Thursday, August 29, 2013

Dr. Knopp follow-up

Life is quickly becoming hectic again as that time of year roles around again. I began my third year of veterinary school on Monday, a long awaited but stressful milestone. I have the opportunity to do live animal surgeries for the first time which is another exciting but daunting opportunity. Karen went back to work for the first time since Landon's birth Monday as well. Her employer was very kind and patient to wait all summer for her to come back. She has slightly reduced hours (1-6 pm Mon-Fri and every other Sat) but the extra income is a great relief and I know working can be a great stress reliever and can relieve a bit of the cabin fever she's had staying home with the baby 24/7 for 4 1/2 months.

Karen was able to go back to work because we have been approved for a registered nurse to come into our home from 10:30 to 6:30 during the week to help care for Landon. Due to the severity of his condition, the state approved us for the maximum hours of in home care. Unfortunately, few babysitters or daycare facilities have the training necessary to care for Landon if he would aspirate or seize while he was in their care. It is very comforting to have someone specifically trained for these circumstances caring for our Little Goat while we are away.

Yesterday was Landon's second visit with his primary care physician, Dr. Knopp. During his examination, Karen notified the doctor of some granulation tissue (AKA proud flesh or granuloma) we've noticed developing around the healing edges of his gastric feeding fistula (hole in his skin and stomach that the feeding tube passes through). Dr. Knopp agreed that it wasn't a major concern but that it was better to remove it than to leave it in place. He used a cauterizer to remove the growth, essentially burning it off with an electric current. The spot where the tissue was removed has been a little sore for Landon but we didn't want the granuloma to grow large enough to displace or put pressure on his gastric tube.

While at the doctor, Landon was measured to assess his growth and development. Landon is 24.5 inches long, 12 1/2 pounds, and still has a cranial circumference of 32.5 cm. For his age, Landon is in the .001 percentile for cranial circumference (which is not a surprise), the 8th percentile group for weight, and the 25th percentile for length. We have been consciously keeping Landon's weight down due to doctor concerns that he could rapidly become overweight due to his reduced activity level. However, these measurements seem to indicate that Landon's metabolism is working at a sub-par level and haven't been providing him adequate calories for growth. This could be due to poor innervation of his intestines or some other undocumented problem. We have increased the amount of food he is getting in hopes that if we give more calories than he needs, his body will be able to collect enough to average out his insufficiency. For example, if his body is only working at 70% efficiency, if we give him 121% of his daily caloric needs he should collect 70% of that which would be our approximate daily required calories target (100%). It takes a little bit of guess work and good luck to hit the right number but we should get there eventually.

The fishoff is quickly approaching and we would really love to have anyone interested come out and join us this Saturday. I know it's going to be scorching hot but we will have cold water and lemonade available and good shade. Even if you can only join us for the meal we would love to see a huge crowd. The tournament registration will start at 7 am but we will be accepting new registrants all day. The final weigh in will be at 4 pm sharp with prizes immediately after and food being served at 4:30 until the last person leaves. Thank you again for all your support and love and have a blessed holiday weekend.

"Healing is impossible in loneliness; it is the opposite of loneliness. Conviviality is healing. To be healed we must come with all the other creatures to the feast of Creation." - Wendell Berry