Friday, November 21, 2008

Report from the High Risk Clinic

Babies who are born before 32 weeks or who are under 3 lbs are considered to be high risk and qualify for a bunch of extra services and tests, including a high risk clinic that evaluates babies at 6 months, 1 year, and 3 years. Kailey was born at 32 weeks (or, really, 31 weeks and 6 days) and was 3 pounds 1 ounce. She was on the borderline between high risk and... moderate risk? Normal risk? Who knows. Whatever - she was right on the fence for pretty much every test and service. The doctors at Kaiser decided to err on the side of caution and Kailey has received all the extra services and tests, and yesterday was her first appointment with the High Risk Infant Clinic. The point of the clinic is to make sure that premature babies are hitting their developmental milestones (for their adjusted age) and to make sure that any interventions are put in place if the baby is falling behind (e.g. physical therapy, speech therapy, etc). We met with a case manager, an occupational therapist, the doctor, and a social worker. Usually there is also a consultation with a neurologist, but that person was unable for Kailey's appointment.

It sounds very overwhelming, but, we weren't nervous about the clinic -- you can tell from watching and interacting with Kailey that she is doing fine. But, we still wanted to go -- if for no other reason than to see her old NICU doctor again and thank her for all of the care and attention she provided Kailey when she was in the NICU (and show her how well Kailey has done since being discharged, of course).

They ran Kailey through a series of tests seeing if she could grasp a ring, transfer it from one hand to another, pick up tiny objects, hold onto two objects at the same time, focus on pictures, identify a new object (they show the baby a page with two identical pictures and the baby is supposed to focus on each one for about 30 seconds and then, once that information is processed, look away. Then they show the baby another page with that same picture again and a new picture and the baby is supposed to focus on the new object), rattle something purposefully (very purposefully, in Kailey's case... she likes the rattle), roll over both directions, pivot, sit up, babble, etc. Kailey did everything (except hold onto two objects at once -- she was too interested in the little red square, and getting it into her mouth, to hold onto two at the same time. But, when we got her home, we gave her two objects and she held onto both of them just fine). The doctor, occupational therapist, social worker and case manager all ohhhed and ahhed about how well Kailey did everything and what a happy, healthy baby she is and then our NICU doctor asked us, "do you want to come for the other two high risk appointments? Kailey is doing great, so I really don't think she needs them. But, it's up to you." The next appointment is at a year, and so we decided to just wait a few months and see if we have any concerns at that time. But, it was a nice to know that Kailey has already "graduated" from the high risk group, at least as far as the doctors are concerned.

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