I had a "dream" pregnancy: no morning sickness, no problems. I felt great, had tons of energy, and we couldn't stop dreaming about what life was going to be like once Ava finally arrived. We talked endlessly about what she'd look like, what her personality would be like, and how "complete" our lives would feel once she arrived. We couldn't wait to meet her!

After an induction and a long hard labor for both of us, Dave and I finally got to meet Ava Bella...all 7 pounds, 10 ounces of her. Despite the cord being wrapped around her neck twice and passing meconium on the way out, there were no obvious problems in the beginning, and we were finally holding the beautiful, perfect baby girl we'd been dreaming about. Despite being exhausted, Ava and I entertained friends and family all day long, and I was just in a dream world. I was so proud of...both of myself and my beautiful girl, and I couldn't wipe the smile from my face. Ava latched on perfectly, and nursed so well, it was like we were just made for each other, and I couldn't have been happier.

My husband left around 9:00 that night, and the nurse came in to take Ava to the nursery, promising to return when she woke up and was hungry. I settled in for a much needed nap, dreaming of the next time I'd get to gaze into Ava's eyes. Imagine my shock when, only an hour later, the nurse woke me up, helping me sit up and telling me that Ava had been transferred to the NICU. She was vomitting bile, and they weren't sure yet what was wrong. Luckily, my husband wasn't far from the hospital, and rushed back to meet me.

When we arrived in the NICU and found Ava, looking so much smaller than she had only an hour before, in an incubator, with an IV in her tiny foot and a tube down her throat to help drain the bile. She waking up to gag, and I couldn't help feeling as if it was all a dream. Where was my perfect baby, and what had happened? We'd had such a great day! The doctors had already done an MRI and were awaiting the results, and in the meantime told us that they suspected a malrotation (when the intestines don't form and "rotate" properly into place before birth) or a bowel obstruction. In either case, our hospital wasn't prepared for this type of pediatric surgery, and we were awaiting transport to take Ava to All Children's Hospital in St. Petersburg.

Dave and I were shocked and devastated. I was released from the hospital around 3:00 am, only about 15 hours after giving birth. We ran home to pack a bag, and hit the road immediately, not knowing what to expect when we arrived at the hospital. They had prepared us for the fact that she may be in surgery when we arrived, so that 35 minute drive was just excruciating.

When we got to the hospital, Ava was in the NICU, and they had just started performing tests. They did and Upper GI endoscopy, a barium swallow, a barium enema, and an abdominal xray and ultrasound. Since they had not found any mechanical or anatomical issues, luckily Ava was not taken to surgery. However, she was still vomiting, forcefully. It was heartbreaking to watch...with nothing in her tiny tummy, the effort it took made her turn red, then purple, and she cried so hard that just the sight brought me to tears. I sat in a rocking chair next to her incubator that night, and hoped and prayed for answers.

The next evening, they inserted a ph probe, which she pulled out several times, and continued to monitor Ava. Breastfeeding was extremely difficult at this point since she was hooked up to so many different machines and my milk hadn't really come in, so on top of being exhausted and emotional, I was nursing and pumping, and getting so frustrated because everything we put into her came directly back out. A few days later, we finally had a diagnosis: severe acid reflux. That was it?!?!?! A little heartburn could cause all this? I just couldn't believe it. My husband has always had terrible heartburn...were they related?

They sent us home with Zantac and Reglan, to help her stomach empty faster and hopefully stop some of the vomiting. Ha! I spent the next several months topless, it seemed. We were nursing around the clock since she vomited so often, and it was truly exhausting, but I knew I wanted to keep nursing since they said it would be easiest for her to digest. I was bound and determined to do everything in my power until Ava outgrew this, as they "assured" me she would, most likely by 9-12 months. Things got a little better around 6-7 months, but by 10 months, things were going downhill again. She got Rotavirus right before Easter, and lost over 4 pounds, starting a downward slide in her weight that she just never recovered from. The Zantac just wasn't cutting it anymore, and Prevacid, Prilosec, and Zegerid also failed to give her any relief. She was up every hour, screaming in pain, often with mouthfuls of vomit, and I lived in constant fear that she would choke in her sleep. She would nurse for 2-3 minutes, just enough to calm the burn and help her get back to sleep before she was up again. Another ph probe at 13 months showed us the direct correlation between waking and ph level, and her lowest reading was 0.5. I couldn't believe that my poor girl was basically living with battery acid in her throat. It was no wonder she was so uncomfortable.

She had always been an adventurous eater, willing to try new foods, but she never ate very much at one time, and drank even less. She had never taken more than a 4 ounce bottle, and usually never even finished that. We knew that she had some lower motility issues, so we assumed that she just stayed full a little longer. She was beginning to eat less and less, associating food and swallowing with the pain of vomiting and refluxing. At the end, she was projectile vomiting fully undigested meals that she had eaten 10-12 hours before hand, and was drinking only about 6 ounces of fluids per day. She wasn't walking yet and we knew her development was suffering, and we knew that she was malnourished and deyhdrated. She had terrible dark circles under her eyes, was skin and bones, and couldn't even lay back for a diaper change without a mouthful of vomit. We knew something was wrong, and after months of being told to "wait and see" and hope that she outgrew it, we and our new GI decided that a Nissen fundoplication would be the best thing for Ava.

She had her fundo in September of 2006, but our surgeon talked the GI out of placing a G-tube at the same time, saying that his laprascopic patients generally didn't need the tube. However, in hindsight and given Ava's eating and drinking issues, both we and our GI agree that the tube should have been placed regardless. Ava healed beautifully from the surgery, and had a fairly easy recovery...she was playing in her crib right after surgery. When we got home, we had hoped that she'd feel so much better that her eating and drinking would just take off, but unfortunately, the food aversion had a strong hold on her. At her 18 month checkup, she weighed less than she did at her 12 month checkup. Our pediatrician showed us her growth curve, pointing out that she had gained less than 2 pounds in 10 months. She spoke with our GI, and it was agreed that she would go in for the G-tube placement.

Ava got her tube in October of 2006, and it was the best thing we could have ever done for her. The combo of the fundo and Prevacid had the reflux mostly under control, and now we could help her put some weight on and really recover. It was a big adjustment coming home, but we soon settled into a routine, and things were going better than we had even expected. Ava had gained over 4 pounds, she started walking, and her development and vocabulary skyrocketed...she was catching right up.

However, about 2 weeks before Christmas, Ava started retching and screaming within an hour of starting her feeds. She couldn't handle even a fraction of a feed, and within about 3 weeks had lost 2 pounds. We've yet to find a reason for this, after more testing and another hospital stay, but we're hoping things will be looking up again for us soon. Ava is able to vomit again, without much effort, she can burp and she does still reflux, but things are nowhere near as bad as they were pre-fundo. Although it's not right for everyone, the fundo was the best choice for Ava, and my husband and I are still happy with our decision.

It's been a long hard road, and I'm just trying to take things one day at a time. We're nowhere near ready to be "tube-less", she just can't eat and drink enough to sustain herself, but we see an SLP for feeding therapy twice a week, and we're making some progress. We've seen some balance issues lately, and we're working with our pediatrician and GI to determine if they're neurological or nutritional. I worry every day, but Ava shows me that no matter what, things really aren't all that bad. She's the happiest, friendliest, most outgoing toddler you could ever hope to meet, and her strength and spirit have been a great lesson for me. She's shown me life may be hard sometimes, but that a positive attitude and a lot of love go a long way. She's beautiful and perfect in my eyes, and as long as we stay strong, I know she'll be just fine.