Just another medical procedure...

Snuggles with Mom.

Zoë went in for her swallow study yesterday in the radiology department at Valley Medical Center.  Just in case you don't remember (I referenced it way back here), the feeding specialist was concerned that she might be aspirating part of her feeds (meaning part of it was going into her airway instead of straight to her esophagus) and wanted to rule it out, because it can be really uncomfortable and, more frightening, unsafe if that were to be the case.

Sleeping on Dad.

We arrived at the hospital and decided we should visit the NICU, since we were nearly next door.  It was the best feeling to have the nurses come running when they saw us standing at the entranceway.  Zoë received a lot of hugs and snuggles and "oh she's getting so big!"s.  I felt like we were visiting family we hadn't seen in over two months, they were fantastic.  They told me what a fabulous job I'm doing and said they missed us.  Wow, when I'm having a bad day I'm just going to go back there for a little pick-me-up.





When it was time for our radiology appointment, we went and met with Amy, the therapist we met with while Zoë was in the hospital, and found out she was going to do the study for us.  We went back to a room and plopped Zoë into an upright chair (after Amy got her own snuggles in) and all of us donned the really fashionable lead aprons (except for Zoë...hmmm, don't you think they could have a really small one to drape over her body?  I guess not.).  The first thing we fed her was a thin mixture of Barium (barium is what shows up on the x-ray!) and they took x-ray video of Zoë eating.  Amy could see immediately that she was partially aspirating the barium, so the next step was to try a more viscous barium mixture (after a palate cleanser of regular formula).  This time, Zoë didn't aspirate anything at all.  The difference was amazing.

After the study, Amy went back through the video with me and described everything we were seeing.  First of all, x-ray videos are awesome.  It was REALLY cool to see Zoë eating (AND I could see her reflux, too...cool).  Secondly, I feel like I learned way more medical terms about how we eat and swallow and why Zoë's been having problems. Her diagnosis is pharyngeal phase dysphagia which means that she had "deep penetration into the laryngeal vestibule on thin liquids".  In other words, part of her feed is going into her airway.  Amy said it wasn't REALLY deep (although, deep penetration describes otherwise, in my head), but she suspects that if we kept feeding her the thin liquid it would have gotten worse as Zoë got more fatigued.  Apparently this is a not so out of the ordinary considering her prematurity.  We've got a prescription for an artificial thickener to add to her formula to mimic the thicker Barium test.  I can already tell the difference from three feeds today.

Zoë should grow out of this issue as her jaw and esophagus matures.  The only concern is that maybe she might have a laryngeal cleft (similar to a cleft palate...something didn't fuse completely) and we'll have to determine if that's the case when we go back for another x-ray after a while to monitor her progress.  Amy was pretty certain she's cleft-free, though, so we'll hope that's the case.

In other news, she's now into her 3 month clothes, although they are a little big on her.  She definitely outgrew the newborn ones though.  I do her laundry every 2-3 days and it seemed like from one laundry day to the next she had outgrown them.  And I'm not talking, "Oh, they're a little bit too snug this time" I'm talking "girl, you're going to pop those buttons right off" tight.  I thought I would be excited to put her newborn clothes away and dive into the new wardrobe but I found myself getting a little teary-eyed as I was folding her clothes and putting them away.  :(

Zoë loves her black and white books.

Captive audience for story-time.

We've started to have daily story-time and she seems really engaged when we're reading.  It's fun to have her sit up and look at the pictures (her favorites are still the black and white books).  We're still working on tummy time.  Chris propped her up on the Boppy today which lead to a few minutes of good tummy time, we'll have to see if it lengthens as she gets older.

Tummy Time with Dad

We now have a week and a half break until her next doctor's appointment where she'll get her 4 month vaccinations.  Four months already!  Sheesh!  Shouldn't she be walking by now?  ;)