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Vonda's Parenting a Preemie Journal

Entry #12 - September 2003
~ Adriana is a big girl!

Where has all the time gone? So much has happened in our household over the last few months, I do not know where to begin. I guess I need to start with the biggest news first. We are pregnant again and due the first week in November. We found out in March, and to be honest, I cried when I first saw the positive test even though we had been trying for a few months. I was so scared at first (still am at times) because of all we have been through with the miscarriage and Adriana's prematurity. I really did not want another baby to have to go through what she did, but I guess the old saying, "Fools rush in where wise men fear to tread" fits our case. So, now we are anticipating a new little girl on October 21 when I will have a repeat caesarean section.

Now, for the updates on little Miss Adriana. She has changed so much in the last few months, I cannot even think of where to begin. Her world has changed a lot this year, but she has taken it all in stride. One of the biggest changes for her has been for her "Nanny" (Bruce's mom) to start keeping her a couple of days a week so I could return to work. Bruce and I talked about my going back to work to bring in a little more income, while at the same time giving his mom something to do so she would not grieve herself to death after the death of his father. I think it has been good for Adriana, too, because she has become used to someone else caring for her. Since her doctor told us that for almost her first year she was not to be in childcare or be out and about, she has become very used to one of us caring for her. I was apprehensive the first day, but she has taken to it all like a real trooper.

Adriana's hematologist released her at her last appointment. He said he did not think she had the condition he was looking for in her blood, and we do not have to take her back unless she has a problem. Yeah! No more needle sticks (or at least from that office). She also returned to her ophthalmologist for her yearly appointment. She was not very cooperative, but the doctor was able to get better readings than he did last time. This is the same doctor who saw her in the NICU and checked her for retinopathy of prematurity. She had a touch of it that corrected itself, but she still has to go to this doctor. He said she is farsighted like most children this age, but she has more farsightedness than normal. She may have to have glasses before she starts school. If this is the worst thing she has to endure from being premature, then we are very blessed.

Adriana had her two-year appointment this summer and did very well. She does not fuss near as much as she used to when she went to the doctor. I think she actually likes her doctor now. I was kind of concerned that the doctor would give us a big lecture about the fact that she was still taking a bottle, but she did not make a big deal out of it. She did give us some tips on breaking her from the bottle, and we are still working on it. The best part of the whole visit was Adriana did not have to get any shots and she does not have to go back for another year.

Another big transition we made in our household was moving Adriana's therapies from a medical facility to our home. I really did not want to do this, but both of her therapists left the facility where I was taking her, and our state has changed the early intervention program. Our state is now requiring that the therapies be given in the "natural environment" if therapists are available in the area in order for the program to pay for them. If the family has insurance, the program pays for the part of the therapies that the insurance does not. Our insurance company does not pay for in-home therapies unless the child is housebound medically. I disagree with our state's ruling, because I feel the decision should be left up to the parents to decide. I enjoyed taking Adriana to the facility because she was getting the opportunity to interact with others that she does not normally get. If the state had seen how she was when we first started taking her, I think those in charge would have to agree. I also feel like some of the funding is being wasted paying for her to have her therapies at home when our insurance company can pay for them at a medical facility. When her therapists left, Adriana's early interventionist, who is also her service coordinator, Bruce and I discussed what we should do. We decided to try the in-home therapies because of the change in the funding and my pregnancy. When Adriana was going to therapies at the facility, I was driving 30 minutes one way, and while that may not seem like a lot, it is when you are having to juggle a toddler who is not quite toddling and a big stomach.

So, Adriana started therapy at home and I really think it has made a big difference. She now gets physical therapy once a week for an hour at a time, and she was getting occupational therapy once a week. Before, her sessions were 30 minutes a week with both therapists. I felt good when her occupational therapist screened her and said that she would not have qualified for OT alone. She stayed with us through the summer, but she decided to give this area up. (We have a difficult time keeping therapists in our rural area.) She and I discussed whether Adriana needed to continue with OT, and we both decided she did not.

During this time, Adriana has been evaluated for speech, and she scored well enough that she does not need it at this time. I was getting worried about her speech because I would read on the message boards about how other babies her age were saying so much, but most of her talking consisted of only one word at a time. Her PT had told me her receptive language was very good, and she thought she would score high on that part. The evaluation is broken down into three parts: receptive, expressive and another area that I cannot remember. She scored around 83 percent in all areas, which means she does not qualify for speech therapy at this time. I think she would have done even more, but as toddlers often do, she did not fully cooperate. She will be reevaluated in a few months. Since then, she has added more and more words and is starting to make some word combinations, so I feel much better about her speech.

Adriana's PT is a little more stern than what she was used to, but I think that has been good for her. At first, I was a little apprehensive because she seemed a little tougher on her than I thought she should be, but I had been told by so many people how good this therapist is. I have now come to appreciate her and Adriana looks forward to her visits. Her therapist recommended a binder for her to wear that looks kind of like a girdle and inserts for her shoes. The binder is to help her with holding her ribs up because premature babies tend to have a sunken stomach and the inserts are to help with her turning her feet in. The inserts have helped, but the binder is missing because I think someone about two and half feet tall has hidden it. The PT has definitely been good for her, because she is now walking! I cannot believe I just said that. She started walking on August 1, almost one month after her second birthday and the day after a high-risk pregnancy doctor told me I may have to go on bed rest (what a sense of humor God has!). I was starting to think we would never see her walk, but she did. She took some steps that day, and did not take any more for a couple of weeks. She started walking again one night at church and has not let up. Her therapist has also taught her how to climb, which is not my favorite thing for her to do, but it is supposed to be good for her.

As the time for the new baby gets closer, I get anxious wondering how Adriana will react to her. Adriana has been given so much extra attention, which she has needed, that I wonder how she will react when someone else is getting a little more attention than she is. I also wonder how we are going to do with parenting a full-term baby without the apnea monitor, medicine three times a day and trips to the emergency room in the middle of the night. I jokingly asked Bruce if he thought we needed to take a parenting the newborn class so we will know what to do. I know we can do it with a lot of prayer and patience.

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