Tuesday, July 20, 2010

Amazing Andrea

Andrea likes to sit in the laundry basket. She likes it even more if the clothes are clean and folded. Then she throws them onto the floor!

Yesterday, we finally had another visit to the Developmental Clinic at Robert Wood Johnson Hospital. Andrea was supposed to be seen there in March, but had an ear infection, so the doctor cancelled her appointment. This was the first time she was there since October 2009, so there have been considerable changes.

At Developmental Clinic, Andrea is seen by Speech Pathologists, Physical Therapists and Neonatologists, who compare Andrea to other (full term) babies based on her corrected age. That means that everyone was looking to see how close Andrea was to a full term 13-month old baby. The thing that was so interesting is that I think Andrea knew she was being assessed. She was at her most charming, smiling and cooing at everyone that came to see her. She was very attentive, and performed all the tasks she was asked to do.

We were expecting a few areas of delay, but she's not as far behind as we dreaded. The deficits are minor, and are in speech and gross motor. Right now, Andrea does not say anything that is recognizable as a word. She does say "DaDaDaDa", but she uses it for many things, not just Ken. A 13-month old baby is expected to have a few words. The other thing that Andrea doesn't do is walk. Now, many babies aren't walking at 13 months, but Andrea is a little further behind than expected. No one was especially worried about these slight delays, and we left with strategies to help her along a little.

Andrea also had a cognitive assessment, to see how her brain is functioning. Now, for a long time we've felt that she's smart beyond her age, and the doctor confirmed that. The first thing the doctor asked her to do was put a peg into a hole. (She modeled for Andrea, since we're not up to following directions yet.) The doctor showed her once, and then Andrea immediately repeated it. She was then given another peg, and on her own put it in the hole. Then the doctor had a ring with a string on it. She dangled it in front of Andrea, and Andrea grabbed the string and used it to "reel in" the ring. The doctor was quite pleased at Andrea's problem solving processes. There were many other tasks she was asked to perform, and the doctor went beyond what would be expected from a 13-month baby to see where she really fell. Well, cognitively, Andrea is 15 months old! WooHoo!!!

The only other finding from the doctors is that Andrea is small for her age. This did not come as a shock to us! She has made up a lot of ground, but still has a way to go. The doctor told us that we might want to consider HGH (Human Growth Hormone) in a few years, if she doesn't catch upon her own. It's not something we need to do now, and it's good to know that the option is there if we need it.

In other Andrea news, she finally has more teeth! She's had the bottom center two for a while, and now the top two (to the sides of center, HAH!) have finally broken through. Once they're out, she'll have fangs!

“The person determined to achieve maximum success learns the principle that progress is made one step at a time. A house is built one brick at a time. Football games are won a play at a time. A department store grows bigger one customer at a time. Every big accomplishment is a series of little accomplishments.”
David Joseph Schwartz

Monday, July 12, 2010

Andrea the Brave...

We are so fortunate in that there has been very little to report in the world of Andrea. I know people want updates, but for the most part, there is nothing going on that is out of the ordinary. Who would have thought that we'd be saying that about Andrea? A year ago at this time, we were trying to come to terms with life on the apnea monitor and PulseOx. Now, we're contending with baby gates in not one, but four locations in the house as Andrea climbs the stairs and basically gets into everything she shouldn't.

Last week was a week of doctor's appointments. We had Andrea's 15 month physical (those are scheduled based on her actual, not corrected, age) a pulmonology appointment, and a follow-up hearing test. The physical went well, although at this age there are always vaccines. We know they're important, but we hate to see Andrea so enraged, LOL! The pulmonologist was pleased with the way Andrea's lungs sounded, and we don't need to go back until October, if she stays healthy. The hearing test was the most interesting. Andrea had a hearing screen before being discharged from NICU, but I wasn't there when it happened. This time, I got to watch. The doctor had me sit Andrea on my lap in a sound booth. (I felt like I was on a game show!) The doctor then spoke to Andrea from outside the booth, and the sound came through speakers on either the right or left side. If Andrea turned her head to the correct side, a box lit up and she saw either a stuffed dog or pig making sounds. The doctor progressed from speech to tones, and each time Andrea turned toward the sound, she got the reward. Fortunately, Andrea did well on the test. Her hearing is adequate for speech and language development. I learned from the audiologist that some of the preemie medications can cause hearing loss. We're not in the clear, but she doesn't need to be retested until she's three.

One of the things we're enjoying this summer is finally being able to go places with Andrea. (Although it's a challenge to travel with her.... we have to bring so much baby stuff!) We've been able to spend a day at the NJ shore, travel to Connecticut for a family wedding, and make trips to the town pool, where Andrea is able to splash in the baby pool. Last summer, we went to the pool with the boys, but Andrea was allowed nowhere near the water, and we left her with my parents to take day trips with the big guys. Now, she can be a part of all of it.

Our most recent adventure was a trip on Saturday to the Bronx Zoo. It was a cloudy, overcast day, which is great for seeing the animals. They're more active when it's not so hot. This time of year, there are usually lots of baby animals, too. We saw the "adolescent" giraffe that was born there last year, along with this year's crop of monkeys, cattle, sea lions, birds and so on. The most interesting thing, and the reason for today's title, was Andrea's response to the animals. She was quite interested in everything she saw, and we could see her eyes following the animals as they moved around their enclosures. She rode the "Bug Carousel" and watched the butterflies in the Butterfly Garden. Nothing intimated or upset her until we got to, of all places, the Children's Zoo. For those of you not familiar with the Children's Zoo, it's a place within the main zoo where kids can experience some of what animal life is like. They sit in giant birds' nests, climb in prairie dog burrows, wear tortoise shells, climb a giant spider web and so on. At the end, there is a barn yard with farm animals for feeding; the usual assortment of cows, pigs, goats, fowl and sheep. After all we went through, the one thing that made Andrea absolutely hysterical was... the sheep! Among the cutest animals in the area, they had the audacity to bleat when we were there, and Andrea burst into tears. Actual heart wrenching sobs of terror! It was so bad we actually left the barnyard and moved on to another area of the zoo. So, go figure... she's had more transfusions, IVs and shots than most adults, endured months on oxygen tanks and monitors, will happily be thrown through the air, but cannot abide by sheep! LOL!

Next week, we have Developmental Clinic in New Brunswick. This will be her first appointment there since October 2009. She had an ear infection for her March visit, and the doctor didn't want her coming in. I hope the doctors will be pleased. We think she's come so far, and seems pretty on-track to us. As before, the doctors will assess her against full term babies and recommend early intervention if necessary. I'll try to post after clinic with the doctors' updates.

“We should come home from adventures, and perils, and discoveries every day with new experience and character”
Henry David Thoreau