Part 3: Update with B-man

Did I mention that someone found his thumb? (and yes, he does sometimes sleep with out closing his eyes all the way...that's like his dad and big sister!)

Sleep deprived? Yes. But I WILL get this blog updated. I WILL get this blog updated. Not only do I need to update ya'll, but seriously, this is like Beckett's baby book! I want to get stuff documented for this boy! Plus, Ellie was restless after I tried to go to sleep. Classic croupy cough, gunky eye, and she says her ear hurts. Dr. appointment scheduled for 11:10 am. So thankful my dad is here, he's on Beckett separate from the sister duty now.


Ok, so Wednesday, March 28 was his 6 month appointment with Dr. Hanson. More vaccines, more being brave. Ellie was so cute, she consoled him too saying "Buddy, Good job being brave, Buddy." What a good sister. Beckett tipped the scales at 12 lbs. 8 oz! His length 24 inches and head circumference 42 1/2, which was a bit of a jump from last month. The nurse measured his head a million times, and than Dr. Hanson also measured it a million times just to make sure it was accurate.
1. His height and weight (according to the preemie growth chart) are still steadily growing along the 50 percentile curve. Head circumference = 95th. Not so proportional little buddy. So we get to still keep our appointment with the cranial specialist on May 11. I was kinda bummed about this. Not going to lie. I thought since his cranial X rays came back normal, no sutures closing, that we were done with that concern. But my loving sister reminded me that X rays are only one glance at what is going on, so it's better to have things checked out further. As far as his height and weight on the regular growth chart.... < 5 percentile. Our doctor only charts until 47 weeks gestation with the preemie growth chart "technically," but I still like to use that one!
2. We noticed that Beckett's left pupil is larger than the other one. Dr. Hanson said we were going to watch it for one more month (we go back for another weight check first week in May), and than will probably move up his ophthalmology appointment. We weren't supposed to see Dr. Packwood until next December, but again...better get things checked out. I also have GREAT friends, and my girlfriend from high school's husband is an ophthalmologist, and called me to talk about Beckett's eyes. He actually said the "normal eye" is probably the bigger one, and the abnormal would be the pupil that looks smaller. Interesting because I just guessed it would be the other way around. He said it could be because of the brain bleed, and did say he would see the opthalmologist too...not urgent, but before December. Thanks for the consult Chip!
3. Dr. Hanson was having us try fortifying two bottles to 27 calorie (down from 4) to see how his weight gain would be. He breastfeeds through out the entire day (YAY! And this is seriously something I didn't think would ever work out for us, and it HAS! Ellie had NO interest in bf so I just continued to pump. It's been a doosy to get my over supply, over active let down under control, but I think my body has finally adjusted to what he eats! I tell you...it's SO nice not to have to do as many pumping and bottle dishes! Ha!) However, Dr. H knew we were meeting with the dietician through ECI for his nutrition consult, so she wanted to see what her input would be too. The Neosure has added nutrients specifically made for preemies, so it is important for B to get some of that, plus added calories are always a GOOD thing! I still secretly want to know what my breast milk is calorie wise. I will just tell myself my milk is high in calories too :) We met with the dietician, and she actually suggested we start with 3 bottles fortified, and took his measurements, asked lots of questions to chart him on the growth curve too, and is coming back in two weeks to see how things are going. Still continuing the Poly-Vi-Sol with iron 1 ml a day too (which we mix in the beginning ounce of his bottle)
4. Pooping issue. So she said it's not good when he has to strain and cries when trying to make a dirty diaper. So we are giving a little pear juice (she said start with twice a day), but I'm only doing once a day because he is definitely stepping it up in the pooping department! CELEBRATING! Don't worry, I do still examine every diaper like I am a NICU nurse. I find myself often times saying, well, they would have said that is normal looking. Those NICU nurses are good teachers!

Ok, I think I got everything from his pediatrician appointment, but mom and Wendy...remind me if I missed something.

Too cute...just checked on Ellie who is still sleeping (and I'm LETTING her because if she really is sick, she needs her rest!) and Dad and Beckett were hanging out in the living room. My dad proudly announced that Beckett had already done his exercises! Guess it helped out having him watch Kelli in our PT appointment. Love it. They definitely are bonding. Poor dad is going stir crazy being indoors this much though. Ellie and Grandpa were going to plant some herbs today, but I guess we will see how Ellie feels later on. I've sure enjoyed having dad here to help all during the day. We are going to try out a new salmon recipe soon. Like my daughter is a daddy's girl...I am a bit too. We like to try out new things to cook and bake! I may or may not have introduced him to pinterest.

Part 2: Update with BTG

Ok, yes, I know mom. It's midnight, and I'm up blogging. But you know it's true. When does a mom get anything done? The kids are asleep. Grandpa is asleep, and already volunteered the 5 am shift. My dad is here helping me out this week because Ben's gone for work. He has been SO helpful. I got to take a shower AND do my hair today!

Back to the OT discussion: Ok, so the infant massage is something we have been working on (sensory) and also we are working on "flexion" which is the fancy word for working on the flailing arms. Our homework with OT is side-lying, placing hands on his shoulders trying to really encourage mid line. I learned where his pectoral reflex is, and that helps prompt the wanting to move his arm part. This past session we also added trying to get him to reach for toys while laying on his side. It's amazing how a lot of their motivation is VISUAL. Lot of truth there. Since we had to take the hiatus because of insurance purposes, Debbie hadn't seen him for a couple weeks! She was very pleased that he has found his fingers, and was bringing them to his mouth. He does sometimes hold his hands in the praying motion too. He does like to try and help with the bottle, but it all supports the whole mid line goal. He does like to grasp my finger too. I love when that tiny finger wraps around mine! We are also still working on tracking, and he seems to be getting better at staying focused and following the toy we shake in front of him. It's also important for us to start introducing different sounds, lights, and textures, again to help develop his sensory areas. Ok, not sure if that really made sense, but you get my drift.

TV Time out. Gotta check on B man. Well, an hour and a half later. This is what happens. I see B stirring, I go prepare his bottle (because I just pumped because I was gone earlier to Bible Study). I change diaper, barely wet. His grandpa (bless his heart) put his onesie on backwards, and it was wet so I change it too. I start feeding him. He dirty's clean diaper. Try making him just wait it out, but he gives me the tongue push. So I change his diaper again, whereupon I learn that he has pooped all the way up his back. and thru his onesie to the sleeper. Change diaper, get new jammers on. Finish bottle. Hold him while he sleep smiles for a bit. Put to bed. And I'm spent too...so the binge blogging will have to continue into tomorrow. But I'm going to try REALLY hard to get caught up. Haven't even gotten to the pediatrician 6 month check up, nutrition consult, family visiting, Big Sister Ellie updates...

Part 1: Update with Beckett

Ahhh! March 23. That was the last time I blogged. It's a bad sign when you have to read back a couple posts to see what you wrote last! We have had some great progress in these past few weeks!

BIG NEWS: I got a call from the pulmonlogist today cancelling our appointment for Beckett's next synagis! Turns out RSV has really decreased, and they aren't giving the next dose now. I asked if it was an insurance thing, and that wasn't the issue at all. I am happy, yet still a little nervous! So I asked what that meant in regards to RSV isolation, and she said "well, I wouldn't be completely relaxed just yet, but the cases are fewer, so the risk is lower." So we shall see...you might start seeing the Gramkows out and about. Baby steps though, baby steps. I do still have an immune-compromised baby, and still have to be cautious. BUT at the same time....EXCITING STUFF! I know it's probably weird to understand...wanting to be out of RSV isolation so badly, but then at the same time...now the reality has come to enter the wild, I mean world. :) Mixed feelings really. Still going to have the fears of him getting sick. I think that just comes with the preemie territory, honestly.

I may or may not be looking back at his sticker calendar (that has now turned into his appointment calendar) to see what has happened!

Sunday, March 25: He kept his head mid line while in his swing for the FIRST TIME! And he BAT at his first toy (on the play mat) for the FIRST TIME! Celebrate. This is a big deal in preemie world. As far as developmental stuff, we just wait and see. So yes, "mini-milestone" celebrations are definitely necessary. I posted this on Facebook last night. (Apparently I get sentimental and reflective late at night when it's just me and Beckett. Honestly, I was marveling at his wrists. He now has that pudge...you know the fat on the wrist that makes it look like he's wearing a perma rubber band. And to think that Ben's ring fit around that wrist when he was born...)

"I would never wish preemiehood on anyone, but I wish all parents could have perspective thru the preemie parent lens. Every little gain of weight, every breath, every developmental mini-milestone...celebrated. I pray that parents wouldn't overlook or take for granted the things that come easier for others, but instead thank God for his true miracle. Seriously, all babies are just amazing!"

Physical Therapy on March 27 with Kelli went pretty well. We did notice he was still prefering his head turning to the left, but she was WAY impressed with how well he was holding his head in the middle while on his back!!! His neck muscles are getting stronger, so we got to add to the Beckett sandwich, by holding his shoulders while facing us. This way he can work on the bobble to the left and right lean-age. So working on getting rid of our bobble "nod yes" and now we've added project "no more nod no."

I may or may not have had to take a TV time out from blogging to A) feed Beckett and B) put in our wedding DVD for Ellie to watch AGAIN. I think this might be like the 8th time in the past three weeks (would have been a lot more if family wasn't in town last week).

Ok, back to PT talk...we also started to help him with the roll motion, but supporting his hips, and supporting his upper chest to finish the roll to the tummy. So fast forward to TODAY's PT appointment. Impressive. Seriously, it is so fun seeing Beckett do new things each time Miss Kelli puts him to the "challenge." He tolerates the therapy quite well, but you can tell he gets tired of lifting that big head. Don't blame him, but he is getting SO much better. On tummy time he can hold his head up for about 8 seconds before he starts to bobble. AND he has now lifted his head higher AND will look side to side while holding up his head. He is nearly on track for development of a 3 month old (which is what his adjusted age is).

She noticed today that he today really liked turning his head to the left (which we had been over correcting before), so now we will just try and alternate, making sure he is doing both ways. It's harder now though since he can keep his head mid line so well! A good problem though. Not complaining here! The BIG challenge that really impressed me today was she supported his hips to roll over, and he got those arms to come over AND he got his arms in army crawl position AND lifted up his head! (although, you have to have patience and give him time for him to realize..."oh, this feels awkward, maybe I better bring my flailing arm over") I as "mom therapist" struggle with this, as I just want to correct, and support him too soon often times. Seriously, nothing like giving your baby a work out...and then you get the sad faces...just breaks your heart. But then a part of me says "buck up boy" ..."you gotta do this." He is seriously starting to master this whole multi-tasking body moving thing.
So our homework for these next two weeks is:
1. More Beckett sandwich, but we can support his chest and back LOWER because the neck is strengthening.
2. Practice the rolling with the hip support, and lift shoulder with finger if needed.
3. Tummy time by holding hips down to help him lift his head more. This phenomenon is so interesting. We are practicing shifting weight. I know right? I wish I could shift weight to my toes. I'd be ok with large toes. But when B started to gain more head control, he would do an amazing seal impression, where his feet will lift up too. But as they learn to balance and shift their weight down their body, it'll get easier for him to keep his head up, and his tush and his feet down. He is able to lift his head a little higher when I basically hold down his bottom.
4. Finding his FEET! He has lifted his feet up at the same time, a few times. Nothing intentional though, I'm pretty sure. So this week, we are working on discovering how cool our feet are. He has found his hands, and it's pretty funny watching him stare at them, and twist his fists, and stare again. Feet it is. Bending will help the belly bulge. We are still working on getting rid of the belly bulge. DRG, that belly bulge is just going to be the last to go, I just know it! (FYI: DRG used to pick on me because every day I would ask about the belly bulge. It bothered me SO much, and every time he would say, it's soft, no hernias, it's not concerning me. But I would still manage to ask again, and again. :)
5. Still working on tracking and batting at toys. Side-lying reaching for toys.
Kelli did notice that he is opening and closing his hands more with his right hand, where as the left likes to stay in the fist pump position. Just something we will continue to watch, again because of the brain bleed.

So this week, my dad asked me a question about the difference in OT and PT, so I thought this link might help explain. We probably know more of Physical Therapists that help with gross motor skills. Occupational therapists help with the fine motor skills. They mention speech therapy as another common preemie therapy, and we are so thankful that Beckett didn't qualify in this area. He has got a good grasp on suck, swallow, breath. And he does like to eat, which is SO good for a preemie! http://www.babycenter.com/404_what-therapies-can-help-my-premature-baby-develop_10304025.bc

"Occupational therapy can help your baby gain competence with the basic activities of her everyday life – what occupational therapists call "activities of daily living" (ADLs). Examples of "baby ADLs" include eating, playing, and interacting with others. Depending on your child's strengths and needs, the occupational therapist may help her learn to manipulate toys, develop her feeding skills, improve her fine motor skills or manage "sensory inputs" such as touch, sounds, and lights.

So we had to take a week hiatus from Occupational Therapy because lovely insurance said they were denying our services. Well, apparently changing the coding from "prematurity" and developmental delay to "developmental delay due to short gestation." I am very thankful they got it figured out, and we got notification that indeed it is covering OT, and so we went back this past Friday. Poor Beckett was a little on the tired side, so he fussed some. Debbie had never seen him cry. Usually he just LOVES the infant massage. (Some research states the infant massage helps preemies gain weight better) And I do believe it helps with the bowel movements. (Speaking of BMs, Beckett has picked it up even more in that area. We give him about an ounce of juice a day, and we've had about 10 in the past three days! We don't know what to do! HA! But it's better than seeing him really struggle and cry when he is trying to poop every week or week and a half! Ok, more on that when I talk about our nutrition consult!)

Back to OT....we learned some infant massage techniques for the back, which I am NOT steller at because you actually place them on your lap, and criss cross applesauce is a little stiff for this lady! Apparently I am not as flexible as the good old days.

Ok...will have to continue later...I'm late for Bible Study!