Children's hospital since it was fairly close, and they would have the proper equipment to perform a more thorough assessment.

In order to catch up to today in the story, the next few entries are correspondences provided regarding the developing situation.