More Progress, More Encouragement

Tomorrow marks Dylan's 5-week birthday. As of his last weigh-in, he is 5 lbs 6 oz, and he continues to grow with each passing day. He is now eating 45cc of breatmilk with each feeding, along with receiving his multivitamin twice each day. He is tolerating his feeds well, with only slight desats after eating, which may be indicative of a touch of reflux. Yup, the same acid reflux us adults can get after too much chili and pizza, he can suffer from as well. The muscle at the top of your stomach that opens and closes to let food in and keep it in is usually a bit weak on preemies, and it sometimes allows for a bit of "bouce-back" when they eat, which can be uncomfortable, causing stress which leads to O2 desaturation. By itself, a mild case of reflux is not a big deal, as long as it is recognized and treated. Left unchecked, it can cause damage to the esophagus and vocal chords. In Dylan's case, it's not so severe as to cause any concern, other than to monitor his O2 sats and make sure it doesn't progress any further.

His oxygen saturation has become a bit of a focus lately, as he has made good progress over a few other hurdles. While his sats never drop dangerously low, they do drop on occassion, and the docs are trying to figure out why. He does drop a bit after feeding, but not always. Sometimes he drops his sats while sleeping soundly, under no stress at all. Other times it may be a positional thing- he is not in a good position to maintain his airway or he maybe a bit squashed and be unable to expand his lungs like he should. The nurses are tracking the instances of desat much more closely to try and determine a cause.

One possible cause that has been advanced by his medical team is that of muscle tone. A physical therapist has been working with Dylan over the last few days. During her initial assesment, she noted that Dylan had low muscle tone in his upper body and torso. Essentially, by missing out on some of the time that would normally be spent in utero, he is lagging a bit behind in the development of his muscles. Any time a baby in the womb kicks or flails about with their arms, they are met with the resistance provided by the uterus. This acts as something of a workout. Since Dylan has instead been in an isolette, he hasn't been able to get that workout. Now, with some help from his therapist, he will. He actually has exercise he needs to do. Who would have thought a 1 month old baby would be doing a workout? It's pretty cool stuff, if you ask me. Some of it is basic movement of his arms and legs, some of it is massaging certain muscle groups to stimulate them. All of it is designed to help him develop his muscle tone to be better able to control his head, arms and legs, and strengthen the muscles that help him expand his chest to breathe. The therapist noted that Dylan tends to breathe shallowly when he is relaxed, which can lead to him not getting as much oxygen into his blood. A stronger core will help him overcome this.

One thing that I feel I should mention is that Dylan continues to do a great job of maintaining his body temperature. He is going to be staying in his open air basinette from now on. That's a big step in the journey on the road home. One other great thing about the basinette is that Barbara gets to dress him up now. All this time in the isolette, he has been naked except for his diaper. Now that he's in his basinette, he's wearing cute little onesies with the little feet on them. It's really something to see how cute he is in them, even if they are a bit big on him. That, plus it's much easier to change his diapers and pick him up and put him down again. It seems to me that he's a bit more comfortable in it as well, but that could just be my imagination.

Anyway, that's all for now. I keep trying to update the blog more frequently, but it seems that when I get home, I'm just too pooped to get it done. I'll try to keep it going every other day or so. We'll see how it goes!