Sunday, February 23, 2014

breakfast, lunch, dinner, second breakfast ...

At our speech therapy session this week we introduced breastfeeding (so if talk of breastfeeding makes you queasy, best to stop reading now!) Anne told me it looked like Calder did better breastfeeding than he did with a bottle and that I can now try breastfeeding prior to his G-tube feed for one feed per day.

forget breast milk,
can't you see I want Graeter's?
Breastfeeding has been on my list for a long time because, in theory, it would be more convenient for feeding, at least while I’m still at home. If Calder could be breastfed, I could cut out pumping – hallelujah. This would be huge. I cannot adequately convey to you the time-suck that pumping is. Breastfeeding would cut out the mixing of milk and formula, eliminate/decrease the washing and sterilizing of all the parts (pump parts, bottle parts, G-tube parts) and just generally combine two processes into one. I wouldn’t have to tote milk and parts to every doctor’s appointment.

best done with a sleepy baby
Calder has also decided that now that he gets a bottle, he is not a big fan of the tube part that comes next (who would be, I suppose), so we have refined our technique: we now simultaneously bottle-feed and tube-feed him. But you have to be strategic, because if you tube-feed him too late, you’ll run out of bottle, but if you tube-feed him to soon, he gets full and doesn’t want to finish the bottle. Throughout the whole process he is probably swinging his hands wildly and grasping at the extension tube while you of course try to keep it from his death grip lest he yank the whole thing one direction, taking the mickey with it. Which would be very bad news. Most times I am left wishing I had two more hands – it’s a miracle I have not yet dumped an entire batch on myself, (knock on wood.) You know, I like to eat as much as the next person (okay, let’s face it, probably a lot more) and will devote as much time to feeding as is necessary, but some days it seems like this is all we do!
obviously, Mom bought this outfit
before she knew she was having
a G-tube baby!
In the meantime, Anne also gave us the go ahead to up his bottle intake, so we are now working on 3 oz per feed rather than 2 oz. Kraemer, who is always confident in our boy’s abilities, is already pushing the limit with 3.5, and Calder has been responding. As you can see from most of the photos, he does not want for calories!

Friday, February 21, 2014

Big night out

I'm crushing your head
bath-time snacking

Calder has been pulling his equipment off and out pretty much since he was capable of bringing his hand to his face. Nowadays the act of removing his equipment not only frees him but amuses him and thus, pulling out his cannula appears to be Calder’s new favorite game. I’d be lying if I said it doesn't amuse Kraemer and I, too, but we've realized that if we do not want this to become habit, we better stop laughing when he does it. I cannot believe I’m already telling this child, “No!”

In other news, I ventured out socially for the first time without Kraemer in what must have been months. My friend Heather was very gracious and came to me, which cut down on transit time so that I could spend longer out. It was SO refreshing to have some girl time. Heather has a darling one-year-old girl, so she could empathize with my pretty typical “mom problems.” I commented about halfway through our outing that I was aware I was talking her ear off; I’m normally a talker, I know that, but I think having been starved of in-person conversation with girlfriends for so long I was barely taking a breath between sentences. Next week I’m scheduled to go out one more time, this time with other moms who were in the NICU this past summer. Amazingly, in a group of a 15 or so on our listserv, I’d only met two of them. A number of these moms though left before or shortly after our arrival, not to mention that there are four separate rooms in the NICU, and perhaps as many as 100 babies, so I suppose it isn't really that surprising. At any rate, I’m looking forward to some heartwarming discussions.

Saturday, February 15, 2014

Single and Loving It!

no, of course i won't smile for the photo!

Oy! The last few days we have had a disaster child on our hands. Calder has been completely inconsolable, nothing like his normal self. Sure, he ordinarily cries, but not nearly as constantly. Recently, if he were awake, he was crying. Initially we speculated he was upset on account of the bottle feeding, which could have increased his gassiness, and/or the introduction of Prevacid this past Sunday, which is supposed to help him with his GERD. Maybe it wasn't sitting well?

so sweet when asleep! thanks, grandma.
Of course this would come to a head on a snow day in DC. Our pediatrician’s office was closed on Thursday, and as I said in the early days of this blog, I have never been one to dial the answering service easily (and as I learned then, maybe I should!) Instead, I emailed both his GI doc and his pulm. Both answered immediately, the GI NP with a follow-up question and the pulm with a very thorough response and tons of follow-up questions: Does he look as if he is in pain? Is his belly distended and/or hard? Is he throwing-up? Et cetera. He said it would be atypical for Calder to react this way to Prevacid.

you people exhaust me!
The next day, as I ducked into the grocery store for some hamburger buns, it suddenly dawned on me that I’d never checked the ingredients in some hamburger buns last week. I Googled the brand and sure enough – milk product! Kraemer asks me periodically when I plan to “test” putting dairy back into my diet, and I always put it off, wanting instead to focus on Calder’s success with the bottle and eventually breastfeeding. So this "test" was on accident, but I think we have our answer for a while: no dairy for Mom.

At his second physical therapy session last week, Calder continued to exhibit decent head control, picking up his head and turning it both directions when prompted. Toward the end of the session, Cristiane was in the middle of telling us we should encourage him to lift his head higher and that that’s what she’d look for next week, when Calder reared his head waaaaay up! Overachiever. Of course, we were glad he went ahead and met that milestone that week because at the session yesterday, during the aforementioned “disaster week,” we could barely coax the poor little guy into PT for more than 10 minutes.

Lucky, lucky for my parents, they chose to visit at this very opportune time. Truly, it was lucky for me, as we had a couple of willing volunteers ready to take a fussy Calder off our hands at any time. Sweet relief.

Also in true parent fashion, they offered to let us have a night out for Valentine’s Day. Kraemer and I had picked out a little place literally three blocks from our house a month or two back, and by now it was so obscenely popular that they already have a line out the door daily, prior to their 5pm opening. We figured out when to show up and wound up having a fun, delicious dinner, complete with my own menu, personally marked up by the owner and head chef. How fun it is to be dairy-free. ;)

Happy Valentine's!
Kisses to my nurses!
Until this point, we have done a fairly decent job of keeping up with our doctor appointments, arriving on time, etc. That is, until this morning, when not two minutes after our alarm went off, Kraemer pondered aloud how we had had NO appointments this past week. Zip. Zero. None. He felt that just couldn't be right, and, of course, he was right. I’m still not exactly sure what happened, whether we’d forgotten to write it down or whether it was never scheduled, but it clicked with me then that right around now Calder was due for his next dose of Synagis. Our ped was adamant that we not be late, as the immunity drops precipitously after 28 days. I got on the horn and had us scheduled for a shot within the hour. Calder is now back to being protected from evil RSV! And I am going to be double-checking at the beginning of each week that we have all our doctor appointments on the calendar. :)

O2 = built-in toy

Thursday, February 6, 2014

Eye of the tiger

I'm a morning baby!
This week, I’m thankful for therapists. Since the day we brought Calder home, every practitioner has stressed the importance of incorporating about 45-60 minutes per day of tummy time, which is necessary to strengthen the core, the neck, the arms, and is helpful for preventing flatness of the head (and as a preemie, Calder has already had a LOT of time on his back instead of inside my tummy) – tummy time has a lot going for it. Knowing that tummy time may not be a favorite activity, our ped suggested starting with five minutes at a time and working up. Unfortunately, Calder typically screamed bloody murder the very second you put him on the ground. Making it past 30 seconds was a huge feat, let alone five minutes. Every once in a while we would get lucky, and he would make it a few minutes.

Enter Cristiane, our physical therapist through Early Intervention. I was astounded when she had him on his tummy for several minutes, easily. In fact, I think he enjoyed it! Calder loves new faces and new friends, and he took to her quickly. We’ll have a PT appointment every week. She told us to practice with Calder every day (sometimes easier said than done, but unless we have other doctor appointments to fit in, we do), and that by next week, she expected to see him holding his head up for longer periods.

pushing, pushing ...

okay, i had a little help,
but check this out!

c'mon in, give me a smooch.

loves hangin' with Dad
I also took Calder in for his first speech therapy session with Anne, the same SLP who saw him for the swallow study (we are very familiar with Children’s National now, too – we visit pretty regularly with five different departments there so far.) What we worked on was very reminiscent of what we had been doing in the NICU until we had to quit: we reintroduced the bottle using a slow/preemie nipple like was used in the study, discussed pacing and arranged a plan for slowly incorporating the bottle into the feeds. We are going to start by using the bottle with every daytime feed, two ounces only (he takes a little over four total), and never allow him to work on those two ounces for more than 30 minutes. Anne is great, very friendly, and she spoke highly of Children’s Hospital in Cincinnati and Corinne’s program there, which was nice to hear.

Lots to work on in the coming week with our little monkey.

resting up!