Last Friday, Tessa went back to the Dr. for her 2 week well baby check up. She looked great, everything was fine, she had gained another 6 ounces, and was up to 8 pounds 3 ounces. After her check up, we went up to the nursery to try her carseat test again since she had failed her first one. They said they usually don't retest but we asked that they would just for our own peace of mind before moving her to her regular carseat from her carseat bed.
She failed, miserably. Again. I was a little discouraged but figured she just wasn't ready. I was also very glad that we had asked them to retest. Well, then things got interesting. They put her in her carseat bed to test to make sure that was fine, and she was just as bad. Even laying in her bed, flat on her back, her oxygen saturation levels were fluctuating between 80=95%. The threshold for passing is above 88%. At one point, her lips got a little blue and her oxygen saturation was 84%, so they had to give her oxygen. This freaked me out, big time. If she's laying flat on her back, asleep, why can't she maintain a good heartrate and oxygen sat. levels. By the way, oxygen saturation is a measure of how much oxygen the blood is carrying through the body. Normal levels are 90% and above. Like I said, a passing grade for the carseat test is 88%, but she wasn't even close.
Joel and I were upset and worried about why she wasn't able to maintain normal levels, and why she would drop during a nap while flat on her back. We also started wondering how many times before had that happened and she should have been given oxygen, and how many times in the future could it happen. We have no way of knowing how often it happens, but we knew that it happened at least once, and luckily she was hooked up to a monitor during that one episode. So, we went back to the doctor to see what he thought. He told us he didn't know what was causing it, but that it's not a big deal and not to worry. HMMMMM... not going to work for us. I won't say his name, but he's the only male pediatrician working for Trimark in Fort Dodge. I was very angry at how he had written us off and told us not to worry, when she needed to be given oxygen during a nap. How would we be able to monitor her to make sure it doesn't happen again? Wait for one of us to notice she's not breathing? I vowed not to return to him.
Luckily, we have awesome family members who are medically trained! We got a few tips for how to help keep her airway open when she's sleeping, like roll a wash cloth up and put it under her shoulders so her head and neck were slightly tipped back. We went to Des Moines on Sunday so Joel's mom, a Physician's Assistant, could look at her. She was able to get a pulse oximeter from her office, which is a machine that measures the oxygen saturation. Sunday night we tested Tessa during a nap to see how she was. Again, she kept fluctuating and couldn't maintain a steady heartrate and oxygen sat. level. Although her heartrate never dropped into a dangerous level, it was fluctuating quite a bit and she clearly was having some labored breathing.
After testing her on many different positions, we realized that the only position she was able to keep consistently high levels was sleeping on her stomach. But, due to the SIDS risk, we realized that wasn't going to work, at least on its own. Monday morning we went to a pediatrician in Des Moines, who Joel's mom works for. We also had a chest x-ray and an EKG for her to rule out heart problems. Luckily the heart was just fine!
After a few hours at the doctor, we had 2 possible answers, 3 temporary solutions, and a plan of attack for the next few weeks. Wow! I was so relieved just to have someone that would take the time to help us figure something out and try to come to a solution! So, here's what we figured out.
She has a possible hiatal hernia, which is where the esophagus meets the diaphragm. They think this is putting extra pressure on the lungs, which could cause her levels to fluctuate. She also has some reflux, which can cause her to choke/gag after eating and can cause spit up to sit in her throat. Her levels fluctuated much more when she had just eaten than when she was more than 2 hours after eating.
She is now on prevacid 2x a day to help with the reflux and the spitting up, which should help with the breathing if she's not constantly spitting up and swallowing it. She is now sleeping on her stomach, with a wedge pillow under the mattress so she's at a slight incline. Since stomach sleeping is no longer recommended and we were afraid of the SIDS risk, she now has an apnea monitor that she's hooked up to when she's sleeping. This will alert us if her heartrate goes above 240, below 80, or if she stops breathing for more than 20 seconds. Although she's not having true Apnea episodes, this will allow us to sleep when she's sleeping without the worry of SIDS. So, she's hooked up to that and a portable machine when we aren't holding her,and when she's traveling. We go back to Des Moines next Monday for a check-in to see how things are going with this new plan, and we'll retest her carseat in a few weeks.
Nobody knows why a fullterm baby is acting like a preemie, even three weeks after she's born, but at least we have ruled out a few things and have a few possibilities for what the problem is. If it is the hernia that's causing the problems, it'll either work itself out eventually or she'll eventually need surgery,but it's definitely not severe enough to cause worry right now. The treatment for it in babies is the same as the treatment for reflux. She's just being difficult for us, but in our families, should we really be surprised?!