Follow-Up

It was so much fun to have family visiting -- we wish they could have stayed longer! (We'll look forward to another round of "keep the toddler from tumbling over onto the babies" at Thanksgiving.)

The boys are starting to grow out of their newborn size outfits. Wow! We're starting to rotate in the 0-3 month sizes.

James had one of his gazillion follow-up appointments today, this one with pediatric surgery. (The appointment was at 1 PM, yet somehow it took us all morning to get ready to get out the door! Feeding and meds are a major production around here.) It all went well; everything (by which I mean the g-tube and ostomy) looks fine from their perspective. The only very minor issue is that James has a little bit of granulation around his g-tube. This is extra tissue that can grow up around wounds, so we have to use some silver nitrate over the next few days to get rid of it. They also gave us some stretchy material to put around the g-tube to keep it from moving around during tummy time. We've been told over and over again that it's okay to put him on his belly (and in fact, very important to do so for developmental reasons), but having that little extra protection for the tube will make us a lot more comfortable doing so.

After the appointment, we went upstairs to visit some of the boys' favorite NICU nurses. We're not allowed in any more -- we had to wait in the hallway! It's perfectly understandable (and we halfway expected that would be the case), but it was a little strange after practically living there for the past five months. Anyhow, it was wonderful to visit with the nurses (and say hi to a couple of the docs), even if only briefly. We miss them! (And James probably does, too -- he gave at least one of the his nurses a smile when she first peeked into his stroller!)

We also talked to the case manager about the diagnosis error in James's referral to the home health company. It turns out that it came from one of the post-operative notes from one of his surgeries. (We don't know how that happened; presumably a dictation error or a mix-up with another patient at that stage.) So, it sounds like it has to go through the hospital risk management process to get corrected (they'll contact the surgeon who should file an addendum to James's medical record). I'm glad we caught it now, because we really don't want those mistakes to remain part of his file.

Matthew has been wonderfully smiley recently. And I think he may be starting to bat at the toys on his activity gym a little more intentionally, instead of just the baby flailing around. And James has given us some smiles as well. We decided that we're not going to try to stick so strictly to the hospital feeding plan, because it was making him and us miserable. (I don't know why it was working for him there and not here, but we gave it our best shot.) Since the higher volumes seemed to be making him throw up more, we're cutting back a little bit with the idea of easing back to the higher levels once he gets settled in. We're also trying to pay good attention to his cues and feed him by bottle when he acts hungry. So far it seems to be going well; he's been doing a good job with his bottles (Mike has the magic touch there), and he's been keeping his medicine down, thank goodness. The key will be whether he continues to gain weight (and so far he seems to be), so we'll be keeping a close eye on that with the home nurse.