Tuesday, September 23, 2008

The Milk Has Run Dry

When I was pregnant, I made it a goal to try and nurse my future child for the World Health Organization's recommended two years. After 16 months of pumping and 19 months of nursing, Truman consumed his last bottle of frozen breast milk today. He spent the first 24 months of his life exclusively on breast milk and another six weeks on a mix of breast milk and whole cow's milk.

This photo is the last sad, partial bottle alone in the vast freezer that was once dedicated (along with the freezer side of another side-by-side fridge) exclusively to breast milk and completely filled with the liquid gold.

Even counting law school, I can say that my ability to provide Truman with 25.5 months of breast milk is one of my proudest accomplishments. When he was born, the only thing I could "do" for him to assist in his medical care was provide milk. Any of you that know me well know that give me a goal, particularly a measurable one like pumping 30 ounces a day, and I will hit it. I thank God for blessing me with certain Holstein qualities because having that goal and knowing that I was providing his nourishment is one of the things that me going through those long months of NICU. It was one of the only parts of being a "mother" that I could say I excelled at during those dark months. I may not have been able to carry babies, but I sure could feed them.

Safety Cuteness

Truman only gets yelled at by Mama for two things -- getting too close to the street and the swimming pool. We'll probably have to add the fireplace to that this year. The lessons have worked.

Last week, Truman and I were playing in the front yard while the boys across the street (8 and 12) were playing ball in their front yard. Truman grabbed me by the finger and led me to the curb. It took a while to realize he wanted me to lead him across the street. Then last night, we were down the street visiting two other preschoolers. When the other two decided to step down into the street to play with the leaves gathered in the gutters, Truman and I were on the curb. He kept pushing me from behind toward the street until I realized he wanted down into the street, too. So, I grabbed a pile of leaves for him and put them on the curb.

My little boy may be growing up, but he still knows he needs his Mama for the scary stuff in this world. :)

Wednesday, September 17, 2008

First Day of Parent's Day Out

With the exception of a little bit of crying when he was dropped off, Truman's first day of "school" went very well. He even stopped crying and was distracted by a toy before we were even out of sight. He enjoyed himself and his only meltdown occurred when his diaper was changed (which often prompts a meltdown at home, too). He also was very upset when the other kids had saltines and he didn't. They called and asked and we allowed him to have a saltine with the warning that it could prompt vomiting. They risked it, and he ultimately just carried it around, happy to simply hold what the others were having. So, three hours of school down, a lifetime to go.
He was so tired after he came that afternoon that he fell asleep for 45 minutes on the floor.

Pediatrician Visit

Weight: 19 lbs, 2.6 ounces
Height: 30 inches

Truman had a follow-up with the pediatrician to discuss the various GI test results and the GI specialist appointment. Dr. Suterwala is on board with Dr. Barth at least as to the initial testing. He was pleased with Truman's weight gain from the last appointment, but did indicate that if Truman loses weight or slows down on gorwth this winter, we will have to discuss pulling him out of PDO and isolating him again through the winter. We don't want an illness setting him back on the growth curve even more, but I don't think I can take another half-year of isolation.

Monday, September 15, 2008

GI Specialist Appointment

We met this morning with a GI Specialist at Children's Hospital named Dr. Barth. We really liked him because he seems like a problem-solving kind of guy and definitely asked some new questions and posed some new ideas we hadn't heard talked about before. He was of the opinion that even if being a preemie is the cause of Truman's eating problems, that doesn't mean we can't find a better solution than where we are now. He made some suggestions we like and some we don't.

First, Dr. Barth wanted to rule out lots of possible causes for Truman's troubles. His plan is for testing for celiac disease (we did the blood draw today at Children's--it was awful because it took more than one try) and a sweat test for cystic fibrosis (the genetic test was done in NICU because they suspected it then, but it came back negative). He also brought in a nutritionist who talked to us about some alternatives for adding calories, so we are going to try Benecalorie in addition / in place of Duocal and add it to everything. We are going to formally monitor calorie intake for a few days to make sure Truman is getting enough calories. We've done it informally before and think he's getting about 1000 calories because of all the fat-loading we do. You would think he would be huge from that.

Dr. Barth prescribed erythromycin in low dosage because one of the side effects is faster stomach emptying. The idea is to make Truman's stomach empty faster so that he will feel hungry sooner. Apparently, it also helps move food through faster so that there is less opportunity for it to come back up.

If the erythromycin doesn't help things, calorie intake is at least 840 a day, and the tests come back negative, Dr. Barth wants to do an endoscopy to look for inflammation, test for GI allergies, and basically check things out. If a "cause" or solution isn't found with those tests, Dr. Barth said a feeding tube may become necessary to get Truman to consume more calories with overnight feeds. We really don't want that to happen because it's another surgery and once you go down that path, it's very hard to wean off of it.

Dr. Barth was concerned that Truman has never had a growth spike and discussed what I have thought about so many times and that's the fact that if Truman doesn't start gaining faster than his peers, he will not catch up. As it is, Truman just falls farther and farther behind. He's yet to experience the "catch up" growth that most preemies do.

So, we feel glad that we've got an "expert" on the case now and that he's trying to solve the Truman eating puzzle. We go back on October 29.

Sunday, September 14, 2008

Parents Day Out Delayed

After almost an entire night of staying up screaming, Truman had to delay his start of Parents Day Out. We ruled out an ear infection and think he may be cutting his two-year molars. I think I felt a little nub in there, but of course, I got bit trying, so I'm not going back in. After several nights in a row of screaming through most of the night so matter what Mama and Daddy did, things settled down a bit this weekend. Truman will start PDO on Wednesday of this week instead.

Monday, September 8, 2008

Rocky Mountain Vacation

We all had a lot of fun on our Rocky Mountain National Park vacation during the week of Labor Day. Truman proved the toddler truism that the smaller the animal, the better. Chipmunks and way cooler than elk and mule deer. The last time we went on a family vacation was in 2005. We had a "babymoon" planned for Yellowstone over the Labor Day week in 2006, but Truman decided to make his early appearance and cancel that one. And then there was the long isolation and fear of germy airplanes that kept us from traveling. So, it was time and away we went on the Saturday before Labor Day. Truman handled his plane ride to Denver with no problem. We can't say the same for the return flight.