Xavier Hugs the Blues
Greetings to all.
Not long ago, Rebecca had an event which required her to dress up in her blues. I wanted to get pictures of her alone, but she agreed to pose with Xavier. Personally, I think Rebecca looks striking in her blues.
It took a while to get Xavier to forget Lt. Mom's chestful of medals long enough to look at the camera. Even then, Xavier used his hands to keep a placeholder for when the shooting ended.
Nine Month Checkup
Greetings to everyone!
Xavier had his nine month checkup today. Dr. Abbey was out of town, so Xavier was introduced to another doctor in the office, Dr. Schimalel.
Dr. Schimalel provided much encouragement. Though we are generally happy with Xavier's development and growth, still we have that little nag of "he's not growing as fast as he should" in the back of our heads. Of course, that nag is put into our heads by his doctors.
Dr. Schimalel told us Xavier is behaving like a 9 month old should. A 9 month old, not a preemie-adjusted 7 month old. She also told us not to worry over his growth, everything developmentally looks good. Glory to God! Rebecca and I know this, but it's nice to hear it from the same source (doctors) who plant the little doubts. Overall, Dr. Schimalel was very impressed by our little man; she predicted he will be tall and lanky.
Rebecca told Dr. Schimalel about how she now wakes Xavier up a couple of times in the night and feeds him while he is mostly asleep (because he drinks most of bottle at such times). Dr. Schimalel laughed and said this technique was inventive.
Xavier had two more shots today, his third and final Hep B and another Polio. He got two pokes and cried very little with today's shots. This impressed Rebecca, who is always sensitive to his pain.
Here are today's stats:
- Weight
- 12 pounds, 1.6 ounces, a gain of two ounces in a week.
- Height
- 25 inches; a full inch longer in 18 days
- Head Circumference
- 43.5 cm, or 17.13 inches; a gain of 0.13 inches in 18 days
Xavier poses in his bassinet, something of a feat as this was taken in a lull of his activity. He often is in the bassinet when Dad has work to do, but needs to keep an eye on him. (one of the "Big Three" rules of the Parents Discharge class at the NICU: never leave a child unsupervised!)
Closing in on 12 Pounds
Greetings to everyone.
We got a surprise check in the mail, a refund from Apria, the company that supplied Xavier's oxygen tanks last summer. They reviewed our file and found we had overpaid about $116.00. We were excited to see Apria reimburse us. Immediately, Rebecca had the money spent!
We went out and found a high chair for Xavier. It's a nice one; the seat can be removed and used as a booster seat later. Of course, it was a little more than the refund, but not that much more. We put it in the cart and headed for the checkout.
Xavier likes the chair, and it's easier to have him join us at the table while we eat. In the last couple of weeks, Xavier has had a "quantum leap" in some development skills. He sits up on his own and is very stable. He is also about to figure out the whole crawling thing--he is so close! The high chair allows him to sit rather than recline, which annoys him now that he has a good command of sitting up.
Xavier had a checkup today. We thought it was his 9 month checkup, but we were mistaken. We learned that, just because he turned 9 months and had an appointment (for his RSV shot), it would automatically be his 9 month check up and exam. Nope, we learned we had to actually and explicitly schedule his 9 month exam. Armed with that knowledge, we have scheduled him for next week.
We do have a new weight for him as of today. It's an impressive number given his recent weighings. He is now at 11 pounds, 15.6 ounces. That's about a three-quarter pound increase in the last ten days. Glory to God! Rebecca has been pulling her hair out trying to get him to eat the amounts the doctors want him to eat. Xavier, however, is having none of it; he eats what he wants, when he wants. Rebecca's newest trick, which is generally successful, is to wake him up and feed him before he becomes fully awake and distracted by every shiny object or noise. Speaking with the PA who saw him today, she told us "he's not on the average curve, but he is maintaining his own curve." That is Xavier's story for the last year!
Sitting in his Johnny Jump-up, Xavier squeezes a slice of banana in his fist. Off to the side and vigilant, but out of frame, Lena the Dalmatian waits for him to drop something to the floor. Lena has been really good around Xavier, but this was a lesson to us to not leave her unsupervised when Xavier has food. It was one of those "aha" moments for us.
Here, Xavier demonstrates how to properly smooch a banana slice on the table of his new high chair. Later, he will try to pound it into the plastic tray top. Failing that, he will drop several slimy chunks into the seat.
An Upper GI Exam
Greetings and hello to everyone.
Late in the afternoon yesterday Children's Hospital and Rebecca finally got connected on the upper GI exam appointment. Rebecca chose the 8:30 AM time slot this morning. Partly, this was driven by the fact Xavier has become stubborn about eating; he is not taking in the amounts he needs. This problem seemed to exasperate itself after visiting the doctor last week (the one who referred us to the radiology center at Children's). Yesterday's attempts to get Xavier to take his full daily amount reached a new limit of frustration as he clam-mouthed and repudiated the bottle with new resolve.
So, 04:00 this morning was his last bottle for a while (he had to fast at least four hours prior to the exam). He drank about 3.5 ounces, leaving one ounce behind. As 08:30 neared, he demonstrated a ravenous hunger setting in. Hopefully, this would encourage him to drink freely of the barium bottle as he lay under the fluoroscope.
That plan was a pipe dream! Three people held him in place while the doctor managed the scope. A four foot, maybe 5 inch nurse held Xavier's feet while a technician worked with Xavier's head and administered the bottle. Rebecca helped hold Xavier's arms out of the way, while I stood to the side with the doctor and discussed the images flashing onto the monitor. All of us except Xavier were dressed in lead-lined gowns; we even wore lead-lined gator-like neck pieces.
His first few minutes under the scope he fought and screamed and grew upset. It's been some time since we have seen him so angry. He managed to swallow a very small drop of barium. It stayed in his mouth for some time, but his fussing let this tiny drop eventually slide down his throat. It was nothing more than a simple test to tell us the fluoroscope was working. After several minutes of struggling, we took a break and Mom held him for a while. He calmed down a bit, enough to go for round two.
Much calmer this time, he drank a sufficient amount of the barium. As he swallowed more and more, the technician and nurse turned Xavier onto his left side, then his right, then onto his back, or some combination of these so the doctor could get good films of the barium moving through his esophagus, stomach, duodenum and upper intestinal tract.
The barium trace moved through his tract as expected; everything looked normal and healthy. It was nice to have the doctor there to interpret the exam results as they were collected. Still, we are waiting to hear the final analysis. The doctor went away to study the films on a higher resolution monitor and dictate his notes. He will send them to Dr. Abbey and we should learn the full results tomorrow. The doctor said he saw nothing abnormal, and he expected not to find anything upon closer review.
We shook hands with the technician and doctor, changed Xavier out of his little hospital gown and back into his street clothes, then followed the nurse back to the waiting room. Xavier was not coy about taking his bottle then!
Waiting for a nurse to take us back to the exam room, Dad and Xavier play with one of the toys in the dressing room.
The smallest gown they had, and still it was too big! The pants alone nearly came up to his arm pits. It's a typical hospital gown, open in back with string ties to hold it closed. The purpose of the gown, we were told, was in case he spit up his barium.
GI Visit
Greetings to everyone.
Late yesterday we got a call from Children's Hospital. The reason was to set an appointment with the GI specialist. Dr. Abbey had, on Monday, made an urgent request that Children's see Xavier as soon as possible. Surprised by the call, Rebecca and I took the opening on Thursday morning.
We visited with the same GI doctor we saw in August, Dr. Shikha Sundaram. We answered many of her questions and explained what brought Xavier to see Dr. Abbey.
Dr. Sundaram told us the white stool is common with babies fighting an illness. Rebecca and I felt a bit of relief. Though we didn't think we held any angst about this, apparently we held a little. Dr. Sundaram also repeated that his growth rate is not where it should be.
The doctor suggested a number of issues for Xavier's slow growth. Several tests were suggested, including X-Rays of Xavier's stomach and upper intestinal tract. During all of this, Xavier was happy, cheerful and flirting with Dr. Sundaram.
We mentioned how Xavier grows distracted while eating, that we generally have to feed him in a dark room, like a sensory deprivation chamber, for him to concentrate long enough to down a whole bottle. When Xavier got hungry, Rebecca pulled out a bottle and he took it. Dr. Sundaram, after tying in some notes, looked up and asked another question. Her voice immediately pulled Xavier's attention away from eating and onto her. "I see what you mean," the doctor stated, then was quiet while Xavier finished.
Near the end of his feeding, Xavier began arching his back, something he does a lot. Dr. Sundaram asked "does he arch his back like that a lot?" That is a sign of an acidic stomach, a condition which puts babies off their feeding. Out (for today anyway) went the X-Rays and in came a prescription of Zantec to see if that will help.
Further, the caloric concentration of Xavier's formula was increased from 26 calories per ounce to 28 calories per ounce. I asked my standard question about having too high a caloric diet, but learned Xavier is past the need to worry about his body getting programmed for high-calorie intake. And, we learned, preemies often need higher calorie mixtures for growth. Because of their early delivery, they generally develop how to use lower calorie milk (like breast milk) some months later than term babies.
After reviewing the lab results Dr. Abbey sent over, Dr. Sundaram told us his liver results look normal. The elevated numbers on some of the metrics are most likely due to Xavier not eating enough. Apparently, it's common to see those particular metrics elevated when a baby is not eating enough.
So, our take-away today was
- Feed him every three hours whether he indicates he is hungry or not (except during his night to morning sleep; it's better for him to sleep a few extra hours)
- Offer him more formula. He has been having four ounces per feeding, now it's four and a half.
- Feed him a 28 calorie per ounce mixture
- Feed him Zantac twice a day
- Have him weight and growth checked in two weeks
Of course, you can't just walk into the doctor's office and not get weighed. Not only weighed today, but length measured and head circumference also. Here are the numbers:
- weight: 11 pounds 3.9 ounces; a 2.7 ounce increase over last week
- length: 24 inches; that is 1.25 inches longer than early December
- Head circumference: 17 inches, an increase of 1.05 inches since November 15th
Xavier plays in his Johnny Jump-up, a new toy he scored from he God parents. He enjoyed it for a few days, but he does not like being confined to it. "Give me the open floor and a scattering of toys," is his cry more often than not these days.
Rebound
Hello to everyone.
Rebecca headed north for her weekend with the WYANG, leaving dad to look after Xavier. Friday's snow closed the highway for a while, so Rebecca's departure was delayed until late in the day.
Over the weekend, Xavier kicked the last of his stomach virus to the curb. His stool began to return to normal color. Though it did not rebound as quickly as it degraded, still, by Sunday night it was nearly normal. By Monday, good color and consistency. Thank You, Jesus!
We are considering whether or not to follow up with the GI specialist at Children's. It means more tests and blood draws, discomfort we do not want to put him through if unnecessary. Dr. Abbey is consulting with some other people who know more about the liver, sending them Xavier's labs for them to review. We are still waiting to hear back from these doctors.
With Xavier's recovery has come his desire not only to handle everything he sees, but to be anywhere he sees. However, his mobility is limited, which generates frustration. This frustration, however, is good. It is spurring him to try various means of moving around.
One of those means is figuring out crawling. He hasn't reasoned it out yet, but is getting closer. He has figured out the back end with his legs and knees, and he has figured out the front end with his hands. This issue is he hasn't figured out both need to work together. He will either push forward to fall on his face, or he presses up and lets his hips collapse and legs slide backward.
As for the Super Bowl, what a miserable game. Xavier and daddy watched it, daddy explaining whom to cheer for and whom to deride. Alas, Xavier became so disappointed, he turned in early, foregoing the second half. Perhaps he dreamed of next year.
Mom and Dad have not purchased a high chair yet, though that is on the list sooner than later. Here, Xavier makes the best of his cushion while watching his parents dine.