Wednesday, December 23, 2009

OT in the preemie?

Yesterday the girls had an occupational therapy assessment.

For a preemie?

It didn't take that long, actually.  But the OT therapist was lovely.  She seemed to agree with everyone else who had looked at the girls:  they are model preemies.  And once again, she gushed about how cute they are.  Well...I'll take that.

What was most helpful was that she gave examples of what cues to look for when the girls are stressed, when they are relaxed, when they are ready to be held, and when they need some 'time-out'.  Preemies can't modulate their sensory input, and they get overwhelmed very quickly.  It is actually best to work with one sense at a time:  if you are holding them, you should be quiet and be in the dark and not move too much.  If they are laying in their isolette, you can let them grasp your hand and talk to them, but still keep things very dark and with very little background noises.  Unlike full term newborns (who still are not that adept at it), they cannot filter out stimuli, and do not know how to direct their attention away when they need to.  So the carer has to do it for them and be sure they are not overwhelmed by too much and one time.  Light touches are not good:  if they are handled you want to have a very firm touch and hold them securely.

The OT said they both have great muscle tone, are flexing their muscles properly, are showing good motor development signs already (bringing hands to their face, staying midline, rooting, grasping, etc).  Again, not too much to assess, but interesting nonetheless.  It was a very positive experience and she gave me some handouts to look at with pictures of preemies who were showing signs of stress, being relaxed, etc., so I could see and remember what she told us.

As they get bigger they will continue to be assessed and when they are discharged we will get an early intervention referral to have the girls looked at later since they are at risk of developmental delays.  I am trying not to think too much about that (although I admit I had a minor obsessive episode the other night and googled CP a bit too much) since it can be years before we see anything, if there even IS anything.  One day at a time.

We did have one minor setback with Tzelia:  it seems the last calorie increase didn't sit too well with her GI and they had to bring her calories back down.  As the doc explained to me, they aren't supposed to be using their GI system at all right now, so having anything in there can be a stressor.  The last thing they want to do is cause damage.  So, we'll back down on the calories and see how she does.  As long as she continues to gain weight (both girls are above their birth weight now!!) it should be fine.

I have a slightly different schedule today:  I am meeting up with my lab from work for lunch.  I haven't seen anyone from work since the beginning of October when I was put on bed rest.  My manager is taking us all out for a holiday lunch and had emailed me to ask if I wanted to join them.  Of course!  So rather than run to the hospital early in the morning, I am going to stay home and just meet them for lunch, and then go to the hospital after.  I printed some pictures of the girls in case someone asks...  should be fun.

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