Thursday night we headed back to Cincinnati for Landon's follow-up with Dr. Levitt Friday morning. Just like last time, we went in and did an x-ray first, and then went up to discuss what it showed and what has changed since our last visit. The x-ray looked much better than his last. His small intestines are no longer dilated and there were no signs of enterocolitis. Dr. Levitt also did a rectal examination and Landon's sphincter is much better as well, which means that the dilations were successful.
We are continuing the dilations at least twice a day for maintenance, but also can do them as needed to help stimulate the area to move things along. We stopped the Flagyl all at once, but left with a presciption for half the dose just in case he doesn't tolerate the change. Dr. Levitt also set up a plan for tapering off the irrigations. He felt that the reason that Landon is not going on his own is because we are keeping him flushed out so often. The irrigations empty him out, and when we are doing it 3 times a day he isn't getting the chance to accumulate enough stool to feel the urge to push. The only problem with that is that Landon is still extremely prone to enterocolitis, and if things sit around for too long he gets an infection. So we have to find a balance between letting things accumulate enough that he learns to use those muscles and push, but not letting things sit around long enough to cause an infection. Dr. Levitt had us drop an irrigation, and so we are already down to two a day and will continue this for two weeks. At that point we will go down to once a day, and continue that for two weeks as well. If that goes well, then we will try to stop irrigating altogether. If at any point he starts showing signs of enterocolitis then we have to go back up to 3 irrigations a day, and then start the process of tapering off again. So we will see how that goes.
Landon is still doing well with starting solids. He has done so well that we have been able to introduce a new food every 3 or 4 days. So far all of the foods we have tried have been a success. Like I mentioned before, we only do foods from the Cincinnati "Laxative Diet" list. I make all of Landon's food which is a new adventure for me. Two of the most common culprits for causing constipation- bananas and apples- are in just about every baby food on the market. Every single combination food that I can find contains one or the other. Fruit and vegetable skins are also known to cause problems, and so when I make his food I'm able to strain everything and know that it does not contain skins. Those were the main reasons that I decided to make his food, so that he could eat a variety of foods and not be as limited by his diet restrictions. So far everything is going well with that, and I have a feeling it will get easier with time.
This afternoon Landon is having his first evaluation with Early Intervention. The physical therapist will be coming to our house to see what she thinks. On Thursday the developmental therapist will be coming, and we are still waiting on the occupational therapist to contact us, which I would imagine will be sometime this week. Landon has actually made a lot of progress over the past week with sitting up unsupported. He is sitting up without propping with his hands and holding it for 5-10 seconds, sometimes longer. He also does well sitting in his high chair at the table, but he isn't strong enough to eat in that position- he leans forward too much and food spills out of his mouth. I have to sit him in either his car seat or bouncer in order to feed him, which works at home, but it is yet another obstacle which keeps us from being able to leave the house often or for long periods of time.
Well, lunch is over for me. I will update soon on how the EI evaluations go. I hope everyone has a great week!
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