Medical Furlough

CURRENT WEIGHT: 12 LBS, 10.6 OUNCES
CURRENT LENGTH: 24 INCHES
ACTUAL AGE: 10.5 MONTHS
ADJUSTED AGE: 6.5 MONTHS

After his doctor's appointment last week, Truman was given the go-ahead to wait until after his first birthday to return. At that point, he will have all the one-year shots, blood work, etc., and a full developmental work up. The pediatrician did a quick developmental work-up at the last appointment and pronounced Truman anywhere from 5 months to 7 months in various developmental areas. He seems to be a little ahead on gross motor skills, but behind in speech and fine motor skills. The doctor is pleased with his cognitive development as well, which is the part we are clearly most concerned about.

He didn't use the term cerebral palsy, but I am kind of expecting that term to be applied after the more extensive one-year workup since the doctor and occupational therapists keep referring to the stiffness and extension in the limbs Truman has. I believe the phrase the pediatrician used was "issues" stemming from the brain hemorrhages Truman suffered in his first weeks. The good news is that everyone seems to think all such "issues" are correctable with therapy. So, it's not really a matter of whether he will achieve most milestones, it's when. Of course, learning challenges are still likely for most preemies, particularly those who suffered brain hemorrhages, but remain to be seen for many, many years.

An interesting note is that Truman's head seems to be outpacing the rest of his growth quite a bit. In fact, I think he may even be on the growth charts for his head. While this is most likely good news because it would mean that his brain is growing, it does raise a slight red flag with his history because it could mean that there's more blood buildup on his brain. At one point, it was suggested that Truman get an MRI shortly after his first birthday for long-term diagnostic purposes regarding the brain hemorrhages. Considering how well he is doing developmentally, I would be surprised if it's done because it's my understanding that it requires anesthesia. However, it will likely depend on the head growth and whether it concerns the medical personnel that it's too divergent from the rest of his body.

He is continuing to lag on his growth rate, but the pediatrician said that most babies slow down some in the second half of their first year, and he is 6.5 months adjusted, so we were told not to change things, but just to push as much Neosure into his breastmilk and solid foods as we can. Speaking of solids, Truman has now tried rice cereal, which he didn't seem to like; sweet potatoes, which were a big hit; and bananas, which were also a hit, but seem to be causing some allergic symptoms, so will be discontinued. Next on the list is carrots. After three weeks, he seems to be getting the hang of not pushing the food back out and opening his mouth for a bite. We still only give 1 TBSP or so a day and try to mix Neosure in with it. We've also given him a sippy cup to try with just an ounce or so of water. He's not sure what to think about that yet.

We are still working on sitting in physical therapy and have made little progress. The stiffness and extension I referenced earlier really seems to be getting in the way. However, his rolling has definitely taken off, and he's discovered he can use it to travel around the room. He's also scooting a little, but fortunately doing less of the scooting on the head behavior. The rolling has also really increased his tolerance for tummy time, which he now is doing on his own.

He's starting to reach out to show that he wants something and has learned to squeal in protest when something is taken away or when he doesn't want to do something, like sit. Swim lessons aren't going quite as well now that we are making him submerge. He knows when he gets perched on the side that he will be going under and gets scared, but he recovers after a short period of clinginess. I feel bad at times about it, but I know with a pool in the backyard that getting him able to hold his breath and not panic in the water is imperative. No matter what kind of safety fencing you get and precautions you take, you can never be too safe with a pool.

He has discovered his tongue and has lots of fun sticking it out and using it to lick the pages of his board books. It's quite hard to read a book to a child who is licking it, by the way. Paper is one of Truman's new favorite toys. We've learned that the pages of the Preston Hollow Presbyterian newsletter are perfect because they are slick enough not to get too soggy and too slick to tear into bits that he can actually eat. Truman had fun leaving his mark the envelope to his grandfather's birthday card this way, too.

Another wonderful development is that he now plays by himself for a few minutes when he wakes up. We leave a small stuffed cow and a flexible loop toy in the corners of his bed now. When he wakes in the morning, he often finds these toys or talks to his mobile for a while, which gives me an opportunity to lounge a little bit in waking and listening to him play. This morning, he played for a half hour before getting up to nurse. It was really nice and fun to peek over and watch.

--Kara

Eek! Mobility Begins!

CURRENT WEIGHT: 12 LBS, 2.8 OUNCES
CURRENT LENGTH: 23 3/4 INCHES

CHRONOLOGICAL AGE: 10 MONTHS
ADJUSTED AGE: 6 MONTHS

In the last few days, Truman has figured out how to move. Eek! Time to think about babyproofing. On May 31, he started rolling both directions. He had been rolling from tummy to back since about 2 weeks adjusted -- way in advance -- but had not yet rolled from back to tummy -- behind the curve. Now, he can go both ways and thus move a few feet across the room. We're not sure if he's aware that he can really get around that way.

However, he definitely has figured out another way to be mobile in the last week or so, and this is one that his occupational therapist says we must break him of. He has figured out how to arch is back and use his feet to push himself backwards on his head. So, he leans his head back and looks behind him and just starts scooting. Imagine a mobile backbend or the little girl going backwards down the stairs in the remastered Exorcist. It's quite odd. Although I'm impressed at his ingenuity, arching the back is a problem developmentally because it causes muscles to develop strengths in a way that will inhibit crawling. That, and he tends to get himself stuck in corners and will make himself bald soon. And, like most of us, if he can figure out how to move in some other way, why learn to do the hard way of crawling. We did sort of laugh when the therapist said we needed to stop him when he starts doing it. "How," we asked? "Haven't you met our headstrong--and preternaturally strong--child?"

In addition to rolling both directions, Truman has also started playing with his feet in recent days and even tried to get one in his mouth during occupational therapy yesterday. We thought he would never do that. If we can encourage that, hopefully, that will help build some the muscles he needs for crawling and counteract all the back arching. He still doesn't sit or really show any interest in it. He is, however, getting a little more willing to be held in a sitting position or spend time in the bumbo seat. That's our currently OT goal -- sitting.

Also, Truman has had a chuckle up to this point, rather than a full-blown laugh. In recent days, however, he's starting to show signs of a more true laugh. We are so excited!

Truman did pick up the pace some on growth over the past three weeks, but he's not back to his usual pace. The pediatrician suggested that if he continues to slow, he will advise that I stop nursing and exclusively pump so that we can add fortifier to more feedings. I might be willing to drop some of the evening pumps, but I am not willing to stop breastfeeding overnight and first thing in the morning. I think there are far too many psychological and bonding benefits that I am not willing to give up.

Truman's pedi and his nutritionist did convince us that it's time to at least recreationally start solids. I've been resistant because breast milk has more calories than any solids, and I don't want to cause a slowdown on his growth. However, we agreed to try 1 TBSP of rice cereal a day mixed with 30-cal formula/breastmilk. We're going to start on Saturday so that I will have plenty of time to be around and take pictures since his best time of day is in the morning. He also has his first water baby swim lesson on Saturday and is going to a picnic with several babies under 1 on Sunday. Quite a Tru-riffic weekend.

Truman had his first out-of-town trip last week. He didn't seem to mind the hotel or the pack-and-play, but the car trip was another story. Needless to say, we have some better trip planning to figure out before his trip to West Texas next month. He was so upset at one point in the car because he was hungry and tired (but refused to do either if we stopped) that the only thing we could do was sing "Row, Row Your Boat" over and over and over. For some reason, it works.

--Kara