2.5 year well check

I had no idea there was a well check at 2.5.  The nurse said it was a relatively new trend and not all pediatricians do it.

Randy's check was uneventful.  It was the first time I did not have a long list of questions.  His pediatrician was pleased to see him walking.  He spent a lot of time flexing his ankle and checking his reflexes.  He noted that the tightness is still there, but that his range of motion is still good.  He asked if he was in orthotics.  I told him that the orthopedic doctor said that they were not needed medically, but they may be helpful for balance if the PT likes.  His PT says that she wants to hold off and see what development does for his flat feet and for his ankles that pronate (lean in).  She says the orthotic will feel awkward and wants him to be a committed walker before adding orthotics (if at all).

His ped remarked that his head looked good for the number of surgeries he's had.  He was pleased with his eyes and very pleased with his growth.  His stats are:

Length - 35.75 inches
Weight - 27 lbs
Head circumference - 45.5 cm

Despite all our feeding woes, he continues to grow well.  He is now 25th-50th percentile for height (up from 10th-25th) and 10th-25th percentile for weight (up from 5th-10th).  His head circumference is still not on the charts, but the growth is following the same curve.  The ped is going to email his head circumference to the neurosurgeon.  Neither of them are overly concerned about his slow head growth, especially since he is developing cognitively.  I could not believe that he grew 3 inches, gained 3 pounds, and his head grew 1 cm in six months!

2-year well visit

Randy's 2-year well visit was.....well great!!!  It is the first time that I have left a doctor appointment without sonething to "do" or "keep working on" or a referral.  He is on the growth chart for his actual age (well in most areas): 5th percentile for weight and 25th percentile for height!! His head is lagging behind and is not on the growth chart, but is continuing to grow.  I asked his pediatrician if it was a cause for concern.  He said not really, especially if he continues to make progress the way he has been.

Weight: 23lbs 14oz
Length: 32.5 inches
Head circumference: 44.6 cm

He was pleased with his progress in all areas.  Randy talked to him and sang nursery rhymes.  He did not give me a hard time about him eating purees and actually supported my decision to comtinue to do this.  He said that it is keeping him growing and that as he gets older, he may begin to overcome some of these sensory issues.

He was pleased with his therapy schedule and was on board with him doing hippotherapy as soon as he is released from the general surgeon (from his hernia surgery).

Oh, I do have one thing to do... I have to take him to the lab to get his iron and lead levels checked.

Whew!

It has been over three weeks since I posted. I guess that what happens when you go back to work. I started work about 2 1/2 weeks ago. It was kind of hard since I had been off for six weeks. I enjoyed going to therapy in the morning and piddling around with Randy. We both loved our mid morning naps and staying up late. But all that has come to an end.

Randy also started daycare. It has been hard. I have been debating whether or not to send him. The daycare specializes in children with special needs: developmental and medical. The staff:child ratio is low and there is a full time nurse on staff. He goes three days a week: Tuesday, Thursday, and Friday. He goes to his home sitter the other two days. He has started in the infant room, but will transition to the toddler room next month. There are five children in the infant room and one or two teachers.

He handled the change great. He did not cry when I left (but I did). He was happy to see me when I came to pick him up, but was ok when I dropped him off on Thursday. But one of my fears became reality on day 3; he got sick! He woke up with a runny nose. By noon, the nurse called me and said he had a low grade temp. She gave him Tylenol. This was Friday.

He began to sneeze that night and his temp crept up another degree. By Saturday morning he was coughing, sneezing, rubbing his eyes, and his temp was up to 102. He was miserable all day, and I could not get the fever all the way down.

On Sunday the fever seemed to break, but the other symptoms stayed. Monday morning he went to his sitter. After his nap, his temp soared again; this time to 103.5. It stayed elevated the rest of the day despite Tylenol.

I took him to the doctor Tuesday morning. The pediatrician hoped it was just a virus, but was a little worried about the cough and the fever. He swabbed his throat and sent him to Children's Hospital for a chest x-ray and bloodwork. The strep screen was negative as was the chest x-ray. The preliminary bloodwork was normal and the culture will be back in a week.

By Wednesday he began to feel better; and today he went back to daycare. I hope this illness is not a preview of what our winter will be. Also my second fear became a reality too. He lost weight.

Eating Woes

I need to vent about one of the most frustrating topics of micro preemie moms-feeding. Randy has had a fairly decent experience in the eating department. He has always had a weak suck and according to his swallow study, he expends a HUGE amount of energy to take his bottle. Randy was diagnosed with failure to thrive in September of 2008. Despite the fact that is was due to his fragile neurological state and many surgeries, I felt an immense amount of guilt. This was the second time I felt disappointed with being able to provide nourishment for my son; the first was when I stopped nursing him due to a milk soy protein intolerance.

He had the NG tube for a month and gained a pound. We shortened the overnight feeds and her gained another pound in a month. We stopped the night feeds and he gained another pound in a month. From October to February he gained 4 pounds! Whoo hoo!!

Now we are at the end of March and he has lost four ounces this past month. He has gone from consistently drinking 24-26 ounces of milk per day to me almost forcing him to take 15 ounces. I don't know what to do?

So far the docs are not concerned; maybe I shouldn't be. But I am. I worry about everything where he is concerned. Every milestone has felt so huge; and every set back has felt so huge.

For right now I will continue to work with the OT from Help Me Grow. She has suggested switching to a different nipple; I will try that. I am open to suggestions from others.