Tuesday, February 9, 2010

OT and doctor appointments...(last friday)

I'm a little behind in post this but better late than never I guess. Last Friday Emerson had her first session with an occupational therapist to look into her continued and persistent resistance to bottles. She has been incredibly hard to feed since coming home from the NICU and the problem continues. She just won't eat. She'll eat an ounce or two and then refuses the bottle, she can go hours and hours without eating, and she's just not getting enough ounces in a 24 hour period. The whole cycle is frustrating for everyone involved me, Marcus and Emerson.

We don't force her to eat but she wakes up at night crying because she hasn't eaten all day. She seems to only be hungry at 9pm every night (3 hours past bedtime). While the occupational therapist didn't have any magic solutions I was relieved that I wasn't imagining all the difficulty.

As I started reviewing Emerson's history I was shocked that every single thing we have tried and experienced was common with babies who have similar issues with the bottle. I mentioned that often Marcus will hold up his cell phone while she's eating so she's distracted and doesn't remember that she has a bottle in her mouth. According to the OT that's pretty typical in these cases.

She asked if Emerson puts toys and things in her mouth and the answer to that is no. I've always been fascinated by the fact that Emerson can hold toys/cell-phones/objects and just study them without ever putting them in her mouth. (Eli instantly puts every thing in his mouth).

She also reviewed our eating log. Marcus and I still record the time and amount that each baby eats everyday. We do this for many reasons. 1). It's just easier with our schedules to be able to reference when they last ate. 2). We are of course worried about the amount each of them eats and it became a habit after coming home from the NICU when we were really working to make sure they were eating enough. As it is Emerson still is not eating as much as she needs to.

But I was relieved that when she looked at the log and compared Emerson's eating habits to Eli's the problem was immediately evident. (I always have this strange fear that I'm imagining things or being a worrier for no reason) so it was nice to have my concerns and experience validated.

Then she watched as I tried to feed Emerson. The timing worked out that Emerson hadn't eaten for over 3 hours so she should have been hungry. But in true Emerson fashion she ate an ounce and then refused the rest of the bottle. The OT then wanted me to feed her some solids which was complicated by the fact that Emerson has stranger anxiety and anytime I set her down or put her in the highchair she flipped out. I had to try and feed Emerson oatmeal from my lap. She did a little better with the oatmeal and then the OT watched her play with objects without ever putting them near her mouth. (Maybe this is why we didn't know she was getting teeth she never ever chews on anything and then one day teeth hmm...)

The OT mentioned that many times babies who have been in the NICU and start out with tubes in their mouths sometimes continue to be resistant to things in their mouths. While we will never know if this is the root of the problem it is one explanation. We are also lucky because Emerson will put the bottle in her mouth (most of the time), she just stops eating after an ounce or two usually.

So we were advised to do several things:
1). Play with toys and other objects around her mouth to encourage her to experiment with having other things in her mouth.
2.) Introduce a mesh feeder
3.) Give her more solids if she's not as resistant to eating them in order to get more food into her.

So no huge revelations more validation and some advice. We'll see next week at their 9 month well baby check-up how Emerson's weight gain has been. The OT is coming back in a month to check in on things and see how it's going.

This same day Eli sounded congested, had a little cough, and a runny nose. Marcus and I always fear the worse (RSV or something) and so after talking to a nurse at the pedi. office she decided we should bring him in to have him checked out. The problem with this was:

1.) The OT was literally suppose to arrive any second
2.) Marcus was in class and had our one car

I attempted to explain this too the nurse and asked if we could have an appointment 30 min. later and she   basically yelled at me. "You're telling me that your son is sick and you want to wait? You probably want him seen sooner than later!" OK... I wasn't suggesting we wait a week but I had a woman coming to my home, no car, and Marcus was in class. I wasn't intentionally trying to be difficult and I appreciate that they could get us in so quickly, but geez she made me feel like I was being incredibly irresponsible for needing a later time than 20 min. from the moment of our phone conversation.

So I had to text Marcus and he left class in the middle and literally ran across his campus so he could get home to take Eli. I tried to call the OT and reschedule but as I called she already at at my door, so I couldn't exactly turn her away.

Fun times. So Marcus took Eli, I stayed with Emerson, and we compared notes later. (Another joy of having twins I suppose to many babies/appointments/ without the ability to be in multiple places at the same time).

Eli was mostly fine he has a cold. The doctor told us it wasn't yet in his lungs and to let her know if it got any worse or he started wheezing, so ultimately probably another case of paranoid parents but better safe than sorry.

1 comment:

~Jess said...

Oh my...it all sounds so frustrating. You'd think that nurse would have been a bit more compassionate...especially considering Eli's symptoms weren't life and death. Hopefully Emerson will be making more progress with the eating.

Thinking about you guys.