Tuesday, October 28, 2014

Day Seven


We pumped ourselves up this morning with sporty apparel
and "Eye of the Tiger."
It's 80 degrees and sunny here. That makes it pretty hard to have a bad day. Our Tuesday was decent. We made it to UVA on time without anyone throwing up. A solid start. Unfortunately Olive was not very cooperative for breakfast. She refused most everything. The only item that piqued her interest was mini M&Ms. She did a good job of putting those in her mouth and keeping them in. Of course once they started to melt too much she felt the need to spit them out. But she sucked the candy shell off of ten of them so that was good to see her actually interested in something. She was otherwise not willing to follow Polly's commands to try something else. It was frustrating. Polly keeps using words like "tenacious" and "strong willed" to describe Olive, and she says that Olive is more determined than most kids to do what she wants to do. This of course is not a surprise to us. We've lived it for almost three years. She also adds that if she wasn't so tenacious she wouldn't be here. That makes me a little sad to think about, but it's true. We're lucky to have her, and she's fought to be here. I remind myself of this, and it minimizes the gravity of her feeding issue. We will get through this. Polly thinks within eighteen months Olive will be an eater. She says she has too much going for her to not figure it out. 2016 tube removal? I'll take it.

M&M tongue.
After snack we played with Ms. Patty, and she gave Olive another book to keep. The books are donated to the hospital, and it is such a great program. We have quite the collection going. Today we received "It's Time to Sleep My Love" and "Monkey Truck." Next on the agenda was preschool with Crystal. Olive is much more enthusiastic about this now. They started with reading a firetruck book, which Olive loved since she has a small obsession with any type of vehicle: bicycles, cars, trucks, planes, motorcycles, boats and most things with wheels. Cement mixers and tractors are especially delightful to Olive. That's our girl. After the book they did a shapes puzzle. Olive surprised us and really focused on it for a good twenty minutes. It's fun to see her mind work as she tries to figure something out.

Preschool.
Crystal had to pull her away from the puzzle she liked it so much. Then they did some art with markers and masking tape, and we ended with free play time with the kitchen. Olive says "wash dishes with Ms. Crystal" at random times so we know she likes it a lot. She puts everything in the sink before washing it all one by one, down to the corn on the cob and piece of cheese. It's great imaginative play.

After preschool came snack with Ms. Polly. This one bordered on disastrous. There were tears and screams and a lot of emotions. It started ok. Polly offered her lime yogurt, whipped berry cream cheese, and easy cheese. She refused the first two and took the tiniest lick of the cheese off of her finger. Polly wanted to help her and have her take one big lick. She flat out refused. She's at the age where everything is a battlefield, especially if it involves the scary world of food. And it becomes a power struggle. Polly threw it down that mommy and daddy were going to leave if she didn't taste something. She screamed and threw things on the floor. Polly warned her again. Olive held her ground. And then we were asked to leave. Cue the hysterics. Olive wailed and screamed. It was so hard to listen to as we waited in the hallway. I realize the point of it. Olive can't win every time. But every fiber of my emotional being wanted to run in there and scoop up my child to protect her from that sadness. I also had the mom guilt that she was somehow going to stop trusting us because we abandoned her.

Hey Olive, make yourself at home.
We were also just waiting for her to throw up, and any time she gets really worked up she tends to do that. Polly told her what she needed to do for us to come back in, and she did finally take a big bite. It felt like an eternity, but I'm sure it was only a minute or two. And she miraculously didn't throw up. We've never really had to discipline her too much before, so it was a hard cold dose of reality for the girl that is used to her parents catering to her every whim. Lesson learned. But she was an emotional wreck after that with her puffy red eyes. She didn't finish all of her milk as she has been doing for pretty much every session with Polly. Every day seems to hold the good, the bad, and the ugly. This morning's snack was the ugly.

Luckily Ms. Jen was our next appointment. Olive's new phrase du jour is "what's next?" And her eyes light up when we finally say it's time for Ms. Jen. She always starts with a gross motor activity to get Olive moving and get out any nervous energy. Today's activity was riding on a toy car on a little tour around the floor. Olive was pretty focused on the fact that the car had a phone attached to it, and she kept picking it up and saying "hello?" But once we made it a hide and seek game where Dain would run ahead and hide around the corner she made her way around the big circle.

Jen explained to us that it was actually kind of difficult to think of activities for Olive because in the occupational therapy world she is very high functioning. So Jen is trying to work on some new skills but also focus on ways that we can try to ease transitions and calm Olive's natural trepidation when encountering the unknown. Jen suggested trying to use some of these strategies before eating times, which is actually a great idea. For example, swinging calms her and doing an activity with lots of movement like running and jumping definitely helps to take her mind away from her nerves. Our minds are already spinning as to how we can incorporate some of Jen's ideas into our home life. An egg swing chair might be a nice installation in our living room, which has remained without proper furniture or a coffee table since Olive came around. More important things to buy and do.

After the car, Jen and Olive worked on some fine motor skills. They used tongs to pick up cotton balls. Olive hasn't quite grasped the skill yet. She still uses one hand to put the cotton ball in the tongs before squeezing it. It's painful to watch the struggle. Jen said it's a great "pre-scissor skill" to work on. I have honestly never considered Olive's scissor skills. She would like to use them at home, but you better believe I hide them. But apparently this is the age she should start learning. Jen has learning scissors that are more like tongs with a loop at the top. They worked on snipping pieces of "snow" from construction paper. Olive did better with Jen helping. After that they did the rice and beans bin, which Olive loves. So much so that she got in. Just climbed right in. And then she proceeded to have Jen bury her hands and feet, and they took turns hiding cars in it. It's the little joys in life. She was beaming. Jen makes a great picture schedule to show Olive all the activities with the last one being "shoes" meaning it's time to go. Olive isn't a fan of that activity, but Jen promised to see her tomorrow and do more swings. So that'll be fun.
Hanging out in the rice and beans.

After OT we had some free time as Polly was unable to have lunch with us today. It actually worked out perfectly because it meant we got to sit outside on a gorgeous fall day. We went to the Mellow Mushroom pizza place across from the medical center. It was delicious. And Olive actually did her best job eating all day. We didn't pressure her. We just offered her food and let her do her thing. She did a great job licking all the salt off of pretzels and taking a few bites. And she dipped a few in hummus and took some good licks. She also licked parmesan cheese off of soft pretzels we ordered, and she took about five good licks of the marinara sauce they came with. She liked the cheese so much she was even willing to dip her finger in it and lick it off, which Polly tries to get her to do with crumbs to get used to them in her mouth. She also drank four ounces of milk with a little encouragement. It was nice to have a meal without the stress of having a showdown with a two year old every minute.

After lunch we took a nap in the day suite. And by "we" I mean Dain slept in a chair while Olive slept in my arms in my chair. It's hard to resist her sweet voice saying "mommy rock you to fweep" before nap. We've created a sleep monster, but we've had enough battles over eating that I just wasn't willing to battle over naps on this trip. So I gave in to her demands and literally rocked my almost three year old to sleep. It's on the list. Believe me. Eating. Sleeping. Getting rid of pacifiers (that she still uses at sleep time.) Oh, and potty training. Just thinking about that list makes me want a nap.

After nap came one more snack with Polly. Olive took a few tentative tastes of guacamole, and a few tiny licks of goat cheese before she shut down. And then she shoved a bowl of chicken noodle soup at Polly sending it flying. I was horrified. Our child is defiant. Polly was very stern with her, pushing her away from the table and saying "no" very authoritatively. But they moved on. Olive took another taste of the soup, and even licked a noodle too. Polly put the noodles on a spoon and asked Olive to give them a kiss. She complied right away. The only problem is that it resulted in a spoon of noodles to Olive's forehead because the girl thinks a head bump is a kiss. She just leans her forehead into your head to kiss you. In all honesty we didn't dispel this notion for awhile because we are total germaphobes, and we certainly didn't want Olive giving kisses when she was itty bitty. She does now kiss with her lips, but you have to specify for her to use her lips because the head bump is so engrained. It's interesting to see that with a nonthreatening command, Olive complies right away. Of course she could kiss those noodles because that had nothing to do eating in her mind.

Guacamole? Meh.
So snack was kind of a bust. Polly said Olive is clearly sick of her and that she had more desire last week. That is disappointing of course, but there's not much we can do to change Olive's internalization of everything she's experienced these past ten days. Her world has changed in a major way. She is now responsible for some of her calories, and that is a big shift. Polly really wants us to try to cut calories to try to stimulate Olive's hunger. She did the math on it and told us that Olive can grow on a very small amount of calories relative to most kids her age based on her weight checks and her calorie counts. I've known this for awhile. Doctors and dietitians have told us a super high number of calories to give her. We tried, and she would projectile vomit because she was being overfed. So we didn't feed her as much despite what we were told. Everybody is different, and she just so happens to need fewer calories. We'll meet with the dietician again tomorrow but for tonight Polly instructed us to give Olive just water for her lunch blend to try to bring out that voracious hunger. So she received two ounces of breakfast blend tubed in the morning with nothing else tubed. She was running on the milk she drank and the small tastes she took. We hesitantly gave her four ounces of water in her tube before heading to the park this evening. The poor girl is obviously hungry. She was almost lethargic at the park just wanting to swing. It's hard to purposefully not give your child what you know they need, but this is the only way to get her eating. I'm 100% sure her empty belly turned her into a little zombie. But she doesn't know how to fix that with food. Instead she turns to milk. She drank nearly 9 ounces of milk after the park. What!? That's more than we even thought her tummy could hold at once.

Clutching her craft projects.
And then she did an amazing job at dinner. She modeled many of the skills that Polly has been trying to get her to do. It's reassuring to know that in a lower stress environment she's willing to try. We were laid back about it and let her do her thing. She bit down on her spoon and took bites of goat cheese, which is so awesome. And she happily placed Cheetos on her molars to practice chewing. She is such a turkey, refusing to do these things for Polly. She's really just a girl who does things on her own terms. And while that's an incredibly frustrating thing for us to deal with right now, it will serve her well in this unpredictable life.  A nurse told us when she was a few weeks old that she would hold her own on the playground. Yes you will baby girl. We're all energized for tomorrow. Olive is now like the energizer bunny after getting all those calories plus about half of her regular dinner blend. She is serenading Dain to "fweep" with her rendition of "Row Row Row Your Boat." Bring it on Wednesday.

Monday, October 27, 2014

Day Six

Another day in the books. Thankfully Olive woke up without a fever and feeling much better. She was still a little tired today, but it's hard to say what that is from, especially since the most common side effect of her appetite stimulant medicine is tiredness. We were just happy that whatever was bothering her yesterday didn't escalate. She was fairly cheerful throughout the day, only throwing fits when Polly was trying to get her to taste something she didn't want or take a bite when she was stressed out. Her new thing is to just scream at the top of her lungs and throw things on the floor when she has reached her limit with her feeding sessions with Polly. So that's fun.
Taking bites of bread.

Olive gagged in the parking ramp right when we arrived at UVA this morning. I grabbed her and ran over to look down the parking ramp at the train tracks. This distracted her enough that she didn't throw up. A good start to our Monday.  Before we arrived we followed the same plan from last week, which was to tube about an ounce of water and two ounces of Olive's typical breakfast blend along with her medicine. Once she got over her initial nerves, Olive settled in nicely to the play area saying good morning to Ms. Patty and heading for the legos to build a castle.

Working at the car wash.
This Monday did not go as well as last Monday. Olive wasn't very interested in tasting anything. She did a good job with her milk taking three ounces, but she was a hesitant taster. Polly had her try to swish lucky charms marshmallows around her mouth. She tried two. Polly couldn't get her to try a cereal bar or yogurt. She reluctantly took a few small tastes of peanut butter. It was kind of painful to watch. Just total disinterest.

After breakfast we had a few minutes in the play area before heading up to our preschool lesson with Ms. Crystal. Olive really enjoyed that today. They started with reading The Very Hungry Caterpillar complete with a plastic caterpillar for Olive to hold and use to play with along with the book. It was Olive's first time with that book, which is totally shocking since it is everywhere. We just don't have it. Of course she loved it so I think it will be on her Christmas list. After reading they did an animal puzzle and then colored. Then they washed cars at the carwash, which Olive thoroughly enjoyed. Crystal used shaving cream as soap, and Olive pretended to wash it off with the little hose on the car wash toy set. Then Olive got to play with the kitchen. She loved it. She served us food and washed food and washed dishes. Before we knew it, it was time to go.

Obstacle course with Ms. Jen.
Next on the agenda was snack with Polly. Olive drank four ounces of milk, but for her to do this takes work. She is asked to take the drinks, and Polly has to persuade her to do so. The winner today was a latches puzzle that she would play with while she drank her milk. She once again didn't do very well with food at snack. She took a few bites of goat cheese and licked some Cheetos. Polly is really trying to teach her to chew on her molars or her "big girl teeth" as Olive calls them, but this really scares O. She'll try once or twice, but then she gets frustrated. She also wants to do everything herself and not let Polly help place the food on those back teeth. So it is still a lot of biting with her front teeth and spitting out the pieces. Polly thinks that once Olive turns three she will hopefully be more open to letting us help and be better at following through with our directions.

Thankfully after snack came Ms. Jen. Olive was ecstatic. She bounded into the room skipping and jumping. First they did an obstacle course with mats and a trampoline. Then they moved on to another fishing puzzle and then stringing beads. The string was a lot smaller than O did last week and the beads were harder to get on, but she stuck with it. Then we did bubbles, which was a great activity for Olive because she got to use her mouth to try to blow the bubbles from wands and various bubble toys. She happily put the unfamiliar bubble toys in her mouth of course unlike food. It was a good oral motor skill activity though, and Olive loved it. They ended with playing with cars before we had to drag Olive away promising to come back tomorrow. We made a very quick lunch run for ourselves and then met Polly back in the kitchen for Olive's lunch.

Bubbles.
Olive did a better job with lunch. She is obviously hungry. She says "I hungry," and while we were out grabbing lunch she told me "Obbie tummy make noise mommy." I think it was grumbling. A new sensation for her. She's trying to grasp that the food will make her tummy feel better, but she just doesn't understand. When we tell her the food will go to her tummy, she lifts up her shirt and tries to put food into her tube. Polly told us that around age four kids start to realize that other people don't have tubes, and they start to want to get rid of it. Let us hope. My goal is for her to be tube free before kindergarten.

For lunch Olive drank her milk again, and she did a good job biting bread. She also took a few sizable bites of goat cheese and some spoonfuls of pickle milk (greek yogurt mixed with pickle juice.) She also tasted chicken noodle soup and even drank some with a straw. She also had a major attitude once she reached her end. It's like she's starving, but she a) doesn't know how to fix that problem and b) is too scared to try even with someone directing her. Polly also thought that she may be so hungry that she felt nauseated. So really all we can do is work on these skills, improve upon them over time, and wait for Olive to get it. It's going to be a long road.
It doesn't come easy.

After lunch we headed to the day suite where Olive took another two ounces of milk from her bottle and then napped for a little over an hour. She played in the play area for a little while before our last snack with Polly for the day. At snack she did a great job of taking a couple bites of cheetos on her back molars. She also took some big tastes of pickle milk off of her spoon. She took more bites of bread, but she wasn't open to it as soon as Polly put peanut butter on it. She threw it on the floor. Polly had to throw down the threat of mommy and daddy leaving. Although I think O is more open to that than she was last week. They moved on with tasting Nutella. Olive took some tentative licks. She did drink four ounces of milk though so that is good calories in. Polly had us tube less than half of her normal lunch blend. Luckily her weight is up from when we arrived. We had another weigh in today. She weighs in at a whopping 10.65 kilos (about 23 1/2 pounds.)

Already training for the President's Fitness Challenge.
After snack we headed back to the hotel to relax. We found a park near the hotel that we thought we could walk to as it was a warm sunny day. We loaded Olive in the stroller for our .8 mile trek following Google Maps. It went great until we realized that we would either have to cross a creek or walk on the side of a highway. Admittedly it did say "use caution." So that was a bust. We drove. But Olive had a great time. And now we are just chilling in the hotel room after a much needed bath on Olive's part. Hopefully Olive will do a good job eating and drinking for us tonight.
The safety totter at Azalea Park.

Sunday, October 26, 2014

Weekend Days

Spreadsheet for Olive's daily intake.
Well we've had the past two days on our own. It didn't go as smooth as we had hoped. Saturday morning was great and then it deteriorated. Olive did a great job with drinking milk yesterday. She drank almost 22 ounces, which is awesome. But she had pretty much no interest in eating food with Dain and I at the helm. Polly told us to keep it light and positive and just offer her what we were having, but she wasn't very interested throughout the day. It is especially difficult to keep her focused at the table in our hotel room because we don't have a chair to strap her in to. So she is basically up and down, sitting on my lap, running across the room, and up again. You get the idea. She is a whirling dervish of motion and when there are so many other things to do (like turn her spoons into boats and float them across the table) she has no interest in eating. So it's really frustrating. Luckily yesterday she took enough milk that we didn't have to tube too much. I kept track of everything on a spread sheet from Polly so we had a baseline idea of calories in.

It is very stressful to be in charge of it all on our own. Obviously we will be the ones doing it long term so we need to get used to it, but when you're already exhausted, it's tough. It was going fairly well up until late afternoon yesterday. We tried a three quarter dose of her medicine, and she woke up from her nap in a fury. Grumpy and whiney and not at all cooperative. Then we tubed water, and she immediately threw up as I unhooked her extension tube. We were just doing what we normally do, but we didn't properly take into account that she had consumed milk orally a short while before. Obviously it made her tummy full so it was too soon to tube something else. That was the beginning.

Family selfie in the Rite Aid parking lot.
Then she took a bath and started to drink bath water. I told her no, but she kept sneakily doing it. Then she started to say "tummy" and look like she was going to throw up again. We avoided it by distracting her with a literal song and dance. She seemed ok for awhile after so we decided to go out to dinner. We obviously didn't think it through. She threw up in the car. It was a whole lot of hot mess to clean up in a random Rite Aid parking lot. We are so nonplussed by it at this point, but we did get a few sideways glances with our naked toddler trying to escape while I cleaned vomit off of her. But we cleaned Olive, put on fresh clothes, and cleaned the car as good as we can. We always travel with paper towels and extra wipes and bags for dirty clothes. You mostly can never have enough of those items.

Olive is also totally unaffected by her vomiting. She moves on like it never happened. She had a time of it playing in the car while we cleaned up. We still went to dinner, and she actually did a great job eating for the first time all day. Probably because she was actually really hungry. She drank three ounces of milk, and she tasted all kinds of things like crackers, pickles, chicken fingers, fries, and pasta. She did the best job with bread that we slathered with an ungodly amount of butter. Calories in. So that was nice to see. Then we hit the hotel for a good night's sleep.

Just drinking milk in her new favorite hangout.
Unfortunately Sunday didn't go well at all. Olive seemed a little tired in the morning. She drank three ounces of milk, but she wanted nothing to do with her food. She took a few very small licks of yogurt and Nutella, but it was like pulling teeth. Then she refused to taste anything for snack or lunch. On top of that she started to have loose stools while we were at the national park. So that wasn't fun for anyone involved. We ended up tubing a snack of bananas, which is easy on the tummy. She slept in the car, and she didn't want any milk when she woke up. We also noticed a very slight fever of 99 degrees. So she obviously doesn't feel well today. This didn't stop her from refusing a nap at the hotel of course. We went to the park to get her some fresh air, and we tubed her full lunch there as she didn't want any milk or anything to eat. She had a great time at the park and seemed to perk up. We decided to just give her a break tonight, and we planned to tube her whole dinner with her usual 60 ml of water first to keep her hydrated. Of course right after we gave her the water, she asked for milk and drank two ounces. So that left us with the conundrum of how much dinner to tube. We think Polly would say to just subtract the amount of milk so we went with 95 instead of her regular 145. But we are debating whether she needs anything else after she goes to bed. It's a lot of math for two not at all mathematically inclined people.
Push carousel on the downtown mall.

So that sums up her eating weekend. Pretty good Saturday and horrible Sunday. We really hope she isn't getting sick. She's done this before a few times where it is just a day long thing so we are praying that's what it is. Because it would be devastating if we had to miss out on the feeding clinic for any amount of time this week. We are heading to bed early in hopes that a good night's sleep will cure whatever is ailing Miss Olive. In happier news, we did some fun stuff this weekend. We really got out there and saw Charlottesville and the surrounding area.

Saturday morning we hit the farmers' market downtown and then walked along the pedestrian mall. It was a great time. We had donuts and a brat at the market. Olive even asked to taste the strawberry glazed donut, and she did. As a total aside, Dain and I have pretty much both gained ten pounds from stress, exhaustion, our hectic schedule, and eating all the things we see. It's like the feeding clinic 15. Oh well. The pedestrian mall was really neat. It's a closed off street for pedestrians only with shops and restaurants and water fountains and other fun attractions. Olive's favorite was hands down this push carousel we found. She could have ridden it all day.

We also stopped in a toy store where Olive picked out unicorn stickers, and there was a great art installation where you can draw with chalk on a slate wall. She jumped right in with the college kids and put her scribbles on the wall.  Olive also enjoyed stopping to see a group of people playing drums outside a coffee shop. She was dancing to the beat. After all that activity, we drove to another apple orchard, Chiles. This one was much less crowded. We picked our own apples, and Olive loved riding in the wagon.  We didn't stay for too long since we wanted to sit down for lunch back at the hotel and then get in a good nap. After lunch and nap, we hung out at the hotel. Olive took a forty five minute bath having a time of it with her toys and her plastic cup boats.We only ventured back out for a quick dinner at TipTop, rated Charlottesville's number one family friendly restaurant. It was like a diner, with affordable prices and fast service. Perfect for dining with a two year old.
Living the life at Chiles Orchard.

Today we decided that we really couldn't be this close to the Appalachian Trail and not hike a piece of it. It's truly one of America's great adventures for those crazy and awesome enough to attempt the whole 2,180 mile trek from Georgia to Maine. It crosses through 14 states. I of course sometimes overly romanticize things and was truly hoping to encounter one of those wild and wooly adventurers and ask them about it. Of course we didn't. It was mostly just tourists like ourselves looking for a short hike on the A.T. We didn't really have any other options with a two year old and without our Deuter backpack from home that we carry O in for hiking. Such is life. We hiked it. That whole mile. And we made it to Black Rock Summit.

The trail we hiked was in Shenandoah National Park, which was only about a twenty five minute drive from our hotel. The whole place was gorgeous. Skyline drive runs through the entire park, and it is literally a beautiful scenic overlook every half mile. It was a fabulous fall drive and short hike. We didn't realize how large the park was and were surprised that the official visitor center was 55 miles in from where we entered. Luckily the park ranger at the gate gave us maps of nearby hikes within the first 20 miles or so of our drive. After we officially hit the A.T., we stopped inside the park at a wayside rest with a restaurant and gift shop for lunch before heading back to the hotel. Olive slept the whole way back, making it hard to get her down for another nap an hour later for her regular nap time. It's hard to stick to a consistent schedule when you're not at home, but we had such a great time. The only other thing we did tonight was grab a Halloween costume for Olive for half off at Kmart and some dinner to eat back at the hotel. And laundry, necessitated by yesterday's events.
Olive chose to be a pumpkin. We honestly tried to steer her towards something else (world's cutest Clownfish?) but she stuck to her original idea all last week. We're pretty sure she picked it because she heard a woman at the hospital who brings her guide dog with her every day telling us that the dog was going to be a pumpkin for Halloween. But hey, a pumpkin is a solid costume choice for a toddler so we rolled with it. Thankfully Kmart had one. Done and done. We tried Walmart first. We didn't find a pumpkin costume but did get to hear one woman yell at the top of her lungs "I'm so fucking ready to go" and saw another woman smack her young child. So that happened. God bless 'Merica. Olive's first trip to Walmart was probably her last for awhile. We are just spoiled at home having a Target we can walk to.
A little jaunt on the Appalachian Trail.

At the end of the day, the weekend was ok. It could have been better, but I suppose it could have been worse. At least she didn't throw up today. That's a small win. Hopefully she will wake up ready to go, and we will hit it hard again with Ms. Polly.

Friday, October 24, 2014

Day Five

Taking a dolphin ride at Pen Park.
Happy Friday. We survived our first week of feeding school. After a trying day yesterday, we had a much better evening. Olive took a three hour nap and woke up a new woman. We ended up going to a great park and made a Target run, being sure to stop to look at the bikes there since that is Olive's favorite thing to see. Snack on our own yesterday afternoon went ok. It was a struggle to get her to take three ounces of milk since she has figured out how to blow bubbles. I realize that's a totally normal thing developmentally, but it is hard to remain patient when you're having a battle over bubbles with a two year old on every single sip of milk.  She did tastes of hummus and goat cheese as well as bites of cheetos.

Dinner on our own went slightly better because in the car after Target she asked for milk and drank three ounces of milk on her own from her little bottle while we were driving back to our hotel. So that was a relief that she already had those calories in, which meant there wasn't pressure to get her to drink as much with dinner. She enjoyed a few big licks of chive cream cheese and did a great job of working on having fruit snacks in her mouth. After she fell asleep we surreptitiously gave her two ounces of water in her tube too because hydration is key in avoiding constipation, which is a common problem when trying to wean tube feeds.
The legos in the car are two people going to the coffee shop.

We've been adjusting what we've been giving Olive by tube based on what she is taking orally. Polly keeps track of everything Olive gets orally and then directs us what to give her as a supplement in her tube. We've really been tubing very little, with less than half of her normal breakfast and lunch with her dinner amount remaining the same. It's been odd to not tube feed Olive really between the hours of 8-4, but her weight was up today so she seems to be getting adequate calories thus far. The ironic part is that both Dain and I agree that tube feeding is actually way easier than what we are doing...keeping track of Olive's hydration, nutrition, oral intake and weight while cutting tube feeds and working 5 times a day to get Olive to eat with her mouth and then still tube feeding some amount. It's exhausting. But after 17 sessions this week with Polly, we are proud of Olive's progress.

Today Polly had a conflict in the morning so we did breakfast on our own at the hotel. It was nice to not have to wake Olive up and rush to UVA. Instead we let Olive sleep until she naturally woke up and then did our routine of tubing water and two ounces of her typical breakfast with a half dose of her medicine and then sitting her down at the table to drink milk and work on eating. She managed to take three ounces of milk despite the bubble battle and did a good job licking Nutella and some yogurt. She also worked again on biting pieces of fruit loops.  Since Crystal, the preschool teacher, had a work day we didn't need to be at UVA until 10:30. We got there a little early to let Olive play though because she seriously loves the play area. She goes on and on about the train table and loves the legos making towers and castles and parking lots.
Licking all the flavor off of a pretzel cracker.

Snack went so much better than yesterday. Olive was cooperative and cheerful. She took another three ounces of milk and surprised us with taking small bites of Ritz crackers. Her instinct is still to get the crumbs out of her mouth as fast as she can, but with some prodding she will try to chew and swallow some pieces. It just doesn't come easy or naturally for her. She also actually enjoyed some key lime yogurt, wanting to take more tastes without being instructed to. Polly told us today that Olive's oral skills are about at the level of a nine month old so we obviously have a lot of work to do with her skill set and confidence in eating. She also doesn't really understand that the food she puts in her mouth goes to her tummy. Polly keeps telling her this and that it makes her belly feel better, which prompts Olive to lift up her shirt and look at her tummy as if she is going to be able to see the food going in like she can with her tube food. She in fact calls her tube fed food "tummy food" so now she just needs to learn that food in her mouth is tummy food too.

After snack we took a nice walk around campus because unfortunately Ms. Jen was out today. Olive was disappointed by this news, but that didn't stop her from talking about Ms. Jen throughout the day. It was actually nice to get out and have time to walk around campus. Olive asked for milk when we stopped at a coffee shop, and she drank another nearly three ounces out of her small bottle there and on our walk. It is nice to see her asking for milk on her own as she is obviously starting to make some kind of connection about thirst and/or hunger. Next on the agenda was lunch. Olive didn't drink too much milk since she had consumed so much on our walk, but she did a great job exploring food. She had some good licks of garlic cheese spread and guacamole along with Ritz crackers. Polly is trying to get Olive to use her back molars to eat as Olive's instinct is to bite with her front teeth, pushing the food into the middle of her tongue where she doesn't know how to move it around. For lunch Olive practiced chewing on her molars with tootsie rolls and slim jims.
Stepping into a slim jim.
After lunch we went to the day suite to give Olive a nap. She took another nearly three ounces before nap, and we gave her another half dose of her appetite stimulant medicine. She took about an hour long nap before she heard kids yelling and sat up asking to go play at the train table. Ironically today we could have let her sleep longer as Polly had a freer afternoon schedule, but it all worked with Olive having a chance to play with the toys again. She did a decent job at snack too. She took more bites of crackers and meltable popcorn, and she is really close to closing her mouth around a spoon full of food and taking a bite. She can do it with an empty spoon, but with food on it, she gets nervous. We'll continue to try to work on that small step in hopes that she can start to take more volume by mouth.

Then we made a game plan for the weekend. It's a little daunting to be on our own, but Polly will also be available by phone. She instructed us to try and replicate what we've been doing this past week and to write down everything Olive gets by mouth and tube. The hard part is that we will have to make the judgment call on how much to tube feed in addition to whatever she takes, and she will be weighed again on Monday. The weight checks remain a constant because at less than the first percentile for weight Olive really doesn't have too much weight to lose. So there needs to be a balance between letting her feel hunger and still providing her with enough calories that she at least can sustain herself. It's complicated, but we are thankful to be working with such an experienced therapist like Polly. She really knows her stuff and is just incredible with Olive. So we will give it our best try this weekend, knowing that it may be a struggle at times.
Enjoying her milk at band practice.

After snack, we came back to the hotel for a short break and we tubed a little over half of Olive's normal tube meal. Then we hit the crowded town. It is homecoming weekend at UVA, and UNC is in town for the football game tomorrow. So it is basically a traffic nightmare around here. We kind of knew this, but it didn't stop us from going with our planned activity. Being the tourist I am, I have been reading the events on the Charlottesville tourism website, and I knew our Friday night activity the moment I read it. Marching band practice? Obviously. Olive loves marching bands. We waded through the traffic jams and ended up parking a good distance away because of the craziness. But we hoofed it over to the practice field and had a great time watching the band practice. Olive loved it. We did too. We brought a blanket and had a snack, and it was a near perfect family Friday night. They don't really compare to the UW band of course, but it was a fun time. Olive even drank nearly four ounces of milk while we there and tried some hummus and fruit snacks. We couldn't stay for all of it, but it was worth the hassle of getting there and back to see Olive's reaction to it. She of course wanted more.
Clutching her fruit snacks as the band plays on.

We grabbed dinner for ourselves and came back to the hotel to sit down to dinner with Olive. She took another ounce and a half of milk, and she tasted some pretzel crackers and onion dip. Then she was pretty much ready for bed after a long day. We aren't quite sure what our plans will be for the weekend. We may venture to the farmers' market tomorrow or another orchard, but it'll be nice to have two days without a rigid schedule. And thankfully Olive was back to her normal self today. We may try a three quarter dose of her medicine tomorrow in hopes that her body may be more used to it now and will tolerate it without the wild side effects from yesterday.  But Polly mentioned today that she didn't see Olive on it for more than a month or two. Overall today was a redeeming day after yesterday, and we always remind ourselves that it always gets better. Sometimes it just gets worse for a little bit before the better part comes.

Thursday, October 23, 2014

Day Four

Ugh. Mostly just ugh. Today was a very difficult day. With Olive's breakfast this morning we started her new medicine before heading to UVA for our daily programming. Olive's nerves got the best of her, and she threw up right as we pulled into our parking spot. Perhaps I was feeling too good about being ten minutes early finally because after we cleaned Olive and the car, we were a few minutes late. Polly was waiting for us at the play area.

Olive was excited to see Ms. Polly. For breakfast Polly offered her chocolate milk, explaining to us that one tablespoon of chocolate syrup adds 45 calories, which is a ton for a little tike like O. Olive drank it at first, but it took a lot of convincing. Olive threw a fit over it, and we finally switched to plain milk, which was still a struggle but slightly less so. She also tasted blueberries, and then sucked on frozen blueberries and practiced spitting them out. She did a great job of moving the blueberries around in her mouth. Polly makes sure to remind her that it's not scary and that she can always take a drink to help wash down any pieces or take a big breath. She took a small taste of syrup as well, and she did a good job biting fruit loops in half and spitting out the pieces.

Then we moved on to preschool with Crystal, where Olive's behavior started to deteriorate. She didn't want to participate or she wanted me to do everything instead of Crystal. Thankfully Crystal pulled out a fun, new activity for Olive before she totally lost it. She had a bin of cars and then made a road on the table out of shaving cream. Olive loves cars, and she thought the shaving cream road was amusing. She drove them around and lined them up and made a big old mess. Then Crystal pulled out dishes for Olive to play with and a bin of water for Olive to wash the dishes with. Since water is another favorite, Olive was amused for a little bit. But after those activities, she totally lost her patience and started to scream and refuse to listen to Crystal. I think it's developmentally normal for two year olds to push boundaries, but this was a different reaction than we have ever seen from her. She was exhausted and really acting out in a way that shocked us. We ended up leaving about fifteen minutes early because there was nothing we could do or say to make her cooperate anymore.

We let Olive calm down in her regular play area before snack with Polly. It seemed to work for a minute, but then it seriously escalated. Olive was a grumpy hellraiser for snack time starting from the moment we walked in. She kicked the table fighting being put in her chair. Then she fought everything. She screamed and whined for a lot of it. Polly had a heck of a time getting her to drink her milk. She did do a great job with Ritz crackers, but it was almost manic. She took bite, bite, bite, shoveling it all into her mouth and then frantically tried to spit it all out. She was able to chew some of it and wash it down with milk though. She seemed to like the garlic and herb cream cheese taking some sizeable licks and bites of that. But when she hit her end, she was done. Polly wanted her to drink her milk, but she was acting wild. The crux of it was when she threw her milk at me. She's never done anything like that before. It took all of my willpower to get her to take one more drink to end on a positive note. Then we were out of there.

Her bad behavior continued when we decided to grab coffee before our next appointment. She refused to hold a hand crossing the street to the point where she started bawling and screaming and kicking. Dain had to pick her up as she thrashed around. It was really not like her to have that big of a reaction and incredibly stressful to watch. It was a lot of yelling and saying "no" to everything. We are pretty sure her behavior was caused by the new medicine we started today. It's side effects are drowsiness and irritability, and I'd say she nailed both of those on the head. She was exhausted, yawning and asking for bedtime (which she never does.) And she was just wild and unruly all morning. It was hard to see our sweet girl turn so tired and grumpy.

Thankfully Ms. Jen was next on the agenda. Olive woke up this morning and yelled "Wake up. Go see Ms. Jen." She'd clearly been looking forward to it all day. At first she was pretty wound up and wild for Ms. Jen, not really listening very well and grabbing all sorts of things that weren't on the agenda. Thankfully Ms. Jen was able to wrangle her though, and Olive settled in pretty nicely. They did the swing again along with a monkey bar. Olive spun so fast on the monkey bar that she fell over from dizziness when she tried to walk. She thought that was hilarious. Next she did a puzzle where she fished for the magnetic pieces. She did a great job with that.

Then they worked on stringing beads again, which Olive really focused on. She loves that activity, and she did it on the big tube from yesterday as well as on a skinnier shoelace. She's really starting to love imaginative play and she informed Ms. Jen that the string was a waterslide and the beads were the people going down the water slide, complete with excited shouts of "splash" and "catch you." It's really fun to see her creativity. It was hard to pull her away from that, but Jen coaxed her with play dough complete with play dough scissors and stamps. Olive liked squishing the play dough into a pancake, and she tried hard to learn to use the scissors. She couldn't quite figure out how to do it with one hand, so Jen will keep working on that skill. They also made a person out of play dough and after Olive put on eyes, a nose, a mouth and arms and legs, she pulled a small piece off and told Jen it was the guy's phone. Then she made a purse, a Target basket, a stroller, and a running stroller. The accessories basically tell the story of our daily existence at home. After play dough, they did the fishing puzzle one more time before it was time to go. Olive was not happy to leave Jen.

Right after that came lunch. I was bracing myself for the worst, but it wasn't as bad as snack had been. Probably because the medicine was starting to wear off. Olive once again took big bites of crackers, even chewing some crumbs. She also took a few really big bites of goat cheese and was able to swish it around and swallow it without gagging. Milk was once again a struggle, but she managed to finish her three ounces with lots of coaxing. She's a great avoider. She tries to hide her head in her hands and talk about random things (like a tractor ride) to see if she can distract Polly into forgetting about the food. She also plays a game where she wants Dain to help her, but then wants Polly when he tries but then screams for me when Polly tries. General avoidance is kind of her coping mechanism for the stressful situation of eating.

After lunch Olive was exhausted to the point where she could hardly walk straight. We decided to forego snack with Ms. Polly since it would have to be earlier today due to her schedule. Instead we came back to the hotel to give Olive an opportunity to get in a good nap after a very stressful morning. She took another three ounces from her bottle before nap, and she was much more herself as I was putting her down. It made me happy to see her sweet self back wanting to cuddle with me. Or as she says "Mommy sleep with you" as the nuance of you and me is still lost on her.

We used the bonus time to do laundry at the hotel since we are all on about our last day of clean clothes. I'm not a sugar coater, much to the dismay of Dain as he is definitely the optimist of the group, so I'll be frank in saying that the morning seriously sucked. That's my g-rated description. My gut reaction as a mother is to never give Olive that medicine again. Polly and Dain, however, think that the medicine did stimulate her hunger. I don't think it did. I think she's hungrier because we've hardly been giving her anything through her tube during the day, and I have seen her bite crackers at home before, although admittedly she has never handled the crumbs so well. I think it was more a function of gaining confidence in her skills and feeling hunger from not being tube fed throughout the day like she normally is. Everybody agreed that it had unpleasant and unwanted side effects though.

Dr. Intagliata stopped by as we were wrapping up lunch, and she cautioned that it's hard to know if Olive was just having a bad day or if it was the medicine. I'm 100% sure it was the medicine, but I understand that it takes a few days to gauge the efficacy of a medicine. On the flip side though, I'd argue that it would then also be too early to tell if that one dose had anything to do with her hunger. The doctor also told us that Olive's body should get more used to it and hopefully handle it better. Because everyone agrees that it will not be used long term, we are going to try it for a few more days. Although at half the dose for the next few doses to see if that helps with the negative side effects. Because it's really easy for someone on the outside to say just stick it out, but when you are the one with your child all day every day, it's a lot harder to say this is worth it to me.
So we shall see. Olive is sleeping like a rock next to me, and I'm hoping she wakes up like a new woman back to her cheerful self, especially since Dain and I are in charge of getting her to eat and drink for snack and dinner. We are also planning to find a park to go to this afternoon as the park is definitely one of Olive's happy places. And some days you really just need your happy place.

Wednesday, October 22, 2014

Day Three


Whew. We passed the hump of our first week of feeding school. Olive had her best day yet. She didn't throw up at all today, which is huge. She did get nervous when we got out of our car this morning. She gagged, but then I distracted her with looking down at the train tracks, which luckily turned her nervousness into excitement at the possibility we could see a train. So that worked out. We once again got there in the nick of time despite waking up an hour before we needed to leave. Time just seriously gets away from you with a high maintenance toddler in tow.

Bravely eating puff popcorn.
Breakfast with Polly went well. Olive drank THREE ounces of milk from a straw. That's a record for her from anything other than a bottle, and even with that, three ounces is a good day. In between her drinks, she also did a good job with fruit loops, practicing spitting them out. Polly also made very fine fruit loops crumbs that Olive would dip her fingers into and lick. She also licked some Nutella. Olive had a hard time focusing because all she could talk about was Ms. Jen. I believe her statement was "Obbie need play with Ms. Jen." She had that much fun with her yesterday.

After breakfast it was time for our first preschool class. We thought it would be with other kids, but it is actually a private hour long lesson with an infant and toddler educator named Ms. Crystal. Olive wasn't feeling it at all, especially because it was way more about meeting us and talking to Dain and me for background info today. Olive really just wanted to go. Hopefully she will be more enthusiastic about it tomorrow, when we will do more things like art and games and puzzles. Olive was excited to get back to her regular play area, and she hit the legos and train table pretty hard.
Goat cheese mustache.
We ate snack with Polly following the play time. Olive once again took three ounces of whole milk. She also did a really great job of taking bites of cheetos and spitting them out, and she once again chewed a small piece of very meltable puff popcorn. She was a pretty good listener, but she hits a wall after about ten minutes where it is like pulling teeth to get her to participate. The threat of mom and dad leaving the room worked again today though, as did the threat of not being allowed to play with Ms. Jen if she didn't listen. Polly was so pleased with Olive's intake from the morning that she didn't have us tube her snack as we normally do.


Thankfully for Ms. Olive, playtime with Jen the occupational therapist was next. Olive mostly couldn't even control her excitement. She was jumping and squealing with delight just at the sight of her, and then she just about lost it when she saw the room we were in with a big swing in it. It was basically like the Publisher's Clearing House just rolled up at Olive's door. Olive jumped right on the swing. Then Jen added an inner tube to make it a boat as well as four rubber frogs, and Olive was tickled with glee. Just absolutely sheer joy emanating from our child, which just makes your heart swell as a parent.
Olive and Ms. Jen with the rice and bean bin.
After swinging, Jen and Olive played games in an attempt to finish evaluating Olive's fine motor skills. They played a peg game putting pegs into a square peg board. Olive referred to it as the "dinner party" and would seat the "guests" (the pegs) at the "table." It was funny to see her imagination at work. Then they briefly colored, with Jen having Olive draw lines. And they wrapped up the games with a beading game where Olive strung large beads onto a thick string. Then they moved on to playing in the rice and beans bin. Olive had a hard time keeping the rice in the bin, but she had no problem getting her hands dirty. The best news is that Jen told us that Olive is completely normal from a sensory perspective. We filled out a questionnaire regarding it yesterday. That was nice to hear because different therapists have thrown around terms like "sensory issues" and "sensory sensitivities" over the past few years, but we never really thought there was any sort of sensory issue. It's just hard to put a label on her feeding problems so people tend to pull from the familiar and say oh maybe it's this or that.

It was hard for Olive to leave Jen. She seriously has a mad crush on her. After we were able to tear her away, we went for a short walk to grab lunch for ourselves to eat with Olive back in the kitchen. Olive asked for milk after the OT session, and she drank an ounce and a half while we were walking and while she was pulling her suitcase. Impressive multitasking for a two year old. The suitcase has been a staple on this trip. Polly calls it Olive's transitional item, as it helps her move from one thing to the next by giving her something to focus on.

Always ready to roll.
Lunch with Polly went well.  Olive took another three ounces of whole milk with a straw. She also did a great job with eating. Dain and I had bagel sandwiches from a local place (Bodo's), and when Olive saw our bread she wanted some too. Polly gave her a piece of bread, and Olive not only took bites of it and practiced her chewing, but she ate a good amount of goat cheese off of the bread. She did more than just licking it too as Polly coaxed her into taking a few big bites of the goat cheese. She still struggles to swallow even that, but Polly helps her to take a big breath and a drink of milk to work it down.

After lunch we headed to the day suite to try to get Olive to nap. She took another almost two ounces of milk from a bottle before nap. Polly had us once again hold off on tubing any extra. Olive had a good nap...in her mother's arms...as she feels is the way both babies and big girls should sleep. We had to wake her up again in order to make it to snack with Polly.  For snack Olive was pretty worn out. Participating was a struggle. Yet she still managed to drink another three ounces of milk from the straw. She also licked chocolate and a vanilla bean cream cheese dip.

The only other change today is that we decided to try a prescription medication (Periactin) to help increase Olive's hunger. We spoke with her regular doctor on the phone, and we all feel it's a logical next step with no likely side effects. So tonight we picked up the prescription from the local pharmacy and tomorrow Polly instructed us to give it to her about 30 minutes before breakfast. Hopefully it will help.

We are encouraged that she drank so much today. She also took about two and a half ounces of milk with us at dinner tonight so in total she drank over 16 ounces today. That's incredible considering her previous record was right around 4 ounces on an exceptional day. It's great to see that she can do that, but it is a lot of work. It's 10-15 minutes of coaxing her to take drinks, but hopefully as she gets more used to it, she'll be more comfortable with it and more willing to do it on her own. She still did not take in very much calorie wise from solid food, but she got a lot of calories from her milk today. I overthink things, and I realized that she took in today right around her goal amount for when she first came home from the hospital. Of course back then she was still under six pounds. So we've made progress, but it's hard not to think about how far we still have to go.

In more fun news, we had an awesome evening outing. A local brewery was having a pumpkin carving party. Pumpkins? Beer? Yes please. The Blue Mountain Brewery was awesome. They had heated outdoor tents decked out for pumpkin carving. You could grab a table and then pick out a pumpkin from the pumpkin patch. Then they would clean it out for you or you could leave it whole. They had a plethora of pumpkin carving supplies as well as these neat foam sticker kits that little kids could attach to the pumpkins for fun without sharp objects being involved. Olive loved it. So did we. There was live music and great beer and food. We tried the bratwurst pizza with apples, caramelized onions and a balsamic reduction. Delicious. It was a pretty great end to a solid Wednesday of trying to teach this girl to eat.

Tuesday, October 21, 2014

Day Two

We survived another day of feeding school as we call it. It was an early start for us since we needed to be there at 8 and give Olive half of her breakfast before that. That sounds easy, but it's tricky with a tube fed kid like Olive. At home our normal routine is to put in 60 ml of water when she wakes up to wake up her digestion and then we follow that with her breakfast blend thirty minutes later, which takes about twenty minutes. It's not a quick process. This morning I put her water in while she was still sleeping. She rustled a little bit but seemed to be open to it. Then she woke up when I tried to put in some of her tummy food.

She wasn't exactly happy to be awake. We were in a hurry, and in our rush to get out the door I look over to see Olive with her bag looking very nervous. Then she threw up. Again. Totally out of nervousness. So that makes it hard for a quick exit. Luckily we made it in time despite the setback. O spent the car ride over yelling out "Good morning Polly!" That's our Olive. Excited and nervous all rolled into one.

We started our day with breakfast with Polly. Olive did a good job licking thin yogurt off of a spoon. Then she worked on spitting food out again with fruit loops. She wasn't interested at all in chocolate milk, but she wanted to try the Nutella again remembering it from yesterday. She took a big lick. Too big. And she gagged and threw up. It's amazing there was anything left in her tummy, but she always surprises us in how long she keeps food in her tummy. Polly explained that anxiety can slow down digestion.
Tasting chocolate pudding.

Unfortunately after breakfast we weren't able to go to preschool as the teacher called in sick. So we went back to the play zone with Ms. Patty. Olive didn't mind at all. In fact we had to pull her away in order to walk down the block for coffee. Olive decorated a construction paper bat and colored a few times at the art table today, and she had a lot of fun with the train table and lego table.

After that break we had another snack with Ms. Polly. Olive is a hesitant participant at times, and during breakfast Polly asked us if there were any characters or pictures that could be motivating. Easy question. We described Olive's love of bicycles and really all vehicles. By snack time, Polly had new pictures printed out that Olive could take out one by one and velcro on the board when she took a taste of something. It worked great for snack, and Olive did a good job licking goat cheese and chocolate pudding. She also worked on chewing on a straw to practice biting down.
The reward system for taking tastes.

After snack we met Ms. Jen, the occupational therapist. She knocked Olive's socks off with her toy selection, giving Olive a big car and people and animal figurines to put inside. Olive played with it for an hour. In fact, it was hard to tear her away to do other things that Ms. Jen wanted to do, like puzzles and stacking blocks. Jen will work with us daily to help Olive desensitize her face in a fun way without food being involved. I don't know what this will look like, but she is going to play games and work on motor skills. She even mentioned having a room with swings so I think Olive and Jen will be good friends.

Next came lunch. Polly pushed Olive pretty hard with taking licks of food and keeping it all in her mouth and swallowing. Olive did a great job with cheese sauce. They also worked on more bites, but with Olive's first cheeto puff, she took three bites in a row and panicked when she had too much food in her mouth. After that she kind of shut down out of fear. Polly had to pull out the big guns and told her that if she didn't listen then mommy and daddy would have to leave. It doesn't sound nice, but it was incredibly effective. Olive very quickly turned and licked the cheeto after refusing for a good five minutes. The best thing we saw is that Olive took two ounces of milk throughout lunch with a straw. Polly would have her taste something and then take a drink, and by the end all of her milk was gone. It was amazing that she drank so much, and she also took a measurable amount of cheese sauce.
Drinking milk from a straw like a big girl.
After lunch we camped out in the day patient suite, where we offered Olive a bottle and then tried to get her to nap. She was not exactly a willing participant. I may have had to rock her to sleep and hold her like a baby the whole time, but it was worth it for her to get in a short nap. All that eating and playing wears a little girl out. We had to wake her up for her next session with Polly.

She was pretty much over it by our snack time. The first thing she said was "all done." But Polly coaxed her into participating with the bike pictures and new pictures of fire trucks and construction vehicles. She took licks of goat cheese and peanut butter. She was clearly tired, and it was a lot of "mommy help" with Olive looking to me to dictate her tastes instead of Polly. We powered through it though and once again, she drank two ounces of milk throughout her snack with a straw. That's an awesome step for her, and Polly instructed us try to get her to take that amount with every meal. We will give it a go at dinner tonight on our own.

Olive was exceptionally amused by the blue gloves today.
Overall it was a good day. Polly mentioned anxiety medication again, and she said she would like to start with an appetite stimulant, Periactin. We haven't decided yet, and plan to discuss it with Olive's regular doctor tomorrow morning before making any decisions. We get that it could help with her digestion, but no parent wants to hear that there are side effects like being grumpy. Because Olive is pretty fun and fabulous as is. We treated her to a park trip after we left the hospital, and she had a time of it. We're hopeful that the progress continues tomorrow despite the fact that Olive has told us about twenty times this evening that she would like to go home. We will girl. We will. Just not today.