Happy Holidays

Let's catch up a bit from the last few weeks....

Samson had his 3 year check-up and he's now in the 80% percentile for height (39 inches) and 75% for weight (34 lbs). Dr. Dudley was very impressed with his verbal and math skills, which of course made us giddy with nerdly pride. Guess we can safely say that the preemie status has been put to rest.

We had our family photo shoot with Alison Eden in mid-November, and it's just incredible how much Samson has changed and yet still looks the same in the 2 years since our last professional portraits. I've uploaded the whole set of recent ones to our Picasa Web album, but I'll share a few favorites here.

With just 5 days left till Christmas, we're busy at home getting ready for our whirlwind tour to visit family over the holiday break. This year, we're heading down to San Antonio for Aunt Kelly's annual Xmas Eve party where we'll get to see lots of Mama's family and Samson will be spoiled rotten as the only child in the whole group of 15+ loved ones. Then it's back to Austin for waking up in our house for the Thomas & Friends extravaganza that Santa will bestow. After that, we're back in the car for the trip to Houston for more spoiling at Pawpaw & Grandma's house. Whew! That's a long while in the car, but since Mama finally gave in and bought a portable DVD player for the backseat, Samson has become a champion road tripper - 2 Thomas movies watched (with headphones on so grown-ups can chat freely) and we're there.

It has been a lot of fun this season sharing all of the holiday traditions and stories with Samson now that he is old enough to understand and participate in what's going on. He loves retrieving the daily treat from the Advent calendar and turning on the lights on the tree and decorations outside. He even got to meet Santa at a toy drive in Pawpaw's neighborhood. And it seems that we have at least 2-3 conversations each day about the actions and attitude required to remain on the nice list and stay off the naughty list. The only wish that he has for Xmas morning is to receive Emily and Molly and their respective coal tender cars... I must confess that Santa & his elves may have reserved just a few more engines and other Thomas paraphernalia for Samson than just those two items....

If you haven't kept up with our Twitter posting, you may be unaware that Samson has gone full on obsessed with Thomas the Tank Engine (aka Thomas & Friends) since about the end of the summer. It began with reading the same two books over & over, which led to Mama recording the single weekly episode off PBS so that Samson could enjoy the characters on-screen, too. After that, the stockpiling of toys began, with Duplo sets for his birthday, and then going bonkers for the Take Along engines and playsets (which are more small, portable, and durable). Since then, Samson's daily routine involves waking up to play with his engines, coming home from school to play with his engines, and before bedtime - you guessed it - putting all the engines in a bucket to move from the living room to his bedroom where he has more tracks for playing with his engines. We've been amused and surprised at the level of adoration Samson has for these toys, and it definitely comes in handy when we need a carrot or stick for behavior modification.

Speaking of behavior modification.... we missed out on the Terrible Twos but we're making up for it by getting slammed with the Tyrannical Threes. Samson somehow recently learned (can I blame one of those bad seeds at preschool?) that there's really nothing stopping him from refusing any parental directive or request. We've had to adapt with an expert level of mind-games (aka cognitive behavioral tactics) to stave off wild-eyed tantrums that occur when Samson feels as though his will is being ignored. Samson insists on independence and wants to do things for himself, in his own way, and on his own time table. When transitions don't occur according to these preferences, the "I'm very displeased" jig is performed (imagine an angry leprechaun), complete with coordinated head, arm, and alternating foot hops accompanied by a piercing howl. Mama and Daddy must be very careful to hide our amusement at this passionate display. The top 5 situations (if not skillfully orchestrated) likely to lead to the angry leprechaun dance lately are:

• Requiring that a coat be worn before going out into cold weather
• Requiring that hands be washed prior to eating
• Requiring that PJs be removed and school clothes be put on in order to go to school
• Requiring that the evening TV watching session be ended and that bath-time begins
• Requiring that Samson get into his carseat without dilly-dallying

Could you say no to this face?

Birthday Gifts Keep On Giving

We had a laid-back 2nd birthday celebration for Samson at home back in early October, basically a toddler free-for-all in our big backyard with a bouncy house and lots of borrowed or Craigslist-found ride-on toys. Unlike the first year, we forgot to specify "no gifts, please," and our friends and family couldn't resist showering Samson with a gigantic mound of presents, most related to his favored theme of transportation.

Upon the advice of our more experienced parenting friends, we decided to stash the many gifts in the closet and parcel them out over time so as not to overwhelm Samson with too many new things and better allow him to enjoy each one on its own. This has worked out fabulously; 7 weeks later, we are still making our way to the bottom of the pile.

This morning's surprise is courtesy of the Turners. We just love the toys made by this British company, as they require no batteries, are totally friction-powered, have no annoying electronic sound effects, have a wide age-appropriate range of 1.5-5 years, and have minimal packaging to hack through & dispose of. The picture is from Mama's phone, so it's a little fuzzy. Still, you can see how much Samson is stretching out & morphing into a big boy:


Samson was due sometime between November 21st and 26th, so he's now officially 2 years old. His health and development are all on track, so we're actually no longer adjusting his age as is commonly done with preemies. This is one time that it feels pretty nice to graduate to "average."

Dental Report at 15 Mos: The Molar Has Erupted

On Your First Birthday

Dear Samson,

This is a picture of the time that we first met, face to face:
















The occasion was much more dramatic than we had expected, and the next few weeks and months were very difficult for us all, but at this moment, your dad and I were bursting with joy and relief that you were with us, kicking and screaming with your tiny body that was not yet really ready to join the world.

It's been 365 days since this photo was taken and boy, have you grown! You're now over 21 pounds and 29 inches tall. You crawl like a commando, you swig from a sippy cup, and your current mission in life (besides consuming all bite-sized objects) is to stalk kitties. You sleep all night (usually) from 7:30p to 6:00a like a big boy in your own room. It's almost impossible to tell that you were ever anything but perfectly healthy; only the little IV scars on your ankles and arms give a hint as to how you lived your first few weeks.

Everywhere you go, people notice you and comment on how big you've become and how very handsome you are. They say you look just like your mama or just like your daddy, depending on which one of us they know the best. They also say that you're an old soul with very observant and curious eyes that seem wise beyond their age. Recently, a burly punk-rock chick behind us in line for a half-hour said about you, "I don't even like kids, but this one's pretty cool."

You adore:

• feet, especially toes
  
• dogs, and you giggle whenever you see a real one
  
• cats, which you will tackle if they allow you to get close enough
  
• tickles, especially under the arms
  
• Mama, pretty much 24/7
  
• Daddy, especially when he arrives home from work
  
• PawPaw in his red shirts
  
• whiffle balls to chase and crash together
  
• swinging in bucket swings
  
• drinking Mama's milk
• eating anything that you can feed yourself
• brushing your teeth
• smiling for people and cameras
  
• songs with hand motions and sound effects, especially Itsy Bitsy Spider, Wheels on the Bus, and Sammy-Pie (sung to the tune of "Lollipop, Lollipop")
• Moose A. Moose and Zee, the hosts from Noggin
• reading Goodnight Moon and Where's Spot?
• playing with things you aren't supposed to have, like the TV remote control, the phone, and the weekend newspaper
  

You detest:

• discovering that you've reached the end of a bowl of food
  
• getting your face washed
• having your nose picked or your nails clipped
  
• pulling a shirt over your head
• knowing that Mama is nearby but not in the same room with you

You are very sociable in most settings, but you're just now learning how to wave good-bye and hello, to give high-fives & pounds, and to kiss. Your most frequent companions of a similar age are Hayden and Samantha. You hang out with Ava, Weston, Kelly, and Owen pretty regularly, too.

Already we can tell that you have a mischievous streak that's likely to cause Mama and Daddy a few gray hairs (or more in Daddy's case). Your response to Mama's recent first attempt at discipline (saying "No!" in a stern voice with a serious face) was to laugh hysterically and immediately continue the behavior that produced the first rebuke. You also find it comical when Mama uses that same tone with misbehaving pets.

We couldn't be any more proud of you, darling son. Your existence has made us a family in ways that we didn't understand we were missing before. As each month passes, we are delighted to learn more and more about the unique person you are, finding the little bits that remind us of ourselves but being most impressed with the things that are singularly yours. Live well, Samson.

Love always,
Mama and Daddy

And then there were five

Teeth, that is. Here's a chart showing Samson's progress so far:

Family Self-Portrait

Samson has become so accustomed to the camera, he knows to smile as soon as the red light shines. What a ham!

Can you see all four teeth?

Sorry about the lack of recent posts, dear readers. We've been super busy at the Hobbit Hole this summer and Mama hasn't had much time to write. We promise to get back on track this month....

Half a Year

Six months ago, Daddy took Mama to the hospital to check out what seemed like a strange stomach flu; hours later, Samson was surgically removed from the womb two months earlier than expected to start his life in the neonatal intensive care.

Since then, Samson has made incredible progress. Here are just some of his accomplishments:

• coming home with no monitors after living for 6 weeks in the NICU
• growing from less than 4 pounds to over 16 lbs
• healing from a heart murmur, sepsis, sleep apnea, and umbilical hernia
  
• transitioning from tube feeding to bottle feeding to breastfeeding over a period of 12 weeks time
  
• going from a "colicky" constant crier to a happy, "rarely cries" baby after we removed all cow milk protein from his (and Mama's) diet
• from soaking 20-30 burp cloths (plus 2-3 changes of clothes for himself, Mama, and Daddy) each day to minimally wetting only 6-10 burp cloths and wearing the same outfit all day long
  
• from staying awake & fussing most of the night to sleeping most of the night between 9pm and 6am (and most importantly, going immediately back to sleep after his night feeds)
• from demanding to be held at all times to enjoying several 20-30 minute independent play periods each day in his crib, exersaucer, jumper, and playgym mat
  

Samson is becoming quite an active boy. He loves to kick and jump and wave his arms. He can hold his head up very well, and sit or stand with assistance. He likes to read picture books, suck and chew his fingers, and giggle and "talk" (especially first thing in the morning). Recently, he's begun to pick up some objects on his own and get them to his mouth for a taste; his favorite teether is a cotton burp cloth. Yesterday, he discovered that he can scoot/wiggle around his crib and he was able to roll from his back to his side for the first time.

Though we kept him cooped up for the first couple of months to protect him from germs, Samson has since made a few trips away from home to meet his East Texas family. He's been as far as Bryan, San Augustine, Beaumont, Houston, and Livingston. In town, he's been to the homes of the Turners, Murphys, and Boriches. He's eaten out at Elsi's, Central Market, Curra's, Opal Divine's, Chuy's, and Logan's. He's shopped at HEB, Whole Foods, IKEA, Sears, and Babies R Us.

Mama and Daddy are very proud of our strong, beautiful boy. We can't wait to see what Samson will do next and we're looking forward to some big milestones in the coming weeks. He will soon be sitting up unassisted, rolling over, and eating his first cereal.

Evidence of recent cuteness:


3/29/07


3/29/07


3/26/07


3/18/07


3/13/07

Fourth month check-up

Wednesday, Samson had his 4 month visit to the pediatrician. After the physical exam (all looks good) and drilling Mama and Daddy with 20 questions on Sammy's behaviors, the medical team had 6 injections waiting for our dear baby - vaccinations plus the RSV anti-viral. Ow! At this point, Samson handles it all pretty well, but Mama needs sedation after the trauma.

Because Samson was born so early, we track his growth on two different charts, one for his birthdate and one for his preemie adjusted age. For a 4 month-old, Samson is in the 25th percentile on height, weight (13 lbs 14 oz), and head circumference. But, for a 2 month & 2 week-old, he is in the 95th percentile. This means that Samson well ahead of the growth curve for most preemies born at 32 weeks gestation.

This is great news, because robust growth is usually associated with optimum health and signals that Samson will likely outgrow his remaining preemie-related issue of the reflux. His umbilical hernia has disappeared though we were originally told that this could take up to 2 years to heal. The volume and frequency of spit-up have decreased significantly as well, to the point that we each now often get to wear a single outfit all day long; this is a big accomplishment.



Mama and Daddy are also excited because Samson has recently become much more social, giggling and cooing when he sees our faces. It's a big reward to finally be able to have a sort of conversation and we can't wait to see what he's going to do next.

We still wake up every 2 to 3 hours to nurse, but for the past 2 or 3 weeks, Samson usually goes right back to sleep afterwards. This means that Mama and especially Daddy are getting longer stretches of uninterrupted sleep. We are hopeful that within the next month, Samson will begin to sleep through one or two of the night feedings and we'll get to have 4 or 5 straight hours of dreamtime. Oh please, oh please!



Next stop, White House

Thirteen Pounds

Explosivo!

Mama was nursing the boy this evening when a powerful force erupted from his pants. The sound was similar to his usual gassy emissions, but Mama knew this was something new as soon as she felt the warmth on her leg. These pictures tell the tale...










Along with our first blowout diaper, we also had our first real on-purpose, wide-awake smile today. We didn't catch that one on film, but we'll try to get the next one for the blog.

Yesterday was Samson's one month (adjusted age) birthday and he has now reached 10 lbs, 2 oz. Whew-hoo!

Still Growing Fast

Someday, these posts will focus on more cheerful subjects, but for now we continue our medical updates.

Friday, the family was on the road going to doctors, the pediatrician in the morning and the pediatric gastroenterologist in the afternoon. The first visit was to look at a rash that has taken over baby's face, neck, and ears; this seems to be normal newborn acne and we are relieved that it should resolve on its own. The second visit was to look at Samson's digestive problems, adjust his medications, and talk about any new strategies to minimize his reflux, cow milk protein sensitivity, and colic symptoms.

The good:

• Weight = 9 lbs 5 oz
• Feeding = all meals by breast; finally, no more bottles & round-the-clock pumping!
  
• The cow milk protein sensitivity is likely to resolve by 10 months of age, and Mama can start reintroducing some dairy (small amounts, always with other food) into her diet by April or May.
  

The bad:

• Reflux is still a problem, although he will probably outgrow this eventually. We have tripled his Prilosec dosing and will monitor progress for 3 weeks; if we don't see improvement, the GI doc wants to do a GI study by X-ray, which will require Samson to fast for 4 hours -- hello, misery!
• The GI upset related to the cow milk protein sensitivity will take some time to heal, and the high acid content in breast milk continues to irritate those inflamed tissues. This means that the colic is likely to continue for a while.

Tomorrow, Samson will have his first outing that isn't related to a doctor's appointment. We're attending a baby shower and Daddy & Mama will take turns being sequestered with the baby in a bedroom while the other participates in the party for a few minutes. We'll give a full report on this momentous occasion then.

One month later, we're still in Punxatawney

Monday marks Samson's first month at home since leaving the hospital. It is 2 months and 10 days since his birth, but his adjusted age is only 13 days. This means that Samson is still very much a newborn baby in his development and behavior, so our 24 hour routine still looks like that of a family with a brand new baby.

Ever see that movie (one of the best movies ever) "Groundhog Day" with Bill Murray? That's kind of how Mama and Daddy are living these days. Every day is the same, except in our case, the cycle repeats itself about every 2 hours: feed the boy, burp the boy, try to catch all of the projectile spit-up, hold the boy upright for 30 minutes (to minimize his reflux); if he falls peacefully asleep, place him in his bassinet and use the next hour to clean & ready bottles, pump breastmilk, take a nap, eat a meal, or do another chore; listen and watch for the boy's hunger cues, get another bottle ready, change his diaper, and start again. We keeping thinking, "Maybe today is the day where he sleeps for 4 hours straight," or "Maybe today is the day when he'll nurse well enough to get his whole meal from the breast," or "Maybe tonight is the night when he'll fuss for less than one hour," or "Maybe it's April, our lives have returned to something sort of normal, and we can go out to eat at a restaurant."

Samson does not sleep for more than 2 hours at a time, and usually it's more like 60 minutes. As a result, Mama and Daddy are basically insane from a month's worth of sleep deprivation. We try to trade off in shifts so that each of us can get at least 3 hours straight sleep, but it is almost impossible with the pumping, since Samson inevitably is shrieking through a colic episode when Mama needs to pump, so Daddy has to wake up & comfort him for 30 minutes until Mama is done.

The good news is that Samson seems to be doing better with his tummy trouble, and he's spending much less time screaming & contorting in pain at night. Even though we're not sleeping, it's a little bit calmer, a little less stressful time. He's also enjoying more, about two stretches of 60 minutes or so, of what we like to call "Sammy Time," when he is content to lie on his back and look around, making funny/cute sounds, and pumping his fists and feet in the air. Sammy Time is SO much better than Hammer Time.

Health Update
After 10 days on Nutramigen hypoallergenic formula, Samson still had blood in his stool (not visible to the eye, but positive on lab tests), so we decided to go ahead and return to an all breastmilk diet on Friday. By this time, most of the cow milk protein should be out of Mama's system, and the advantages of breastmilk far outweigh those of the formula. Plus, Samson is still gaining weight like a champ (8 lbs, 10 oz now), and his pediatrician says he looks healthy in every other way. We have an upcoming appointment with a pediatric GI specialist to look further to find the cause(s) and cures for Samson's bleeding.

So now we're back on the breastfeeding project. Samson's suckle power has improved dramatically over the past two weeks, but he still has trouble with his latch. This is probably because his mouth and facial muscles & nerve systems are still maturing, and also because he has been bottle feeding since he first began eating, and he has a learned to thrust his tongue forward in a way that makes his latch too shallow for nursing. Doulas Veronica and Ryka will be coaching us this week to correct this problem. Our goal is to be off the pump & bottle by the new year.

Christmas Elves
On Tuesday, some family came over to deliver a home-cooked meal and some holiday cheer. Aunt Jane, and Cousins Janice and Amanda put up our Christmas tree and got the chance to meet Samson in person for the first time. Thanks, Waltons!














And last weekend, we had visits from Uncle Kevin, Aunt Kelly, and Cousin Lauren.














Aunt Kelly first offered to stay over and take a 3 hour night shift so Mama and Daddy could get some sleep, but after experiencing a few hours of Hammer Time, she bailed and drove back to San Antonio in the middle of the night. Wuss!

Eight Pounds

Our boy is an eating machine. He gained 9 ounces in 4 days and is consuming enough formula for a baby that weighs 3 pounds more than he does. We are working hard to convince him that he isn't hungry after eating a reasonable meal for a person his size. Oink-oink!

As the volume of his feeds comes down to a reasonable level (and the CMA problem is resolved), much of his colic symptoms (reflux and gas pains) should dissipate, meaning less discomfort for Samson and more nighttime sleep for Mama & Daddy.

Tonight, we're on our own again after having had three blissful nights with a doula, Ryka, over to take care of Samson while we got some sleep. For the past three nights, Daddy got 6 straight hours while Mama still had to get up to pump milk, so hers was broken into two blocks of three hours.

Now that we're rejuvenated, we hope we can better manage the nightly ritual we call "Hammer Time." This starts after Samson's 9pm feed, when he begins to get more and more irritated, gassy, and inconsolable, and it lasts until about 4am, with brief 15-30 minute stretches when he sleeps. Daddy and Mama take 3 hour turns comforting the wailing baby, patting and bouncing, walking and talking, singing and humming, swaddling and holding, feeding and burping, wiping and changing. When the sun finally comes up, Samson is exhausted and finally quiets down to sleep, while Mama and Daddy collapse to steal a hour or so nap between feeds & pumping, and the daily cycle begins again. Here we go...

Set him free already...

The doctors had been telling us that at some point, it would be like a light bulb turned on in Samson's brain and suddenly he'd be an expert suckler, ravenous for nipples and able to keep going long enough to get a full meal at each try. Well, it looks like that day may be here, and it means that we're getting very close to putting him in that fancy carseat and bringing him home to the Hobbit Hole. Here are Sammy's latest stats:

Age: 5 wks, 3 days
Adjusted: -18 days
Gestational: 37 wks, 3 days
Weight: 5 lbs, 12.5 oz
Feeding: All nipple, every 3 hrs; 58 cc by bottle; ?? by breast; gavage at nurse's discretion, depending on volume consumed by nipple

Now we can go in at any of his feeding times and attempt to nurse. This is a huge relief, since it makes our schedule much more flexible and we can try to avoid the horrible gridlock during rush hours. Plus, Mama gets to spend more time holding Samson "skin-to-skin," which helps with increasing the hormones that raise milk production levels.

But enough with the details. We know you're only visiting to see the latest pics. Here you go:

Ahhh... relaxing after a long lunch














Interesting. This time, she's wearing the color of my diaper contents.













Okay, enough admiring me. Off with the shirt, woman, and give me my breakfast!

Quick Status Report - Day 25

Weight: 4 lbs, 11 oz
Feeding: 44 cc every 3 hours, 3 breastfeeding sessions and 1 bottle feed; additional nipple feeds added as tolerated
Meds: None! Stopped caffeine on Monday.
Bed: Open bassinet

Did I mention that Samson moved to the Continuing Care Nursery (aka Level II) section of the NICU on Saturday night? This place is SO much more comfortable than the Level III section, as the babies are more stable and the noise & activity level is much lower. There are about 10 babies there and 3-5 babies per nurse. Our stress level (and surely Sammy's) has fallen a few notches with this move. Now it's all about sleeping, eating, & growing. No more needle sticks, no more terrible treatments. It won't be long now....

Quick Status Report - Day 18

Weight: 4 lbs, 6 oz
IV: no fluids, only a lock to load the twice daily antibiotics until 10/21
Breathing: Nasal cannula is gone! No A/B episodes today.
Meds: Caffeine, Vancomycin
Labs: Stool still negative for blood
Routine Cranial Ultrasound: no evidence of bleeding
Feeding: 38cc every 3 hours, 2 nursing sessions/day, 1 bottle/day (the rest by gavage); if continuing to tolerate well, up feeds by 5 cc every 4th feed
Other notables: Umbilical stump fell off today! Excellent nursing sessions at 10:30am and pm with the aid of the nipple shield (which makes the nipple more noticable in the mouth, encouraging the baby to suckle more effectively).

Tonight's nurse was Dina, someone we met in the first few days when Samson first moved to Bay 1. She, too, had a 32-weeker by emergency c-section after developing HELLP syndrome. Her story gives us much hope, as her daughter is now 8 years old and about to achieve a black belt in karate.

Our first homespun gift, a blanket knitted by Aunt Zaney:

Quick Status Report - Day 16

Weight: 4 lbs, 4 oz
IV: only sugar water now
Nasal cannula: room air; no apnea since 10/12
Meds: Caffeine, Vancomycin
Labs: Stool still negative for blood; blood sugar = 76
Feeding: 32cc every 3 hours, 2 nursing sessions/day, 1 bottle/day (the rest by gavage); if continuing to tolerate well, up feeds by 5 cc every 4th feed
Bed: Isolette

Nurse Sarah reported that mighty Samsonite tried to launch off the end of his platform in the isolette again. Strong baby!

Today is the baby shower that was supposed to occur 8 weeks before Samson's arrival. Lots of family & special friends in town for the big event. Can't wait to see everyone and celebrate that our baby's here (even if not the way we expected). Thanks, y'all!

Here's a pic from Papaw Walton's first visit last night:
He says those slender fingers are made for guitar pickin'.