Beck's actually been well since last Wednesday, but we wanted to complete the full 10 day course of antibiotics. That's what kept us here over the weekend. Either way, we'll be glad to get back into the rhythm of home.

As of Day 3, he's already feeling much better. His lungs sound better, he's stopped the constant coughing, he was able to get some sleep, the doctors were able to remove the nasal cannula, and he's smiling and playing again.

Mom and Dad have been sitting on the couch, taking care of Beck, going home to play with Elliott, and getting some sleep here and there. Speaking of Elliott, he can now stand on his own for up to 30 seconds, and has started to lunge forward in a motion that could optimistically be seen as 2-3 real steps of walking. He's also has teeth #5 and #6 starting to come through.

As a side note... we had a few people ask about our doctors, the NICU, and other hospitals... where they are located, and other stuff. Houston is very fortunate to have the Texas Medical Center. TMC is the largest medical center in the world, with over 45 medical institutions, medical schools, and hospitals, over 4000 physicians, and lots of other insane statistics. Beck is currently at Texas Children's Hospital. We live really close to the TMC. We just have to turn left, and drive beneath the shady live oaks of Montrose, the Museum District, and Rice University for a few miles.

Well, the inevitable has occurred... we have hired a nanny. G, Tito, Grammy and Paw Paw could avoid work for only so long, and despite our insistence, none of them was willing to quit their jobs. So, in order to fill the large void left by their daytime absence, we looked outside the family. We were extremely fortunate to find a wonderful Londoner named Sabrina. She'll be joining us on Monday, and I'm sure a few pics will follow. She's super sweet, and Elliott immediately flashed her a huge smile at their first meeting.

Other than that, Beck has continued to grow. We have lots of doctor's visits, but they all like what they see. We've had very little J-Tube drama over the last week, and everything has stayed in its proper place. Elliott is learning to stand on his new activity center (courtesy of the super-cute Jackson triplets, and their parents, Jimmy and Lindsey). He's also moved on to juice, and a few new foods.

There are a few more pics after the break...

Beck has surpassed the 7000 gram mark. That really just means that he has continued to grow well since coming home... and 7000 is a nice, round number to declare. He's actually at 7060. It also means that he's inching towards his first pound, grown solely at home. We'll let you know when he gets there.

Elliott's about to get his first sip of pear juice... it might even be out of a sippy cup. Lately, he's been making this guttural sound. It reminds us a lot of the youngest kid in Overboard (the one that tries to imitate Pee Wee Herman), or Froggy from the Our Gang (Little Rascals). Either way, we're hoping it's just a phase, as it sounds rather evil.

Here are some pics to boot... a few more after the break.

Elliott the explorer found a hidden waterfall coming out of the bathroom wall.

(Warning: This video may only be cute for a few seconds, unless you are a parent or grandparent of the baby. Proceed at your own risk.)

Bath time for Elliott.

Here are a few pictures for you, the photo deprived masses. Elliott is clean and happy. Beck is sleepy and growing.

More pictures after the break...

Another first...

Beck was actually much happier than the picture makes him out to be. It was a nice day for a nice walk... albeit a short one.

Show me the love.

Everyone is doing well... just a bit tired. Elliott is getting used to sharing the attention he receives, and Beck is adjusting to life away from the hospital. In general, he really likes the change, but... being at home brings its own challenges, like: When J-tubes pop out, you have to make quick visits up to see the surgeons (Wednesday); When the G-tube stops draining, and Beck starts crying you have to take verbal instructions from the surgeon over the phone at 2 in the morning on how to irrigate and flush the tube (Friday, a little bit like that commercial where the guy is making his own incision); You realize exactly how much work a skilled NICU nurse does in a 24-hour period; You become confused and blurred by the 20-30 meds/treatments your baby gets over the day; You become confused and blurred when you sit to close to the meds during treatments, and inhale all of the excess Albuterol.

What?!?!

Why, yes... that is our couch. That is also Bree, holding two babies for the first time.

Beck had a grand homecoming today, after nearly 9 months in the NICU (that's longer than he was in the womb). He's feeding well, he's growing, and he got over the flu that stymied his last exit strategy. We should have a video of the first encounter up tomorrow, sometime.

Whew! Now, let the real adventure begin.

Overall, we can't complain. He really is looking much better, and the loss of the IV fluids has done wonders for his appearance, color, and demeanor. He's been alert, playful, and anxious to get out of that crib (and the hospital, in general).

Elliott is so close to crawling, it hurts. It actually does hurt his face a bit, as he gets up on all fours, and just as he's about to successfully move alternate limbs... spread-eagle, faceplant into the blanket. He's been eating bananas, apples, pears, avocados, sweet potatoes, and mangos. Yesterday, while shopping for kitchen faucets with dad, he spit up pears in the plumbing section of Lowe's. Dad decided that cleaning the floor at a hardware store was counterproductive, and went about fixture shopping. Is that wrong?

The new J-Tube has been able to effectively stop the leaking from that site. This in turn has caused less irritation to Beck, both physically to his skin, and mentally, as we aren't messing with him as much. It has also meant more time to process and absorb the food. His G-J Button system also seems to be working well.

As for feedings.... he's been off of the Lipids for about 10 days now, and we turned off the TPN about 6 days ago. With no fluids through the IV, he's on formula alone. This has always been the hard part for Beck. He has a difficult time gaining weight without the TPN/Lipids. Despite the history, he's been making positive numbers over the last week. Hopefully, he can keep the trend going for a while longer.

Side Note: Did you know that in the Chinese New Year, 2008 will be the Year of the Rat? Why is that good? Because it (the Year of the Rat) is the first year in the 12 year cycle that is the Chinese New Year. A fresh start for everyone involved!

Well, since our last entry, Beck continued to up the formula and lower the IV fluids. About 2 weeks ago, the doctors decided to see if he could gain weight on formula alone, so they turned off the TPN/Lipids, and gave it a few days. He basically, lost weight over those days. That continued the general trend of the previous few weeks, which was not a specific loss of weight, but a failure to gain weight (which is a loss in the end, as a kiddo can't stay 14.5 lbs forever). All of this called for an overhaul of the master plan.

There are 3 major issues that contributed to the changes:

1. His Broviac line was continuing to maintain a low-grade infection. He was on antibiotics to keep this infection in check, but that goes hand-in-hand with two other problems: a) continuous use of antibiotics is bad for the system and long-term effectiveness of the meds, and b) deciding to discontinue the antibiotics would surely lead to a new blood infection stemming from the line (this had already happened once).

2. His J-Tube was having increased leakage. The more we increased the amount of formula, up went the amount of leakage from the J-Tube site. Basically, the intestinal contents were leaking back out around the J-Tube. [The best example I can create involves putting a straw into a Coke bottle. If you turned the bottle upside-down, the Coke would flow out around the straw. Ideally the straw (or catheter, in real life) has a tight seal around it. His non-ideal nutritional state doesn't really allow his body the freedom to heal things like oversized J-Tube holes... it's busy growing hearts and brains.] When the contents leak, you lose in two ways: a) food that is being processed, leaves the system early, and is only partially absorbed, and b) formula that was just fed in, comes right back out, and never gets a chance to digest. All of this means that he not actually absorbing anywhere near the calories that he should be, from the feedings.

3. Because we were feeding Beck through the J-Tube, only the lower half of the intestines were being utilized. This results in less chance for absorption by his body... again lessening the actual calories absorbed.

With those three problems contributing to each other, everyone involved agreed that a few changes were in order. So, yesterday morning, Beck went down to the operating room for a few hours, to have the following procedures performed:

1. A new Broviac line - the surgeons were able to place one on his left side (the last one was on the right)

2. A new G-J Tube button - the old G-Tube (in the stomach) was removed, and a new "button" was inserted. This is a much smaller access point, and one which he'll be going home with. It allows venting of, and feeding into the stomach. It also consists of a J-Tube that continues on, into the intestines, for feeding access. This will be eternally helpful, as his stomach isn't quite up to regulating food volumes into the intestines, and allows feedings to drop into the upper intestines... using the full gut is better than just half.

3. A new J-Tube - rather than remove the old leaking J-Tube, the surgeons replaced it with a different type. This new J-Tube has a flange within the intestines that should help seal the hole. The reason for choosing to keep it in again revolves around Beck's healing ability. The hole is likely extremely well formed, and wouldn't close readily on its own. Therefore, surgery will be involved to close it up. I think Dr.Cox's exact words were, "That baby will not be having ANY intestinal surgery". Period. End of story. Come back in two years. Bye. Beck's intestines have been through enough, and a silly little tube is easier to deal with than a whole new round of risky surgery.

To make matters worse, Beck got a new blood infection on Wednesday, which resulted in some fever, irritation, and a snag in the new plan. We had to wait a few extra days for the surgery, so Beck's blood could be cleaned up (sticking a clean Broviac into infected blood dirties up the line, and gets you right back where you started from). Beck's inability to keep any long-term IVs in over the weekend also added some difficulty.

So, here we are on Wednesday, and Beck is slowly starting feedings through the new and improved G-J Tube. We'll see how it goes from here, but hopefully, he has been upgraded on all fronts, and put in a better situation to recover.

Where were we...

Beck finally got rid of the CPAP. They moved him to a nasal cannula a few days after the last post. On Thanksgiving day, the doctors surprised us by delivering a cute face... free of tubes! Since then, the game has been all about feeding. The primary goal is to increase the percentage of his calories that come from formula (flowing into the J-Tube, in his intestines), while decreasing the percentage of nutrition that he receives from TPN/Lipids (IV fluids). 2 months ago, he was 0% formula and 100% TPN/Lipids. Today, he is around 95% formula and 5% TPN/Lipids. It has been a long, slow process to get to this point, but his intestines seem to be handling it well. Ideally, if he can consistently gain weight on formula alone, then this central IV line is unnecessary. If it's not needed, it can come out... for good. This central line (along with general nutrition) is one of the primary hurdles when considering when he can come home. Maintaining a central line at home is an extremely difficult task, that would require in-home nursing and sterile conditions... not the easiest thing to do when you've got another baby in the house, and two cats that like to run around, get in your face, and lick things. So, our current wish is that things just keep on moving along.

Elliott seems ridiculously adult-like. He's eating rice cereal and pears from a spoon, at the table. He even has conversations of babble with us. I'm sure he's trying to say something... what, I don't know.

I'll try to get some new pics up soon... thanks again for all of your help and support. It really means the world to us.

Elliott is babbling himself awake. Trying to get a nap out of him is getting harder as he learns to lay in the crib and talk to the mobile. He's also started to notice Gary and Jeffrey. I believe those cats are about to receive a taste of their own medicine. Elliott is happy with them, until they choose not to stare at him... then the screaming begins. They turn back towards him, and it stops... turn away, it begins. Elliott will be riding them pretty soon.