Henry turned 6 months (adjusted) today. Today didn't quite go as expected. Veronica came over at 7:30AM. I had a meeting at 9:30AM. Before I left the house, I heard Veronica coughing. I asked if she was sick. She thought she was coming down with something. Ugh. Monday is a teaching today, so Jeff took care of Henry, while I dropped Veronica back at her house before heading into school.
Jeff reported that Henry ate quite in the morning. He weighed 15 lbs 8.5 ozs. I suspect that a good portion of what he lost was "water weight" and that's the weight that he is gaining back rapidly. Jeff gave Henry a workout, which means working on his sitting skills and doing some modified tummy time on his lap. He also took a two hour nap, which allowed Jeff to get some work done. Henry usually doesn't take long naps. Perhaps he is going to have a growth spurt soon.
I got home around 1PM. We went for a walk. Henry got to see Nick and Janice's horses. It is nice having neighbors with horses. You get all the benefits (i.e., looking at magnificent creatures) without the disadvantages (i.e., spending a lot of time using a wheel barrel and a shovel).
Grammy came in the afternoon. Henry spent a good deal of time bouncing up and down (his new favorite thing). Unfortunately, his favorite time to play "bouncy, bouncy" is after having a large meal. Rather than getting sleepy after eating, he tends to have bursts of energy.
Jeff, Henry, and I went for another walk with the dogs in the evening; we helped capture our neighbor's spirited dog Annie (she is a fireball). Henry ate and took a nap. Grandpa came over. Henry looks like he's getting ready for a long snooze on Grandpa's chest.
Veronica called in sick for tomorrow. So, it looks like I'll be spending the morning with Mr. H (as Tara calls him). In the afternoon, we have an appointment with Dr. Tsai, who will assess his development.
Monday, February 11, 2008
Sunday, February 10, 2008
Burrito Boy
I'm not sure where the time went today. Henry ate well in the morning. He weighed 15 lbs 6 ozs. We went over to Carmen and Eric's house to pick up a high chair. Their son Dennis (18 months) has outgrown it. Their son Gordon helped carry the high chair tray to the car. We really appreciate all of the clothes and stuff that they have given Henry!
We went over to my parents' house to watch the UofA vs. ASU game. UofA lost. Put everyone in a bad mood. UofA has always been a b-ball powerhouse and rarely loses to ASU. They have lost both ASU games this season. Henry wore some of his UofA wear today. Even Henry's cuteness couldn't save the Wildcats.
When Henry came home, he rolled around on his UofA blanket. We had a receiving blanket on top of the UofA one. He grabbed a corner and rolled himself up like burrito with Henry filling. He also got his caboose up in the air a couple times.
Henry did well on his milk intake today. He was so hungry that he even drank 2 ozs of Neocate without protest. It happened by accident. We usually reserve the Neocate for his rice cereal. Glad that Henry didn't seem to mind it. It had been his fortifier for a long time, so his taste buds must be used to it. His milk/Neocate intake was 721 mls today (24.86 ozs). That's more than yesterday, so we are still headed in the right direction. The night is still young, so perhaps he'll have more. At the moment, he looks pretty darn sleepy, so I'm assuming that he's out (until at least 3AM or so).
That's all for now. Henry turns 6 months adjusted tomorrow.
We went over to my parents' house to watch the UofA vs. ASU game. UofA lost. Put everyone in a bad mood. UofA has always been a b-ball powerhouse and rarely loses to ASU. They have lost both ASU games this season. Henry wore some of his UofA wear today. Even Henry's cuteness couldn't save the Wildcats.
When Henry came home, he rolled around on his UofA blanket. We had a receiving blanket on top of the UofA one. He grabbed a corner and rolled himself up like burrito with Henry filling. He also got his caboose up in the air a couple times.
Henry did well on his milk intake today. He was so hungry that he even drank 2 ozs of Neocate without protest. It happened by accident. We usually reserve the Neocate for his rice cereal. Glad that Henry didn't seem to mind it. It had been his fortifier for a long time, so his taste buds must be used to it. His milk/Neocate intake was 721 mls today (24.86 ozs). That's more than yesterday, so we are still headed in the right direction. The night is still young, so perhaps he'll have more. At the moment, he looks pretty darn sleepy, so I'm assuming that he's out (until at least 3AM or so).
That's all for now. Henry turns 6 months adjusted tomorrow.
Saturday, February 9, 2008
Henry's Day at the Park
On Friday night, Henry woke up around 11:20PM. He was wide awake. Jeff gave him a bottle, which eventually settled him down. He had a good daily total milk intake of 665 mls. Not quite where we'd like it to be (i.e., a liter) but headed in the right direction. Here are some pictures of the nightlife around the house...
We decided to take Henry to Tohono Chul Park, a desert preserve near my parents' house, today. We hate that Henry has to be kept cooped up all of the time in our effort to keep him away from germs. We want him to see some of the world. So we have decided to take him places on the weekends, where exposure to other people is limited to non-existent. That leaves us the great outdoors. Henry had a great time. His favorite part was grabbing the creosote bushes.
Afterward, we headed to my parents for a couple hours. Henry tried sweet potatoes for the first time and loved them. He almost ate a whole jar. He did a lot of rolling around in the evening. His final daily milk total today was 695 mls (just short of 24 ozs).
Friday, February 8, 2008
Henry's Active Day
Henry went to bed early last night (around 7PM or so). He woke up around 3:15AM. Jeff fed him his bottle while I pumped. He had a good appetite. He wasn't particularly tired when he was done with his bottle. Jeff held him for awhile to keep him upright (one of the reflux precautions). Then, we brought him into our bed so that he would be propped up on a pillow. We have mixed feelings about bringing him to bed. On the one hand, we love snuggling with him. And, keeping him propped up is good for his reflux condition. On the other hand, it is safer to have babies sleep in their cribs. I heard some horror stories from nurses while in the NICU that made me really aware of the problems of babies sleeping in beds. So we don't do it often. It will be nice when he is a little bigger and won't have to worry about such things. I sleep much lighter when he is with us, just because of those concerns. Henry slept well. He started stirring around 6AM.
Henry had a busy day. Veronica described him as much happier than he had been the past few days. His voice rung throughout the house.
Veronica helped me give Henry a much needed bath. Tara and Cuyler came in the afternoon. Tara arrived a little early. She worked on getting Henry in a crawl position. He had worked up an appetite. I ended up giving him a bowl of rice cereal before Cuyler arrived. He washed it down with his bottle.
Because Henry had eaten, Cuyler spent the time on Henry's sitting skills rather than feeding issues. Henry isn't eating what he needs, but he has done much better keeping foods down. We think that he is still combating the remnants of the virus, but we are hoping that things will be OK. Today, we weighed him at 15 lbs 2.5 ozs.
Having railed at the medical community on my last few postings, I will say that Tara and Cuyler are bright spots in my view. Tara is working hard as Henry's coordinator, making sure that Henry gets the therapists he needs. And Cuyler is one of the most intellectual and diligent medical personnel that we have come across. She is observant and methodical. I don't know Cuyler's age, but I'm getting that she is about 26 years old. She has a really good touch with babies (kind of reminds me of Joyce's touch with the neonates). It was her comment last week about the dosage on Henry's reflux meds that prompted me to ask Dr. Beskind about the dosage when we were in Urgent Care. Had I not asked about dosage, Henry would have still been on a dose that was appropriate for a 6 lbs not a 15 lbs baby.
Henry has a tendency to balance on the back of his pelvis when trying to sit. This doesn't work terribly well. Cuyler observed that he needs to be loading his weight toward the front of the pelvis. She also observed that his hamstrings are rather tight. She has given us some stretches to loosen the hamstrings. Basically, Henry doesn't lay his leg flat when trying to sit. The hamstrings come off the ground, which makes his body position less stable. It is unclear to us whether this is a "preemie issue" or somewhat genetic. I'm not sure that Jeff can lay his legs flat without a lot of work; he isn't very flexible! She also gave us some exercises to teach Henry how to balance with his arms tucked closer to his body when he is on his tummy. The way Cuyler breaks down movements is amazing. Cuyler grew up in Texas and received her B.A. and M.A. from the University of Texas at Austin. Not a bad pedigree. She followed that up with a fellowship at the top neonatal unit in the country in Houston, where she specialized in feeding issues. I'm obviously in awe over this woman. She is first rate.
Cuyler said that Henry is much easier to work with compared to most babies. He tolerates a lot of handling. Henry's massage therapist Miriam had made a similar comment a few weeks ago. Henry does have his limits, but he does enjoy a lot of human interaction.
Jeff and I took Henry on a walk this evening. It was warm to the point where Jeff and Henry didn't need to kangaroo under Jeff's jacket. When we got back, Henry had a large bottle (100 mls) plus a large bowl of rice cereal made with 40 mls of Neocate and pears. For him, that's a large meal. And he kept most of it down. He spent some time with me and Jeff after the meal making a wide variety of ga-ba-ooh-eew and raspberry sounds.
Grandma and Grandpa brought dinner over tonight. They played with Henry for a little while, but then he crashed on his UofA blanket. He's still asleep. I'm hoping that he wakes up before going to his crib so that we can give him his reflux meds.
Henry had a busy day. Veronica described him as much happier than he had been the past few days. His voice rung throughout the house.
Veronica helped me give Henry a much needed bath. Tara and Cuyler came in the afternoon. Tara arrived a little early. She worked on getting Henry in a crawl position. He had worked up an appetite. I ended up giving him a bowl of rice cereal before Cuyler arrived. He washed it down with his bottle.
Because Henry had eaten, Cuyler spent the time on Henry's sitting skills rather than feeding issues. Henry isn't eating what he needs, but he has done much better keeping foods down. We think that he is still combating the remnants of the virus, but we are hoping that things will be OK. Today, we weighed him at 15 lbs 2.5 ozs.
Having railed at the medical community on my last few postings, I will say that Tara and Cuyler are bright spots in my view. Tara is working hard as Henry's coordinator, making sure that Henry gets the therapists he needs. And Cuyler is one of the most intellectual and diligent medical personnel that we have come across. She is observant and methodical. I don't know Cuyler's age, but I'm getting that she is about 26 years old. She has a really good touch with babies (kind of reminds me of Joyce's touch with the neonates). It was her comment last week about the dosage on Henry's reflux meds that prompted me to ask Dr. Beskind about the dosage when we were in Urgent Care. Had I not asked about dosage, Henry would have still been on a dose that was appropriate for a 6 lbs not a 15 lbs baby.
Henry has a tendency to balance on the back of his pelvis when trying to sit. This doesn't work terribly well. Cuyler observed that he needs to be loading his weight toward the front of the pelvis. She also observed that his hamstrings are rather tight. She has given us some stretches to loosen the hamstrings. Basically, Henry doesn't lay his leg flat when trying to sit. The hamstrings come off the ground, which makes his body position less stable. It is unclear to us whether this is a "preemie issue" or somewhat genetic. I'm not sure that Jeff can lay his legs flat without a lot of work; he isn't very flexible! She also gave us some exercises to teach Henry how to balance with his arms tucked closer to his body when he is on his tummy. The way Cuyler breaks down movements is amazing. Cuyler grew up in Texas and received her B.A. and M.A. from the University of Texas at Austin. Not a bad pedigree. She followed that up with a fellowship at the top neonatal unit in the country in Houston, where she specialized in feeding issues. I'm obviously in awe over this woman. She is first rate.
Cuyler said that Henry is much easier to work with compared to most babies. He tolerates a lot of handling. Henry's massage therapist Miriam had made a similar comment a few weeks ago. Henry does have his limits, but he does enjoy a lot of human interaction.
Jeff and I took Henry on a walk this evening. It was warm to the point where Jeff and Henry didn't need to kangaroo under Jeff's jacket. When we got back, Henry had a large bottle (100 mls) plus a large bowl of rice cereal made with 40 mls of Neocate and pears. For him, that's a large meal. And he kept most of it down. He spent some time with me and Jeff after the meal making a wide variety of ga-ba-ooh-eew and raspberry sounds.
Grandma and Grandpa brought dinner over tonight. They played with Henry for a little while, but then he crashed on his UofA blanket. He's still asleep. I'm hoping that he wakes up before going to his crib so that we can give him his reflux meds.
Thursday, February 7, 2008
Not Out of the Woods Yet
Sorry for the ominous blog title. It seems that whenever we post some positive title things take a turn for the worse. My most recent post was titled "On the Mend" and Kate posted "Improving" and today he vomited and weighed the lowest he has in a long time. So I thought I would try to gloom and doom him on his way to good health.
Henry seems to be still feeling the effects of whatever virus he has. He is much happier and is eating more. However, he is sleeping much more than he used to, his temperature is still dropping while he sleeps and today he had another massive vomit, all over Veronica. He weighed 14lbs 15ozs today. We had thought he hit bottom a couple days ago at 15lbs 1oz but that was not the case. Hopefully this is the lightest he will be for the rest of his life.
On a more positive note, he is still having fun with his mouth, making new sounds. He's sticking his tongue way out, making raspberries, and starting to make sounds that just might turn into words.
He was supposed to have his first real appointment with the physical therapist today. However, she didn't call and didn't show up.
He spent that afternoon with Grandma and is currently asleep on Grandpa. He has had a resurgence in his enjoyment of sleeping on people. He went through a phase where he didn't really do that anymore. Now he is back to doing it daily. I thought I would include some pictures of Henry on his Grandpa to demonstrate how he has grown. As you can see, he is now quite the handful.
Henry seems to be still feeling the effects of whatever virus he has. He is much happier and is eating more. However, he is sleeping much more than he used to, his temperature is still dropping while he sleeps and today he had another massive vomit, all over Veronica. He weighed 14lbs 15ozs today. We had thought he hit bottom a couple days ago at 15lbs 1oz but that was not the case. Hopefully this is the lightest he will be for the rest of his life.
On a more positive note, he is still having fun with his mouth, making new sounds. He's sticking his tongue way out, making raspberries, and starting to make sounds that just might turn into words.
He was supposed to have his first real appointment with the physical therapist today. However, she didn't call and didn't show up.
He spent that afternoon with Grandma and is currently asleep on Grandpa. He has had a resurgence in his enjoyment of sleeping on people. He went through a phase where he didn't really do that anymore. Now he is back to doing it daily. I thought I would include some pictures of Henry on his Grandpa to demonstrate how he has grown. As you can see, he is now quite the handful.
Improvement
Henry had a good day yesterday. He was using his voice a lot. He practiced making different shapes with his lips. He made "Ba" and "Ma" sounds. Not a lot, but definitely experimenting with new sounds. Veronica came in the morning. I went to school. When I came back in the afternoon, Henry looked good. Much happier than he has been in weeks.
When Grammy came in the afternoon, he gave her a huge smile as she walked in the door and threw his hands up toward her. She sat down on the floor with him. He put his hands forward to balance himself. With his hands on the floor, he spent some time sitting up without assistance. He still doesn't quite have the balance thing down yet, but he is working on it.
At some point in the afternoon, Jeff and I filled up a new toy with air, so that Henry could play with it. It looks like a cylinder beach ball with clear plastic sides so that you can see the balls inside of it. The idea is that babies can lean on it, which is supposed to help them learn crawling techniques. Jeff put it on the ground, and for whatever reason, it scared Henry and he started crying. It is the second time this week that Henry has gotten scared (an emotion that we hadn't seen in him before). The first time was on Tuesday when Henry was playing with his cloth picture book. The book was stretched out like a wall (about 8 inches high). Veronica reported that Bitsy was trying to play with Henry and jumped out at him over the book, which scared the heck out of him.
Henry sacked out on Grammy in the late afternoon yesterday. So Jeff and I took the dogs for a walk without him. Grandpa arrived in the evening. I ended up taking a nap. When I left, Grandpa was playing with Henry on the floor with the Phoenix Suns in the background.
Jeff said that Henry fell asleep around 9PM. He woke up at 11:30PM very upset as he was hungry. Went back to sleep and woke up again at 6:15AM. Yesterday's total milk intake was a little over 21.5 ozs...a huge, huge improvement over the last several days. I think that the Prevacid is making a big difference in his ability to intake foods. He is choking and gagging less when drinking his bottles.
When Grammy came in the afternoon, he gave her a huge smile as she walked in the door and threw his hands up toward her. She sat down on the floor with him. He put his hands forward to balance himself. With his hands on the floor, he spent some time sitting up without assistance. He still doesn't quite have the balance thing down yet, but he is working on it.
At some point in the afternoon, Jeff and I filled up a new toy with air, so that Henry could play with it. It looks like a cylinder beach ball with clear plastic sides so that you can see the balls inside of it. The idea is that babies can lean on it, which is supposed to help them learn crawling techniques. Jeff put it on the ground, and for whatever reason, it scared Henry and he started crying. It is the second time this week that Henry has gotten scared (an emotion that we hadn't seen in him before). The first time was on Tuesday when Henry was playing with his cloth picture book. The book was stretched out like a wall (about 8 inches high). Veronica reported that Bitsy was trying to play with Henry and jumped out at him over the book, which scared the heck out of him.
Henry sacked out on Grammy in the late afternoon yesterday. So Jeff and I took the dogs for a walk without him. Grandpa arrived in the evening. I ended up taking a nap. When I left, Grandpa was playing with Henry on the floor with the Phoenix Suns in the background.
Jeff said that Henry fell asleep around 9PM. He woke up at 11:30PM very upset as he was hungry. Went back to sleep and woke up again at 6:15AM. Yesterday's total milk intake was a little over 21.5 ozs...a huge, huge improvement over the last several days. I think that the Prevacid is making a big difference in his ability to intake foods. He is choking and gagging less when drinking his bottles.
Tuesday, February 5, 2008
On the Mend
It seems Henry is getting better. He ate more today than he has in a while. He is still not consuming as much as he needs to be to grow but at least his intake is improving. He is still gagging and coughing quite a bit while feeding from the bottle. I believe it takes a little while for the Prevacid to fully kick in. He didn't vomit at all today, thank goodness.
One concern I still have is the low temperature. It seems to happen only when he is sleeping. I don't remember ever noticing it before and it makes me think he still has some lingering sickness. I feel it is strange because I associate fever with sickness, not coolness. We put a hat on him tonight while he sleeps and have a portable heater near his crib.
He was more active today. It was nice to hear him do some of his squealing. Today he started to really make some bah sounds. He started to work his mouth open and closed in kind of a chomping fashion a few days ago and now the bah sound. It is so fun to see his progress.
He had a visit from a physical therapist today for an evaluation. She thought he looked very good for a baby born so early. She saw a couple minor issues but nothing major. Her assessment was that he was at about the 3-4 month old range and she is going to visit a couple times a week for the next week or two. It will be interesting to see what techniques she can show us. She recommended lots of tummy time. She also had us use the boppy pillow, an almost circular shaped pillow that is most frequently used to prop up an infant while breast feeding, to sit him up in. That works really well. She also commented on how adorable he is.
Henry went to sleep a little early tonight and I held him while we watched Lost and election results. Grandma visited in the afternoon and Grandpa took the day off.
One concern I still have is the low temperature. It seems to happen only when he is sleeping. I don't remember ever noticing it before and it makes me think he still has some lingering sickness. I feel it is strange because I associate fever with sickness, not coolness. We put a hat on him tonight while he sleeps and have a portable heater near his crib.
He was more active today. It was nice to hear him do some of his squealing. Today he started to really make some bah sounds. He started to work his mouth open and closed in kind of a chomping fashion a few days ago and now the bah sound. It is so fun to see his progress.
He had a visit from a physical therapist today for an evaluation. She thought he looked very good for a baby born so early. She saw a couple minor issues but nothing major. Her assessment was that he was at about the 3-4 month old range and she is going to visit a couple times a week for the next week or two. It will be interesting to see what techniques she can show us. She recommended lots of tummy time. She also had us use the boppy pillow, an almost circular shaped pillow that is most frequently used to prop up an infant while breast feeding, to sit him up in. That works really well. She also commented on how adorable he is.
Henry went to sleep a little early tonight and I held him while we watched Lost and election results. Grandma visited in the afternoon and Grandpa took the day off.
Trip to Urgent Care
Henry woke up at 4AM yesterday. Jeff gave him a bottle and became concerned when he felt Henry. Henry was cold (head, hands, and feet). He took his temperature. It was 95 degrees under the arm. I called the nurse hotline on the back of Henry's insurance card. I explained Henry's situation (e.g., vomiting, diarrhea on Friday night, 9 oz weight loss, and feeling cold). The nurse said "get a new pediatrician" and that we should probably take him to Urgent Care. However, seeing as that it was 4:30AM by this point, she said we could wait until morning, call his pediatrician, and then see if his ped could arrange for appointments with specialists (rather than spending 6-8 hours in urgent care/ER).
We waited a little while. Henry still felt cold. I decided to call his pediatrician's office and get the telephone number for triage (which eventually gets you in contact with a pediatrician on-call). Jeff talked to the triage nurse who recommended taking another temperature reading in 30 minutes after bundling him up. 30 minutes later, we took another temperature and the nurse called back. Still cool. His temperature had increased to something like 97.3. She then called the on-call pediatrician. Explained the weight loss and feeling cool. I figured that we would be told just to keep an eye on things. A temp in the 97s isn't as concerning to me as a temp in the 95s. But the on-call pediatrician (a Dr. McPherson) said that we should take Henry to the ER. The triage nurse said that we should go to TMC or UMC. She said that it shouldn't be crowded at that time of the morning (it was about 6AM by this point). I asked if it was OK to take him to Northwest Hospital (the one closer to us). We knew that the neonatalogists and nurse practitioners at UMC's NICU rotate into the Level II nursery (handles neonates at 30 weeks or older and babies not needing a vent for more than 24 hours) at Northwest. We also know that Northwest has questionable billing practices. We heard that the NW staff has competitions to see how much money they can swindle out of people beyond the co-pays. They double and triple bill the elderly (e.g., my grandmother on several occasions). They have tried to press my mom several times and lied about the co-pays (her doctor uses Northwest), which of course resulted in my mom threatening them with a lawsuit (they backed off). They have lied to my mom's friends about what is due. In an emergency, Jeff and I aren't afraid of their billing practices as long as the doctors are good. The triage nurse on the telephone said that "under no circumstances" should a parent take a baby to Northwest. So it was back to UMC.
We arrived at UMC around 7AM. Just a couple of people were in the large waiting room. It was a completely different scene less than 24 hours earlier. A nice nurse named Wendy saw us almost immediately at the registration area. She did a thorough job recording our concerns. Wendy is the mother of a 2 year old and a 6 year old. She was the complete opposite of Ashley the day before. Wendy gave us to the option to weigh Henry with or without clothes. She said that the doctors wouldn't use their scale weight as the assessment benchmark of whether or not Henry's weight was declining. We decided to keep his clothes on (7 kg, which is where he was the previous day on their scale with clothes on). She measured Henry's head at 43 cm and his length at 64 cm. She handled all of the registration (no two part registrations this time of the morning). She decided to sign him into Urgent Care. The doctors would arrive at 8AM. Henry was first in line.
We waited in the near empty waiting room for about 20 minutes. It looked clean, which was nice to see. We were then called by the next nurse, Chuck. Chuck took us and two other patients to some waiting rooms in the back. Even though the doctors weren't coming into the hospital until 8AM, he wanted us ready so that we could be seen immediately. Henry was seen by a Dr. Beskind (an assistant professor). I have to admit that it was really nice not to have to go through the whole resident thing and to see a "real" doctor right away. I'm all for the teaching hospital thing, but we have seen a lot of residents in Henry's short life already, and a lot of them truly don't know much (Dr. McLain from May and Henry's resident from August, whose name I have already forgotten, being strong exceptions). For the stressed out parent, it is nice to cut to the chase.
I guess the basic rule of thumb is that if the baby looks alert, then they don't consider the problem terribly serious. Henry has been alert the last three weeks. He was very sluggish on Thursday and Friday, but when awake, he is alert, although not as active as a couple weeks ago. Clinically, Henry looked OK. The doctor did discover a rash on Henry's stomach, which neither Jeff nor I had noticed at his earlier diaper changes. Henry has had a rash on his chin, but Jeff and I figured that it was from all of the drooling that he has been doing over the last 2 months. His chin did look more aggravated than usual. On his stomach, he had a rash patch that looked rather angry, about an inch above his diaper on his right side. The doctor said that the rash suggested that Henry had a virus. Consistent with the "ick" that is going around. Given Henry's other symptoms (e.g., gagging during feeds and refusing bottles), Dr. Beskind thought that Henry's reflux was acting up. He told us to put Henry back on his reflux meds. I asked whether the dosage should be the same. He was taking 7.5 mg of Prevacid once a day. This dose was prescribed to him back in September when he was 6 lbs. Dr. Beskind said that he was going to call Henry's pediatrician to consult with him, but suspected that the dosage should be increased. In the meantime, Chuck brought Henry a bottle of Pedialyte. They wanted to see if we could get some liquids into Henry before we left. We tried giving Henry the Pedialyte, but it made him upset. We did manage to get some breast milk into however. A woman came by with a teddy bear for Henry. He played (chewed) on the bear for a while.
Around 10:30AM, Dr. Beskind came back with Chuck. Final prognosis: Henry has reflux and a virus. They would rather not run tests on Henry at this time, because there are RSV cases in the hospital, and it would be safer for him to stay away from it. Regarding his weight loss, they won't do anything about it until Henry loses 10% of his body weight, at which point he would be diagnosed as failure to thrive (FTT) and then be admitted. I completely understand the logic of keeping Henry away from RSV cases, but the logic on the last bit on waiting until the child is FTT before one takes action is...well...asinine. Here is a wild and crazy thought...how about try to figure out what is going on before letting the child turn into a FTT case. Sigh. I know that Dr. Beskind was just following hospital protocols, but I just find the logic of "modern" medicine screwy. I will say that Dr. Beskind and Chuck did have very nice bedside manners. They are both fathers to young children, which probably contributes to their sensitivity. Incidentally, Dr. Beskind's son had reflux as a 1 year old and required medication as well, so he is familiar with the problems and symptoms of reflux.
Our 3.5 hour trip (4.5 hour trip including driving time) to UMC wasn't a complete waste of time. Dr. Beskind did raise the dosage of Henry's reflux medications to 7.5 mg twice a day.
Henry had a pretty good afternoon. We gave him his Prevacid. Grammy came over and played with Henry. Henry loves to play with Grammy's hair. Henry ate a whole jar of pears at some point. Jeff and Grammy weighed Henry at 15 lbs 3 ozs. We were pleased that he didn't dip below 15 lbs.
In the late afternoon, we got a visit from Shelly, a UMC nurse, who was doing an evaluation of Henry so that Henry could be entered in their home health care program for physical therapy visits. Tara tried to get a PT through DDD, but none of the PTs want to work on the west side of town. Henry's insurance will pay for most of the PT visits from UMC. We'll have to take care of the co-pays, but in the larger scheme of things, that's no big deal. The important thing is that Henry will have a PT. Shelly was really nice and upbeat. She had a great personality. And most importantly, Henry liked her. His temperature was still in the 97s (can't remember the exact number), but he seemed to be doing fine. When she held him, he started gnawing on her shoulder. I hadn't really noticed that before. She observed two things: (a) that he was teething, and (b) that he was making coughing sounds consistent with a reflux diagnosis. With his teething, she said not to be surprised if he runs a little fever. She said that her children vomited and back end issues when they teethed. She had some good suggestions for his teething, things that had worked for her kids. She also suggested that we get a bed wedge so that Henry stays elevated when he sleeps, which is suggested for reflux babies.
Grammy and I went to Babies R Us after Shelly left. We got some Pedialyte popsicles and more pears for him. Got a bed wedge. Grammy bought Henry an early Valentine's Day gift. It's a dinosaur toy that has balls and slides for the balls. It's pretty cool. Grammy left in the evening. Shortly after, Grandpa arrived. Henry fell asleep around 8PM or so. Overall, I think that his milk intake was up a little (just up an ounce, but given that he has only been consuming 10 ozs a day, that's a 10% increase!). He didn't have as much to eat though. But at least he didn't throw things up. And, he had a couple feeds where he didn't choke or gag.
This morning, Henry woke up shortly before 2AM. Jeff gave him 2 ozs, while I pumped. Henry wanted more. He had an additional 1 1/3 ozs before going back to sleep. He had another 2 ozs when he woke up again at 7AM. So far, so good on the food intake. Well, maybe not good, but not terrible. It is an improvement anyway. Veronica is watching Henry now.
We waited a little while. Henry still felt cold. I decided to call his pediatrician's office and get the telephone number for triage (which eventually gets you in contact with a pediatrician on-call). Jeff talked to the triage nurse who recommended taking another temperature reading in 30 minutes after bundling him up. 30 minutes later, we took another temperature and the nurse called back. Still cool. His temperature had increased to something like 97.3. She then called the on-call pediatrician. Explained the weight loss and feeling cool. I figured that we would be told just to keep an eye on things. A temp in the 97s isn't as concerning to me as a temp in the 95s. But the on-call pediatrician (a Dr. McPherson) said that we should take Henry to the ER. The triage nurse said that we should go to TMC or UMC. She said that it shouldn't be crowded at that time of the morning (it was about 6AM by this point). I asked if it was OK to take him to Northwest Hospital (the one closer to us). We knew that the neonatalogists and nurse practitioners at UMC's NICU rotate into the Level II nursery (handles neonates at 30 weeks or older and babies not needing a vent for more than 24 hours) at Northwest. We also know that Northwest has questionable billing practices. We heard that the NW staff has competitions to see how much money they can swindle out of people beyond the co-pays. They double and triple bill the elderly (e.g., my grandmother on several occasions). They have tried to press my mom several times and lied about the co-pays (her doctor uses Northwest), which of course resulted in my mom threatening them with a lawsuit (they backed off). They have lied to my mom's friends about what is due. In an emergency, Jeff and I aren't afraid of their billing practices as long as the doctors are good. The triage nurse on the telephone said that "under no circumstances" should a parent take a baby to Northwest. So it was back to UMC.
We arrived at UMC around 7AM. Just a couple of people were in the large waiting room. It was a completely different scene less than 24 hours earlier. A nice nurse named Wendy saw us almost immediately at the registration area. She did a thorough job recording our concerns. Wendy is the mother of a 2 year old and a 6 year old. She was the complete opposite of Ashley the day before. Wendy gave us to the option to weigh Henry with or without clothes. She said that the doctors wouldn't use their scale weight as the assessment benchmark of whether or not Henry's weight was declining. We decided to keep his clothes on (7 kg, which is where he was the previous day on their scale with clothes on). She measured Henry's head at 43 cm and his length at 64 cm. She handled all of the registration (no two part registrations this time of the morning). She decided to sign him into Urgent Care. The doctors would arrive at 8AM. Henry was first in line.
We waited in the near empty waiting room for about 20 minutes. It looked clean, which was nice to see. We were then called by the next nurse, Chuck. Chuck took us and two other patients to some waiting rooms in the back. Even though the doctors weren't coming into the hospital until 8AM, he wanted us ready so that we could be seen immediately. Henry was seen by a Dr. Beskind (an assistant professor). I have to admit that it was really nice not to have to go through the whole resident thing and to see a "real" doctor right away. I'm all for the teaching hospital thing, but we have seen a lot of residents in Henry's short life already, and a lot of them truly don't know much (Dr. McLain from May and Henry's resident from August, whose name I have already forgotten, being strong exceptions). For the stressed out parent, it is nice to cut to the chase.
I guess the basic rule of thumb is that if the baby looks alert, then they don't consider the problem terribly serious. Henry has been alert the last three weeks. He was very sluggish on Thursday and Friday, but when awake, he is alert, although not as active as a couple weeks ago. Clinically, Henry looked OK. The doctor did discover a rash on Henry's stomach, which neither Jeff nor I had noticed at his earlier diaper changes. Henry has had a rash on his chin, but Jeff and I figured that it was from all of the drooling that he has been doing over the last 2 months. His chin did look more aggravated than usual. On his stomach, he had a rash patch that looked rather angry, about an inch above his diaper on his right side. The doctor said that the rash suggested that Henry had a virus. Consistent with the "ick" that is going around. Given Henry's other symptoms (e.g., gagging during feeds and refusing bottles), Dr. Beskind thought that Henry's reflux was acting up. He told us to put Henry back on his reflux meds. I asked whether the dosage should be the same. He was taking 7.5 mg of Prevacid once a day. This dose was prescribed to him back in September when he was 6 lbs. Dr. Beskind said that he was going to call Henry's pediatrician to consult with him, but suspected that the dosage should be increased. In the meantime, Chuck brought Henry a bottle of Pedialyte. They wanted to see if we could get some liquids into Henry before we left. We tried giving Henry the Pedialyte, but it made him upset. We did manage to get some breast milk into however. A woman came by with a teddy bear for Henry. He played (chewed) on the bear for a while.
Around 10:30AM, Dr. Beskind came back with Chuck. Final prognosis: Henry has reflux and a virus. They would rather not run tests on Henry at this time, because there are RSV cases in the hospital, and it would be safer for him to stay away from it. Regarding his weight loss, they won't do anything about it until Henry loses 10% of his body weight, at which point he would be diagnosed as failure to thrive (FTT) and then be admitted. I completely understand the logic of keeping Henry away from RSV cases, but the logic on the last bit on waiting until the child is FTT before one takes action is...well...asinine. Here is a wild and crazy thought...how about try to figure out what is going on before letting the child turn into a FTT case. Sigh. I know that Dr. Beskind was just following hospital protocols, but I just find the logic of "modern" medicine screwy. I will say that Dr. Beskind and Chuck did have very nice bedside manners. They are both fathers to young children, which probably contributes to their sensitivity. Incidentally, Dr. Beskind's son had reflux as a 1 year old and required medication as well, so he is familiar with the problems and symptoms of reflux.
Our 3.5 hour trip (4.5 hour trip including driving time) to UMC wasn't a complete waste of time. Dr. Beskind did raise the dosage of Henry's reflux medications to 7.5 mg twice a day.
Henry had a pretty good afternoon. We gave him his Prevacid. Grammy came over and played with Henry. Henry loves to play with Grammy's hair. Henry ate a whole jar of pears at some point. Jeff and Grammy weighed Henry at 15 lbs 3 ozs. We were pleased that he didn't dip below 15 lbs.
In the late afternoon, we got a visit from Shelly, a UMC nurse, who was doing an evaluation of Henry so that Henry could be entered in their home health care program for physical therapy visits. Tara tried to get a PT through DDD, but none of the PTs want to work on the west side of town. Henry's insurance will pay for most of the PT visits from UMC. We'll have to take care of the co-pays, but in the larger scheme of things, that's no big deal. The important thing is that Henry will have a PT. Shelly was really nice and upbeat. She had a great personality. And most importantly, Henry liked her. His temperature was still in the 97s (can't remember the exact number), but he seemed to be doing fine. When she held him, he started gnawing on her shoulder. I hadn't really noticed that before. She observed two things: (a) that he was teething, and (b) that he was making coughing sounds consistent with a reflux diagnosis. With his teething, she said not to be surprised if he runs a little fever. She said that her children vomited and back end issues when they teethed. She had some good suggestions for his teething, things that had worked for her kids. She also suggested that we get a bed wedge so that Henry stays elevated when he sleeps, which is suggested for reflux babies.
Grammy and I went to Babies R Us after Shelly left. We got some Pedialyte popsicles and more pears for him. Got a bed wedge. Grammy bought Henry an early Valentine's Day gift. It's a dinosaur toy that has balls and slides for the balls. It's pretty cool. Grammy left in the evening. Shortly after, Grandpa arrived. Henry fell asleep around 8PM or so. Overall, I think that his milk intake was up a little (just up an ounce, but given that he has only been consuming 10 ozs a day, that's a 10% increase!). He didn't have as much to eat though. But at least he didn't throw things up. And, he had a couple feeds where he didn't choke or gag.
This morning, Henry woke up shortly before 2AM. Jeff gave him 2 ozs, while I pumped. Henry wanted more. He had an additional 1 1/3 ozs before going back to sleep. He had another 2 ozs when he woke up again at 7AM. So far, so good on the food intake. Well, maybe not good, but not terrible. It is an improvement anyway. Veronica is watching Henry now.
Sunday, February 3, 2008
U.S. Healthcare Bites
My mom said that she read that the U.S. health care system was rated the most favorably by residents in comparison to other nations by their residents. Wow. That's quite a sad statement. We've run into a few good people, but I think that the system is composed of a lot of charlatans. They make money, but they aren't responsible, smart, or helpful. The only thing that they excel at is passing the buck.
We took Henry to Urgent Care at UMC today. What a disaster that place is. They apologized for being short-staffed. Reminiscent of the last time we were there when they offered the same apology. I filled out an admit paper. Waited in the waiting room with people coughing and hacking. Jeff waited with Henry outside. It simply wasn't safe for him to be in the waiting room. Good thing that we don't live somewhere where the temperatures are in the 40s or lower this time of year. We finally got called into the registration room where a nurse decides whether or not you fall into the ER or Urgent Care category. We explained his rapid weight loss. "Well, how do you know he's lost weight?" We explained that we weighed him on our scale at home. She seemed suspicious. Frankly, it doesn't take a PhD or a MD to weigh a kid on a scale accurately. "Well, what does his pediatrician say?" We explained that we saw Henry's pediatrician on Thursday, but that was before he dropped another 7 ozs. Monday: 15 lbs 10 ozs; Thursday: 15 lbs 8 ozs; Today: 15 lbs 1 oz. The dumb*** nurse weighed Henry but insisted on keeping his clothes and diaper on, and then said that his weight was fine. I explained that his clothes weigh a couple ounces, plus his diaper weighs at least another ounce (if dry). She didn't listen to me at all; she couldn't see why it would be a problem. They took his temperature, which was 36.4 Celsius (normal range is 36.5 to 37.5), with an ear thermometer. Ear thermometers are of course the least reliable of temperature devices (according to some of the NICU nurses and our Dr. Sears guide). His hands, by this time, actually felt a little warmer, so I was a little less concerned about his temp, but his rapid weight loss is very distressing. She then turned us over to a guy who started Henry's registration.
We were then sent to the waiting room where they said it shouldn't take too long. An hour later, Henry's name was called for the second half of the registration process. This is the part where they ask you for your address (again) and double-check the telephone number (again). During the time that I was in the waiting room, no one was called into the Urgent Care center. There was one elderly woman who looked like she should have been admitted to the ER. She was shaking tremendously. I went outside to switch places with Jeff. After half an hour or so, Jeff came back out and told me that they had called two people. The waiting room was packed with both admits and their friends and family. We could tell the admits by the yellow slips that we were given during registration (part deux); there was probably 15 people or so ahead of us. At that rate, we figured that we wouldn't be seen for 3 or 4 hours (at least). I didn't have my pumping equipment, and Henry was getting upset at being outside in his car seat. So we decided to come home, where we could try to get some food into him. Three hours wasted.
Henry had some bottle in the car. He is way under his total intake for the day. I'm guessing that he had about 10-12 ozs today. But he also had a major vomit episode in the evening. I suppose that we'll call Henry's pediatrician tomorrow to let him know about Henry's weigh loss. I suspect that unless Henry starts coughing up blood, he won't be inclined to do anything, except "wait and see." Wait and see my son wither away instead of take action. I obviously need to find another pediatrician. My nerves are frayed. I'm signing off.
We took Henry to Urgent Care at UMC today. What a disaster that place is. They apologized for being short-staffed. Reminiscent of the last time we were there when they offered the same apology. I filled out an admit paper. Waited in the waiting room with people coughing and hacking. Jeff waited with Henry outside. It simply wasn't safe for him to be in the waiting room. Good thing that we don't live somewhere where the temperatures are in the 40s or lower this time of year. We finally got called into the registration room where a nurse decides whether or not you fall into the ER or Urgent Care category. We explained his rapid weight loss. "Well, how do you know he's lost weight?" We explained that we weighed him on our scale at home. She seemed suspicious. Frankly, it doesn't take a PhD or a MD to weigh a kid on a scale accurately. "Well, what does his pediatrician say?" We explained that we saw Henry's pediatrician on Thursday, but that was before he dropped another 7 ozs. Monday: 15 lbs 10 ozs; Thursday: 15 lbs 8 ozs; Today: 15 lbs 1 oz. The dumb*** nurse weighed Henry but insisted on keeping his clothes and diaper on, and then said that his weight was fine. I explained that his clothes weigh a couple ounces, plus his diaper weighs at least another ounce (if dry). She didn't listen to me at all; she couldn't see why it would be a problem. They took his temperature, which was 36.4 Celsius (normal range is 36.5 to 37.5), with an ear thermometer. Ear thermometers are of course the least reliable of temperature devices (according to some of the NICU nurses and our Dr. Sears guide). His hands, by this time, actually felt a little warmer, so I was a little less concerned about his temp, but his rapid weight loss is very distressing. She then turned us over to a guy who started Henry's registration.
We were then sent to the waiting room where they said it shouldn't take too long. An hour later, Henry's name was called for the second half of the registration process. This is the part where they ask you for your address (again) and double-check the telephone number (again). During the time that I was in the waiting room, no one was called into the Urgent Care center. There was one elderly woman who looked like she should have been admitted to the ER. She was shaking tremendously. I went outside to switch places with Jeff. After half an hour or so, Jeff came back out and told me that they had called two people. The waiting room was packed with both admits and their friends and family. We could tell the admits by the yellow slips that we were given during registration (part deux); there was probably 15 people or so ahead of us. At that rate, we figured that we wouldn't be seen for 3 or 4 hours (at least). I didn't have my pumping equipment, and Henry was getting upset at being outside in his car seat. So we decided to come home, where we could try to get some food into him. Three hours wasted.
Henry had some bottle in the car. He is way under his total intake for the day. I'm guessing that he had about 10-12 ozs today. But he also had a major vomit episode in the evening. I suppose that we'll call Henry's pediatrician tomorrow to let him know about Henry's weigh loss. I suspect that unless Henry starts coughing up blood, he won't be inclined to do anything, except "wait and see." Wait and see my son wither away instead of take action. I obviously need to find another pediatrician. My nerves are frayed. I'm signing off.
Something is not Right
On Friday, I dropped off Henry's a urine sample and a stool sample to Dr. Bianchi's office. The urine sample came back negative for a possible UTI. And, the stool sample was "unremarkable." They don't think he's sick. Tara came in the afternoon, and Cuyler came in the late afternoon.
Why isn't Henry eating? Possibilities include:
(a) he has a virus (although his pediatrician doesn't think so)
(b) his reflux is still a problem
(c) he is allergic to something he was fed
(d) he has developed a negative association with food and is thus resisting eating/drinking
(e) some combination of the above
Cuyler showed us some techniques for giving him liquids via cup (in the event that the negative association with the bottle becomes so strong). Henry threw up all over Jeff during Cuyler's visit. After Cuyler left, Jeff gave Henry some Prevacid, which was thrown up shortly thereafter. And then, Henry had some major diarrhea. Needless to say, Henry's fluid intake is way down (again). But this child isn't sick.
On Saturday morning, the Arizona Daily Start had a cover story that said that the norovirus ("winter vomiting disease") has hit Pima County. Symptoms include: severe vomiting, diarrhea and cramps. Henry cried all afternoon, which simply isn't like him. He had another diaper with "brick dust" urine in it.
This morning, Henry had a large diaper. I weighed him. Surprise, surprise, he only weighed 15 lbs 1 oz. This is down from 1/28 when we weighed 15 lbs 10 ozs. I don't think that losing 9 ozs over 5 days is normal. His hands and feed are cold. He took a little bit of his bottle, but he is still refusing it for the most part. He's asleep now. Jeff and I are debating taking him into Urgent Care. Jeff doesn't want to. He doesn't want Henry to pick up an illness in the waiting room. He also doesn't think that the medical establishment knows much. He thinks that they'll just tell us to give Henry Pedialyte (which we've tried) and send us on our way. I don't disagree with those arguments. I guess I'm holding out for the possibility that we'll run into a doctor who doesn't have his or her head up his/her "fill-in-the-blank" and might take the time to listen to our observations. Even better yet, have some solutions. But I guess that isn't what the medical establishment does. My former OB, the fraud, being a good case in point.
Why isn't Henry eating? Possibilities include:
(a) he has a virus (although his pediatrician doesn't think so)
(b) his reflux is still a problem
(c) he is allergic to something he was fed
(d) he has developed a negative association with food and is thus resisting eating/drinking
(e) some combination of the above
Cuyler showed us some techniques for giving him liquids via cup (in the event that the negative association with the bottle becomes so strong). Henry threw up all over Jeff during Cuyler's visit. After Cuyler left, Jeff gave Henry some Prevacid, which was thrown up shortly thereafter. And then, Henry had some major diarrhea. Needless to say, Henry's fluid intake is way down (again). But this child isn't sick.
On Saturday morning, the Arizona Daily Start had a cover story that said that the norovirus ("winter vomiting disease") has hit Pima County. Symptoms include: severe vomiting, diarrhea and cramps. Henry cried all afternoon, which simply isn't like him. He had another diaper with "brick dust" urine in it.
This morning, Henry had a large diaper. I weighed him. Surprise, surprise, he only weighed 15 lbs 1 oz. This is down from 1/28 when we weighed 15 lbs 10 ozs. I don't think that losing 9 ozs over 5 days is normal. His hands and feed are cold. He took a little bit of his bottle, but he is still refusing it for the most part. He's asleep now. Jeff and I are debating taking him into Urgent Care. Jeff doesn't want to. He doesn't want Henry to pick up an illness in the waiting room. He also doesn't think that the medical establishment knows much. He thinks that they'll just tell us to give Henry Pedialyte (which we've tried) and send us on our way. I don't disagree with those arguments. I guess I'm holding out for the possibility that we'll run into a doctor who doesn't have his or her head up his/her "fill-in-the-blank" and might take the time to listen to our observations. Even better yet, have some solutions. But I guess that isn't what the medical establishment does. My former OB, the fraud, being a good case in point.
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