Sunday, July 12, 2009

July 11th

Abe is 12 pounds 5 oz and 26 inches long. I question the length since this would be a significant jump for him. However he appears to be growing quickly. He is Hugh compared to when he was born. Also my left elbow is hurting from holding him all the time for meals. I might have to make a doctor's appointment. I think I have tendinitis. However the medication they would probably prescribe for this might make me drowsy. I told Motrin the other day and it did make me very drowsy. His doctor is concerned about the significant increase in his head size however on the growth chart everything is straight up rather than following the normal growth curve. Therefore it is questionable if this is healthy normal growth or something to be concerned about. I had typed a long summary of what is currently going on and my computer exit out before posting. So now I will do the quicker version while he is still sleeping. He is off affine, hopefully will not need it again. Caffeine is given for apnea. He still has occasional low oxygen "desats" as low as 85% if the nasal cannula is not in his nose. He still needs the oxygen, monitor while sleeping and tube feedings. I really want to be done with all of it. He is taking more oral feeds, bottle or breastfeeding. However he is content when he takes 40cc and he is supposed to take 88 cc every 3 hours day and night. During the day I don't use the tube feeding unless absolutely necessary. Over the last week he has required the 3am tube feeding and occasionally the midnight, 6AM or 9AM. All the other feeds have been orally. I asked about discontinuing the 3am feed however his doctor is concerned about his reflux. Until he can tolerate increased volume he will continue to need the NG tube and 3AM feed. I am hoping that next month his lungs will be mature enough that he no longer needs the oxygen. He has an eye examination this week. Please pray that the ROP has not progressed and that his eyes are mature. Also pray that his reflux is less. I am wondering if his reflux is attributed to the immaturity of his esophagus, the NG tube and something in my diet that is transferred in breast milk. He pulled out this NG on Friday night and I left it out until 3:30PM on Saturday. I was going to leave it out however I worried about him not getting enough to eat and getting dehydrated. It was so hot on Saturday, his diapers were not as wet as usual and his lips were a little dry. Also his doctor wants the NG tube to remain until the reflux is less. I read in my peds book that 6 French NG tubes were not found to contribute to reflux in some studies. His reflux was less when the tube was out. We are transiting him to taking his medications orally since the new reflux medication is not compatible with NG tubes. This will be difficult since it does not dissolve that great and we can't mixed in a large amount of water. He is on 3 meds: thyroid, reflux and multiple vitamin. His doctor wants to continue with the iron because he did not get all iron stores that he would have received if he was full term. AAP (American Academy of Pediatrics) recommends that all breast feed babies get vitamin D too. So he will have to continue on his. Developmentally: he has increased head control, puts his hands in his mouth and is starting to focus more. He moves his left side more than the right side. I think he might have right sided weakness and will need glasses at a early age. he wants to eat now.

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