Abigail had an appointment with the aerodigestive team this morning. It was a long one—about three hours—but it was incredibly informative and encouraging.

GI:
They are switching Abigail from Kate Farms blended meals to Compleat Pediatric Organic Blends because it’s more calorie-dense. This means she’ll be able to get the nutrition she needs with less volume. They also asked us to stop overnight feeds. They explained that feeding overnight—especially heavier feeds—can sometimes increase the risk of aspiration while sleeping.

Moving forward, her feeds will run over about 30 minutes, and she’ll have three meals a day with a snack in between. During those snack times, we’ll focus more on oral feeding. The goal is to allow her to actually feel hunger at times so we can better work on building her oral feeding skills.

The head GI doctor also took a moment to encourage us, telling Devin and me that we’re doing an excellent job with Abigail. Hearing that she looks healthy despite how complex her medical needs are—and that she’s acting like a typical, playful, social 4-year-old—meant so much to us.

Pulmonology:
They’re very happy with how healthy Abigail has been from a respiratory standpoint. Next Monday, they’ll do a test where they place a cap on her trach that measures how much she’s breathing through her nose and mouth. If there’s too much pressure, it could indicate an obstruction, possibly related to her jaw or something else.

They’re also planning a salivagram to check if she’s aspirating her saliva. Because Abigail drools a lot, this is something they want to evaluate closely.

Feeding:
The feeding specialist worked with Abigail using some baby food to observe how she eats. She’s recommending a swallow study to help determine whether Abigail handles thicker or thinner textures better.

Nutrition:
We learned that Abigail is currently being overfed based on her 24-hour intake. Switching to Compleat Pediatric is expected to help balance her nutrition while also supporting a gradual transition toward more oral feeding.

Team Takeaway:
One consistent concern across the entire team is Abigail’s drooling. They feel this needs to be addressed sooner rather than later, and they believe another jaw surgery could help. They explained that excessive drooling can make swallowing more difficult and may even cause gagging. Reducing drooling is also important to keep the area around her trach dry and lower the risk of infections.

They plan to share all of this with the plastic surgeon ahead of our appointment tomorrow.

Today was another strong confirmation that we are in the right place for Abigail’s care—and we’re so thankful for that.