Allergy Rx

After last weeks struggle with allergies, including skipping gymnastics because he was wheezing and just not himself, we headed in to see Dr. G.  NYC had a bit of rain so the pollen counts came down and his eyes seemed better so we were able to "get ahead" of the symptoms and hopefully keep them in check for the rest of the pollen season.

Dr. G prescribe Panaday eyedrops once a day and Singulair once a day for the next month or so.  He also got some albuterol to help with his breathing, which sounded much better after the first two treatments.  She figured he'd need just once a day for the next five or six days.

He's not a fan of the eyedrops, although he is getting better.  I dread the day he'll have to learn to swallow a pill.  For being such a tough guy at the doctor's office, he turns to nothing but whine when mama needs to give him some medicine.

Allergies

This picture is after a dose of Claritin, a dose of Zyrtec, and a double dose of Allegra topped off with two doses of Naphcon eye drops within 24 hours.  And he actually looks pretty good, believe it or not.  He has some mild congestion, but the big problem is the red, itchy eyes.  I'm not sure what to do next since nothing over the counter seems to be working.  The weed and grass pollen levels are low and tree pollen is moderate to high right now (oak, birch, and maple).  He has a similar issue in New Orleans in March, so my bet would be that it's the oak pollen that's bothering him.

Pollen levels are down today with some rain, so he'll get a little relief.  Making and appointment with the pediatrician though to see if she has any other ideas on what might help.

Freddie's Six Year Well Visit

Stats:

• 44.5 lbs (39th percentile)
• 45 inches (35th percentile)

Vaccinations:

• None

All healthy!  Dr. G asked about school, and household responsibilities.  She said now is the time for Freddie to start taking on some chores.  He's eager, so Mama needs to figure out how to add this to the routine, but I let her know he is responsible for helping in when asked which he usually does without much fuss.  Dr. G is also curious as to what his response to spring pollen will be this year.  She recommended Naphcaon A eye drops and Zyrtec.

She asked about his diet, which has improved by leaps and bounds over the past year or two.  He's growing and even catching up on the growth charts.  Who would've guessed after all that worry I put into it when he was young and so tiny?  

Everyone's been very healthy so we really have only seen Dr. G for well visits and flu shots.  Hoping Freddie's next visit is to get his flu shot next winter.

3 Year Well Visit

Roar!

Hans' Stats:

Height:  38 inches (75th percentile)
Weight:  33 lbs (75th percentile)

Vaccinations:

• None!  

Vision:

• 20/30

My Concerns:

• None

Dr. G's Concerns:

• None

He had his vision checked, and did really well.  I was surprised that he knew the names of the shapes to even complete the test.  Dr. G said he looked good and healthy.  She commented both boys have a good track record of staying healthy.  We'll see her for flu shots in the fall.

Side note:  Dr. G listened to Freddie's breathing to check after his last breathing treatment in the office and he was all clear.  I didn't give him any additional breathing treatments since he sounded better to me the next day, and apparently whatever it was cleared up. Whew.  Hopefully his allergies are just some seasonal irritations that bring some congestion.  

Allergies

The red watery eyes and sniffles over the last two weeks seem to be a sure sign that my guy has some seasonal allergies.  The pollen count is exceptionally high lately, which I kinda figured considering Freddie cannot stop rubbing his eyes whenever we step outside. Not sure what the options were for a five year old, we popped in to see Dr. G who is also a pediatric allergist.

Who needs a tissue when you have a sleeve…yuck.  Boys are gross.
Thankfully he will scramble for a tissue of some sort when he has a particular bad sneeze.

Apparently five is right around the time when allergies begin to appear in kids, so Freddie is right on target.  Sigh. She heard some wheezing in his chest so hooked him up for a breathing treatment, which didn't do any good.  She suspects the cough is viral and not related to allergies, but she sent us home with a few vials of albuterol just in case but suggested skipping steroids or other aggressive treatments since the cough hasn't been restricting his activity and she thought his body would sort it out on its own.  She recommended either Claritin or Zyrtec syrup, 5mg, but said it was fine to give him the 10mg dissolve tabs since I had my doubts about him swigging syrup each morning.  She recommended eye drops if he'd tolerate them.  He's on day 2 of Zyrtec and there's a marked improvement.  I'm hoping the pollen counts come down soon so we can see if that helps as well.

*Note:  Active pollen right now:  oak, mulberry, birch.  The grass and weed pollen levels are low to none.

5 year Well Visit

Stats:

• 37.5 lbs (25th percentile)
• 42 inches (25th percentile)

Vaccinations:

• DTaP (5th dose)
• Polio (4th dose)
• MMR (2nd dose)
• Varicella (2nd dose)

2 shots today, so none at his 6 year well visit.  He was brave and *insisted* he didn't even need an hand to hold during his shots.  

He hd his vision and hearing tested.  20/20 vision, no hearing concerns.

Dr. G spoke with Freddie about the importance of a variety in his diet, and he agreed to try more vegetables.  We'll see about that.

She recommended some foot stretches to help with his ongoing issue of being a toe walker.  I think this is just a habit, although he complained some of pain when she was stretching his tendons.  Although he's definitely reduced the time he spends on his toes, I'd still estimate he does it 60-70% of the time particularly if we're out walking long distances in the city.  The concern is tendons not lengthening properly and his have to wear braces to stretch them (or even surgery, as Dr. G warned) down the road.  We'll be trying to add in some stretches here and there throughout the day because I cannot imagine one more thing added to the evening post-bath pre-bed routine which is where Dr. G recommended we add them.  

Dr. G commented that his tonsils were really large…like his daddy I suppose.  She asked about any sleep apnea concerns, and suggested monitoring him as he does snore at times.  (Although Hans is the big snorer and I guess we'll talk to her about that when he visits in June.)

Big news is he's growing!  He is up to the 25th percentile from the 15th percentile a year ago.  

All around healthy boy, thank goodness.

Vaccination Visit

Dr. G scheduled us before her first appointment, since it was just one shot and I promised I'd be happy with a quickie visit.  Perfect.  Freddie, however, had other ideas.  His need to chit chat probably made the appointment longer than she expected, but she let him talk as long as his heart desired.

Vaccinations:

• Influenza for Freddie

No tears.  He just asked a few questions about the flu through the process.

Hans' lab results weren't available yet.  

Three Year Well Visit

At 3 years, 1 week, 3 days:

Stats:

• Weight:  27.6 lbs (12th percentile)
• Height: 35.25 inches (7th percentile)

Vaccinations:

• None

He's growing.  He's gained his 2 inches per year estimate since the last visit.  I asked about percentiles being a predictor of adult height and she said if I was worried we could see an endocrinologist or do a "bone age" study.  Not necessary, I was just curious.  Anyway, she thought growth spurts later down the road do happen and a bone age test would say if that was most likely in his future.  But, he's growing. 

Freddie LOVES going to Dr. G.  He's been looking forward to this visit all week.  He commented on the child screaming bloody murder in the next room, but didn't seem bothered.  He's crying, Mama.  His shots must hurt.  No shots for Freddie, and he seemed ok with that, I suppose since Hans didn't get any it was fair. 

Well Visits

Freddie at 2 years, 8 months:
Stats:

• Weight: 27 lbs (15th percentile)
• Height: 34 inches (5th percentile)

Vaccinations:

• Hep A, 2nd dose
• Influenza

Right on track with growth, with the 1 inch growth in about six months!  Dr. G said to expect about 2 inches per year.


Also, the child DID NOT CRY for either shot.  And he watched the needle go in both times!  I was amazed.  We have been talking about going to see Dr. G for the past week and told him he was going to get a shot.  We also told him that shots hurt.  He went with Charlie to get his allergy shot and he's seen Hans get his shots.  He knew what he was in for and this morning he was actually *excited* to go to the doctor to get a shot.  It was if he was getting initiated into the club.  I told him it'd be ok if he cried because it does hurt.  Not a tear. 


No concerns.  Development looks great.  She was impressed with his toileting, vocabulary, and imagination. 

Mama at 37 years 4 months:
Stats:

• 3 lbs from prepregnancy weight and nowhere near fitting into my prepregnancy pants.  Sigh.

Vaccinations:

• Influenza

I asked if she thought my OB had the vaccinations and would administer one to me, and she offered to take care of it.  She said I had too much other stuff to worry about and didn't need to schlep into the city with two babies for a vaccination.  I agree!  I didn't cry but man my arm is aching!

Hans, 4 month well visit at 4 months, 5 days:

• Weight:  12 lbs 5 oz (2nd percentile)
• Length:  25 inches (40th percentile)
• Head circumference: 41.5 cm (35th percentile)

Vaccinations:

• Rotovirus, 2nd dose
• Hib, 2nd dose
• DTP, 2nd dose
• IPV, 2nd dose
• PCV, 2nd dose

Well, can you spot the problem?  Hans is only in the 2nd percentile for weight.  A drop from the 22nd percentile at his last visit.  And even thinner than Freddie at the same age.  All of his percentiles dropped, actually, but the weight is the most significant.

We began the visit with my concerns, where I brought up the issue of his bowel movements being infrequent, once every 7-9 days.  Although there have been a few days of daily bowel movements here an there, he continues to go long stretches.  And she said this was normal, even if he is showing some signs of "discomfort."  I've been doing some weight checks on the scale at home and knew he was not gaining a significant amount of weight and had a feeling she might change her opinion of the "normalcy" of his infrequent bowel movements once she saw his weight.

Sure enough, she's concerned about his weight.  The fact that he's not pooping as often in addition to the weight supports her concern.  "As much as I hate to say it, I think you should supplement with formula," she said.

And I said, "I really don't want to do that."  So we talked about why: 

• Supplementing often results in the baby refusing the breast and at the very least means I will produce less with the baby getting (some) nourishment elsewhere.  
• I breastfeed to pass on antibodies.  Charlie suffers with allergies, and I want to take whatever steps necessary to prevent Hans from having allergies.  The recommendation is a year, and I want to nurse for a year.  She, as a pediatric allergist, wholeheartedly agrees with nursing for this reason. 
• Freddie was (is) small, and he's fine.  I think it is completely in the realm of normal for both boys to be similarly sized.

So she gave me the name of a lactation consultant who may have some suggestions.  She said she wouldn't dare recommend waking him during his 9 hour slumber to nurse, and hoped the lactation consultant might have some other ideas.  I sure hope those other ideas don't include the pump.  Sigh.

She checked his urine, for what I don't know, and it was "normal."

She talked about the expected drop in weight for babies around the 6 month mark because of their increased activity, but still thought this drop at 4 months was a little premature and quite severe.

She thought starting solids might help and gave me the go ahead, although she said her typical recommendation is to wait until 6 months.  At the very least, she wants me to come back in a few weeks to check his weight.

His development was normal, cooing and babbling, smiling, wiggling, and lifting his chest and head off the table nice and steady. 

My general feeling is that he's doing just fine, but I do feel it necessary to follow through with the next few precautionary steps just to be certain.

Next appointment:  November 9th with Dr. G.  Appointment pending with lactation consultant

Freddie Goes to the Dentist

Today was Freddie's first visit to the dentist.  We'd been preparing this past week talking about what dentists do and we had a book about the dentist.  We'd find him in his room looking through the pictures during the week.  He seemed pretty excited to make sure his teeth stayed healthy and "didn't get sick."

Mama went first, and he watched.  But when the noisy cleaning began he covered his ears and began crying.  I asked him to stand closer and hold my hand to help me be brave.  That seemed to do the trick as he clamed down.  I thought that had pretty much sealed the deal and there'd be no way he'd let her into his mouth.

But he climbed up into the chair and said "aaaahhhhhh" just like we'd been practicing.  He held his mouth open wide the entire time.  The dentist poked around and "no signs of any cavities."  She then showed him her "special brush" and let him feel the movement on his hand first.  He sat still through having his teeth polished.  His favorite part:  the little cup filled with water, rinsing, and spitting in the little sink.