Doctor updates

Gabriel had two specialist appointments this week: one with a gastroenterology doctor and one with the nephrology doctor.

We made the appointment with the GI doctor because we needed some direction with managing the g-tube and how to know how much to feed Gabriel and what bolus amounts would be appropriate. Since they had never seen him before, I got "the look" when I told them that he was a 22/6 week preemie. He certainly doesn't look it -- I don't think people really believe me. They think we just seriously miscounted our pregnancy weeks. But we didn't. Anyway, even though baby boy is ginormous by preemie standards, they still want him to put on some weight. Apparently, preemies have to get fat and chubby before they'll grow appropriately taller. Gabriel looks good, but his growth trends are starting to plateau instead of continuing to follow the growth curves. They told me I need to feed him more than I have been and gave me the official amount I should be feeding by calorie count. This was nice, because I'd kind of been making it up as we go based on the calculation formula the NICU was using for him. She also helped me figure out how to increase his daily bolus amounts so that we can get Gabriel onto fewer feedings a day and off the feeding pump at night. Today is the last day of his initial increase set, so we could try not using  the pump tonight if we're feeling brave. We are also fortifying all his breastmilk to make it more calorie-dense, so we may end up with a butterball baby by Christmas.

The nephrology doctor was rechecking an issue that they found in the NICU - kidney calcifications. So, in an all-morning appointment, Gabriel first had and ultrasound, and then a meeting with the doctor. While we were in the hospital, the diagnosis was that the calcifications were probably due to long-term use of the steroid medications that were helping him breathe and helping is adrenal glands manage certain hormones. The ultrasound this visit showed the calcifications decreasing, which is good. She said that being a preemie, he still will need to be watched for things like high blood pressure because his body will most likely have not made as many nephrons as a normal person, so high blood pressure would be harder on his kidneys than someone else, and he also would need to not turn into an exclusive carnivore since the high-protein diet would also be hard on him. But overall, he's doing well. I may work with exclusive carnivores, but I don't think my son will turn into one.

Next week, Gabriel finally gets his RSV shot so we can breathe a little easier about cold and flu season and the week after that he will have his g-tube button replaced. This is a quick, in-office procedure where they show us how to do it, because next time we'll be doing it ourselves at home. The button is replaced every three months so we may get more practice at it then we want.