Super Noggin

We went to UMC today to get Henry's blood work done before his appointment tomorrow with Dr. Hassan. Dr. Hassan had ordered a basic metabolic panel and an alk-phos test with electronophensis analysis. We left the house early and arrived at the UMC lab at 7:15AM. It was a good time to go to the lab. Only two people were ahead of us in line at the desk. Then, we waited in the waiting room for about 15 minutes. They had a beautiful salt water fish tank that we watched while we waited. Once called into the lab, we went into a room that had four people in it. I gather that given Henry's size, they decided that the supervisor should draw Henry's blood. He did a fantastic job. While I understand the need for students to practice on patients, I feel like Henry has already contributed enough as a test subject, so I was very happy that the most experienced person in the room drew his blood. Given the tests, he actually had to go into Henry's left arm with a needle, rather than do the heal stick, because the tests required more blood than a heal stick could provide. Henry wasn't happy about being stuck of course, but it was a much more efficient experience than what we've had at Sonora Quest Labs, so Jeff and I were pleased. At Sonora Quest, we always start off with someone who is inexperienced, then move onto someone with slightly more experienced, and then they resort to the big guns, when all else fails...meaning that Henry is often stuck several times before a viable sample is taken. After our last two Sonora Quest experiences, we have made sure to tell whoever is drawing the blood that he's a difficult patient and his veins are likely to blow.

We stopped by the NICU briefly to see if Joyce was around. Alas, she wasn't on duty today. Next time, we'll email Joyce ahead of time and plan our trip to the lab around her work schedule. I suspect we'll use UMC again when Henry needs lab work, because it was such a good experience (for lab work, that is). We got to see Michelle, Shelley, and Penny, which was nice.

We came back to the house for about 40 minutes and then headed out the door to the pulmonology appointment with Dr. Brown. The waiting room at the Wilmot Clinic was packed, which was a first. The nurse took Henry's measurements. He weighed 13 lbs 5 ozs. His head circumference was 40.7 cm. And, his length was 23.25 inches! According to the charts, that means that his head is just under the 50th percentile on the preemie charts, his weight is midway between the 25th and 50th percentile marks, and....drum roll...his length is almost touching the -1 standard deviation mark! This is the first time that his length has made it well into the bands of normality for his adjusted age. When his head circumference, height, and length are plotted on the regular growth charts for boys (from the CDC) for his adjusted age, his head circumference is at the 25th percentile, his weight is above the 25th percentile (about a third of the way between 25th and 50th), and his length is at the 10th percentile. We are pleased that he has made it onto the regular charts so quickly for a preemie. We weren't surprised that his head has done well (he does have a Super Noggin), but we were so surprised by his length. Way to go, Henry! We suspect that sleeping is really making a difference for him.

The appointment with Dr. Brown went well. Henry was in a great mood. He laughed when the first nurse checked his lungs with the stethoscope. And, then Dr. Brown did a thorough lung check with two stethoscopes, which Henry also found very funny. After Dr. Brown's check up, a nurse whom we hadn't seen before did the pulse-ox check. It took a really long time because Henry kept moving around. With his oxygen on, he was at 100%. Without oxygen, he was 96%-97%. Dr. Brown came back to consult with us. Under normal circumstances, he would simply send Henry home without oxygen, because things look good. But given Henry's history, he wants to do an overnight study again with Henry off oxygen. Hopefully, the brain trust at Schaller Anderson won't reject the overnight study again. If they do, we'll fight them on it. Henry's not coming off oxygen unless we are sure that it is safe. I told Dr. Brown about how Schaller Anderson refused last time to pay for the overnight study last time, but Dependable Home Services picked up the tab, because they felt sorry for Henry. He wasn't surprised. He said that he once ordered an overnight study for a patient, which was rejected by the insurance company. So he then ordered a sleep study (an in-patient study), which the insurance company accepted. Ironically, the overnight study would have cost $100-200. The sleep study cost $2500. We really, really, really don't want to go back to the hospital for a sleep study, so I'm hoping that the claims department at Schaller Anderson does the right thing. The overnight study would be more cost effective for them and safer for Henry (the last thing Henry needs is to spend time in the hospital around sick people during RSV season).

Right now, Henry is snoozing in his Grammy's arms. He has had a busy day.