Hello California!

Knott's Berry Farm

This is the longest I have gone without updating the blog...so this one is a big one! Josh and I left for California on the 15th and we arrived here on the 17th. We have been here almost a week and have already taken Joshua several places. The San Diego zoo, the beach, Knott's Berry farm, the park, you name it and we've done it. We are very much enjoying the shift in weather from the humid 100's to the cool breezy 70's.

Welcome to the zoo!

Before we left, Joshua had two appointments. The first appointment was with the cranial technicians to check the progress of his flat spot. They were pleased with the rounding out of his right side, and said it will take a little more time for the back of his head to round out as well. No helmet will be necessary for this little guy.

Joshua's second appointment was with the Gastroenterologist. Last month, Joshua had his procedure done and they concluded the reason for his reflux was that the milk was sitting too long in his stomach before being absorbed. To fix this, they started him on medicine that would help his stomach empty faster, and it has been working great. He gets a small amount of medicine 4 times a day, 1 hour before eating, and it has worked miracles. He very rarely has reflux anymore, and the doctors were so pleased to hear this. He will stay on this medicine for the next three months until his next visit in September. They hope by this time, we can stop the medication for good.

Now for some exciting updates! As of June 14th, Joshua weighed in at exactly 16 pounds. Although he is still below the 25th percentile, he is looking happy and healthy. In addition to milk, he is enjoying carrots, pears, sweet potatoes, and bananas...with pears being his favorite right now. He definitely likes the sweet stuff.  Now that I have the summer off, I have been experimenting in the kitchen pureeing lots of fruits and vegetables for him to try! This month, his favorite play time is in his activity jumper. When he hears music, he goes to town with those little feet! He loves looking in the mirror and staring at his hands and feet. He is so close to sitting up by himself, but still needs some more practice before crawling.

Now that we are here in California, we are looking forward to family and friends finally meeting Joshua this weekend! What a long awaited celebration of this little miracle....we are so thankful for an amazing God.

Four Generations!

Joshua trying to get the map from Grandpa

Grandma's partner in crime

Uncle Chris showing him the animals

Enjoying the water...

Joshua surprised us all and built a sandcastle! 

enjoying the ocean breeze

boo

Time for a bath!

love those feet...

Baptism, Swim, and Sweet potatos for a Sweeet baby

 Joshua is 27 weeks today..almost 7 months (5 months gestational). As of yesterday he weighed 14 pounds and 13 ounces and is 24.7 inches long. He is laughing, giggling, smiling, grasping hands, feet , toys and anything he can get in his mouth. He grabs thing with his feet like a monkey and he loves music, bath time, standing up, and napping with his binky. He is really starting to get some brown hair and his eyes are bright blue.

Does this look like the face of a hungry baby? Tonight was Joshua's first experience with sweet potatoes and he loved them! He is starting to be so expressive and show his personality, we love it! Bananas and sweet potatoes are the only thing on the menu for now....apples were too tart for this little guy.

 On memorial day we had our first swim! Joshua was very curious at first, and enjoyed it for the first 15 minutes. Then he realized his diaper was all wet, and this boy does not like to be in a wet diaper. He relaxed in the shade while the rest of the family enjoyed the pool!

Some very exciting news...this past Sunday Joshua was baptized at the church where Josh and I wed. The same reverend that married us, also baptized Joshua. Joshua wore an outfit that was made by a family friend, thank you Rosemary! Family and friends were there to witness the special event, and what a blessed day it was. God is great!

As far as health, Joshua is doing fantastic. He has been on medication that helps to empty his stomach quicker, and we have seen an improvement with his reflux. He doesn't seem to have as much reflux and when he does have it, it doesn't seem to burn his throat as much. We have another appointment in June to check this progress with the gastroenterologist. Next week, we have a second evaluation for Joshua's flat spot. We have seen a dramatic difference with the physical therapy and tummy time. His last measurement was taken about 3 months ago, so we just want to be sure the measurements confirm what we see. All is great in the Altman home, thank you for keeping Joshua in your prayers.

Only 2 more days of school....cannot wait!!  Mommy and Joshua are going to have so much fun over the summer.  Much love from Team Altman!

Test Results!

Today we got Joshua's test results from the doctor. The doctor said that Joshua's stomach is not emptying food fast enough and therefore the milk is sitting in his stomach too long in between feeds. Because the milk is sitting in his stomach and is acidic, it is coming back up into his esophagus later as acid reflux. Fortunately there is a medication to help with this. I am not sure how it works exactly, but essentially it helps his stomach empty the food faster. This was one of the "easier fixes" the doctor had mentioned before this procedure, so I was pleased to hear that was one of the reasons and its just finally nice to have an answer.

The biopsy also showed that his esophogus had mild inflammation, which is why the doctor wants us to not only continue but increase his prevacid medication so the acidic stomach contents is buffered and it wont burn his esophagus. I cannot wait to get this medication and start it so Joshua can start feeling better and won't have to have reflux every day. Those of you who have had reflux can imagine how awful that would be! The pharmacy actually called us tonight and told us that they are unable to fill the prescription because it has to be made from a powder in a laboratory, so hopefully a local pharmacy can get it for us. We will know tomorrow morning.

In addition to his procedure this week, Joshua also had his 6 month check up this Thursday. He weighed in at 14 lbs and was just about 24 inches long! Using his adjusted age, which is 4 months, he is in about the 20th percentile for both weight and height. Using his actual age of 6 months, he is still in the 3rd percentile. He is still on the lower end of the charts...well actually he is actually barely on the charts, but he is making great progress because that growth line is almost vertical on the charts!

Joshua is still on full bottle feeds, but he is eating about 1/16 of a banana every day. That sounds like nothing, but he goes crazy for that banana. As for apples, they are still a little tart for his liking and his facial expressions were priceless. Too bad I didn't have the video camera going. I will have the video camera going next sunday, because on the 29th Joshua is being baptized! We are so blessed to celebrate Joshua's presence in our lives and in the church. We are looking forward to seeing family and friends for this special event.

The many faces of a baby....

Playful

Interested

Silly

Shy

Full of giggles

Content

Amused

Out for dinner at Rainforest Cafe...he loved the aquariums

Sweet chubby cheeks

 Joshua's daily routine...grab it, put it in my mouth, lose it, start again!

Grab it

Put it in my mouth

Lost it

Here are some recent pictures of Joshua! The countdown begins for summer... 11 days of school! Much love and thanks from Team Altman.

Glad to be back home!

We called Joshua a kitty because his tape looked like whiskers..he thought it was funny

Joshua did great at the hospital yesterday. His procedure started about 7:30 and he was waking up from the Anesthesia around 8:30. It took him a little longer than normal to wake up from the Anesthesia. The nurses said he was pausing his breathing causing bradycardias, but he eventually got past that and they let us go back to see him. I guess he was reminiscing about all the attention he used to get in the NICU when he would have bradys...he is very good at  getting attention!

Joshua was pretty groggy for a while and fell asleep in our arms for quite a while afterwards. They placed the pH tube in through his nose and down into his stomach which is why you see all the tape on his face. This was left in all night and they finally took it out the next morning. He was not a fan of it at all. They put his arms in those little slings so he wouldn't tug on it and pull it out. We should have the results from this pH monitor in a week.

The doctor said everything was normal from the scope. He showed us all the pictures he took as he navigated down his esophogus and through his digestive tract. He also took some small biopsies of the tissues in several areas to determine if there are any problems. We should have these results in a couple weeks. In the meantime, we will continue with his medication. Thank you for all the prayers!

Packing for the Hospital...

Tomorrow morning is Joshua's procedure at the hospital. The actual name for the procedure is....ready......Esophagogastroduodenoscopy. It looks like a bunch of letter thrown together but its actually pretty simple, here is the breakdown:

esophago = esophagus = food tube
gastro = stomach
duodeno = duodenum = small intestine
oscopy = to look with a scope

The EGD, as doctors call it, helps to find ulcers, bleeding, infections, and many abnormalities in the esophagus and stomach. Hopefully they will be able to determine the cause of Joshua's constant reflux. The EGD uses general anesthesia, and because of Joshua's age and history with prematurity, he will have to stay overnight at the hospital after the procedure for observations. Therefore, I am packing some much needed things and probably some unnecessary things, but I really don't know what to expect.

Joshua's last meal will be at 12 midnight tonight, because he has to fast before the procedure. Normally he goes to bed around 9pm, but tonight we are staying up a little later so that tummy will be full for a few extra hours.  We have to be at the hospital by 6:30 and his procedure will start promptly at 7:30am. Please keep Team Altman in your thoughts and prayers. Much love from us <3

Happy 6 Month Birthday Joshua!

Peek-a-boo

I am 6 months old!!

Im silly

I use my feet like hands

Its my party and ill stick out my tongue if I want to

Joshua is 6 months old today! Its hard to believe he has been here for 6 months, and been home now for 4 months. Yesterday was such a wonderful Mother's Day. I am so thankful to be a mother to my little 2 pound miracle! Enjoy the birthday pictures!

Joshua's First Procedure...

Today we had an appointment with a gastroenterologist. Joshua has had moderate reflux since he was in the NICU and it has continued since he has been home. He has been on medication to help with this for almost 5 months now and unfortunately we haven't seen a huge improvement. After talking with the doctor she told us what we needed to do in order to get some real answers as to what is causing this. On May 16th, Joshua will undergo a procedure in which they send a small camera down his esophageal tube and into his stomach. They will take multiple pictures along the way, focusing on the sphincter that holds the stomach contents back from leaking into the esophogus. Unfortunately the procedure requires that he is sedated, so this will be his first time to have anesthesia. The actual procedure only takes about 30 minutes, but mommy can't go in the room during the procedure, so I'm most worried about leaving him. After taking him home from the NICU, I guess you could say I have had a bit of separation anxiety...can you blame me?  The doctor should know of any major problems right away as he is navigating down his digestive tract, and he will talk with us after the procedure to let us know if any further procedures or surgery is necessary to correct the problem.

In addition to this, they will insert a tube through his nose down into his stomach, similar to what he had in the NICU. The other side of the tube has a machine attached, and it will read the pH of his stomach at certain times of the day. When he has reflux, we will push a button on the machine, and it will make sure to record all his physiological changes at this time. He will wear this for 24 hours, then we will simply pull out the tube from his nose, and take the machine back to the hospital where they will process the data into meaningful information.

There are many different causes to reflux, some are easily treated with medication and usually things they grow out of, but some can be major and require surgery.We ask that you continue to pray for Joshua, for his quick recovery after the procedure and pray that surgery is unnecessary at this time. Your uplifting prayers make all the difference in times like these, and we appreciate all the love and support. We will keep everyone updated. Much love from Team Altman.