Lincoln's appointment with Newborn Medicine was at 12 noon. Lincoln was in such a bad mood before we even left that I didn't know if I could get him in the car without desaturating so I called the hospital to let them know we would probably be late. We ended up only being ten minutes late though. We used the stroller this time since we had two appointments to go to and would be at the hospital for several hours. Lincoln actually liked being pushed around. I think he liked being forward facing so he could see everything. With the seat on the stroller propped up, I could get his oxygen tank to fit underneath so we had less things to tote round.
Lincoln was actually in a good mood for his first appointment with Newborn Medicine. We actually saw the neonatologist that we met with way back when I was still pregnant and touring with the Fetal Care Center. Lincoln weighed 10lbs 15oz! He is now 23 inches long with a head circumference of 40.5 cm (all still <5th %). I told the doctor how Lincoln has been eating really well and I that I think he is going through a growth spurt since he is up eating every 2-3 hours even through the night! She was very pleased to also hear that he is on a wean plan for his morphine.
I told the doc that Lincoln has been doing great on 1 liter of oxygen and only desat's when he is really angry, never at rest. She said that she is not concerned with his desating during crying spells, especially since he recovers easily when he is comforted. She said she is more focused on if he has enough energy to eat and is taking good volumes, which he is. When Lincoln has his sensor on for the pulse ox (which is only when I am sleeping or out of the room since it alarms if Linc moves too much) his saturation always shows 100%. She also looked Lincoln over and did a few tests to see how well he could sit and hold his head. She asked about his therapy sessions and whether or not he was smiling and cooing yet, which he does both frequently!
The doc was very happy with Lincolns progress and decided to wean his oxygen flow to 0.8 liters as his baseline. The way his flow meter is on the concentrator I have to set him between the 1 liter line and the 0.5 liter line, but she said that is fine. She said that we should try not turning him up to eat anymore and see how he does. If he is taking less on volume or taking much longer than normal to finish to go ahead and turn him up and let her know. Her office called today to check on Lincoln and see how the new oxygen setting is working out and I let them know he is doing just fine. He has not shown any signs of distress thus far. We have another appointment on Oct 5th.
All three of us ate lunch between appointments and then went over to Imaging to get Lincoln's chest x-ray. His surgeon will want to see an x-ray at every visit to check for rehurniation. Our visit with her was brief. The doc said that she wants to wait for an official report from the radiologist, but she said she thinks Lincoln's x-ray looks good. She inspected his incision sites and generally looked Lincoln over. She was also pleased to hear he is doing well and happy to hear that Newborn Medicine weaned his oxygen. She will want to see Lincoln every three months to monitor him for reherniation. She said signs to watch for are reflux (with vomiting) and a decrease in volumes during feedings. She also said to stretch out his morphine wean a little longer just to three weeks just to be sure he does not show any withdrawal. She would like Linc to stay on his same dose of Sildenafil until he no longer needs oxygen support.
The drive home was much easier than the drive to the hospital. Lincoln fell asleep really quickly since he didn't get a nap at all during the 5 hour hospital visit. He slept in his car seat for about an hour, woke up, ate, and fell back asleep within about 15 mins. What a day for Lincoln!
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