Sunday, March 28, 2010

Ain't I cute?

No coughing, no wheezing, but plenty of heartwarming smiles! Bryce sits completely unassisted now, and has been filling the Spring air with a constant stream of various vowel sounds. Best of all, we're planning to finally get the little guy out of the house for Easter! New beginnings indeed.

Sunday, March 21, 2010

Merrily marching along

Naught but happy news to cap off a quiet weekend. Bryce has more or less quit coughing, and we've only been using the nebulizer once a day. He's still wheezing more heavily than normal, but has been acting like the bubbly baby boy we know and love.

On Thursday, Bryce had his first follow-up with the urologist, and I'm pleased to report that his kidneys are growing and his ureteral reflux is no longer a concern. So, he's off the amoxicillin, which was the last pharmaceutical vestige of his NICU days. When we finish up with the neb, Bryce will be drug-free!

The urologist said, "Now you can treat him like a normal baby." Amazingly, it's kind of starting to feel that way. Scary.

Wednesday, March 17, 2010

A half year at home

With all the excitement of the past few days, I almost forgot to post Bryce's quarterly update! Depending on who you ask (he came home on September 11th, so I think his "adjusted" birth date is 9/11; Christie prefers to use his more auspicious original due date of 9/15), Bryce hit the half year mark either last Thursday or last Monday. As promised, I'll post a quick overview of his progress to date.

Before I dive into that, I imagine that our devoted readers are wondering how he's doing with his bronchiolitis. Bryce was back in the pediatrician's office for a check-up on Monday afternoon, and the news was encouraging. His lungs sound less congested, his breathing has slowed and his O2 sats are up to 93-94. He still has bad spells, especially if we wait too long between nebulizer treatments, and the doc says we could need the neb for up to six weeks, but we don't expect to be rushing over to the ER.

On to the report!

Feeding/Growth: Bryce is still the micro-preemie growth champ! To be honest, I can't tell you exactly how big he is, because we've quit with the nightly weigh-ins, but it's somewhere in the range of 16.5-17 lbs. The infant growth calculator says that for his adjusted age, he's rapidly closing in on the 50th percentile. Not too shabby for a kid who started off the charts. We recently weaned him off the high-calorie Elecare formula, so he's been getting all his nutrition from Mama's milk, rice cereal, and homemade veggie puree (avocado, sweet potato, carrots, and squash). He's a bit choosy with regard to food texture (won't eat that Gerber stuff), but he's generally enthusiastic about eating solids.

Development: Bryce is right on track for his adjusted age. He picks up toys that interest him, gets mad when he loses them, and will play happily in his exersaucer for up to an hour. He can sit unassisted for a couple minutes, or tens of minutes with a Boppy behind him. He makes several sounds, and uses some consistently to express different emotions (e.g., the "I'm super excited!!" squeak and the "I'm frustrated" whine). As far as personality goes, Bryce is a very mild-mannered baby. He has a big smile for just about everyone, and especially enjoys peek-a-boo with Daddy, dancing with Mommy and just about anything with Logan. At this point, we've observed nothing that would indicate any sort of developmental delay.

Ears: Yep, he's got 'em. And they work, too. In all seriousness, we think Bryce's hearing is just fine. You can holler "Hello, Bryce!" from the other end of the house and his face will light up with a smile. We were concerned that his cleft palate was affecting his hearing, but the cleft (which was almost certainly caused by the ventilator tube) is healing over all on its own.

Eyes: Bryce can see very well as long as the object is near and the light is good, but it's becoming increasingly clear that he didn't make it through retinopathy and laser surgery completely unscathed. He'll react to changes in our expressions when he's four or five feet distant, but doesn't seem to be able to make out our faces from six feet away. If the light is low, we're not sure he can see at all. One evening, we lost power in the house and had only a small portable lantern to see by. Bryce acted terrified and cried inconsolably even when our faces were inches apart and the lantern was right alongside. I'm not sure how well a baby is supposed to be able to see at this age, but the opthamologist said that his vision is bad enough that he'll need baby glasses, which are currently set to arrive in late-April.

Lungs: Even when he's well, Bryce works much harder than a typical baby to breathe, and he wheezes audibly whenever he's active. We've been told that Bryce has Chronic Lung Disease (CLD); however, his blood oxygen saturation has always been very good when he's healthy (99-100%, vs. 93-95% for typical CLD babies)and we recently learned that his wheezing is due to a damaged windpipe (tracheomalacia), rather than damaged lungs. We're cautiously optimistic that there isn't too much scar tissue in his lungs, but we (unfortunately) now know for sure that even a mild respiratory infection can make life difficult for Bryce.

All said, it's hard to believe that he's doing this well. We certainly didn't expect such a positive outcome, but we're very grateful that he's an ex-micro-preemie star!

Sunday, March 14, 2010

Me and my neb

Bryce seems to be on the mend. The coughing fits are occurring much less frequently, and for three hours following each nebulizer treatment he seems almost like normal. Convincing Bryce to sit still for ten minutes while we gas him is a challenge, but it sure beats the alternatives of sitting in the hospital or watching helplessly as your kid coughs until he starts to turn blue. Ahh, the wonders of technology.

Saturday, March 13, 2010

March madness

The first two weeks of March have been mostly crazy good, though we spent the morning running around like chickens sans heads due to Bryce's worst illness since he left the NICU.

I'll start with some good news. This:

has been driving Christie to tears for close to a thousand hours over the past nine months, and I'm happy to say that we've finally bid it adieu. For those who haven't had the pleasure of being milked by a mechanical pump for 30 minutes between 2 and 12 times a day, it might be hard to understand how frustrating it is to sit on the couch with two plastic cups attached to your chest while your infant screams and your preschooler crawls all over you. In truth, I don't fully appreciate the depth of her hatred for the Medela Symphony myself, but I suspect much of it is rooted in the early months spent waking up 3-4 times a night to "feed" a machine.

Thankfully, Bryce has done so well with his eating and growth (a fact which we attribute, in part, to the milk produced by all that pumping) that we've finally weaned him off the Elecare. With the exception of his solids, he gets all his milk straight from the source now, which is a big win for everyone. Our little champ, who turned six months old (corrected) on Thursday, is up to 16.5 lbs. and continues to exceed expectations in nearly every way.

Unfortunately, we replaced one machine with another. This:

is probably a familiar sight to anyone with asthma. Bryce doesn't have asthma (as far as we know), but we are now the proud owners of a nebulizer, because he is suffering from a "RSV-like" illness that just about landed him in the hospital. Earlier in the week, Logan came down with his second (very mild) cold of the season, and Bryce started to exhibit symptoms yesterday. Early this morning, it was clear that the cold had settled into Bryce's chest, and he was scaring everyone with one coughing spell after another and severe wheezing. Being the good-natured kid that he is, he had nothing but smiles for Mom and Dad in spite of his suffering, but Bryce's pediatrician felt it would be best if we brought him into the office.

The doc said that his lungs sound clear (no pneumonia), his RSV test was negative and he doesn't seem distraught. However, he's working far too hard to breathe (65-75 breaths per minute), his airways are clogged with mucus (bronchiolitis) and his blood oxygen saturation was borderline hospital-admissible (88%). So, he offered us the choice of admission to Children's or nebulizer treatments and careful observation at home. With some trepidation, I opted for the latter, but after the nurse helped me give him his first albuterol treatment, Bryce was like an entirely different baby. In the past three hours, he's only coughed twice and he's breathing much easier. Thus, we're cautiously optimistic that this happy guy will be able to avoid another weekend in the ER.

UPDATE: At 3.5 hours, the coughing is back with a vengeance (he's due for treatments every four hours). That albuterol stuff really works!

Sunday, March 7, 2010

Look what I can do!

His proprioception has improved a lot in the past week or so. Provided that Bryce is sitting on a hard surface, he'll frequently recover on his own when he loses his balance.

Bryce is still liking this, too:

In fact, we're in the middle of our third attempt at weaning off the Elecare. Three's the charm, right?

Tuesday, March 2, 2010

The end is nigh

While the title may lead you to believe that I'm about to don some sandwich boards, head downtown and start haranguing passers-by, today actually marks a return to saner times for the Sonneks. Bryce had an appointment with the pediatrician today (shocking, I know); officially, it was his "nine month" well-baby visit, since no one at the insurance company can understand the concept of adjusted age (and that's probably the nicest thing I can say about them). Anyhow, when posed with the micro-preemie parent's version of "Are we there yet?" for the umpteenth time, Bryce's pediatrician shocked and delighted Christie when he said, "Yes, yes you are." So, come the end of March, the littlest member of the family will have official medical sanction to start exploring the world outside these walls. In four weeks, we're free!

Bryce is still doing fairly well with his transition to solid food. He's eating two "meals" a day -- we've been rotating between rice cereal, avocado and prunes, with sweet potato on deck. He generally does well, but he definitely inherited his Mama's sensitivity to food texture. We tried making his rice cereal with water instead of milk once, and as soon as the cereal hit his tongue he started gagging and retching. Nevertheless, he's still doing better than we expected. Plus, the pediatrician informed us that he has not one, not two, but six teeth that are ready to pop through! Two on the bottom, which should be making an appearance "any day", and four on the top that won't be long behind.

Finally, Bryce treated us to his first sound on Sunday afternoon: "ba." He said it four or five times, but hasn't started doing it consistently yet. Given how much time he spends pursing his lips and spitting, it's not too surprising that he decided to start here. Perhaps he'll "B" ready to impress all of you with his burgeoning vocabulary when that special day in April rolls around.