Tuesday, July 31, 2012

How to Spruce Up Your Baby Brother

Alas, there was no "magical sleep experience" to be had last night.  Michael woke just short of three hours after I first put him down, and proceeded to wake again two hours after going back to sleep.  I was too exhausted to go through the whole process yet again, so I curled him up in the crook of my arm and sacrificed my quality of sleep in exchange for the feeble hope that I could stay in my own bed until morning.  It mostly worked.  Sleep was rather fitful for both of us, and I had to sneak in a feeding at around 5:30, but when he didn't settle down after a 6:30 am snack, Tom took pity on me and took Michael downstairs with him, where they hung out together until almost 9:00 am.  I live for those precious few hours each morning, in an empty, quiet bedroom, when I can temporarily release my insidious, insomnia-producing anxiety over being startled out of my hard-earned sleep by a baby's cry.

Despite business as usual overnight, however, Michael was in fine spirits today.  His few periods of fussiness were rather quickly soothed by a dose of Mylanta and/or a nap.  And we can officially boast of having had a completely vomit/spit-up free day.  It seems as though the Prevacid is finally kicking in.  I don't know that I'm brave enough to be optimistic just yet, but I'm certainly tempted.  And I'll take what I can get, for now.

I can definitely find the patience to let him take his time with figuring out the sleep stuff if I can spend more days seeing him so happy and independent.

Also, Abby made a new discovery.

That little Hello Kitty book she's been carrying around for the past month?  It's full of "sickers."  And they're just perfect for decorating little brothers.

I had to peel them off for her, but she placed them all herself.

And then proceeded to remove them.

Michael was a real trouper, as he always is with his big sis, even when she proceeded to put them back on again.

But Mommy had to end the fun when Michael decided that stickers looked like a pretty good snack.

Abby wasn't too keen on giving up the game, and some amount of tears ensued.  But she eventually found a good book to curl up with.

And all was well, again.

Monday, July 30, 2012

Michael's Post-Appointment Update

Today's appointment didn't really yield any definite answers, but it did allay many of my concerns and provide me with a new game-plan for the immediate future. 

Here are a few of the all-consuming fears that I've been nursing, that I can now put to rest:

  • That he's no longer growing: actually, his doctor says that because he's so healthy, strong, and clearly not dehydrated or malnourished, Michael's weight is the least of his concerns.
  • That I'm not producing enough for him: given the difficulties that I've reported in actually feeding him, it's more likely that the discomfort he's experiencing is inhibiting him from eating as much as he should, and if we can figure out how to effectively treat his symptoms, he can pick up the pace and make up for what he's been missing.
  • That he's suffering from Celiac Disease, or some other serious condition: his doctor has seen only two cases of Celiac in infants (it usually develops later on in life) and those cases were so extreme as to be unmistakable.
So, the consensus is that Michael may be suffering from reflux, or possibly from some kind of allergy, or likely from a combination of the two.  However, since allergies are so incredibly tricky to pinpoint, and his reaction, if he is having one, is so mild (he's not having any of the classic, obvious reactions such as hives or bloody stools), our first step is to find a treatment that actually eases his reflux symptoms.  Barring any improvement from tweaking his medication regimen, I plan to meet with a dietician, if possible, to come up with a healthy way to start eliminating some significant elements of my current diet, such as gluten/wheat, that may be causing Michael problems.

One thing we think that we may have determined: Michael's got some kind of sensitivity to legumes, which would explain his recent difficulties with passing them through his system.  No more peas for him a long while.  No more solids for the immediate future, either.  And no legumes for me.  But I can live with that, no problem.

For now, we're going to give his new antacid (Prevacid) a chance to prove its efficacy, while continuing to offer Zantac just before bed, in a much higher dose than previously.  If the Prevacid does not bring about improvement within the week, we are to try going back to the Zantac, only on the higher dose, three times a day.  In the meantime, I'm to try giving Michael a bit of Mylanta when he seems to be struggling or fighting a feed, to see if that placates his stomach enough to allow him to get a good meal in.

We tried it once this evening when he was in the midst of hysterics (he's having a really hard time transitioning to the new medication), and didn't see much of a result.  We did, however, observe pretty swift and marked improvement after he received his dose of Zantac.  So, I'm going to try to be patient about continuing with the Prevacid, but I'm thinking that Zantac may ultimately be the way to go.  I only hope we can get him some real relief with it, finally.  This new dosage is nearly twice what he was receiving before, but only time will tell.

Mei Mei was over this morning to watch Abby during the appointment, and hung around until the late afternoon, so I felt free to play around a little with the camera again.  This time, I wanted to try some close-ups with the 55-200 mm lens, practicing in manual.  I opened the aperture up as wide as the lens would allow, set the ISO to 400, and managed to figure out how to meter in my camera.  However, I couldn't get the exposure level close to zero (up from somewhere on the negative end) until I had the shutter speed down below 60, which I thought would be way too slow.  Even setting the ISO down to 200 didn't seem to allow me more flexibility with shutter speed.  Ultimately, I put the shutter speed somewhere up around 80, and despite that I started off with way too much light.  Then I had problems with the auto-focus.  It kept locking, and then instead of allowing me to take the shot by pressing all the way down, it continued to refocus and refocus.  After getting about five shots of Abby, only a couple of which I felt were worth sharing, I gave up in frustration.  I changed the second one to black-and-white, because it makes the overexposure a bit less obvious.

 When Michael woke up from a brief nap shortly after this, he allowed me to place him in his Superseat for awhile.  I spent a good five minutes lamenting the potential shots I was missing, afraid to try again with the camera for fear that I would break it in frustration, before I finally gave in and picked it up again. 

I did not have problems with the auto-focus lock this time, but unfortunately, Michael began to get fussy just as I crouched down on the floor to set up a shot.

I knew that my time was limited, so I had to fire the next few off pretty quickly (many of which were soft- or out-of-focus as a result).

I think this one was my favorite.

Despite a couple of failed attempts between 8:30 and 9:00, I managed to get Michael down to sleep by around 9:15, and I haven't heard a peep yet at five-to-eleven.  The last couple of times he's had his Zantac dosage increased, he's slept for four-plus hours.  An earnest attempt to get to bed before midnight may be in order- I've got my fingers crossed that we get a repeat tonight.

Sunday, July 29, 2012

Like Mother, Like Daughter

I've let a couple of days go by without picking up my camera, and I've missed it.

I have spent some time, though, catching up a little more on my favorite blog, and read some really helpful posts on photography there.  I live for her technical photography posts, because I can just never seem to find the time to sort through all of the information in my one photography book, and she lays everything out so clearly, just a little at a time.  Today, I ran into a post explaining the relationship between ISO, f-stop, and shutter speed, and how all that relates to metering (a concept that has escaped me thus far).  Unfortunately, I can't get my camera to do what hers does, and I'm not sure if that's because she has a D40 and I have a D50, or if I'm just doing it wrong.  So, while I was finally able to figure out how to adjust the f-stop (I put it down to the minimum my lens allows- 3.5) by looking up a manual for my camera online, I was not able to adjust the shutter speed by metering, and had to simply pick a speed myself.  I think I ended up at 160.  I set the ISO to 400.

And then, Tom laid Michael down on the floor next to Abby.  They looked so adorable playing together, I saw a definite opportunity there to try some new things out.

I'm never sure what really "good" lighting is supposed to look like.  I think in most of these, it is okay.  However, this being my first time using manual settings on the camera (as opposed to Shutter or Aperture Priority), I was not prepared to have to so carefully choose my focus points as well.  The plus side is that now I am starting to understand what having focus points means, and how to use them.

Unfortunately, in these first two, I focused on Abby (who is in the background) instead of my foreground subject, Michael.

I finally got it figured out for this one:

But in this one, the focus on Michael is a little soft- I think my focus point was actually on the blanket in front of him.

And in this one, I managed to focus on the little green truck instead of either child.

Abby, by the way is here pictured declaring "no, no," to Michael.  I can only assume that she thought he was "playing with it wrong."

And here's another shot that's actually in focus.

Here's where it really starts to get fun...

...because Abby discovered a new game.

It involves rolling over her brother...


...and again.

I've learned, from old photographs, that I was a big fan of doing this to my older brother, Michael, when I first learned to crawl.  Despite the fact that he was a bit bigger than me at the time, it reduced him to angry screaming.  My tiny little Michael, on the other hand, seems to be taking it like a pro.

Though I wonder at his expression here.  He seems a bit shell-shocked.

I really wish I hadn't ended up with such a soft focus on him, here.  Such a cute little face.

And I wonder what he really thought of it all.  What a silly big sister he has- just like her mommy.

Saturday, July 28, 2012

Only a Mother...

If I were actually keeping a list of the numerous things I never expected to experience as a parent, it would be pretty long.  And while I don't really intend to make one, I have an entry to add:

Responding with excitement- nay- elation, at the poop flying towards my face this evening.

As if to counter the relief I've been experiencing over how well Michael has taken to the introduction of solids, despite his digestive issues, I had a new mini-crisis develop over the last couple of days.

Well, mini-crisis is an exaggeration of the circumstance, but an understatement of how it's made me feel.  Michael's gotten a bit backed up.  And at first, I wasn't concerned when a couple of days went by, and I hadn't seen those peas come full circle.  I figured he was just adjusting his version of normal.  And when they finally appeared, but just a tiny bit at a time, I felt sympathy over the discomfort it must be causing him, but figured it would all work itself out. 

Until it didn't, and an angry, horrible rash ensued, along with a (much more than usually-so) miserable night, and clear signs of discomfort and straining.  We tried 2 ounces of prune juice last night, to no avail. 

I followed up with another visit to Urgent care, nonsensical in my exhaustion, at which it was determined that there was no blockage, there was a cream for that rash, and he could keep on drinking prune juice (and laying off solids and formula) until we made some progress.

A four ounce bottle (50% prune juice/50% water) was mostly-consumed upon our return.  I thought I heard some movement in his belly, but dinner was ready, and I figured he could use more time.  I expected to find something to be proud of in that last diaper change before bed.

But, no.  Just a teeny tiny bit, like I've seen so many times before.  Frustrated on my little guy's behalf, I carefully went in for the clean, and suddenly it was "all systems go."  He whined, he cried, he strained, and I cried a little for him, even as I tried to encourage him along.  He didn't get much for his effort, but it was more than I've seen in all the times before, and I was pleased for him.  He continued to cry as I bent down to give him one last wipe, and found myself face-to-face with a little projectile.  He finally got that last piece out.

I whooped so loud that Tom called down to see if I was okay.  I assured him that all was well, and that his boy "done good."

And thankfully, it stopped short of my nose.

I want that to be the end of my worrying, but it's not.  I'm terrified to make any changes to his diet, ever again.  And I'm still staring at the pile of paperwork in front of me, of growth charts and medical records, that I was given for the GI Specialist to whom we've been referred.

Before I started this post, I pulled up a bunch of pictures, one for each month, to track how much he's changed, how far he's come.

How skinny he's gotten.

I'm counting down the hours until Monday's appointment.  I pray we get some answers there.

Friday, July 27, 2012

Fabulous at Four Months

I remember Abby's fifth month being full of laughter.  She had (and still has) the most amazing, joyful, belly laugh, with which she would burst forth over the smallest things.  I have a little video (the original of which is still trapped in my dead laptop) of her being reduced to near-hysterics over some silly faces I was making at her while playing a video game as she lay in a bouncy chair at my feet.  (Oh, the days when I had the time for that kind of thing..)  Just the greatest sound, ever.

You can really see her budding personality coming through in the "month" pictures that I took.

"Thank you, thank you, I'll be here all day."

Her teething was in full-force by this time, and she developed a fondness for chewing on certain things, one being my chin.  I was pleasantly surprised the first time she went for it, as one of my favorite baby pictures of myself is a shot of me doing the same to my mother.  Plus, it tickles- until those hard little gums really find purchase.

Her brother shares the same preference.  It's amazing to me how much she looks like him in this picture.

It was a busy month for us all: Abby got a vibrating rocker chair from Mima...

and a jumperoo from Mommy and Daddy.

There was some amount of debate over the purchase, as the maximum weight was 25 lbs, and she was already over 20.  We weren't sure how much use she'd get out of it, but she ended up being able to play in it for about as long as it was good for her developmentally, anyway.

She got a new car seat, too.

I feel compelled to add that we knew better about strapping her in with such a heavy outfit on, and I'm not sure why we did it here.  I'm a big believer in minimal layers for car seats, especially since kids overheat so easily in them, and generous use of blankets over-top.  The picture is also out-of-focus, but it's the first one I've got of her in it.

Some notable firsts:

First nap on a hotel bed (we were in NJ for Ali and Joe's wedding).

First time dressing "to the nines" for above-mentioned wedding...

...at which she charmed everyone that she met, napped like a pro in her stroller in the middle of the reception, and even stayed up late for the after-party.

She was specially announced as the "flower baby" during reception introductions, accompanied by Mommy and Daddy, though she did not process up the aisle with us during the Mass.  And you can't see it in the photo (it's covered by the bib), but she was sporting a sash that matched the color of the bridesmaid's dresses. 

This was also the month of her baptism, but more on that next week!

Thursday, July 26, 2012

Our Six-Month, Not-So-Well-Visit

Michael had a six-month well-visit this morning, and I made sure that Tom and I were both there.  To add to the frustration I've regularly felt after each appointment, having gotten no answers or hope for relief, I always seem to think of one or two things that I forgot to mention when I get home.  It was my hope that if both Tom and I were present, sleep-deprived as we each are, we could fill in the blanks on what the other forgot.

The result was a lot of desperation and frustration pouring from both of our mouths simultaneously, as Michael's increasingly-overwhelmed-looking doctor looked on.

Mostly all he could do for us was offer his sympathy, and offer to try a stronger medication.  It has been my hope (and his, I believe) that we could avoid having to use anything stronger, but Michael is clearly still uncomfortable for a great deal of the time, and, even more concerning, is simply not getting the amount of sleep that he needs.

Most concerning, however, were the final numbers on his weight.  The scale settled at 17 lbs, 1.2 oz, bringing him down to the 38th percentile.  And that was with a fairly heavy diaper, which, in retrospect, I should have pushed the nurse to let us take off first.  When I felt the weight of it, removed from his body, it occurred to me that without it on, he may not even have registered above 17 lbs.

I should clarify now that I realize that these numbers do not sound bad, in-and-of-themselves.  And they are not!  Just below average, which accounts for a fairly large population of babies.  But this particular baby started out in the 80th percentile for weight at birth.  He had dropped to the sixty-somethingth by four months, and 43rd by five-and-a-half months.  His weight curve is trending towards a plateau.

In the meantime, his head circumference (16 inches), and height (27.2 inches- 67th percentile) look pretty good.  Because he is otherwise growing as he should, Michael's doctor does not think that the problem is a blockage.  But he does feel that we should, at this point, get a GI specialist involved.  So we've finally gotten a referral.

I don't know whether to be relieved or overwhelmed.  Michael will have to be seen by someone at either INOVA Fairfax or Children's Hospitals, and I've been lead to believe that there may be some wait-time involved in getting seen, since this will not be considered an urgent case.  Michael is, after all, still gaining, just not as quickly as any of us would like to see.

I called the number I was given as soon as I arrived home, but after waiting on hold for awhile, ended up leaving a message.  It is my hope that I will hear from someone by early tomorrow, within the promised time-frame of "one business day."  If not, I guess I'll be camping out on the phone for as long as it takes, to get something scheduled before the weekend comes and pushes back my opportunity to talk to someone.

In the meantime, I've had to make some hard decisions regarding whether or not to attempt supplementation.  After a long talk with a lactation consultant over-the-phone in an attempt to determine whether Michael's battles at feeding time might be indicating a dwindling supply on my part, she and I reached the conclusion that at least trying to offer some formula might be best.  Not only will I not know if it will help until I try it, it will be one more step that Tom and I will have taken to remedy the current situation by the time Michael is seen, which will give the GI specialist a clearer picture of where we stand if there is no improvement by then.

Breast-fed babies are notorious for refusing formula initially, and the smell of the Enfamil Gentlease that we settled on trying did not make me feel any more confident about my chances at getting Michael to take it, so I tried to pump some breast milk to mix it with while Tom took the kids for a walk.  All I could get was an ounce, and I had wanted to start with a 2/3 breast milk to 1/3 formula ratio, while having at least two ounces to offer.  I ended up doing one ounce each, and then adding an additional ounce of water, since Michael's been having some trouble pooing now that we've really gotten going with solids (he's up to 2 ounces of peas at dinnertime now).

To my great relief, Michael gulped it down.  And so far, has kept it down.  He's been sleeping for an hour now, and I pray that there will be no issues when he wakes.  Only time will tell.

I can't say that I'm going to enjoy the formula-breath that he's now sporting, though.  Never was a fan of that.

Despite his continuing tummy troubles, I have observed a growing streak of independence in Michael, which has been a wonderful relief as well.  More and more, he has been willing to spend little bits of time in the various activity centers we make available to him: the swing, the bouncy chair, the jumperoo, the playmat.

Tom played photographer the other day while Michael was in the jumperoo.  The focal points are off in a few of the pictures, unfortunately (he was snapping off a bunch in quick succession), but Tom still captured a few pretty great expressions.

He's also starting to really pay attention when we read to him, which, God willing, when things settle down some more, we can do more often.  I tried to take some pictures of him with Tom and Abby, but struggled with the lighting a bit.  I had to brighten these up some, and they're still a bit dark and uneven.

This led me to playing around with white balance/metering for the first time yesterday, with some- er- interesting results.

"Fluorescent" setting (0)- much too cool
"Incandescent" (0)- even worse

So, I put it back to where it was before for that last one- "flash" (also at 0).  That setting has been working well for me for awhile now, but I know that metering is something that is supposed to be adjusted for different conditions, and I'd really like to understand just how it works.  Clearly, I have some research ahead of me to do on that front, if I can ever find the time.

Which maybe might happen soon, if we can find some relief for poor, little Michael.  Let's hope he has a nice, looooong sleep tonight.

With the help of some new medicine, and (maybe) some formula.

In his new little bed.

Nah, pink isn't his favorite color- that's just the only sheet we have right now that fits.