Last night was a bit rough. He had lots of reflux, no vomiting. His g tube extension popped out of the button since it was the wrong extension and never locked into place, therefore leaking his feeds on him and the bed for part of the night until it was caught during a diaper change. He’s had some coughing from the reflux as well and that makes him really upset when he coughs. Also, had a short, less than 30 second facial twitch seizure. Didn’t need meds to help it end and never returned (could be from poor sleep, sodiums fluctuating, stress). The docs here are aware of the seizure and will just monitor at the moment as it’s the same as his subdural seizure and we know it’s still there on the left side. 

PT: did good back, trunk and neck stretches. Worked on sitting more independently with head control (improving but it’ll be awhile until he’s truly independent). Tried a sit to stand piece of medical equipment, although it seems convenient but quite bulky. Will see if it’ll be a good fit for him when we go home one day (if needed). 
OT: worked on head control, leaning and trunk control. Placed in the stander and walked around the floor. Worked on trying to lift his hips up when on his back. Got to be on the sensory swing to help restore vestibular balance. 
Speech: tried to find ways to get him to communicate without words: bells, buttons, and eye tracking but nothing really stuck. Worked on eating foods at lunch (only semi interested today due to his reflux issues). 
Random: trying to get to the bottom of his weight gain despite being on a diet. He’s been third spacing fluid to his hands, feet and abdomen. Therefore making his blood sodium low and diapers have been more dry (showing he’s “over hydrated” at the moment). Will be doing tube feeds but hold the free water until the blood sodium comes up to higher normal levels then can add back in water at a much lowered amount per day then when he was in a DI. His diapers have been on the dryer side but that’s because his body thinks he has to retain fluids (opposite of when he’s in a DI). It’s like SIADH (syndrome of inappropriate anti diuretic hormone-ADH makes you retain urine) but endocrine doesn’t want to label it as that. Will be doing daily sodium checks and weights until we get him back on track.