It's Friday....already!?!?

Knew this would be a busy week but PHEW!

It's FLOWN by.

Okay first off Makily's gastro appt went well. Since April of 2007 she has gained a whopping:


EIGHT YES 8 POUNDS!

They were thrilled with this!

She is in the 10th percentile for her weight (32.5 lbs) and she is not quite on the charts for her height (36.5 inches, she's a little shorty!).

We went over the upper GI and her small bowel follow through.

The upper GI DID in fact state "mild reflux noted past the esophagus suggesting a slipped Nissen". The doctor and I discussed this in length. He said that since it's mild that at this point we will just monitor her. I told him she recently did vomit about 5 cc's of triaminic when she was sick. Other than that though she has not been able to get anything else up. He said as long as she is not vomiting often, spitting up large amounts or having a chronic cough that it is okay. He said the increase in retching most likely IS in fact due to the mild reflux that is surpassing the Nissen. Makily does not take much by mouth and so her gag reflex is super sensitive. He feels like the reflux triggers her to gag and then she starts retching.

He said that the small bowel follow through showed that her small intestines moves things QUICKLY. That would explain the diarrhea but not the constipation issue we have more often. He says that most likely since most of the water is absorbed in the small intestine that once it hits the large intestine things LAG and slow down tremendously and since it sits there a while it hardens.

I asked him his thoughts on the puree's through the G tube. He asked why I wanted to do it and I told him that we had tried Miralax last year and that we didn't really find a happy medium. I told him that I wanted my child to be able to poop. His concern with the puree's is that Makily has such a sensitive GI system. She was on ALIMENTUM for two and a half years (a year and a half longer than recommended but she couldn't tolerate anything else). That when we switched her to Nutren the weaning process took almost six months to do and he is afraid if we switch to puree's she will have a hard time adjusting. He wants us to try the Miralax again in a different dosage schedule. He says if it does not work this time that when we go back in four months he is willing to assist us in trying purees through the G tube. I am willing to compromise and so that is the plan for now. The nutritionist came in and we discussed Makily's caloric intake. She said we could increase her a smidge right now but that since she is doing well and gaining weight we will keep her at the amount she is at. It's quite a balancing act as far as calories, volume, retching and weight gain with Makily.

All in all it went well and we will be going back in four months for a follow up.

Yesterday Makily's class had another Field Trip to the Villages. She zonked out on the bus right over there, I woke her up a little later though. Yet again it was an amazing time and the all the kids just choke me up so much. I just want to hug them all. Makily and I rode the golf carts twice and she giggled on every bump. It was INCREDIBLY cute. Then all the little boys in her class flirted with her like crazy. I have tons of pictures (see montage below). Makily enjoyed every moment of it and flirted right back. What a popular little girl she is!

There has been LOTS of drama surrounding our foster licensing but all of the revisions requested were completed and sent to the zone yesterday morning! It really won't be long now. My friend Sarah that was literally one week ahead of me in the process got her FIRST PLACEMENT yesterday. HE IS ADORABLE. I am so thrilled for Sarah as they had many of the same "glitches" in the process as we have had. What's really exciting is that they were officially licensed on Mon or Tues and got their first placement yesterday! THAT WAS QUICK HUH!?
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We are gearing up for Makily and Delaney's birthday party tomorrow. We have all kinds of pools and water slides for the kids. It should really be so much fun and I can't wait to see what a great time the kids having playing. I can't believe my baby girl is four. WOW. Expect lots of pics and video from the party!

Enjoy the montage from yesterday's Field Trip.

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