5 Year Well Check

Well here it is... the last "baby" milestone checkup. So hard to believe this guy is going to kindergarten this fall. I'm not ready and he's told me he isn't ready, so we both need to get on same boat by September. Oh yeah and pick a school.

We had kindergarten required immunizations done. Ugh. I was dreading these, wishing we would have done them last year. I really didn't know how to break the news that he needed to get a shot (well actually 2---OOPS my bad) at the appointment. I fought with even telling him at all...Telling him when we got there or telling him the night before. Seriously all these choices all had their perks, but when it came down to it I told him the night before. I am too honest of a person and if I knew I was going to get poked and it would probably hurt I would want to know a head of time.

After the 20 minutes of crying and pleading with me not to get a shot I found a you tube video of Sid (the science kid) needed to get a shot. After this he seemed pretty cool with "everything" until we got there of coarse. He even did just fine talking to the nurse and getting weighed and height measured (btw he's the highest in the percentiles as he has ever been 36% for height and 39% for weight), but after we actually got in the room cooperation pretty much stopped. He did tell me before we left the house he wanted to get his shot done for so it would be done. I guess he is my kind of guy, just get done with hard stuff first. Though I should have known this because he always does the "hard" part of his school work books before he does the easy side!

Overall the doctor's appointment could have gone better, it could have gone worse. Once his doctor came in, he was a little more Harrison and when I say a little, I mean a teeny weeny little bit.

We found out he still has a tube left in his left ear... which is awesome because usually the most mileage you get out of tubes is maybe 12-18 months and we are going on over 2 years and his left is his bad ear! The right is out and just hanging in the ear canal. They will both eventually work their way out at some point.

We discuss his eyes/glasses a bit and obviously he pediatrician isn't and eye doctor so he didn't have any more information about his exact eye condition that I STILL don't understand. It's call midline crossing. I explained to him I am thinking of seeking a second opinion, not because I don't think his eye doctor is qualified, that's not at all, but to be frank...Her bed side manner sucks. She especially sucks with kids. How she ended up in peds I don't know. Our doctor said he's actually heard a bit of the same from other clients and gave us a recommendation to another eye doctor in peds that is awesome and he has 3 kids of his own, so lots of own personal experience with kids.

His heart, lungs, belly are all normal. We also got good news that he is getting arches in his feet. This is actually not good, but awesome news! He was really flat footed last appointment and his doctor is very please with the progress he has made on his own getting these arches and building muscle tone. When you are born premature, you pretty much spend the first 5-6 years of your life trying to build up muscle tone that is comparable to an non premature child. Way to go buddy, just another thing you are awesome at! I can hardly believe that on Monday marks 5 years since we brought him home from the hospital.

The shots sucked. I think he would have done better if they could have been done a little more on his terms. He was fine with getting the shots done in his legs, but they wanted him to lay down and me hold him down. Obviously Harrison was fine with hugging me, but he didn't want anything to do with lying down. I even said to the nurses, "I think he would do better just sitting upright and I will hold on to him."  Their response was, "he will be more relaxed lying down for the shots." Relaxed? I am freaking holding down this kid and your telling me his muscles are more relaxed because I holding him down on the table? He was more upset about lying down than getting the shots for goodness sake. I honestly don't know if he really even felt the shots because he was too angry he had to lie down. It all worked out... The shots are over and the next time he gets another one won't be any time soon! We do the flu mist here and we are sticking with that.

If you ask Harrison the best part of the appointment it was getting the prizes. He did get a really cool color changing pencil---so the shots just might have been worth it.

After the appointment we headed to Hobby Lobby to pick up white boards for the kids and then stopped at the mall for blizzards are DQ and stopped at the play place. Seriously Miles scores big when Harrison has appointments. Even today he scored a bouncy ball and a sucker without even having to get his hair cut. Being second born obviously has it's advantages.


 

Miles @ 9 Months

I always wondered after having a second baby if all the firsts are just as incredible and they were with the first born. Truly they are just as amazing. I think he learns something new everyday and definitely keeps us entertained and on our toes!

NINE MONTHS.


Likes:

• Untying shoe laces/strings/bows
• Rocking back and forth
• Standing up holding on to things (with assistance)
• Listening to Harrison (big brother) sing and act goofy
• Anything that makes noise
• Cell phones are a hot item
• Petting (yanking) puppy dog fur
• Tickles/Kisses
• Swinging at the park
• Peek-A-Boo
• Stroller Rides
• All food in general
• Music

Dislikes:

• Getting dress or having anything on his head
• Swimming in the lake/river
• Not warm enough bottles
• Long car rides
• Being cradled like a baby
• Waiting for food
• Dogs barking/too loud of noises

Biggest Achievement of the Month:

• Getting in a routine. So it's taken roughly 9 months to have what I can finally label as a routine...But all that matters is we got here. Sleeping, feeding and playing finally put together (for now anyways). Up until his recent ear infection he slept through the night 5-7 days a week.

Biggest Challenge of the the Month:

• Sickness. Miles had cold type stuff that turned into an ear infection. He was crabby and pretty much didn't want anything to do with anything for about a week. I think we pretty much did everything we could possibly do to make him happy and we miserably failed. As short as the duration of sickness was, that week felt like a year.

Sleep: I know I am better parent when I get some sleep and heck you even start to feel human again too. Miles sleeps probably a little more than babies his age...Harrison did too. In fact Harrison is still a 3+ hour napper in the afternoons.

We put Miles to bed between 7-8 at night. He wakes up between 6/6:30. He naps again about 8:30/9 to 11 and the again from about 1 to 3 and sneaks in some cat naps between 4-6.

The one thing is for sure is...he will let you know when he is ready to when he is ready for you to lay him down for a nap.

Personality/Temperament: He knows what he wants and he won't stop until he gets it. :) If you ask anyone, he is pretty happy baby overall. I think he's getting a little board with sitting around, he would love to get this crawling skill mastered. As far as stranger anxiety, he has a touch of it from time to time, but overall he is pretty accepting of anyone.

He is most happy: 1:1 play--he loves attention!
He is least happy: Tummy time...he just want to crawl away already!

Baby Talk/Communication: Clapping is new! When you do something he really likes he starts clapping in applause. Since he started clapping I've introduced the sign "more" so far. That sign is closest to clapping which I know is at his ability level. He has followed the sign back yet, but repetition will help build that. Our hope is for Miles to know as much or more signs than Harrison knew. Likely Miles won't be able to sign regularly for a month or two more. For now, crying does the job.

Eating: If he had teeth, man this boy would  be eating EVERYTHING. I don't think he has met anything he didn't like yet. He had his bite of burger at 5 Guys a couple of weeks ago, tried some ham last night, loves mashed potatoes, yogurt, veggies and fruit. I finally have relaxed enough and I stopped cutting his puffs and yogurt bites in half. Choking is something I absolutely freak out about. I still cut Harrison's hot dogs in quarters and when he eats it without a bun. Hot dog on a bun, I am coaching him how long he needs to chew as well and having him drink with each bite. I would rather overact the underact.

Sizing him up: Miles had his 9 month well check last Friday. He weighed in at 20 lbs 1 ounce (about the 50th percentile) and measures 26 1/2 inches (5th percentile). Miles weight currently is more than Harrison weighed on his first birthday. Height wise I need to look back and see where they compare. If you take Harrison's prematurity 3 months back I think they would be pretty equal in size comparison. Currently he wears a variety of sizes, some of his carter jammie sleepers are still 6 month, onesies at 9 months and one piece outfits are 6-12 month sizes and some outfits 12 months. Diaper wise he's size 3, shoe size I have no idea (I'll need to order some soft soles for fall). Over all, he's a good sized boy.

Teeth: None. We don't expect them to pop through for another 2-3 months. My siblings and I were all late bloomers with our chompers.

Motor Skills: Miles scored almost off the chart for motor skills. He basically already has the pincher grasp that usually isn't present until 12 months. Obviously he is food driven---picking up those puff and Cheerios! I think he makes up for fine motor as rolling over and tummy play are overrated. He has to be where the action in.

Out & About: Loves people and watching things be done. He gets plenty of attention especially with the ladies and bald men.

Firsts of the month: Getting on all fours! He's so close to crawling. He gets up, starts rocking back and forth on all fours, cries and then sits back down, repeat. Music and food have been great incentives.

Fave baby gear: Tub bath chair. Every parent of a young child should own one of these. Blow up/plastic baby baths/form mats aren't worth it.

9 Month Well Check: Miles had his well baby check last Friday (a day shy of his 9 month birthday). Dr. Gerhard is very happy with Miles growth and development. He scored within normal in all categories, not even taking in account of his prematurity.

The only concern I brought to the appointment is on/off fever and fussiness which was confirmed with an ear infection. 10 days of amoxicillin should clear it up. Finally after about 3 days of the antibiotic we started to get a glimpse of our happy baby again.

6 Month Well Check

I am pretty excited to sit down and write about a well check. Yes, W-E-L-L. After what seems like 6 months of sickness this is well deserved.  We ended up seeing our regular Dr. Gerhard's Nurse Practitioner Emily as we had to reschedule his 6 month well check. She was OK, but I really prefer Dr. Gerhard and Miles will see Gerhard again at his 9 month well check (that doesn't include shots---yeah).


This baby boy turned 6 months old already. How did that happen? It couldn’t have? Oh wait…it did. EEK!!!

Alright…drum roll please!

Weight: 16lbs 4 ounces (that’s the 25 percentile)

The nurse’s reaction…”He’s got some good legs.” “I don’t like the scrawny ones that I’m afraid I’m going to break!”

This guy’s not only got good legs, he’s sports a double chin and cheeks you can’t resist wanting to give a squeeze. Let’s just say Mr. Chunk can draw in a ladies crowd and he did on our Wisconsin Dells trip (which I promise post soon).

Height: 2 ft something (that’s just under the 3rd percentile). I don't have the exact measurements because the nurses we had didn't write down the stats like the normal nurses we have. He’s very short…following in the steps of his big brother who wasn’t even on the growth chart of height for months. I guess we can blame that on genetics.

Head circumference: I can’t remember the exact measurement but I do know the measurement was in the 13th percentile. Again on the petite side, but even as a adult his Momma doesn’t have a very big head—so another genetic thing.

Development: On track. He can sit with support, roll over from tummy to back both sides and lift his head from his belly and he can stand up and support himself on his legs. The nurse practitioner said the only thing she would like to see is that he uses his hands to push himself up further rather than rest on his elbows. (Already in the week since this appointment, I’ve seen an improvement thanks to his enrollment baby boot camp).

Immunizations: The same immunizations were given today as at his 2 and 4 month checkups with the exception of the flu vaccination he received. Due to such a hard year of the flu they are still recommending immunization. We did it…though honestly after both Harrison and Doug having the flu with being vaccinated themselves, I’m not that strong of a believer in that vaccine anymore. The effectiveness is than 60%. The site itself from the flu vaccination was swelled up, red, hard and I am sure painful. Unlike his last set of vaccines he didn’t run a temperature, but he was so irritable for 3 days. He would be crying one minute and laughing the next---a roller coaster of emotions that I don’t care to ride again. He’s up for a booster (second round) of the vaccine in 5 weeks. I’m honestly not sure if I’ll follow through with that. Point and call me a bad parent all you want---but after what he endured and put his parents through we might just wait until next flu season to re vaccinate.

Even though Miles was premature by 5 weeks---things are so different the second time around especially with medical appointments. No blood draws, nutritionists, immunologists, no physical therapy---rather boring. I like boring.

28 Week Appointment

(This week's Linked 52 post below)


Today marks exactly one week in pregnancy from where Harrison was born prematurely at 29 weeks and 3/7 days.

I have been flooded with emotions lately. Each week of this pregnancy is such a victory. At my 28 week appointment yesterday the doctor confidently said, "if baby was born today, he would most likely survive." That's not new news to me...since I have became a statistic freak. However, hearing it from a doctor somehow makes those numbers stand stronger.

This week brought more good news. The ultra sound done last week shows no funneling or opening of the cervix and baby is still is 6 cm above the cervix (which is normal, but doesn't sound very high to me). At yesterday's appointment the doctor confirmed once more the cervix remains closed. He did note this week baby was very low again during the appointment and this explains the intense front pressure/pain I have and only confirmed yes, Miles head is directly on my bladder explaining the "having to pee" every five minutes feeling I have. With this said, Miles won't need to drop for delivery and delivery will probably be faster than Harrison's. FASTER? I can't imagine faster! We have to give our birth photographer enough time to make it for Miles debut into the world!

We talked about the potential blood clot I had over the weekend, which has resolved itself since then. He spent some time examining my leg and noted it's clot free now, but to continue to watch for any changes.

I also did my best being honest in telling him I had a day of contractions and mild/moderate pain on Tuesday. I actually hadn't told Doug this either not to worry him, so he found out at today's appointment as well. It wasn't the kind of pain that worried me, it was more a weird pain. With my pregnancy with Harrison I never felt pain, only pressure, even in a drug free delivery.

The pain on Tuesday lasted most of the morning into the afternoon and went away only to return about 9 or 10 that evening. By morning things had seemed to settle down and I was feeling better. I have had nothing since then.

As the doctor explained to us is that no one can explain why pregnancy has the pains it does and why I might have episodes like this that come and go. As long as the pain and contractions don't increase and go away on their own is what needs to happen. The doctor also suggested if this happens again I need to take the opportunity to leave work, go home and lay down. I explained to him that I already sit most of the day behind a computer. He said, "that's a reclining position which still puts pressure on your cervix and uterus, the only real pressure relief is laying down taking that pressure off." In the end bed rest is still a real possibility, which scares the heck out of me. We aren't there yet which is the good news...it was just laid out on the plate again. My blood pressure remains good and I continue to show no signs of gestational diabetes.

I did share with the doctor today that I am expecting Miles to be born on Halloween. That is just day after 38 weeks. I told him, "I hope you don't have any plans that day." So I said here on the blog, so if (and when I am right) I have it in writing. I think Doug thinks I am crazy with all of my predictions, but a majority of time I am right, so I am going with this. The doctor said, " I would be very happy if you made it that far."

My next appointment (30 weeks) is the 6th with the doctor. On the 7th I have some new birth/baby preparation class that our clinic started that is a pre-natal requirement.

This week I started freak out mode at work. Maybe a little pre-nesting trying to get some things together an in order for maternity leave. Thank goodness I am planner...when Harrison was born I planned so far in advance the transition from his birth back to work and then to maternity leave and return to work was nearly flawless. I want the same minus the going back to work before maternity leave.

Some days I can't believe we having another baby. It's like someone pinch me, is this really real? I love every moment of being pregnant, even the trying to stand up straight after you have been sitting too long pain. I love when Harrison and I are reading stories together and he lifts up my shirt and says, "momma, wake baby up," or "I see baby," or my favorite when Harrison does a little jump when Miles gives his hand a kick.

I can honestly say I am happy, very happy, with that said, "Happy Friday!"












 

The Specialist

A bit of relief. A bit of a novel.


Today we met Dr. Assel, she is a perinatal specialist. Dr. Assel was absolutely fantastic, I immediately liked her the minute she walked through the door, despite the fact she was 45 minutes behind schedule.

We discussed options for this pregnancy helping us reach full term or at least 32-37 weeks. The hardest determination of deciding our coarse of action for Bee is the fact that my case is not typical. Dr. Assel was honest in saying she doesn't have an answer to the best coarse of treatment for this pregnancy. During my first pregnancy I showed a lot of signs of incompetent cervix, but following that diagnosis most babies are miscarried between 15-18 weeks typically where I held Harrison 28-29 weeks. Looking at my case though I could have started dilating early on and it just didn't progress as fast as it typically would have in most incompetent cervix cases. Another view into Harrison's early arrival could have simply just been pre-term labor which expectantly occurred and they just don't know why. However, most preterm labor is very painful, which I experienced little to no pain with Harrison's labor and delivery. If you remember I walked into the Emergency Room and was dilated to a 9 with Harrison and my biggest complaint was pressure, not pain which more resembles an incompetent cervix. The real cause to Harrison's preterm birth will never be known. Dr. Assel said to me today, "What I would have given to be your doctor on the day you came in dilated to nine and not knowing it."

We discussed two very good options to approach this second pregnancy.

#1. Cerclage: Cervical cerclage helps prevent miscarriage or premature labor caused by cervical incompetence. The procedure is successful in 75% to 80% of cases. Cervical cerclage appears to be effective when true cervical incompetence exists, but unfortunately the diagnosis of cervical incompetence is very difficult and can be inaccurate. Ideally, an elective cervical cerclage is done between weeks 12 and 16 of pregnancy. Dr. Assel explained that they want to use the highest part of your cervix and close that off and securing stitches on both sides of the cervix. The procedure is done as a outpatient surgery. I would receive a spinal/epidural before the procedure and abstain from any physical activity for 2-3 days or longer depending on the situation. But like I mentioned early on in this post, if this isn't true cervial incompetence the cerclage WILL NOT prevent preterm labor. However, having a cerclage put in, I might feel contractions I might not have been able to feel if I hadn't had the procedure done and those are very painful because of the cerclage. Knowing this, I maybe able to make it to the hospital and receive medication to stop the labor. In saying this, everything has it's risks. Dr. Assel mentioned in some of her readings she has done the cerclage can actually stir up premature labor if placed for an incompetent cervix when really it's premature labor, not cervical incompetence.

#2. Watch/Wait & Progesterone Injection Treatment: Progesterone is a hormone. It plays a key role during pregnancy.In early pregnancy, the hormone helps your uterus grow and keeps it from contracting. (If your uterus contracts in early pregnancy, this may lead to miscarriage.) In later pregnancy, progesterone helps your breasts get ready to make breast milk. It also helps your lungs work harder to give oxygen to your growing baby.Recent studies show that for some women, especially if they have a short cervix or if they already had a preterm birth, being given progesterone during pregnancy may help reduce the risk of having a premature baby. There are two kinds of progesterone treatment: vaginal gel and shots. Studies to date show that gel may help reduce preterm birth for pregnant women with a short cervix. Shots are recommended for pregnant women who already had a preterm birth. Choosing injections is about 50% effective in preventing preterm labor. I would receive one injection per week starting at 16 weeks and going through 37 weeks. This would be a watch and wait approach would be measuring my cervix regularly (often) using a trans vaginal ultra sound and long with progesterone injections. The benefit to the watch and wait/injection approach is the fact my cervix may not be incompetent Harrison's preterm but was just spontaneous. Spontaneous preterm birth means labor began on its own, without drugs or other methods. Or the sac around the baby broke early, causing labor.


Each of these two options have benefits and risks and Dr. Assel told me I am a big decision maker in this process I should have a say in what I (we) want to do. I really valued Dr. Assel, everything about her (bet you can't tell I really liked her). I asked about a combination of the two options, but we can only choose one coarse of treatment, doubling up does not increase the success rate.

Currently we are in a good position to make any decision we want. I am 13 weeks, right smack in the middle of these options, which both are good, but not a guarantee for a full term baby.

As far as I know I am not dilated at all. We didn't do an ultra sound today (like I hoped)...but Dr. Assel said measuring the cervical length in the first trimester isn't an indicator of what will happen in the second trimester, it's a just a starting basis.

I've done hours and hours of research on prematurity and preterm labor since Harrison was born. I can whip off statistics like crazy and honestly could probably write a book about it. I know pros and cons inside and out and we are choosing to do an elective cerclage. The cerclage will be done this month. I am not sure if my primary OBGYN will do it or Dr. Assel will do it. Dr. Assel was going to call Dr. Birdsall and discuss today's appointment and our decision and we can go from there. Dr. Assel said she has performed many cerclages and never regretted doing one of them. She said,"I can't make decisions for you, but I think you are making a good choice, I don't know if you would be as lucky the second time around."

Overall mixed news at today's appointment...Something I expected, I am not a text book case to anything. Our trip to the ER two weeks ago? Unexplainable. I am mystery, so I must make life more colorful not just black and white.

I see Dr. Birdsall on Thursday next week for a regular prenatal visit and to discuss a surgery date. Other than if Dr. Assel does the surgery I won't see her again as a specialist. She's a specialist that travels and only stays at hospitals for short periods of time and travels on to another hospital, she's great and I wish she could stay. If things progress well my plan is to still deliver in Winona, if complications a rise I will deliver at Gundersen as they are equipped with a NICU we know all to well.

Hoping and praying for the best.