Over the past few weeks Jonathan has really started to talk. He knows a ton of words when we say them, but he's only saying a few of them. He'll say a few things like "ball", "uh-oh", "big sis", "Dadda" and make a barking sound for a dog. It's great fun to hear him say new words.
He started making a few noises last night at about three in the morning. Since we're still using a monitor, we can hear everything that's going on in his room. There were a few noises and then a distinct "uh-oh" came across the airwaves. It was pretty funny. I thought something might have gone wrong, but since everything was fine I'm pretty sure he was just dreaming and talking in his sleep...
30 December 2011
27 December 2011
Eighth Anniversary
Is it just me, or does the word "eighth" spelled out completely mess with your head? It looks like a typo.
Anyway, that about sums up everything we did this year for our anniversary. Between birthdays and holidays and family in town, our anniversary doesn't really get celebrated on the day we were married. We have to celebrate it sometime later, like on our half-anniversary on June 27th. I like that idea better too - there's so much more you can do at the end of June then at the end of December.
Eight years has gone by really fast! We're already talking about trying to do something special in 2013 to celebrate the tenth. It's probably going to involve a vacation somewhere exotic, like Milwaukee (kidding).
I love you Stacey (sorry folks, this is where it ends - no mushy stuff online).
Anyway, that about sums up everything we did this year for our anniversary. Between birthdays and holidays and family in town, our anniversary doesn't really get celebrated on the day we were married. We have to celebrate it sometime later, like on our half-anniversary on June 27th. I like that idea better too - there's so much more you can do at the end of June then at the end of December.
Eight years has gone by really fast! We're already talking about trying to do something special in 2013 to celebrate the tenth. It's probably going to involve a vacation somewhere exotic, like Milwaukee (kidding).
I love you Stacey (sorry folks, this is where it ends - no mushy stuff online).
25 December 2011
Merry Christmas
This was the first year that we opened presents at our house on Christmas morning. We wanted to start our own Christmas morning traditions now that Julia is old enough. Like most people that have grandparents in town, we had two different present opening sessions. We held ours first thing in the morning and made it over the river and through the woods by late morning.
Both of the kids woke up a little later then usual, so we decided to have our pancake, coffee and hot chocolate breakfast before opening presents. Both kids were excited about their gifts, and although we tried to keep the opening somewhat organized, the wrapping started flying simultaneously and I missed most of Julia's openings. It was fun to let them go after it for once, but for the most part as they get older we'll try to slow it down so we can watch their reactions.
Opening presents - showing me his new car - playing with the box for awhile before opening it
Playing with the cars before I was even able to assemble his toy - once again, using the box as a toy - Julia peering through the hole while both of the kids enjoyed Jonathan's new toy
Everyone enjoying their new chair/turtle shell/top Daddy spins me in at the Grandparent's
Jonathan making engine sounds (cheeks puffed) as soon as he realizes his latest gift is a dump truck - a team effort to remove the pesky ribbon found on all gifts - Julia taking her new sleeping bag for a test snooze
Both of the kids woke up a little later then usual, so we decided to have our pancake, coffee and hot chocolate breakfast before opening presents. Both kids were excited about their gifts, and although we tried to keep the opening somewhat organized, the wrapping started flying simultaneously and I missed most of Julia's openings. It was fun to let them go after it for once, but for the most part as they get older we'll try to slow it down so we can watch their reactions.
Opening presents - showing me his new car - playing with the box for awhile before opening it
Playing with the cars before I was even able to assemble his toy - once again, using the box as a toy - Julia peering through the hole while both of the kids enjoyed Jonathan's new toy
Everyone enjoying their new chair/turtle shell/top Daddy spins me in at the Grandparent's
Jonathan making engine sounds (cheeks puffed) as soon as he realizes his latest gift is a dump truck - a team effort to remove the pesky ribbon found on all gifts - Julia taking her new sleeping bag for a test snooze
23 December 2011
21 December 2011
Next Steps For Jonathan
We had another followup appointment with Dr Yazdi today. Things haven't been progressing that well, so we went to the appointment hoping for some answers. Although we've tried our best, we're barely keeping up with his caloric requirements. We seem to have hit a ceiling that we can't get past...so we were ready to take the next step. To be honest, we were expecting Jonathan's doctor to tell us the same thing we have heard over and over for the past few months, that is, "feed him more". Our opinion going into the appointment was that something needed to change because the current approach wasn't working.
The appointment went pretty well. Although we've been barely keeping up, Jonathan had gained a pound over the past two months and grown a couple of inches, bringing him up to 18.5 pounds and 30 inches. I don't know if something finally clicked in the doctor's mind, but he took an entirely different approach this time around and came across as much more proactive. He seemed to agree with us, and finally gave us a plan and next steps that we could take to help Jonathan.
The doctor is giving us two weeks to see how well Jonathan does when we push the rate of feeding overnight up to 55 mL/hr - about a 20% increase. Right now he's on a constant drip overnight for 10 hours. We've had good luck with the drip, so we're going to try to push that as high as possible. If that works, we should be able to meet our goal of 1000 calories per day. We're supposed to give him a call back in two weeks to talk about our progress.
If increasing him overnight doesn't work, then we're probably going to switch out the kind of button he has implanted. As a side note, we have an appointment with a different doctor in a few weeks to get a second opinion before we would make any changes. Right now his button empties directly into his stomach. This works well unless you have a case like ours where it appears that the stomach is the bottleneck. The other option is to get a GJ button, one that has two ports. One port empties into the stomach like we have now, but the second port via a balloon or tube empties below the stomach into the small intestine. We would use the second port into the intestine overnight, dripping the amount we need to past his stomach. During the day we'd still feed him into his stomach, but we'd always have the ability to get past the suspected bottleneck.
There are other advantages to doing this in addition to getting him the food he needs. First, it will help us narrow down what's going on. If dripping into the small intestine works well, then the stomach (motility) is the obvious culprit. It's just emptying too slow and not keeping up. If for some reason feeding him into his intestine still causes him to vomit, then we know he probably has some reflux (GERD) issues. We can only vomit food that's in our stomach, so if we're feeding him past the stomach and he starts vomiting, then we know things are moving in the wrong directly and going back up into his stomach. That is, his stomach can empty fast enough in theory, but things are backing up farther down his system and that is the real problem. I've talked to Stacey a few times about this idea in the past, considering her family history with intestinal problems. We'll see what happens if we go this route. Depending on the outcome, it could mean trips to see specialists for testing in other states.
One drawback to a GJ tube is that it would need to be replaced every three to four months. However, a second advantage of a GJ tube is that we could really start working on introducing solids during the day. We may be able to replace one day feeding with real food, and over time gradually replace all of the day feedings with solid food as he learns. I guess we have a few weeks to see how increasing his feeding overnight goes. At least we feel like we have have some options and some direction now.
The appointment went pretty well. Although we've been barely keeping up, Jonathan had gained a pound over the past two months and grown a couple of inches, bringing him up to 18.5 pounds and 30 inches. I don't know if something finally clicked in the doctor's mind, but he took an entirely different approach this time around and came across as much more proactive. He seemed to agree with us, and finally gave us a plan and next steps that we could take to help Jonathan.
The doctor is giving us two weeks to see how well Jonathan does when we push the rate of feeding overnight up to 55 mL/hr - about a 20% increase. Right now he's on a constant drip overnight for 10 hours. We've had good luck with the drip, so we're going to try to push that as high as possible. If that works, we should be able to meet our goal of 1000 calories per day. We're supposed to give him a call back in two weeks to talk about our progress.
If increasing him overnight doesn't work, then we're probably going to switch out the kind of button he has implanted. As a side note, we have an appointment with a different doctor in a few weeks to get a second opinion before we would make any changes. Right now his button empties directly into his stomach. This works well unless you have a case like ours where it appears that the stomach is the bottleneck. The other option is to get a GJ button, one that has two ports. One port empties into the stomach like we have now, but the second port via a balloon or tube empties below the stomach into the small intestine. We would use the second port into the intestine overnight, dripping the amount we need to past his stomach. During the day we'd still feed him into his stomach, but we'd always have the ability to get past the suspected bottleneck.
There are other advantages to doing this in addition to getting him the food he needs. First, it will help us narrow down what's going on. If dripping into the small intestine works well, then the stomach (motility) is the obvious culprit. It's just emptying too slow and not keeping up. If for some reason feeding him into his intestine still causes him to vomit, then we know he probably has some reflux (GERD) issues. We can only vomit food that's in our stomach, so if we're feeding him past the stomach and he starts vomiting, then we know things are moving in the wrong directly and going back up into his stomach. That is, his stomach can empty fast enough in theory, but things are backing up farther down his system and that is the real problem. I've talked to Stacey a few times about this idea in the past, considering her family history with intestinal problems. We'll see what happens if we go this route. Depending on the outcome, it could mean trips to see specialists for testing in other states.
One drawback to a GJ tube is that it would need to be replaced every three to four months. However, a second advantage of a GJ tube is that we could really start working on introducing solids during the day. We may be able to replace one day feeding with real food, and over time gradually replace all of the day feedings with solid food as he learns. I guess we have a few weeks to see how increasing his feeding overnight goes. At least we feel like we have have some options and some direction now.
20 December 2011
19 December 2011
Outside The Box
I love how little kids think, it's completely out of the box. Usually it's just funny and cute, but every once in awhile they come up with a legitimate idea worth trying. Julia did this the other day while we were watching the news. What made it even better was that her great idea was followed by a completely random, yet legitimate, alternative that reminded me she's still a little girl.
Overnight we received a decent amount of snow, so this morning I had to go outside and shovel our long driveway and sidewalk. Even though the snow was very dry and light, it still took me about 45 minutes to clear the entire area. By the way, a dead giveaway that you're not originally from the front range is if you own a snow blower. I'm not going to explain why - those who have lived here long enough know what I mean. Anyway, both kids kept their noses pressed against the sliding glass door, watching me as I shoveled the snow away.
Later that day I turned on the national news when I got home from work. Julia had apparently never seen a snow blower before, so when they showed a clip of people in the Midwest digging themselves out from the same storm I had to explain what she had just seen. I explained I don't have a snow blower, so I have to do it by hand with a shovel. Her response was, "but Dad, you have a LEAF blower. That could work!". I was very impressed with her idea, so I told her that I would give it a try the next time it snows. If the snow is as dry as it was this morning, a leaf blower might actually work.
After I praised her and told her that I would try it the next time it snowed, she came up with a backup plan. If the leaf blower didn't work, I could simply buy a bulldozer and use that to remove the snow. She had also seen that on the news. She assured me it would be OK since I could just park it outside. However, the model I purchase would need to have windshield wipers on it so I could see what I was doing.
Overnight we received a decent amount of snow, so this morning I had to go outside and shovel our long driveway and sidewalk. Even though the snow was very dry and light, it still took me about 45 minutes to clear the entire area. By the way, a dead giveaway that you're not originally from the front range is if you own a snow blower. I'm not going to explain why - those who have lived here long enough know what I mean. Anyway, both kids kept their noses pressed against the sliding glass door, watching me as I shoveled the snow away.
Later that day I turned on the national news when I got home from work. Julia had apparently never seen a snow blower before, so when they showed a clip of people in the Midwest digging themselves out from the same storm I had to explain what she had just seen. I explained I don't have a snow blower, so I have to do it by hand with a shovel. Her response was, "but Dad, you have a LEAF blower. That could work!". I was very impressed with her idea, so I told her that I would give it a try the next time it snows. If the snow is as dry as it was this morning, a leaf blower might actually work.
After I praised her and told her that I would try it the next time it snowed, she came up with a backup plan. If the leaf blower didn't work, I could simply buy a bulldozer and use that to remove the snow. She had also seen that on the news. She assured me it would be OK since I could just park it outside. However, the model I purchase would need to have windshield wipers on it so I could see what I was doing.
16 December 2011
Bon Voyage Daddy
Every morning Julia and Jonathan give me hugs and kisses before I leave for work. Just like his sister, Jonathan loves to stand at the sliding glass door in the kitchen and wave goodbye as I back out of the garage past him. Then, when I'm out of sight, he runs as fast as he can to the front of the house to wave goodbye from the window next to the front door. I usually have to wait for several seconds in the middle of the street for him to make it to the other side of the house.
This morning I got ready a little bit faster then usual, so I decided to head into work a little bit early. It was still dark outside when I left. As expected, Jonathan stood at the side of the house and waved goodbye. I backed out into the street and sat there for a few seconds waiting to see if he would make it to the front door window. Eventually I saw the blinds moving and light coming from inside the house. As I mentioned, it was still dark outside so I couldn't make anything out other then what was farther inside the house then where Jonathan was standing. As he pulled the blinds back from the window, all I could see was a dark, round shape that looked like the very top of his head lingering above the window opening and a silhouetted little hand waving goodbye back and forth in the shadows. The back lighting in the house perfectly outlined his little hand flip-flopping back and forth in the air, wishing me a good day.
This morning I got ready a little bit faster then usual, so I decided to head into work a little bit early. It was still dark outside when I left. As expected, Jonathan stood at the side of the house and waved goodbye. I backed out into the street and sat there for a few seconds waiting to see if he would make it to the front door window. Eventually I saw the blinds moving and light coming from inside the house. As I mentioned, it was still dark outside so I couldn't make anything out other then what was farther inside the house then where Jonathan was standing. As he pulled the blinds back from the window, all I could see was a dark, round shape that looked like the very top of his head lingering above the window opening and a silhouetted little hand waving goodbye back and forth in the shadows. The back lighting in the house perfectly outlined his little hand flip-flopping back and forth in the air, wishing me a good day.
15 December 2011
Second Opinion
This week we had Jonathan's 18 month check up. Unfortunately, his pediatrician was slightly concerned about the progress made on his weight. He weighed in at about 18.5 pounds, not much more then he was two months ago at Dr Yazdi's office.
We thought we had been making good progress on his feedings, but our journal didn't back that up. I went back and averaged the calories he's been getting over the past 45 days and it was on the low side of what he needs for his current weight, let alone growth. Past trends showed that we would do great for a week or two and then not so great for another week or two. Overall, it's not been quite good enough though.
The reason why we haven't been able to consistently get enough through his system is because he's been sick a lot. It seems that any time he gets a sniffle or a bug, like all of us, his system slows down and he doesn't want to eat as much as he normally would. The issue we see is that he always seems to catch something and that it seems to take him longer then normal to get over whatever he has.
We're to the point where we can't do much more considering his response to feedings when sick. So, we've scheduled an appointment in January with another Peds Gastro from Denver for a second opinion. We hope that a fresh set of eyes will reveal something we haven't explored yet. At the very least, we'd like to have her run some of the tests a second time to validate the first set of results. Maybe there is something else going on that is also impeding our progress and his growth.
We thought we had been making good progress on his feedings, but our journal didn't back that up. I went back and averaged the calories he's been getting over the past 45 days and it was on the low side of what he needs for his current weight, let alone growth. Past trends showed that we would do great for a week or two and then not so great for another week or two. Overall, it's not been quite good enough though.
The reason why we haven't been able to consistently get enough through his system is because he's been sick a lot. It seems that any time he gets a sniffle or a bug, like all of us, his system slows down and he doesn't want to eat as much as he normally would. The issue we see is that he always seems to catch something and that it seems to take him longer then normal to get over whatever he has.
We're to the point where we can't do much more considering his response to feedings when sick. So, we've scheduled an appointment in January with another Peds Gastro from Denver for a second opinion. We hope that a fresh set of eyes will reveal something we haven't explored yet. At the very least, we'd like to have her run some of the tests a second time to validate the first set of results. Maybe there is something else going on that is also impeding our progress and his growth.
10 December 2011
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