Thursday, February 2, 2012

Intensive feeding day 32

8:30am - weigh in and measure
My teachers were here with me today!  I SURE MISS SCHOOL!
8:45am-9:30am - Meal 1

I showed off extra special for my teachers this morning.
11:45am-12:30pm - Meal 2

One of my teachers got to sit in on my feeding.  She even cheered me on when I took my bites and drinks!
12:00pm-2:00pm - Nap time

So tired today... wonder why.
2:45pm-3:30pm - Meal 3

My teacher gave me my bites during this meal.  Ms. Emily was still in the room giving me my drinks
3:45pm - head home

It was a one-eyed, one-horned, flyin' purple people eater
One-eyed, one-horned. flyin' purple eater
One-eyed, one-horned. flyin' purple eater
Sure  looks strange to me
I wonder...
Are you serious Bro-Ther?
In the store?
OOOO,Can I play too Sis?
Only if you promise to never embarrass me in the store again.

Bro-Ther, where did you go?
Dang, let the embarrassment begin...
Mom's notes-
School - Gabriel's teacher and paraprofessional came to train today.  His teacher came to observe and his paraprofessional came to train.  She will be Gabriel's feeder at school.  I am worried for them.  They have a class of 13 with just the two of them.  Gabriel's feedings will take his paraprofessional out of the works for at least 20 minutes.  We had feeding therapy write up a couple things.  Gabriel is going to need help feeding for a while so I had them put in writing that his feedings are to be 1:1.  This is huge.  If his teacher and paraprofessional find that things are too difficult, I can use this to get Gabriel an aid for feeding time and due to how it all works, the class would get a extra set of hands for the half day Gabriel is at school.  It is more effective for a parent to push on an issue like this than it is for a teacher so at this point I will leave it up to his teacher and paraprofessional if they need the extra hands so that Gabriel's feedings continue to run according to what they have learned.

Swallow study - Oh Gabriel, I knew things were running too easy.  Gabriel, you are always so stinking good at doing 'odd' things.  Our therapist has watched Gabriel's swallow study time and time again. She has called in others to watch it as well.  Gabriel has several things going on that with out the swallow study we would never know. 
He is refluxing a lot of food into his sinus's, more than originally thought.  Why isn't his snot always different colors then?  Well it more than likely is flowing back down his throat after visiting his sinus's and only occasionally is coming out to visit in the form of snot. I have to say carrot snot is quite shocking but it is the white chicken and mashed potato snot that turns my stomach the most.  What will we do to fix this.  We will be calling Gabriel's ENT to figure out what he suggests.  According to the swallow study the little flappy thing (yup, Erin's made up medical terms) that keeps food from going up Gabriel's nose is in a unusually low place.  Nothing really that can be done about that, it is just an observation.
Gabriel aspirated on a lot more of the drinks that were presented.  He did not aspirate a lot which is why it was difficult to see originally on some of the drinks until the drinks were at their thinnest.  To help stop this from taking place we are going to thicken Gabriel's drinks more than originally thought.  Eventually he will be able to work his way down to think liquids. 

The shocking - Gabriel is really showing interest in chewing.  The therapist decided to go with it and see what he can work on to strengthen his mouth. We started with putting gold fish and cooked carrots (not together, separate tests)  in mesh bags that let liquid though but no pieces of food.  Gabriel chews the object inside for about 10 total bites.  He did so good with that he went to the mesh with little holes, what comes out is like the texture found in gritty foods without the liquid.  Gabriel rocked that.  Now we are on a larger mesh that puts pieces out that are about the texture of chopped food with out the liquid.  Gabriel is able to manage the pieces.  Instead of choking or pushing the pieces out with his tongue, he manages to move the pieces around until they are at a spot where he can swallow them.    This is a very good sign, we just have to strengthen his jaw and we will be looking at soft solids.  This may come as early as out post intensive feeding therapy six week check up!