Yesterday I took Lincoln to SLCH for his clinic appointments for Newborn Medicine and Pediatric Surgery, and Lincoln got his second good "report card!" Lincoln also did excellent in the car! He barely cried at all and seemed to enjoy himself at times. He likes to look in the mirror and just give him a blanket to feel and chew and he is alright!
Newborn Medicine was our first appointment and Lincoln was very fussy by that point. (It was time for his morning nap). After he was weighed and measured (12 lbs 11oz, 24.5 inches long) I was able to calm him and he slept for about 15 minutes while I talked to the doc. Lincoln was refreshed enough for a quick exam after that and a breathing treatment of Albuterol to help with his on-going wheezing and coughing. He hates the treatments, but they help him a lot. His wheezing was completely gone after the treatment. I am to continue nebulizer treatments of Albuterol at home ever 6 hours throughout the weekend and then switch for twice per day to help Linc get over his wheeze, hopefully stopping all treatments within about 10 days. The doc said it is very common for kids that were on the vent for a long time to wheeze, especially the first winter. She does not expect Lincoln to be "asthmatic" or to need treatment long-term.
Otherwise, no changes for Linc. His doc was pleased with his weight gain (approx. 20 grams gained per day since our last visit - perfect!) and happy with Lincoln's tone and physical development. He will remain on the concentrated formula to help him catch up. Even though his average weight gain was good, he is still well below the average weight for his age group. Linc will remain on 0.8LPM of oxygen, probably throughout the winter. His doctor doesn't want to push him too hard when he may be catching colds. I am still really hoping Lincoln is free of lines by the time he crawls! That would just be a nightmare!
Linc also had an echocardiogram and chest x-ray in between the two visits. Lincoln did great for both. There was a TV in the room for the echo so Lincoln pretty much watched cartoons the whole time. The last echo Linc had was back in June right after his repair surgery. At that time he was still on the ventilator and Nitric Oxide so the two echos are really not exactly comparable but it was all the doctor had to go on. Although Linc's echo yesterday did show improvement and good function overall for someone who is oxygen dependent, there are still signs of some hypertension. Therefore, Lincoln's surgeon, neonatologist, and cardiologist all agree that he should stay on his small dose of sildenafil. The hypertension does not appear to be severe enough to justify increasing Lincoln's dose, but since he still has some hypertension present, so discontinuing the med is not wanted either. The doctor said that she would like to see another echo in about to months.
Lincoln was not too happy to get his chest x-ray, but it was over quickly. They were able to get good pictures the first time. His x-ray looks good, with no signs of reherniation or pneumonia. After the x-ray we headed up to see Linc's surgeon. She was also happy with Lincoln's growth and health.
Lincoln has had a suspected inguinal hernia since birth that has not caused any issues until recently. (Yes. That makes three birth defects in all.) I actually brought Linc to the ER Monday night after a short episode where he seemed to be in pain, but everything turned out to be OK. His surgeon was notified of our visit and she suggested setting a surgery date to repair the hernia. I was hoping to have Lincoln's inguinal hernia repaired at the same time as his hypospadias but the urologist wants to wait until Lincoln is closer to 1 year for that and the inguinal hernia is more urgent. I scheduled Lincoln's surgery to repair the inguinal hernia for December 9th. It is expected to be an easy, outpatient surgery and Linc can go home that evening. It will be nice to have another thing fixed and off of the "watch list."
Lincoln was exhausted by the time our five hour trip was finished and he fell asleep fast in the car on the way home. Overall, it was a really good trip with lots of good things to report on Lincoln. His doctors and I are just pleased as punch. Lincoln's next clinic will be next month, just before his surgery.
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