Slowly Weaning Off Medications

Once Karlie’s breathing was finally stable, Karlie’s doctors decided to try to wean her off of her many medications again. The first ones to go were morphine and versed. She had been on both a morphine and versed drip for a couple months at that point so we knew the weaning process would be rough. Karlie was again given methadone while the morphine was being weaned to help with withdrawal symptoms. Karlie was the most miserable that I had ever seen her. The methadone was supposed to help but I don’t know that it did all that much for her. She was vomiting every day, multiple times a day. She spent most of the day uncomfortable and fussy. I tried so hard to console her but there was only so much I could do. Her body was sensitive to touch and only certain things would calm her. I remember holding her in a recliner for hours having to constantly pat her butt. Any time I stopped patting her she cried. I would sit there so uncomfortable but if she was calm and happy I didn’t dare move and make her upset.

Karlie’s vomiting became so frequent that her doctors became concerned that her body was just not digesting food properly. They thought that maybe her stomach just couldn’t tolerate food so they wanted to try a different type of feeding tube. Karlie has always had an ng tube, which goes through the nose and sits in the stomach. They wanted to try a different type of feeding tube, called a nasoduodenal tube (NDT). A NDT tube is still inserted through the nose, but rather than sitting in the stomach, it goes through the stomach and sits in the duodenum. They were hopeful that if they kind of bypassed Karlie’s stomach by putting food directly into her small intestine, her stomach could get a break and she would stop vomiting. The placement of a NDT tube unfortunately isn’t as straightforward as an ng tube. They can do it bedside, but typically it’s inserted with the use of X-ray to ensure proper placement. Karlie was not an ideal patient to move and they didn’t want her to have the prolonged radiation exposure if it wasn’t necessary so they attempted to place the tube bedside. The nurses placed the tube and then had a quick X-ray taken in Karlie’s room to see if it landed in the correct place. The tube was sitting in Karlie’s stomach so they left it in for a couple of hours hoping it would migrate its way to her small intestine. The tube never moved so they decided to take it out and just stick with the ng.

I never doubted the doctor’s theory, but my mama instinct told me there wasn’t anything wrong with the way Karlie’s body was digesting. I thought it was just the combination of medicines she was receiving and withdrawals that was making her vomit. Unfortunately the weaning process is not quick. Karlie was miserable for weeks as she slowly came off of morphine and versed. She had the most miserable look on her face and it broke my heart. She would get really sweaty and have the saddest frown I’ve ever seen. I felt so bad for her but I knew it was temporary and she just had to get through it. Once she was off of morphine and versed, they slowly decreased the amount of methadone she received every day. Once she stopped receiving methadone, the vomiting stopped instantly. She began tolerating her feeds again and we were able to start slowly increasing her food every few days. As Karlie’s volume of milk intake went up, the amount of IV nutrition (TPN) she received went down until she no longer needed it. Things were really starting to look up once Karlie was off her medications and tolerating more milk. It meant we were closer to being able to take her home.