The Crunchy and the Smooth

Day 58: Heath in Heath

Greetings from Heath, Montana!  This is the place Heath is named for, a big green valley with a spring creek running through it where Peanut roamed and explored as a kid.  It's pretty glorious this time of year.  Heath has had the time of his life over the past couple weeks here at Grandma and Grandpa's.  Cousins Elle Lee and Luke were up from Billings for the 4th and we all had a wonderful time catching up.  Here are Luke and Heath examining some agricultural reference materials. 

Grandpa loved taking all the kids on the four-wheeler when he wasn't chasing wayward cows back into the field. 

Today I got to see Peanut running down the highway after a big black bull waving a whip and cussing.  Good thing Heath couldn't understand what his dad was yelling.  "Now you know why I never talk about wanting cows!" Peanut said.

This weekend we had a campfire, lit fireworks, and Heath got to eat his first S'more.  Mmmm, warm and ashy!

He has regained most of the weight he lost when he was sick and we can stop the night feeding again when we get settled back in Seattle later this week.  Heath has been eating like a champ here in Montana -- he added oranges, bananas, gingersnaps, pumpkin bread, ham, and chicken wieners to his diet, and those are only the things I can remember!

I had a fantastic yoga retreat last week outside Helena at the Feathered Pipe Ranch.  Wow!!  It was my first time away from Heath and though I missed him like crazy, it was a golden opportunity to study with my teacher JJ, spend time with old and new friends, and clear my head and heart in the mountain air.  Here's the venerable old yoga lodge on the pond.

 

And my wonderful yurt-mate, Kara.

It was indescribable to experience so much natural beauty, peace, contemplative solitude, great yoga, and wise friendship after the past year's adventure of motherhood.  I felt the great richness of all our little family has been through together and honored the struggles we have faced at times.  I celebrated Heath's transformation over the past two months into an eater, a scooter, and a much bigger boy, and how he has drawn from his own deep courage and intelligence to do it all.  I left Feathered Pipe grateful beyond words that it is Heath's beautiful soul that has come to us and none other.  Seeing him again got me all lit up! 

Hope everyone had a safe and happy Fourth.  We are looking forward to the rest of the summer in Seattle and our move to Missoula next year!

Day 47: Merry Go-Round

It's been a whirlwind since last we wrote!  Lots of new developments....

1)  Heath had his first days off the tube entirely!  On Sunday, Monday and Tuesday he was eating and drinking 100% on his own.  That was because...

2) He started to drink milk for the first time!  Over twenty ounces daily.  Unbelievable progress -- he went from tolerating a few drops of milk mixed in water to loving 100% milk over about ten days.  And then....

3) On Tuesday, he got his first fever.  Boo!  102 degrees, not too bad, but he had a cough and didn't want to eat or drink much at all.  His weight dropped back down to 19 lbs 5 oz. -- his all time low -- mostly from dehydration, so we decided to supplement with an overnight feed and fluid again until he regains some weight.  Today he is eating much better so it won't be long, I imagine.

4) Before he got sick, Heath visited a preschool for the first time!  This is a class for little ones that meets twice a week with parents attending, starting in fall.  It was an off-the-charts thrill to see him soooo excited about taking part in all the activities, smiling at the other kids, and bibbing up for snacktime!!  

He's totally focused on the teacher and keeping up with the program.  What a big school boy!

5)  For the first time, Mom is leaving for a whole week.  We are in Missoula now, en route to Helena where my boys will drop me off for a yoga retreat at Feathered Pipe Ranch.  I'm sure Heath will get along just fine in Lewistown at his grandparents, but my heart will be missing him and Peanut. 

6)  We visited a space that may soon become...Montgomery Distillery!  It seems we are just loony enough to take the plunge and open a micro-distillery here in Missoula next year.  We plan to make peated whiskey, gin with delicious botanicals, a nice clean vodka, and some experimental spirits.  The industrial building is walking distance from the main drag and just right for our purposes.  We'll have to punch out some space in the ceiling to accommodate our 21-plate column still, which will look something like this.

The distillery building has room in the back for what I envision will one day become a yoga place serving kids, caregivers, and seniors.  Here's the view from the possible yoga space.  Mr. Landlord says he'll remove the fence and equipment.  Wouldn't that be pretty at night with all the stars?!

Big sky sure feels good.  And Missoula is awfully green at the moment -- last winter the mountains around the town were all snowy.  Here's a view from a downtown park, looking toward Mount Sentinel.

So, we are all excited about new beginnings.  It feels like we've turned a corner and are now able to peer ahead at things to come.  I'm sure Heath will come back from Grandma and Grandpa's fat and happy!

Day 39: Mom vs. The Robot

Weight, weight, weight.  It is a huge preoccupation for parents, as it is for this whole crazy culture, I guess.  Over the past few months, while I tracked points in a Weight Watchers notebook in an effort to shed baby poundage, I also kept a log of Heath's intake, hoping to nudge his weight higher and higher.   I was delighted when I finally fit into my clothes again, but my moods ultimately rose and fell with the digital readout on Heath's robot scale. 

Peanut has more sense than I do.  Whenever Heath loses an ounce or two overnight and I start yammering on about the inexplicability of it all, Peanut declaims, "It doesn't matter!" in the same tone one might yell, "Snap out of it!" in the face of a raving cult member.  And he's 100% right. 

Before the wean, we rented a fancy digital baby scale which sits on the floor in the dining room.  Heath used to be weighed every few weeks, but since we started cutting calories May 9, he's been weighed daily.  The number on the scale was objectively useful as we monitored his dehydration and he approached 10% weight loss, beyond which most kids don't do well.  It was lovely to see his weight start going up rapidly in the first week after he began eating.  And lots of fun every time he gained.  But then he lost a bit.  Then he gained it back and a bit more.   Then his weight wavered and now here we are, more or less where we were ten days ago.  All that time at the scale, undressing and dressing him, hoisting him up and trying to coax him to stay still, squinting and hoping and willing the numbers to go up, up, up.  And for what?  Just to find out what we already know.  He is eating well and maintaining his weight.  But he weighs a lot less than he used to when he was tube fed.

Yesterday at the pediatrician's office, Heath was 4 ounces heavier than he was at his last visit two weeks before.  Great news, everyone is happy, we don't need to come back until he gets more shots in six weeks.  There was no mention of the fact that his growth curve looks like a diagram of someone jumping off a cliff.  So, if the pediatrician is relaxed, why I am so preoccupied?

Markus taught me that there is a concept in psychology called the Motherhood Constellation.  It has to do with what it means to become a mother.  One of the most important inner questions that new mothers must answer is:  Can I help my baby live and grow?  This question gets very mixed up for moms of children who don't eat, fail to thrive, or must be tube fed. 

"Yeah, I can help him, but I'm going to need a surgeon, a gastrostomy button, lots of equipment and a blender." 

Or, "Yeah, I can help him, but I'm going to have to stuff him to the point of discomfort for the growth chart to look pretty."

Or, "Maybe not.  I've done all I know how to do and he's still not gaining."

Gulp.  That last one feels pretty scary:  "Maybe I'm not meeting the most important requirement of motherhood.  Sh!#. Where's the dark chocolate?"

Meanwhile, the kid is probably fine.  If he or she is happy, active, playing, learning, progressing and discovering, i.e. thriving, all is well.  If he is getting taller and his head is growing, why worry?  Kids come in all shapes and sizes, just like grown ups.  Growth charts are compiled from data on healthy kids, not sick ones, so even Little Mr. 1% was perfectly OK.  But somehow, irrationally, we want every kid to be at the 50th percentile or above.  I suck at math, but even I know that's impossible.

Here's a picture of Heath last summer with cousins Elle Lee and Luke.

SUPER CHUNK.  In retrospect, he looks like a human bowling ball.  I have vivid memories of him vomiting multiple times a day during that period.  I think he threw up not long after this photo was taken.  He was at exactly 50% on the weight curve and getting every last calorie recommended to us by the dietician.

Here's Heath at his pitiful skinniest, shortly before he had his breakthrough and became an eater.

Poor kid.  He was only 19 lbs 5 oz. and had lost 12% of his body weight.

Here he is now!  Back in business and feeling super at 20 lbs 5 oz.  He is still a pound and a half below his pre-wean weight of 21 lbs. 14 oz.  Will he get back there quickly?  Should he?

In the past couple weeks, at the lowly 3rd percentile for weight, Heath has made some of the most incredible developmental strides of his life.  He became an eater, with no previous qualifications for the job.  He became mobile, scooting at first just a couple feet and now from room to room.  He started pulling up on his toybox to reach in and demanding to be spotted as he "walked" up the stairs.  He started vocalizing more, even talking in a high-pitched "pretend" voice as we acted out meet-and-greet scenarios with Lego people.  Clearly, his skinniness is not holding him back from loving life and doing increasingly awesome stuff.

And yet.  I find myself fervently hoping that the number on the scale will go up tomorrow.  Will it be 20 lbs. 6 oz?  Or a disappointing 20 lbs. 4 oz?  If I sneak some more egg into his cereal, will it hit 20 lbs. 7 oz.?  Oh, please don't let it be a devastating 20 lbs. 2 oz.  

Observing this idiotic inner dialogue, I can see how meaningless it is.  A)  He is fine.  B)  My son is not going to weigh 20 lbs. for the rest of his life.  C)  No one on his medical team is concerned.  D)  What he weighs is, for the first time, totally out of my control.  I can show up with good meals, but he is the one who decides whether to eat them and how much.  E)  He's eating a lot!  

I'm glad we won't be back at the clinic for an official weigh-in for six long weeks.  It's silly, but I can breathe easier when Heath's weight is just between me, Peanut, and the robot scale.  We understand that it can take weeks or months for a kid to regain lost weight after tube weaning.  We know he might just be a skinnier guy from now on, like his Grandpa Ed whom he takes after.  We know that considering the flux his mind and body have been in, Heath is doing fine.  He's doing great.  He's doing miraculous.   It might just be time to send that robot scale back where it came from.

Day 36: New Perspectives

Wow!  More big changes this week!  Heath doubled his daily water intake from an average of 145 to 300 mls.  He is also accepting more and more milk in his water, which used to offend him greatly.  We've reduced the amount of water he is getting via tube at night from 200 to 100 mls.  And he has maintained a stable weight all week!  I was hoping he would gain some after last week's big jump, but we have dropped his tube supply and he is teething.  He tried hot dogs, pierogis, ultra-crispy bacon, potato salad, and pretty much anything that we were eating.  He accepted eggs and pumpkin empanadas as A-list foods, which gives him more protein and veg in his diet.  Yaay!!    

Heath is working hard on lots of things besides eating.  He is becoming quite the happy talker and loves having little conversations like this one...

His incredible focus on becoming more dextrous is paying off.  I don't think I would be half as patient as he is, trying over and over to reach an elusive goal.  Here he is with Gay working on a puzzle.  And.....got it!!

Heath continues to be a joyful and adventurous yogi.  Like all little ones, he loves experimenting with new things his body can do and delights in the surprise of different perspectives.  Here he is in an inverted pose, pushing with his hands as he extends his spine into a lovely arch.

Inversions are any poses in which we place our hearts above our heads and they are perhaps the most important in yoga.  Turning upside down increases venous blood flow return to the heart, raises the ratio of air to blood in the lower lungs, and seems to reduce blood pressure and heart rate as mechanisms in the carotid arteries prevent the brain from being flooded with too much blood.  One study shows that headstand makes blood vessels in the brain more efficient at dilating and constricting to efficiently shunt blood to active areas.  The spine decompresses, fluids drain from lower body tissues, and internal organs receive additional breathing space.  It feels good!

We also conquer a little bit of fear when we go upside down.  I think Heath loves yoga because he feels exhilarated doing something courageous, interesting and unexpected.   Good job, fella!  

Grandma and Grandpa Montgomery's book club in Montana raised a toast (or three) to Heath's eating success tonight.  Thanks to Mary, Floss, Marilyn, Eldon and the gang for your all your kind thoughts and prayers!  He can't wait to visit soon and eat his way through town.  :-)

Day 31: A Month of Yumdays

That's broccoli cheddar soup, hard boiled egg, potato salad, french fries and a bit of dover sole in Heath's bowl.  He will taste darn near anything, though there is a special spot in his heart for his beloved sesame cereal.  His unbounded enthusiasm for food is hilarious to watch as he can barely contain himself.  He hops up and down in his highchair, hoots and wiggles and gets all worked up in anticipation of tasting something good.

As of last Sunday, Heath had gained 5 ounces (142 grams) in a week.  He's now up to 20 lbs 5 ounces (9.2 kilos), a full pound up from his lowest weight during the wean!  He is scooting faster and faster around the living room, pursuing his projects, carrying out his plans and causing all kinds of things to be stacked up and toppled down in his little boy world.  His furry animal friends continue to receive passionate hugs and kisses.

It's been one month since the wean began and life is returning to normal.  Come to think of it, we've never really had "normal" so it's more of an arrival than a return.  I'm having a great time unpacking my bags in this amazing place and so is Heath.  Previously unimaginable things happen every day.  Here's Heath reveling in a mountain of warm chocolate chip cookies, which cheered him up considerably after an afternoon of hardcore teething. 

Almost as good as Motrin!  He probably ate four or five whole cookies.  Good boy!!  We are continuing our laissez faire nutritional policy until he gains back more of his weight, indulging his desire for buttery, creamy, nutty, chocolaty, ooey gooey foods and fresh baked goods.  I'm happy that he got cozy with both avocado and pumpkin empanadas this week, but we don't expect veggies to grab his attention until he's got a little more meat on his bones.  It has taken him so long to come to the point of enjoying food -- it feels too early to do more than just celebrate it.  He's already gotten sick of some of his early junk food favorites, so I'm confident his tastes will evolve along with his needs.

Heath is drinking more than ever, around 150-200 mls daily of water (5-7 ounces) from his huge array of colorful cups (Two sips from this one!  Now that one!  No, that one!).  We supplement his oral intake with 225 mls of water via tube as well as 200 mls of milk, overnight.  When he hits 9.5 kilos we can drop the supplemental calories and he'll be eating all on his own!  He's getting dairy products mixed into his cereals and peanut paste, but perhaps he'll start drinking some milk eventually.  He had a bit of strawberry smoothie today and seems to be thinking it over.  We'll try again tomorrow.

Heath's therapist Gay showed us a neat trick!  I was using the spoon to deposit food behind his upper teeth and then raking it forward.  She suggested that I press the spoon down on Heath's tongue instead.  For some mysterious reason, this made him bring his upper lip down and clean off the spoon very neatly.  Now we have much less mess and it probably feels more natural to Heath.  Thanks, Gay!

Baby picnics are popping up around town!  We were happy to meet a new friend at picnic this week, Zoe from Bainbridge Island.  She is a warm, bright ray of sunshine and a very courageous girl.  She may be getting ready to wean soon and we are wishing her lots of luck!

Day 26: Scoot Scoot Scoot!

We have a scooter on the premises!  At long last, Heath is on the move.

He was in the middle of working on this last month when we interrupted his programming with the wean.  It's so wonderful for him that he has finally reached his goal -- I think he'll soon be all over the place!  

Scooting is great, but I am still celebrating being the mom of an eater!  For over a year, I looked on with skeptical amazement as other babies breast fed, bottle fed, and ate all kinds of things at playgrounds and other public places.  A part of me couldn't believe they were really doing it, since my child was perfect and, well, he didn't eat.  But deep down I yearned to feed him and had fantastic visions of what that would be like. 

Fast forward: Our grocery bill is shockingly obscene because I'm at QFC or Whole Foods every single day, relishing my dream come true and looking for tidbits Heath will enjoy!  He loves going too, since he has finally figured out what the grocery store is.  I feel just like an ordinary mom, pushing Junior down the aisles, casually tossing fishsticks and Annie's mac 'n' cheese in my cart like it's no big thing.  I even bought him Pepperidge Farm Goldfish, which he reached for, and which I've noted are a playground favorite.  My ordinary boy loves them!  I break them in half for him and he mooshes them up against the roof of his mouth.  Plus they are like little toys -- he works intently on putting them in and out of a bowl.  

It's so delightful getting to know a whole new side of Heath.  I always wondered what he would like to eat, and now we are both finding out together.  Here are some foods he eats, grouped according to favoriteness:

"Keep It Coming!!"

• Greenmax Black Sesame Cereal made with 1/2 and 1/2
• Greenmax Black Bean and Rice Cereal made with 1/2 and 1/2
• Torto Peanut Paste
• Nutella
• Peanut Butter and Co.'s "Dark Chocolate Dreams" (PB with chocolate)
• Graham crackers
• Goldfish crackers
• Baby oatmeal 
• Chocolate milk
• Pancakes with butter and maple syrup
• Avocado & salami sandwich (but only off of Mom's plate)

"Yeah, I'll have some"

• Ella's peach and banana puree
• Refried beans, watered down
• Mum Mums
• Pesto sauce
• Cream cheese
• Ice Cream and Sorbet
• Tortillas
• Cheddar cheese
• Fresh baked crescent rolls with butter
• Carrot potato soup
• Biscuits and gravy
• Scrambled egg
• Fishstick or pureed salmon
• Mashed potato
• Townhouse or Ritz crackers
• Greek yogurt
• Mango Tango smoothie, watered down

"I'm Over It"

• Veggie Straws
• Plumtots Fiddlesticks
• Pretzel sticks
• Happy Baby Os

It's kind of a lopsided food pyramid, and I worry a bit about the fruits and veggies he's missing out on now that he used to get through the tube.  But I think Heath's body knows it's trying to put on weight and he's focusing on the richest foods for now.  It will be interesting to see what he does when he feels he's reached his ideal weight.

Heath is drinking more and more!  His fluid intake really dropped off during the most intensive phase of the wean, which was paradoxical since he was super thirsty.  Markus said this happens sometimes when kids are switching their attention to eating.  It's great to see him really chugging water again from his soft spout Nuby cup, his favorite one.  We set up a special, drive-by Drinking Station on the kitchen windowsill and he thinks it's fun to cruise by for a sip now and then. 

Today he drank more than he has in ages!!!  This is great since we can now decrease the electrolyte water we give him via tube by 100 mls.  (BTW, Kai's mom, Maria, found this recipe to make your own Pedialyte.  I feel so resourceful and thrifty...)  Once Heath no longer needs supplementary calories and fluids by tube, we'll wait a little while to remove his button, just to make sure he doesn't need it due to illness.  He is doing so well, I can actually see this on the horizon.  Good job, Baby Bird!

In non-parenting news, I am looking forward to a whole week at a yoga retreat in Montana by myself soon.  It feels so good to have reached the point where this is possible.  It will be hard to leave my guys, but they'll be OK.  Heath and Peanut will stay a couple hours away at Grandma and Grandpa's, where I'm sure they will all have a grand time and Heath will chub up on Grandma's homemade cinnamon rolls and other goodies that are part of his family tradition.  (Look out Heath!  Here comes Grandpa's famous jello salad with olives and mayo!!)  

Have a nice weekend, wherever you are.  It feels like summer is approaching!

Day 24: Nacho Mama

Mexican food?  Check! 

Heath enjoyed refried beans and a nacho last night, topped with guacamole and sour cream.  Our delightful waitress (who didn't mind a bit that Heath was spattering the carpet with nacho schrapnel) explained to us that in Mexico, babies often eat boiled pinto beans mashed with a little oil on a tortilla.  She sent us home with doggie bag and Heath had six more spoonfuls for dinner! 

Today, he visited Dr. McPhillips and had gained 3 ounces since Sunday.  Yes!  He is now up to 9.2 kilos and eating like a miniature truck driver.  He had a 400 calorie lunch (two packets of sesame cereal with half and half), had a nap, then crunched his way through a small mountain of graham crackers while working seriously at the scale.  

Do you think he's calculating his intake?? 

Dr. McPhillips had lots of great suggestions about dealing with Heath's transforming personality, and hints about why he swings from being on top of the world to having his heart broken over having to put on socks.  Some of it is due to the seismic developmental shift that has come with eating, some is teething, and some of it is just run-of-the-mill toddlerism.  She suggested a couple of books to his confused mother and congratulated him on how far he's come.

Heath is talking more these days!  Now he has lengthy, two-way conversations with us about what various animals say, what the pictures in his books show, and what we should do next (although it's not always clear what those funny sounds are meant to stand for).  He says them ever so seriously and emphasizes them with vigorous nods. 

It feels like life has taken a flying long jump toward healthy, regular, and ordinary.  How wonderful to know that Heath can survive and thrive without the tube, right now!  How liberating to go to a restaurant and order something he loves off the menu and watch him enjoy his food along with us!  It does a body good to see such a happy kid.

Day 23: Ladies and Gentlemen, He's Gaining!

We've reached another wonderful milestone.  Rather than just maintaining his weight, Heath is now gaining!

And he did this while his supplemental calories were going down:

What we can deduce from this is the obvious:  He is eating!!  More and more and more. 

I've done a data dump on the nuts and bolts of Heath's wean for the benefit of parents in the Resources section.   My head feels a lot lighter!

We are off to Heath's first Mexican dinner.  His weaning buddy Kai has become a pro at polishing off nachos with refried beans and guacamole.  We are so proud of him!!!

Day 21: Auf Wiedersehen Markus

Boo!  Peanut took Markus to the airport today.

What an amazing journey we shared.  It was hard to say goodbye after so many conversations, beers, laughs, meals, baby picnics, puppet dramas, weigh-ins, doctors' visits, sightseeing trips, and endless Q&A sessions (sorry Markus!) about how he does what he does.  I will always be grateful for this man's crazy, exuberant willingness to get on a plane and jump into our lives, kitchens, and living rooms and to work so incredibly hard to make food fun for our kids.

We have learned so much these past two weeks (it feels like two months, seriously).  About our kids, and what lay under the surface of their tube dependency: what fears, conflicts, and what incredible guts to overcome them.  I learned the magic of backing way off and respecting Heath's wisdom and independence in certain matters, even though he is just a wee sprout. 

One of the biggest lessons for me was about the nature of our undertaking.  We weren't "getting Heath off the tube" or "getting him" to do anything at all.  Neither was it about just believing in Heath or knowing he could do it.  It was about giving him a choice, for the very first time, about eating.  How could he choose if he didn't know what hunger was?  Given the chance, the overwhelming majority of tube-fed kids will elect to take that brave flying leap into the unknown and discover something good.  For a few kids, it will never be a safe choice to eat, and that's OK too.  No one should force anyone else to eat. 

Heath amazed us again today, devouring almost two packets of his favorite sesame cereal at one sitting (145 cals per packet, and even more made with 1/2-and-1/2!).  He had five glorious sit-down meals today and we both loved every minute of it.  His weight is holding steady at 9 kilos (19 lbs 14 oz) despite the fact that he is only getting 200 mls of supplementary milk overnight.  Since he's not losing, this means he is getting lots of calories during the day, and since he eats more and more all the time this means we'll soon see him start to gain back what he's lost (10% of his body weight or about two pounds).    Once he's gaining well, we can see about dropping the night milk.  Markus spoke to Dr. McPhillips on the phone today and they agreed that things are looking good for now.

Heath thinks the digital scale we are renting is actually a far-out supercomputer.  He enjoys his daily weigh-ins now, as long as he gets to push some of the buttons.  Here he is carefully weighing some of his toys.

Markus' lecture at the hospital last night was fantastic.  He was funny, frank, and presented great anecdotes and thought exercises.  There were lots of feeding therapists, parents, and even a pediatric gastroenterologist there.  Huge thanks to Karen Quinn Shea and the OT-Rehab department for being so wonderfully welcoming to an outsider and taking video so others can watch the lecture online.

Markus' main messages were: 

All professionals involved in caring for tube fed kids need to work as a team and know something about each others' disciplines:  Medical specialists, GI, therapists, nutritionists, psychologists, pediatricians,  neonatologists, and all the rest.

Tube fed kids usually don't feel like eating for very good reasons.  Only when true hunger is experienced can the nature of the child's feeding disorder be seen and treated.

We must understand trauma in order to understand oral aversion in kids with rough medical histories.  We should study those histories carefully and imagine what the kids underwent in the oro-facial area.

Medical professionals involved in caring for tube-fed kids should consider having a nasogastric feeding tube placed for a day in order to understand the discomfort and feeling of fullness that comes with being tube fed. 

We must help children encounter food in a way that is good rollicking fun, not pressuring or clinical.  Baby picnics, where children set the rules and initiate their own contact with food, are a good way to do this.

To eat or not to eat is always the child's choice.  

That's the long and short of it!  Next week I will write a bit more about how we managed Heath's weight, hydration, caloric supplementation, psychological challenges, baby picnics, etc. on the Resources page.

Thank you again, Markus, for your empathy, intuition, creativity, endurance, sense of hilarity, and your deep respect for children.

Day 19: Pancake Diving

Day 19 already??  Time has flown!!  We just returned from a much-needed vacation with Markus and my parents and aunts to Seaside, Oregon.  Markus did a lot of surfing and Heath continued to eat more, more, more!  Today's firsts included: polishing off a 200 calorie breakfast of peanut paste with utter gusto, nibbling buttery braided Finn bread for over an hour on the drive home, then demanding second and third helpings of oatmeal with butter, cinnamon and syrup for dinner.  Here he is diving face first into a pancake!

Heath is still getting some nutrition and fluid overnight via tube until he gets closer to gaining his weight back.  Maybe for a couple more weeks?  It doesn't matter, because he is catching on so fast that it's only a matter of time.  We are still so incredibly proud of him!  Rosie and Kai are both doing so well with eating and weight that they are no longer getting any nutrition via tube, only some hydration at night. 

Along with the celebration and joy that has come with Heath's breakthrough, there have been big and small adjustments for all of us.  One interesting aspect of tube weaning is that it often triggers teething -- more food in the mouth inspires previously unneeded choppers to bust out.  Indeed, Heath has at least three molars tormenting him at the moment.  This made for a quite a bit of discomfort over the past couple days, but nothing a little ibuprofen (and Mom's trusty earplugs) couldn't handle.  Heath also has some occasional constipation to contend with (Miralax and suppositories to the rescue) as his gut adapts to new foods and textures for the first time. Our daily routines, which every family relies on for sanity and structure, all fell apart for awhile but are slowly reforming themselves.  It is still a colossal thrill to prepare and present a plate of food to my eager, open-mouthed Baby Bird.

There are deeper, more mysterious developmental shifts taking place too.  Heath as an eater is a different guy.  He is more grown up, more expressive of his needs and wants, likes and dislikes.  He nods, "Yes" and shakes, "No" not just for more crackers but for other things that impact his life, like staying on the swings or having his diaper changed.  These are signs of toddlerism, but they are new for Heath, and his yes-and-no communication has become much more direct over the past week -- a shock for Mommy, but also:  Go, Heath!  It's healthy and good to see.  And it's no wonder, since these transactions happen dozens of times over the course of a meal ("More custard? No? How about these potatoes?  Aha!  Coming right up!"). 

Tube feeding was so different.  Heath would be oblivious to it at the beginning of a meal and then grow more lackluster, nauseated, or defeated looking as we pumped the requisite amount of calories in while entertaining him with food he didn't want to eat, then books and toys when the food started to piss him off.  We would grow anxious, caught between our intution that he was on the verge of vomiting and our duty to keep his weight up (Markus suspects tube-fed kids may not use calories as efficiently; as we all learned in high school, digestion begins in the mouth.) What a wonderful relief for Heath to now be able to make choices, enjoy food along with the family, and find his own way!

The other night, I had a dream that Heath looked into my eyes and a psychedelic, mind-meld took place between us.  It's as if he is coming out of a bubble, or a layer of insulation is being taken down between him and the world.  The ability to claim that primal piece of independence that goes along with eating stirs up something very powerful, apparently.  Sometimes, Heath is just plain mixed up, tired, cranky and confused, as often happens when kids are contending with identity-changing milestones.  Who he was yesterday is not who he is today.  It can't be easy.  But most of the time, he's still our uber-exuberant boy -- especially at mealtime.

Here are the details on Markus' lecture at Seattle Children's Hospital tomorrow evening:

"Principles of Self-Regulation Based Feeding Disorder Treatment"

Thursday, March 27
7-9 pm
Wright Auditorium, (1st floor, Giraffe entrance).

Parents can park in the 1st parking lot as you enter Penny Lane.

Parents do not need to register or pay.  Hope to see you there!