Sunday, September 26, 2010

Unequivocally one


I had every intention of finishing this post two weeks ago to celebrate the anniversary of Bryce's homecoming from the NICU and his official adjusted birthday. Unfortunately, I've managed to let my life get so busy that by the time I have a few minutes to write, I'm already dog-tired. Hopefully Bryce will understand when he's old enough to be interested in reading this. :)

The upside of my tardiness is that I can share the results of Bryce's one year exam at the NICU follow-up clinic yesterday. As luck would have it, the physical exam was conducted by the same neonatologist who admitted Bryce to the NICU what seems like a lifetime ago. His enthusiasm and amiability once again put us at ease, except this time the the mood wasn't tempered by a grim diagnosis. The doctor was thrilled with Bryce's progress and said that he is definitely at the head of the micro-preemie class. 21 lbs. and 29" tall is not very big compared to most kids his (adjusted) age (~15th percentile), but he's in the 80th percentile compared to other Very Low Birth Weight (VLBW) babies. This is especially impressive because Bryce was actually an Extremely Low Birth Weight (ELBW) baby, so he's competing against babies that were 2-3 times his size in this comparison. Our only concern about his physical development is that we may have to take on second jobs as he gets older to provide the mass quantities of food he consumes to maintain that growth!

Near the end of his exam, the discussion turned to the looming cold and flu season. A year ago, we were told that Bryce should be isolated as much as possible until he's two years old to give his lungs time to develop healthy tissue. Bryce's primary pediatrician, who is typically the least conservative of his doctors, said his lungs and immune system are much stronger, but that we should avoid crowds and large family gatherings. The neonatologist concurred with the first part of this statement, but said that Bryce should just be isolated from people who are sick. Unfortunately, both doctors agreed that he's too healthy (by insurance standards) to qualify for the Synagis shots which protected him from RSV last winter, but not healthy enough to avoid landing in the hospital if he caught it.

Given that the virus season is also the holiday season, we'd vastly prefer to follow the second doctor's advice. However, wiping down everything an increasingly mobile baby might touch with antibacterial wipes and interrogating family about the status of their health is also stressful, so we'll probably end up falling somewhere in between isolation and cautious freedom. So, if Bryce can't make it to your party, blame it on those nasty little germses.

Bryce also visited with a child psychologist at his follow-up exam. Like most people who meet Bryce, his first comment was, "Oh, those are some cute glasses", and then, "Is he always this happy?" Thankfully, the answer to that question was yes for the duration of Bryce's Bayley Infant Development exam, and his scores reinforced our optimism about his future. Bryce is currently demonstrating the cognitive skills of your average 14-month-old, the fine motor skills of a 15-month-old, the gross motor skills of an 11-month-old and the language skills of a 9-month-old. All in all, we felt that this was an outstanding report card, and the doc said he has no concerns about Bryce's mental development. He's cleared until next September!

Like all micro-preemie parents, I made a lot of bargains while Bryce was in the NICU. I'd come to accept that life, no matter it's limitations, is a beautiful thing, and I desperately wanted that for Bryce. However, even my most naively optimistic visions of our future together pale in comparison to our reality today.



-4 months old : Our "wimpy white boy" (yes, that is a technical medical term) is clinging to life. His parents live in a state of constant panic. Bryce refuses to give up.



-3 months old: Still critical, but stable. Bryce overcomes life-threatening challenges every day.



-2 months old: Survival is likely, as are significant medical challenges. Odds are that Bryce will be effectively blind. Bryce stubbornly fights on.



-1 month old: Learning to eat and breathe. Bryce endures nasty apneic spells on a daily basis.



"Newborn": Bryce is home! He can't take in enough calories to meet his needs, and his parents fear he will be re-hospitalized for failure to thrive. Bryce is too busy growing to worry.



1-2 months old: Bryce is growing slowly, but spends most of his time in various specialists' offices. His parents fret about upcoming surgeries and other challenges. Bryce starts showing off his trademark smile.




3-4 months old: Bryce's health is improving and he's starting to show a little personality. Bryce's parents fret over every potential exposure to germs. He's already conquered many of his preemie challenges.



5-6 months old: Bryce struggles with the occasional respiratory infection, and is nearly hospitalized twice, but he never complains. His infectious smile puts everyone at ease.



7-8 months old: Amazingly, Bryce has functional vision that can be corrected to near normal sight. With every passing day, his parents treat him less like a preemie and more like a baby.



9-11 months old: Bryce is a happy, healthy boy. The entire family enjoys a fabulous summer.



Today: Need I say more? I wish I had one tenth of the courage and perseverance of my son. Thank you, Squeaker, and enjoy your reward.