Tuesday, March 25, 2014

let's get physical

Calder seems huge! It’s not like he’s grown exponentially since my last post, but since I see him every day, I don’t think I notice his growth as much as the next person. Today when I was feeding him I looked down and literally exclaimed at his size; I told him he was so big he actually sitting on my lap, and that when he was born he was probably barely the size of his own leg.

Last week we participated in our first visit with the follow-up clinic at Inova Fairfax. When we were discharged it was explained to us that information gleaned from this visit would be used both for a study of NICU babies as well as to give us suggestions on what to do to aid in Calder’s development. Since Calder already had seen a physiatrist at Children’s National since discharge and has another appointment coming up there, and since he sees a physical therapist on a weekly basis, we did not feel a huge need to attend. But given our day jobs (monitoring and evaluation), we have a penchant for research, and so we were happy to make the drive to Fairfax to be part of a longitudinal study. During our NICU stay we oftentimes asked to see studies to help inform our decisions regarding specific treatments, but we were told in many cases such studies did not exist. 

The therapist had me hold Calder in my lap at a table and reach for toys of various colors and shapes while the doctor observed. She dropped a rubber ducky on purpose to see whether he’d follow it with his eyes. She made noises behind him on the right and left to see whether he’d turned toward the sounds. Even though they’d told me everything had been sterilized, including the table, it was hard for me to watch him shoving every block, string and ring into his mouth when I knew other babies had done the same thing. Ahh! NICU-Mom paranoia. Next we lay down on a mat, where they observed him on his back, his side, his tummy, watched whether he could roll over, etc.

yes, i CAN touch my toes and it is FUN
I have no idea what he scored or whether there even was a score. But the doctor said he looked great, and she gave us a few tips. She said to stay away from certain playthings, specifically jumpers. Her opinion differed a bit from our current PT, who says that equipment doesn’t help baby but doesn’t really harm him either; this doctor told us that preemies are predisposed to toe-walking, and that using a jumper or similar walking/jumping device might further encourage that behavior. So we’ll skip those. She gave us suggestions for what to work on next (have him reaching for objects to either side of his face from a seated position) and stressed that we should continue to work on everything from both sides, not to favor one side or the other. When he makes sounds, we should repeat them back to him, but when he makes vowel sounds, we should repeat them back, though with a consonant.

Not too long ago another Fairfax NICU mom emailed the rest of us asking about helmets. I hadn’t given it much thought until this point. The nurses had paid attention to turning his head from side to side while he was in the NICU, and our pediatrician seemed pleased with the shape at his first visit. One of the moms responded with photos of her child in a helmet (total cutie!), and others noted that they were considering it. After any medical concerns were ruled out, they said, there were still cosmetic concerns, mostly on account of possible bullying in school. Perhaps it seems a long ways out to be worrying about something like that, but the specialists told them the head shape could be corrected now, with a helmet, over a span of 3-4 months, while it would self-correct over a span of 18 years. Since then, I’ve consulted with our PT as well as the PT and physiatrist we saw at the follow up clinic, all of whom looked at me like I was nuts to even consider it. Sounds like we have lucked out in the head-shape department!

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