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****VP SHUNT PRECAUTIONS: NO MAGNETIC TOYS, CAN RESET THE VALVE ON THE SHUNT****
***NO LATEX DUE TO MOTHER'S EXTREME ALLERGY***
NKDA/NKA
Abraham was born at 26 weeks gestation, weighing 2 lbs 2 oz by emergency c-section. His breathing tube (ET tube) dislodged during flight, causing oxygen deprivation. As a result of his extremely premature birth, Abraham has grade IV bilateral bleeding that extended into the gray matter of the brain resulting in cerebral palsy, hydrocephalus (VP shunt placement,right side of head) and cortical vision impairment. Other diagnoses include stage 2 retinopathy of prematurity (ROP), bilateral nystagmus, hypothyroidism,chronic lung disease, constipation, tooth decay, eczema, GERD, delayed swallow however no recommendations to thicken liquids as he was deemed "able to protect his airway". In addition he has global developmental delays including gross/fine motor skills and speech.
Most of the damaged happened on the left side of the brain therefore he is weaker on the right side of his body. He keeps his right hand tight and contracted sometimes however other times he does relax it. His legs have been tighter than normal lately and increased tone especially with diaper changes, bathing and dressing. The left leg tend to cross over the right leg. He has clonus in bilateral lower extremities
Abe is 3 years old however he can not sit with assistance. Therefore can not stand. He depends on adults for assistance with mobility and feeding. He is able to sit in a reserve "W" position however this should be discouraged due to the potential damage to his knee and hip joints. He can feed himself small pieces of food however adult assistance is required since he throws food and silverware on the floor. We don't want him to continue using the same fork or spoon that has been dropped on the floor. Please get him a new one or make him use his fingers. We have not started potty training yet however he has started to acknowledge it. We would require some PT or OT recommendations about this for proper positioning.
Abe bangs if he is trying to communicate, tired, does not feel good and occasionally to the rhythm of music. Most of the time he does this he is crying screaming but sometimes he giggles as he is doing it. Ignoring him does not make him stop. I have left the room but peeked down the hall and he continues. He will be starting ABA therapy to assist with this.
Things Abe likes: Music, lights, cuddling, cars, trucks, books, slides, hearing other kids, bird noises, duck noises, animal noises. He loves to dance too.
Things that bother Abe: sudden loud noises like a room full of adults clapping, vacuum cleaner noise and some times the sound of a hair dryer. He really does not like to play with sand, grass or snow. He does not like crunchy foods. He will touch crunchy foods just does not like it in his mouth.
Diet: apple sauce consistency foods like carrots or anything hard has to be pureed. Macaroni and cheese is his favorite food, some days this is all he will eat.2nd favorite food: chewy fruit snacks. Yogurt, cheese burgers, mashed potatoes, toast if soft, peanut butter however seems like the eczema increases after he has it (will be checking with PCM about this) small pieces of cut up cheese, pizza (I gave him some of the crust last week on different occasions and both days he gagged and threw up). Beverages: breast milk, whole milk, prune juice, and grape juice.
Hospitalizations (In patient stays):
NICU Madigan: 11 days
NICU Seattle Children's Hospital: 96 days, 2/13/09-May 2009
August 2009; Seattle Children's Hospital: VP shunt placement, overnight stay
November 2009; Seattle Children's Hospital: 14 day stay for pneumonia and H1N1
February 2010; Seattle Children's Hospital: 2 in-patinent stays during this month for respiratory virus
June 2010;Seattle Children's Hospital: respiratory virus
September 2010; Phoenix Children's Hospital: 7 day inpatient stay for flu
Surgical History:
March 2009: external shunt
August 2009: Internal VP shunt placed
August 2010: bilateral hernia repair and orchiopexy
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