Preemie Power!!! A Contest for preemies

Reasons I like Hand to Hold's annual photo & essay contest for premature babies:

1. The title. Preemie Power. It speaks volumes to parents of premature babies. Our children had to learn to do things the hard way, and they powered through.

2. The stories. When my son was born, I felt like we were alone, like 23 weekers just didn't make it. That's what the internet seemed to tell me. But Hand to Hold's photo and essay contest tells me a different story. It tells me that there are many many kids out there whose parents were scared to death for the first few weeks and months. It tells me that despite the rough start, those kids made it. And that brings hope. Hope is good.

3. The spin. I admit, I entered this year. It's our first time entering, and I did it in part because I really really looked forward to throwing a superhero spin to my son's NICU experience.

I pretended I was future-him, a junior high kid with an overactive imagination, explaining to all his
comic-book-geek friends what all his scars are about. I made up this elaborate story, complete with super-villians. And then, when I was done, I had his dad throw in a few good touches, and a friend who is better at comics than I help me get the genre right. I was excited with my finished product (which I might post here when voting opens, we'll see).

I realize my essay probably won't win. It is light-hearted and lacks some of the sympathy, tear-inducing language that the judges will likely gravitate toward. It makes fun of some of the scariest NICU diseases out there - but it does so on purpose. I learned something from five months in the NICU and from my chronically ill father. Namely, we need humor. In our darkest times, humor is like a firefly, shining a bit of light. Not enough to read by, but enough to remind us that there's an end to all of this.

And there's something delightful about an escape into fiction, into a world of superheros. In that world, the good guys always win. And that's something I longed for in the NICU. An easy, straight-forward fight.

Pontificating aside, you all should check out the Preemie Power contest for inspirational stories and pictures of other cute kids who beat the odds.

And -- if you are the parent of a preemie -- you should enter this contest. You can win cool stuff. Entries are accepted for the next two weeks, and voting begins mid-October.  CLICK HERE for more information.

J's progress - 25.5 months old

J woke up with a huge smile and kisses today.  Real kisses. He was so proud of himself. He's given them before, but not for a while, and he's only recently learned to pucker. I think he was just excited to see what I'd do. He smothered me with them and then laughed with joy.

Bad news:

I put this first because it's short. He has obstructive sleep apnea. We'll consult with an ENT later this month.

Good news:

It is day two of no projectile vomiting. A week ago I finally broke down and bought emesis bags online. He had been vomiting three to four times a day all summer. They'll probably come in the mail today. Maybe we won't need them much after all.

What has changed? We're not particularly sure. It's week three back on reflex meds, so that helps. Also, we've been more proactive with the inhalers, and we've finally gotten a new filter for his bedroom air filter, so he's breathing better. Plus, we're running out of high calorie formula, so we're using more pureed real food and less formula. Not enough to make the difference, but maybe just enough that things are sitting better on his stomach and moving better through his bowels. There is a correlation between constipation and vomit, so keeping things moving is one of many keys.

Jonathan has also learned the word "burp." (He says "buub" which sounds a lot like "bahbah" -- bottle, or "bah" -- ball, so you have to listen carefully.) In context this is hugely helpful. He now tells us clearly that he'd prefer to not drink anything for a bit while his stomach works on other things. In truth, it has less to do with the word he's saying and more to do with the fact that he's trying to communicate with words. In the past, he'd scream because he didn't want a bottle, we'd have no idea what was bugging him, we'd reintroduce the  bottle or sippy cup thinking he was still hungry, and the mere sight of it would induce gagging, crying, and unless we were very lucky, vomit.  Now he stops, arches his back, says "buub!" and we wait. He believes we'll listen to him, we now know to listen to him, so everyone is a lot more patient with everyone.  The whole household is happier.

(His meds for his acidosis always give him gas bubbles, so this new word is useful at least three times a day.)

He's more curious about things, more talkative, and has that bright look in his eyes that says, "oh yeah, I totally know what's going on here."  Today on the swing I'd say "ready, set" and he'd answer "GOOOO!" before I'd push him. He loves people more than just about anything, but balls and music are second best.

He's 18.75 pounds. Almost 19. That's a gain of nearly three pounds this summer -- more than three times what he gained from October until May of last year.

We're working now on building strength. He can climb up and down stairs, but his right leg is weak. We're trying to get him to lead with the weak leg in order to strengthen it. When he stands, he locks the right leg, which isn't good long term. He hasn't added to his record of last month of five steps yet, but maybe when his new AFOs (ankle foot orthotics) come in he'll be able to make strides with his strides.

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And again, J has taught me just how much small strides can lead to greater things. Maybe I'll run a half marathon tomorrow. If I do, I'll be remembering him around mile eight or nine, when things get hot and my feet start to blister. I'll remember that hard things are still possible and still worth doing. I'll remember that even if our bodies have betrayed us, often we can reshape and strengthen them. I won't ever be an athlete and J won't ever be a goalie (his vision being what it is). In all likelihood, I'll never be able to finish a 5k in under a half hour, and J won't look like a two year old until he's three.  But just as with J, I can always grow, too. I'll stop comparing myself to others and instead just look at that next step. 

Okay, let's be honest, J gets distracted. Half way up the stairs he stops and turns around to see how far he's come. So he doesn't always look at that next step.

But there's something to looking behind, too. To seeing how far we've come.

Keep on growing, baby J. You've come a long long  way.

RTA update

Me returning a call: Hello! How ARE you?
Man: Good. You?
Me: Doing fine. ... wait, is this Steve?
Man: Who?
Me: Steve?
Man: No. This is Alex.
Me: (wracking my brain for any Alex I know) Oh... um... I think I got the wrong number.
Man: Dr. Alex
Me: OH!!! Jonathan's nephrologist!  Sorry. I recognized the number and thought it was my husband. ... He just got a new job and I thought this was his work phone.
Dr. Alex: I wondered why you were so excited to be hearing from me. I just sent you an email, too. Wanted to let you know Jonathan's renal panel looked great. His HC03 is up to 26. So keep the dosage the same.
Me: That's exciting, too. ... Sorry about that, again.

I need to program Steve's new work number into my phone.

Embarrassing conversation aside, I was excited to hear from Dr. Alex. Maybe not as excited as if it were Steve, but who can blame me?

There's a reason I recognized Dr. Alex's number (that's not his real name, but you probably already figured that one out). We've chatted a lot over the past month. And truth be told, I am happier and happier to hear from him. He's had to change Jonathan's dose of renal medication once, but since then, my son has turned into one thriving little man.

He's only gained a pound since we started treatment for his renal tubular acidosis a month and a half ago but he's gained so much else that we're bouncing from excitement.  And considering he couldn't gain even a pound all winter long, we're quite happy with a pound in a month and a half.

Things gained:
Energy
Regular BMs
Height
Alertness
Energy
Talking
Walking
Energy

He's bouncing off the walls. He's so much more interested in learning things. He's not walking around in a tired stupor any more. It's not surprising that he hasn't gained as much weight as we'd hoped -- he's burning off all those correctly metabolized calories in learning to do all the things he only wished he could do before.

Continued struggles:
Gag reflex. It's too strong. That boy gags too well. I continue to use the techniques we learned in feeding therapy to help him be willing to experience new textures and foods, but it's a struggle. Crying will also induce the gag reflex, so an accidental bonk of the head often means a misplaced lunch on the floor. We are so glad we bought a home with wood floors.

Chronic lung disease / BPD. We don't talk about this often, but it's still there. It's the middle of the summer, so we didn't expect to see a ton of it, but it's also the middle of the summer, so his pulminologist thought we might want to try a half dose of his steroid.

The Vision of Trees - ROP

This post first appeared in Catapult Magazine and is a raw look at how I processed JAM's potential blindness when he was diagnosed with one of the worst versions of retinopathy of prematurity, "AP-ROP" or "Rush Disease," and I found myself coming to terms with the knowledge that, even with laser eye surgery, he would never have normal vision and may never see more than shadows. 

 

Emerald, orange and yellow flashed at crisp sunlight, shading my windshield of dead bugs. I arched my neck to look past the filth. Leaves had never been those colors before. I thought I knew what color was, but this display was different. Never in the history of the world have trees given such delicious colors. On this day the trees had decided to become deeper, more majestic, merged together to make the most beautiful bouquet, each at perfect peak.

 

Our crabapple tree, just days before his birth.

I knew why they’d done this. It was for me, in celebration and in mourning. They’d heard his news. He’d make it to his first birthday. That was almost certain. The worst was behind us. But his eyes may never take in an autumnal feast. They had called it one of the worst forms of retinopathy of prematurity. Fast progressing.  They showed me the pictures, thick veins twisting to and fro, pulling at the thin retinas, stuck beneath a protein cloud that prevented veins from growing into the sunlight. He may soon be blind.

 

So the trees chose that day, as I drove home from the hospital with this news, to give me their fruits — a gift and a sacrifice.

The wind blew hard in the weeks that came. I didn’t mind at first. It took away the stifling summer, with its long days and no answers. It threw aside the canopy of leaves, the curtain that hid the true frame of things, giving cool clarity.

 

The trees showed off their shape. Some grew straight and strong. Their roots were secure. Nearly each branch would gain another set of leaves to join in next year’s autumnal feast.

 

It was the crab apples that darkened my vision. They would pull at my eyes as I drove so that I could not look away. Gnarly, thick, with roots that yanked at the retina of the ground like the vessels in my son’s eyes, unable to reach further into the sky.  The branches on the bottom had died off, shaded by the new growth that would not grow high enough, would not let enough sunlight through.

 

I wanted his eyes to be maples, tall and thin, stable and continually reaching for the edge of their world. Maples could see. Apples were full of retinopathy of prematurity, and that made it impossible to stretch high enough.

 

Everywhere vessels called branches flashed to my retina images of his eyes. I wanted the canopy of colors back again. Why hadn’t I minded on the day when the leaf curtain left the sky? I wanted it back, to shield and clothe the tree frames, to help me forget blindness, darkness, to help me see light again. A tree is a tree, always. I tried to convince myself it didn’t matter its frame. Please, give me back light and color and beauty. Show me your leaves, not gnarly death. Leaves give hope.

 

I parked my car.  Time for footsteps, for movement forward even if this is not the road I’d have chosen. Push on, feet heavy, anticipating a long, dark winter. At that moment of cold reality, and without warning, the leaves beneath me gave way. With their final cry, they gave a gift.

 

Crunch.

 

Crunch — kick — crunch.

 

Sunlight hit my forehead, warming my face. Dark winter was not yet here.

 

I looked down again, with purpose, looking for the crunchiest leaves.

 

Crunch, crunch, crunch.

 

The oak trees might be brown and ugly, but they won every crunching competition. The feeling under my feet was satisfying, the heels on my shoes were best for crunching. I liked the small almond apple leaves for the kick, the way they gathered close and exploded into the air.

 

The texture of the world took shape. And the texture of the world was good.

 

The gift came from both the short and tall in the woods and on garden paths. The gift required no light, no color, yet it was still beautiful.

 

Without light, there is still beauty. In beauty, there is vision. My vision was made new.

 

I saw a child, healthy and four, crunching oak leaves in his fists, laughing and throwing them into the unreachable and unseeable sky, basking in warm sunlight, unaware that his eyes were like the crab apple tree that threw speckles of cool on his forehead.

 

He was going to live. And life would be good. I would make it so. I would pass to him the gifts of the trees.

 

Comparing

Last year not-smiling

Parenting rule #2:  Don't compare. Just don't. Unless you're comparing your own child to themselves.

Granted, no parent actually FOLLOWS this rule, but we know we should. And that is at least something.

JAM weighs a hefty 18 lbs 4 oz at two years old. We're not thrilled because that's a horrible gain in the last year. (See? I'm only comparing him to himself! What a good parent I am.) I'm not concerned any more, though, since the amazing nephrologist just recently figured out all that "failure to thrive" stuff.

This year not-smiling (see mom, I grew THIS much)

There are a few plus sides to being small. T-shirts last longer.The pictures below are from his first birthday AND his second birthday -- same shirt. And, at least he's behaving developmentally appropriately (he's advanced even) for his appearance.  He looks like about a 12 month old now, don't you think? That's what our neighbor guessed when we told her it was his birthday today.

Last year's smiles: part 1

He deserves an extra year. At birth he was 4 months behind his peers. Then he had six surgeries before discharge. I figure every surgery puts me around a month behind -- so there's another six months. Well, we'll say five, since one was "merely" eye surgery, and he's a kid, so he heals faster than us adults. Add two more major surgeries before he was one, each requiring about a month of healing, and you've got a total of eleven months of disadvantaged environments in his first twelve months of life. Ugh. Math only leaves him one good month in that first year. (I'm guessing that was the month of May.)

Okay, so that's rough. Then add to that that in his second year of life he spent most of the time undernourished and exhausted, with his body stealing from his muscles and bones to keep his pH closer to balanced -- and you'd expect to see a kid who is just barely hanging in there.

But that's not the kid we see. (Anymore.) Our child is doing so remarkably well considering it all. There were moments in the last few months where we were really really concerned, where I cried tears of frustration and hurt at the small tired baby that lay staring at the light because his energy reserves were gone. But then, even then,  he'd bounce back up again, moments later, and trot around the room on all fours, his head high like he was showing off for the world. His spirit was not crushed. Perhaps this babe has figured out the secret of how to live on love alone.

Next year, bud, next year we'll add good-old-fashion nutrition to all that love friends and family have poured on you. Next year is going to be amazing. You'll finally outgrow that shirt.

Last year's smiles: part 2

This year's fuzzy smiles

Last year: awkward pose

This year: awkward pose part 1

This year: awkward pose part 2

Bonus picture. (This year.) I love this kid.

Happy Birthday, JAM

Happy Birthday, little JAM man!

We don't have anything as cool planned for your second birthday as we did for your first, but on this day, no matter the year, we remember the wonderful gift that is you and the provisions that carried you through.

Your first year was the year of survival. You had many surgeries and brushes with death.
Your second year was a year of discovery in the midst of medical mysteries.
Those mysteries have now been solved.
Let's have your third year be a year of thriving. A year of normal toddler-hood.

You seem to agree. Let's be normal. You started today with a normal terrible-two temper-tantrum.

I'll take the temper-tantrums as a good thing. This is a new phenomenon for you, my normally laid-back child, but you've discovered you have a will, and that you can't figure out how to bend the world to this will of yours. I don't blame you for being frustrated. You have preferences, and while your mouth still won't say "no, mother, I'm teething now, so I'd really prefer the bottle to the sippy cup. And could I have water instead of formula to start off with, please?" your brain knows that this is what you want.  We're going to figure this thing out, babe. This year will be remarkable.

Thanks for sticking around.

Sweet. Presents.

That was it mom? Just a shirt?
(This one is 12-18 mos and way too big for him. I'm thinking
of putting last year's green shirt on him again for pictures later today.)

JAMmin! Drumming is one of his favorite things to do.

Yep, I'm TWO!

He gained a pound!

Only two weeks into our fight against the acidosis monster (otherwise known as "Renal Tubular Acidosis") and already we are starting to see some HUGE gains.

As in a pound.

As in more than he gained between November and May combined.

All in two weeks.

This momma is really really happy.

Tomorrow my baby turns two, and he is finally over 18 lbs. 4 ounces over, to be exact.

Take THAT you nasty acidosis monster,  you. You can't hold JAM back ANY MORE. We've found your cryptonite, and it's only a little more medicinal than baking soda. Ha.

(Sigh of bliss.)

Say goodbye, failure to thrive. Because THIS baby? This baby is going to THRIVE now. Just wait and see what this next year will hold!