Wednesday Night - A Josiah Update

He swallowed!!!

Josiah passed his swallowing test with flying colours, and will be able to begin partial bottle/breast feeding tonight to see how he will respond! WooHoo!!

All in all, it was a crazy hectic and awesome day for our Josiah. Lots of stuff was accomplished: he had his first outing, which was a success despite our slow start. Josiah was a little upset about being put into a stroller right after waking up (I think he just wanted some quality time); further, placing him in an upright position can really move his secretions and so we were suctioning him a lot as we were trying to leave the room. Then he throw up THREE TIMES because he had a lot of air in his belly (he had a bit of a gaspy moment earlier because he wasn't happy about getting into the stroller, and so he swallowed a lot of air). Once we realized all he needed was his belly vented, we opened the g-tube and wow did that air bubble out! Tons of it!

Marie, Josiah, myself and an RT took Josiah out to Starbucks and the fountain and he did really well. He kept his eyes closed most of the time when he was outside (even in the shade) because he has to adust to sunlight. We had lots of opportunities to suction and assess him in public, and he had one episode were he got scared and needed oxygen because the wind shifted and blew a lot of water from the fountain over his covered stroller (the noise inside must have been deafening!).

Josiah was also put on a new feeding plan because he hasn't really gained any weight over the last 2-3 weeks. Partly to blame is the fact his throwing up some food, some is lost when we open/close the g-tube, and he's coming of his 'medaz' (sedative). He is getting better at not throwing up, and his throw ups often come up with a loud burp (kind of cool!). So now he's getting more food every three hours which we are really happy for.

Josiah's treatment of his staff infection under his chin is also changing: he's getting two different creams now, and we're going to change his trach ties twice a day until the infection goes away.

Finally, Josiah really blew away the audience with his swallowing study. He really liked the sugar water (baby crack as the OT put it!) to get him going, and he was sucking so hard that he was pulling the barium-sugar water mix out of the syringe without the OT even injecting it through the modified soother. Josiah's throat was on x-ray the entire time and the barium showed up black on the screen, so it was easy (and really cool!) to see where the fluid was going. Josiah was then given a couple of bottles to drink from (two different sizes of nipples) and did great! The doctors had to give his x-rays a really close examination because even though the fluid was going to the right place, his throat arrangement/formation is quite abnormal. His trachea is quite to the front and so for food to even get into his lungs, it has to take quite a jump. The doctors were really surprised by what the saw, since the position was so drastic, and now the really why he was so difficult to intubate. So yeah, he's going to be given small amounts of milk to drink 3 times a day (bottle or breast) and his progress will be assessed next week! God is so good!

Oh, and I'm sorry it took so long for me to post an entry. The computer has been busy all day, and I've spent most of the afternoon with Josiah. Marie had to go back to Easter Seal for a nap (she was physically and emotionally exhausted from all the joy of the day). I didn't shed any tears today, but Marie was crying both when Josiah went for his first trip ever and when he passed his swallowing test. What a great mom. But it's so true: we always take trips and swallowing for granted, and there is really reason to celebrate when our son takes these two big steps in one day 4 months into life. We can't stop talking to people - I think everyone in the NICU nows! NOBODY was expecting him to do this good, and it's a big answer to prayer.

OK. I'm going to google-up some celebratory supper options. Thanks for all your prayers today.

In God's Goodness.
- Andrew, Marie & Josiah