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Pyloric Stenosis: Vomit & Mommy Freak Out

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Warning: this post is long!

As many of you know, when Porter was 15 days old he had surgery for Pyloric Stenosis. While the name sounds scarier and more serious than it actually is, it was still absolutely terrifying to have my 15 day year old infant go through such an ordeal, especially one that required surgery!

First off, what is Pyloric Stenosis? Basically for whatever reason, when a baby has Pyloric Stenosis his/her pylorus muscle thickens and prevents food from entering the small intestine from the stomach. This causes severe projectile vomiting (because the food cannot be passed.)  Symptoms usually appear between 3-8 weeks and it is most common in first born males. David had Pyloric Stenosis as an infant (when he was around 3 weeks old) and it is thought to be at least somewhat hereditary.

It all started at 4 a.m. on Friday, January 11 when Porter was exactly two weeks old. I had just finished feeding him and began to burp him when he very forcefully projectile vomited (what looked to be) the entire feeding. I’m glad David was awake and helping me, because I’m not sure he would have believed me if I would have tried to tell him what the experience was like later. This is not just “baby spit up.”  The amount of vomit and urgency of when it was vomited scared me and made me jump. However, we didn’t think too much about it and just assumed it was more spit up than usual. After cleaning up and changing, we all went back to bed.

When I fed Porter again a few hours later, he projectile vomited again. David had already left for work, but even at this point, I still wasn’t too alarmed. It worried me a tad, but as a new parent whose only parenting experience was what had occurred in the previous 14 days, I assumed that sometimes babies just spit up quite a bit.

Our morning continued and I was preparing for my good friend Rachel to come over to see the lil guy. I showered and fed him about an hour before she was due to arrive. Almost immediately after eating he vomited again, though it wasn’t quite as much as earlier. I started to worry a bit and the wheels in my head started to turn, but I wasn’t in “freak out” mode yet. In fact, when Rachel arrived, I even mentioned his throwing up, though it still wasn’t something I was majorly concerned about.

At his next feeding, he kept all the food down, so I assumed that whatever had been bothering him (if anything) had passed. I felt relieved and went on with my day; however, when I fed him around 4 p.m., he vomited, and the mommy in me began to think that something might be wrong. It was Friday afternoon around 4:30 p.m. and I decided to call the pediatrician. I knew they would be closing soon, so I didn’t hesitate any longer. When I called, I apologized for acting like a paranoid new mom and then told the nurse what was happening. She asked me a few questions (Is it after every feeding? Does he seem generally happy? Is he crying constantly?) and she decided that he was probably a “happy spitter” or that he might have reflux and to just keep my eye on it.  Since she wasn’t worried about it, I decided not to worry about it, despite the fact that the vomit was projectile and it was in large amounts. It occurred to me that I should maybe mention that David had Pyloric Stenosis as an infant, but she seemed so confident that I had nothing to worry about that I didn’t even mention it.

The evening continued and he kept his “dinner time” feeding down.  David got home around 8:30 p.m. and I was just preparing to feed Porter again. I told David about what had happened that day and relayed what the nurse had told me. Sure enough, Porter vomited again after that feeding, and it was at that point that David and I looked at each other and mentioned the possibility of him having Pyloric Stensois. We immediately got online (because Google is the answer to everything, right?) and started reading about Pyloric Stenosis and I was convinced that Porter had it. We knew our pediatric office was open on Saturdays, so we decided to see how the rest of the evening went and that we’d call in the morning if it was still happening and we were still worried.

I fed Porter again around 11:00 p.m. and as we expected, he vomited again.  At this point we decided to call the pediatrician on call and he told us to try feeding him smaller amounts and more often until we could come into the office the next morning. I barely slept a wink that night.

We went to the office around 9 a.m., and Dr. Miller evaluated Porter and felt his tummy as well as weighed him. Sometimes with Pyloric Stenosis the enlarged pylorus muscle can be felt from the outside, but Dr. Miller didn’t feel anything. Porter had lost weight (which wasn’t surprising) and given David’s history, Dr. Miller sent us to the hospital to get an ultrasound.  The first available ultrasound was at 11:00 a.m, and it was about 10:15 at this time, so we decided to head to the hospital instead of going home for the very short amount of time. The ultrasound lasted quite awhile (at least an hour), and we fed Porter a few rounds of sugar water while the technician watched to see if the sugar water was being passed through into the intestine.  While some of the sugar water passed, it wasn’t as much as she hoped to see. She sent us out into the waiting room while the doctors interpreted the ultrasound.  We were told that our pediatrician would call the waiting room to speak to us as soon as they made a decision. Thankfully Porter peacefully slept in his car seat as we waited to hear the results. I have to admit that I shed some tears in the waiting room. I knew that if he did have PS that it was fixable with surgery, but that didn’t mean that it would make the news any easier to hear. At this point I was also developing a migraine. Around 1:00 p.m., the doctor called and said he did indeed have PS and that they would be admitting him. We were told to stay in the waiting room and that someone from pediatrics would come get us when a room was ready. We waited for another hour to hour and a half and finally a nurse came to get us to bring us to his room.

Once we got to the room, we had to wait some more. We had no idea when the surgery would actually be and had to wait for Dr. Thomas–the surgeon on call–to arrive. They hooked Porter up to an IV (he needed fluids since he wasn’t allowed to eat and wouldn’t be able to for quite some time) and we basically just waited. We stood on opposite sides of his bed and held his tiny little hands. I was definitely a wreck at this point and couldn’t stop crying. Finally the doctor on call showed up and they scheduled the surgery for about an hour later. I continued to stand next to his bed and hold his hands (and continued to cry.)  Occasionally, the nurses came in to check on him and each assured me that he would be fine. One of the surgical nurses who was going to be in on the surgery even came in and told me that they would take good care of him. None of their words made me feel better. My poor, tiny, 15 DAY old baby was going to have abdominal surgery and have to be put under anesthesia. Not to mention, he was probably STARVING because he hadn’t eaten since that morning. I knew that there was nothing I could do, but I felt absolutely awful and felt so badly for Porter. I kept sobbing and telling David that Porter was probably feeling really scared. I couldn’t handle it.

When they were ready for surgery, they came in with a wheelchair so that I could hold him while they took him down to surgery. He needed to stay hooked up to his IV (which was on a wheely thing) so a wheelchair was necessary. I was 100% sure that this was not normal protocol and that they were just doing this for my sake (David confirmed this later). I cried the whole way down to surgery and when they took him from my arms, I was convinced I’d never see him alive again. Even though I took extra strength Tylenol earlier in the afternoon, my migraine at this point was probably one of the worst I’d ever felt; however, it didn’t compare to the pain of my heart breaking (may sound dramatic, I know, but it’s truly how I felt.)

We were sent to the waiting room and about 45 minutes later the anesthesiologist came out and told us that the surgery had gone well. This was the same anesthesiologist who did my epidural for my delivery. This was the second time he had “saved” us, and I feel like we owe him so much. He wasn’t even on call to work that day, but David’s mom called him and he came in on his day off just for Porter’s surgery. He told us Dr. Thomas would be out shortly to see us.  Sure enough, Dr. Thomas came to see us about twenty minutes later and told us that Porter was awake and doing well (Of course, this sent me into crying mode again.)  He told us they would come get us when we could go back to the room. We waited for another hour and then a nurse came to get us and we went back to Porter’s recovery room.

When we got to the room, Porter was sitting in a bouncy chair and while he seemed sleepy, he was awake. He was still hooked up to an IV and the nurses carefully took him out of the seat and let me hold him for awhile. Something was wrong with the IV in his hand, so they took him away to re-do the IV. Apparently they had difficulty getting it back in his hand, and when they brought him back, the IV was coming out of his head. According to the nurses, our tough little guy didn’t even cry when they took out his old IV and put in his new one.

The surgeon came to see us again a bit later and told us that we should be able to go home the following evening (Sunday) if all went well. He put us on a strict feeding schedule and said that Porter could not eat for 6 hours (not until around 12:30 a.m.  if I remember correctly). After that, we could feed him every 2 hours, starting with a very small amount (15CCs) of sugar water and eventually moving to diluted breast milk and full strength breast milk. He needed to keep down 7 feedings before we could go home (which is why the surgeon predicted Sunday evening for our discharge.) He warned us that sometimes babies continue to spit up for awhile after the surgery. We hoped this didn’t happen. At this point Porter was starving hungry and was extremely fussy. We had to hold him and give in and let him have a pacifier for the first time to keep him somewhat appeased. This went on for several hours.

Below is a picture of David holding Porter after he got out of surgery. All of the pictures were taken with our cell phones, so I apologize for the poor quality.

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We attempted to get a few hours of sleep before his first feeding (though that didn’t happen) and when it was time to try to give him his first feeding, he didn’t keep it down. Not only did he spit up, but his spit up had remnants of dried blood, which was worrisome to us, even though the nurses said it was probably just blood from the surgery.  We were told to continue with the feeding regiment and to try again in 2 hours. Two hours later, we tried again, and he spit up again (and the spit up was still bloody). The nurses called the surgeon and he wanted us to wait four more hours before trying again and starting the regiment over. Since we had 4 hours, we tried to get a little bit of sleep, but this is nearly impossible on the fold out chairs provided in the hospital (not to mention we were still worried, as well.)  This cycle continued a few more times and each time we were told to wait and/or start the regiment over.  It was pretty early on Sunday morning that we realized our predicted discharge was not going to happen. We were going to have to spend at least another night in the hospital, since Porter had yet to keep a single feeding down, let alone 7.

It wasn’t until Sunday afternoon that Porter started keeping feedings down. I felt terrible, though, because it was obvious that he was hungry. He sucked down the first few feedings so fast, and I highly doubt they were satisfying. I mean, how satisfying can sugar water be after that long without eating? Not to mention, we could only feed him such a small amount. Later in the evening we started giving him larger amounts of diluted breast milk and finally full strength breast milk. At 12:00 a.m. on Monday morning, I was allowed to breastfeed for the first time, but he had gotten so use to taking a bottle that he didn’t want anything to do with me. This was hard for me, but I knew he had to get food somehow, so for the next two feedings we bottle fed him. Finally later on Monday  morning (I think it was 7:00ish) he breastfed for the first time since this whole debacle began. Since he seemed to be keeping the feedings down, it was looking like we’d get to get to go home that day! Though he looks grumpy in the picture below, he was much happier once he was keeping some food in his belly.

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When we were finally released to go home Monday afternoon, the first thing we did was take a nap. Essentially we had close to 72 hours with very little sleep, and Porter was still exhausted as well. It felt good to sleep in our own bed and to have Porter back home.

The doctor warned us that he may still spit up from time to time and not to worry about it too much. For the first week after surgery, he did spit up every now and then (and sometimes it was projectile vomit), but for the most part he was eating well. It took him some time to get adjusted to full time breastfeeding, as he got a little lazy when he was bottle fed in the hospital. The doctor also said that he would probably eat more as he tried to “catch up” on what he had lost. And boy oh boy, our boy ate! There was one day when he literally ate every hour for ten hours straight. Eventually everything returned to normal, though.

A lot of people have asked about his scar. I took the following picture a few days after returning home. It was already starting to heal so nicely!

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I took this picture yesterday, so you can see that it’s still red and a little inflamed even 3 weeks later, but at our check up with the surgeon, he said it was looking good! Even now, David’s scar is noticeable (though not extremely), but it’s much larger and vertical. I’m sure Porter’s will heal to the point where it’s not easily seen at all, and even if it is, David says that “Chicks dig scars.”

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Finally, I’ll end this post with an unrelated picture.  This past Monday Porter officially turned one month old. I can’t believe how much he’s grown, changed, and affected our lives. We are so in love with our little man!

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2 thoughts on “Pyloric Stenosis: Vomit & Mommy Freak Out

  1. You are such a strong mama… I would have been a mess too! So glad porter is doing so well. Lots of love and prayers!

  2. Oh my gosh, I assumed this experience was physically and emotionally exhausting, but I had no idea it was this bad! I am shaking my head, marveling at what awesome and dedicated parents you guys are. You must have felt SO terrified. What an ordeal. I’m so glad he’s doing perfectly now! I have to say, that picture of him looking grumpy in the hospital might be one of my favorites of him, despite the circumstances. He just looks SO pouty and adorable, I can’t help but grin. His face just seems to say, “I am NOT a happy camper, but I can take it, man!” I think he’s going to be one tough little boy!

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