Vaccinated

Freddie and Hans got flu shots today.  No tears.  They were both so pleased with themselves that they told everyone we passed on the walk home.

All four of us are set.  Fingers crossed that we're healthy all winter long.

4 Year Well Visit

Stats:

Height:  38.5 inches (15th percentile)
Weight:  32.25 lbs (18th percentile)

Vaccinations:

• none

Freddie had his well visit with Dr. G today.

He's gaining on the growth charts.  His height is at the 15th percentile, up from the 7th percentile a year ago.  His weight is 18th percentile, up from 12th percentile a year ago.  She is not at all concerned about his size and thought he'd turn out to be average like his mama and dada.

He had his vision and hearing checked, and all good.  He had a tendency to try peeking with the eye that was covered but she estimated his vision to be somewhere between 20/20 and 20/30.

She thought his development was on perfect course physically, socially, emotionally, and laid on lots of praise for his bicycle riding.  She also was very complementary of his manners and general independence.

We talked again about his toe walking.  Last year she thought he'd outgrow it and was surprised to hear he's still at it.  She said he's a bit old to still be doing it, recommended some exercises, and asked to touch base in about a month.  She spoke with Freddie about the importance of walking flat so his tendons develop normally.  I'm not sure if it's just a bad habit at this point or if his feet hurt when he walks flat, but either way he's got to stretch out his tendons.

There are a few (3 maybe?) vaccinations which are recommended between ages 4 and 6, one of which is MMR and is required in NY state before entering kindergarten.  She asked if I wanted them all now, or one or two now, or none at all.  I gave Freddie the choice because last time he was a bit bummed about not getting any shots.  He didn't want any so I asked if we could just get them all when we see her for flu vaccines next winter, which she said was a fine idea.

I'm thankful for a healthy four year old who loves going to the doctor.  Hopefully he gets to walking flat footed and we don't need to see Dr. G again until the next flu season.

For my record: Sick Visit

Freddie has been running fever for the past five or so days.  Mostly about 100 degrees,  but peaking at 102.5.  He's refusing anything to control the fever after our last medicine fiasco.  He did request a shot, however.  Sigh.

Went to see Dr. G today although his fever's been at or below 100 the past two days with the exception of the middle of the night.  She suspects a virus, again.  His ears, nose, throat look fine and his lungs are clear.  She wants to wait and see, and advised rest. 

Sick Visits (updated)

Took the boys to see Dr. G this morning since Freddie had fever, again.  He's had fever for at least five days, hovering around 100-101.  He's congested and coughing and complaining his throat hurts.

His gunky nose and bad breathe are signs of a possible sinus infection.  She did say a virus piggybacking on another virus because of his weakened immune system is more probable but went ahead with an antibiotic because of this other symptoms.

This would be only the second time he's ever had an antibiotic.  The first time was for an ear infection and the amoxicillan went down smoothly.  This time he's got a z-pak, and it is not going down.  At all.

The kid doesn't cry for shots, but he's not swalling yucky medicine.  Had I known, I think talking about it ahead of time might of helped, but once he got the stuff to his lips there was no way it was going down.  

My attempt at brute force to quickly get it into his cheek with the syringe resulted in his puking all over the two of us.  Putting it in Coke, the only liquid he's agreed to drink all day, made him gag with each tiny sip.

I'll call the doctor in the morning.  I'm feeling like a bad Mama for now.  I apologized for forcing it down and he says, "It's ok, Mama. I sorry, too."

In other news, Hans is healthy, and weighed in at 14lbs 10oz putting him in the 8th percentile.

Thursday Update:  I spoke with Dr. G  and she advised masking the taste with chocolate, but actually just recommended skipping the antibiotic for another day or two until it was 100% evident it was an infection rather than viral.  And sure enough, Freddie's fever broke on Wednesday and he's been fever free today, so I suppose no meds needed.  I know for next time that zpak ain't happening and to ask for something different.  Dr. G has been very kind and helpful and has called to check in with us three times in the past 48 hours.  Although she doesn't keep the most convenient office hours, which aren't even the same week to week, she is very accessible over the phone.

2 year well visit (at 25 months)

Freddie's Stats:

Weight: 24 lbs (5th percentile)
Length: 33 inches (9th percentile)
Head Circumference: 49.5 cm (68th percentile)


Vaccinations:

• None!  I opted to do the second dose of Hep A in 6 months in order to allow Freddie a shot-less visit this time around, since this was our first meeting with Dr. G.

My Concerns:

• Whole milk or low fat:  I know the general recommendation is transition kids to low fat milk after the age of 2.  With cholesterol being an issue on both sides of the family it was something on my mind.  But I also know Freddie doesn't get a lot of fat calories, so I needed some more information.  Dr. G told me what "the" recommendation is, and then echoed my feelings about family health history as well as his current fat intake.  She left if at my doing what I thought was best depending on his eating habits, throwing in that I can feed him anything he'll eat and not to fret too much over his getting a "balanced" diet because the favorites eventually change and eventually his eating habits will evolve, which has been my approach with food thus far.  I'll probably continue the whole milk as long as he's eating like a bird.  I'm also on the hunt for some solid (peer reviewed) resources (i.e. not just what "the" recommendation from physicians or from "Earthmother.com" are) in regards to whole v. lowfat milk in children.

Her concerns:

• None, for the most part.  Of course she wanted to "monitor" his growth so thought another appointment in 6 months would be a good idea, and that would allow for an opportunity to administer his second Hep A dose.  
• He does have a big head, doesn't he?  I filled her in on his past history and she said, well, that's that.  Nothing to worry about.
• She did mention vitamins were the "fashionable" (her word) thing in pediatrics these days, primarily because there is a concern that kids aren't getting enough vitamin D.  She kinda shrugged and said I may want to consider giving him a chewable vitamin each day.
• She also asked that I send the results of his lead screenings.  She said lead screening is required when kids enter preschool so she just assume have this on record rather than repeat testing.
• Her biggest concern was that someone was coming to stay with us for a while when the new baby arrives..."post docs keep crazy hours and you'll definitely need some help."

This was our first appointment with Dr. G.  Finding doctors has been bit of a daunting task for me, as we had such great relationships with our previous healthcare providers.  After having a handful of doctors I wasn't totally happy/comfortable in with in the past I resigned myself to not settle in the area of healthcare. I want someone we trust, who knows our family, and partners with me in my care.  So, how'd it go?  She's a very "seasoned" pediatrician and has a pretty laid back attitude about things.  I'm sure she's seen it all.  She's in private practice, her office is small and informal, and her equipment is not on the cutting edge.  And right now I am fine with those things.  When Freddie was an infant I was thankful for our massive healthcare provider and the resources within the office.  I'm now at a point where Freddie's healthy and more than thriving, and so she'll suit us just fine.   

Next appointment:  October 3rd, 9am, weight check, Hep A vaccine, and flu shot.

Sick

Taking the lizard's (from the advent calender) temperature

Freddie called me into his room about 11pm on Wednesday night.  I thought he was having a bad dream and I tried to rub his back to sooth him.  He immediately sat up and began throwing up.  He was in a panic and so was I.  This was his first time puking.  I picked him up and he proceeded to finish emptying the contents of his tummy. 

Note to self:  Although it may seem vain and not in the spirit of motherhood, pin up hair before picking up a puking child.

Poor guy was so rattled over the whole experience.  He was not happy seeing his bed disassembled and even resisted having his yucky pajamas changed.  Thank goodness for Charlie.  He changed the sheets and wiped up the floor while I tended to Freddie.  What on earth to single mamas do?

After getting some medicine in him to help with his fever we watched some TV and I got cleaned up before all crawling back in bed together.  It was not a restful night for any of us. 

His fever hovered between 103.6 and 101 for most of the day on Thursday.  It was difficult to get any ibuprofen in him and when I did it only lasted a few hours.  The facebook advice received:  Tylenol suppositories.  Yep.  "They work quickly and he can't exactly refuse it."  Everyone swears by them.  We'll be adding them to our medicine cabinet for next time.  Sorry, Freddie. 

He was pretty pitiful.  So was I.  I think we're better today.  We'll spend the day around the house, and the laundry room, just to make sure.

18 month well visit

Freddie's Stats:

Weight: 20 lbs 2 oz. (Below the charts)
Length: 30.25 inches (5th percentile)
Head Circumference: 47.5 cm (40th percentile)

Vaccinations:

• None!

My concerns:

• 5 poops a day?  Seriously?:  There's a wide variance in pooping practices out there, and she definitely felt his average of five and range of four-six poops a day to be a bit on the high side, but still normal.  She did ask about poop appearance to make sure he wasn't passing fat.  (Note:  His poops have been greatly diminished the past two weeks.  I know part of this is just due to the schedule shift, but he has only had organic milk the past two weeks as well.)

Her concerns:

• None!

We filled out the M-CHAT screening for Autism and there are no concerns.  His development is completely on target as well.

His height is back on the charts and his weight is back on the upward curve getting closer to the charts.

We'll miss Dr. J.  Hoping we find someone who shares her instruments, reads books before the exam and notices each of his new tricks in NYC.

Where's my Freddie?

• He wants up, he wants down, he wants up, he wants down.
• Telling me "no" for just about anything and everything.
• Will not eat anything.
• Drinking more milk and water.
• Runny nose.
• Generally whiny and unpleasant
• Not interested in playing for long independently.
• Will not let me out of his sight.
• Only 2 poops yesterday

Is he consitpated?
Is he sick?
Is he gearing up for more teeth?
Is he entering a new phase?

He's sleeping fine and no fever.

Of course I am not feeling well and am feeling very impatient, but this is definitely not my agreeable, easygoing child.  

15 month well visit

Freddie's Stats:

Weight: 18 lbs 12 oz. (Below the charts)
Length: 28.5 inches (Below the charts)
Head Circumference: 47.5 cm (60th percentile)

Vaccinations:

• DTaP/DTP/Td, 4th dose
• Hib, 4th dose
• Hep A
• PCV, 5th dose

My concerns:

• None!

Her concerns:

• None!

Dr, J said we've got a perfect toddler on our hands. His language, social, and motor development are all right on. She suggested substituting 8 oz of PediaSure for 8 oz of milk because it has about 30 calories per ounce as compared to 20 calories per ounce in whole milk, and continue to offer high calorie foods.

We hope to see her in August for his 18 month well visit before the big move.

Perfectly Normal

Dr. J just phoned to say the sweat test results were normal. Everything looks "perfectly normal" so he's just a little peanut of a guy.

Yippee!

No Sweat

Working up a sweat talking on the phone.

Literally. The kid barely sweats.

When we got there the nurse attached two electrode type things to him that came from a machine labeled "sweat inducer." No kidding. And did he ever sweat squirming and having a fit that he had to sit still. After a few minutes of having his sweat induced she attached a little contraption to his leg, wrapped in it plastic, and sent us on our way. We were to return in 30 minutes so she could retrieve the sweat filled device.

After 30 minutes of following him through the hospital we returned to the lab. No go. No sweat. (She said this is typical of underweight kids.)

Repeat the above process 3 more times. There was a little in the tube, but she wasn't sure if it'd be enough. We'd had enough for the day though. He was tired and hungry so we called it quits.

I assume I'll hear from Dr. J before the end of the week with results or with another sweat test appointment.

Updated Info for the Inquiring Minds

I've had a few messages with questions, so I though I'd put the information here, because I like to document. Documentation here makes tracking down information easier.

According to our lab results in June 2008 neither Charlie or I are carriers of cystic fibrosis. We indeed checked that during all of our infertility testing. However, it is possible (not probable in Caucasians is my understanding) for a mutation to go undetected.

Babies in Louisiana (and many other states) are screened for CF at birth. The screening is not diagnostic but gives indicators which may prompt further testing. It is possible for the screening to be negative and a baby still have CF. I am not sure what the probability is for that, but I imagine it isn't that high considering the large number of babies screened and the relatively small number of children with CF.

Anyhow, it seems unlikely that Freddie has CF. I am not too, too worried about it currently, but appreciate Dr. J's efforts for early diagnosis. I don't find her to be an alarmist but she does believe early intervention to be a best practice. And I agree with this wholeheartedly.

Thank you for checking on us and and keeping us in your thoughts. I am sure the sweat test will be an experience. I'll report back tomorrow.

Lab Results

Dr. J called about 8.00 this morning. All results are within the normal range.

We chatted for a bit and she again empasized her feelings that all is well with Freddie based on his health and milestones but thought it best to rule everything out. I agree. It will ease my mind.

She confirmed the sweat test for tomorrow morning.

Doctor Visit

The red bandages on my arms match my outfit!

Freddie's Stats:

Weight: 18lbs, 8oz. (not on the charts)


Concerns:

• Coughing: His coughing has steadily gotten worse over the last week, and it was the worst it's been upon our arrival home on Sunday. He's sounding a bit better today but I can hear him breathing and his coughing is interfering with his sleeping. Of course I wonder if his being reunited with the dogs and dog hair made the cough worse, but that I won't know for some time. The cough comes and goes and has lingered for months. She though he sound congested in his sinuses and she could hear it in his breathing but didn't think it was really in his lungs. He did give a "croopy" sounding cough while we were in there so she went ahead and prescribed steroids, prednisone, once a day for three days. She didn't seem totally sold on the idea of his needing it, and I am not totally sold on the idea of him taking something which may really not be necessary, but we'll follow through and hope this clears things up once and for all. We'll start tomorrow morning since she warned that it will "amp" him up and should be given well before nap or bedtime.
• Diapers: She doesn't seem at all concerned by his stools. She didn't think the yogurt was at all related since he tolerates milk. I probably just need to suck it up and accept the messy diapers, but I would be miffed if my own bowel movements were consistently pasty so I shall continue trying to figure it out. Anyone have any ideas for me to explore? I'm holding off on yogurt for a few to see what happens.
• Weight: He's falling further off the growth charts. While he is gaining it does appear as if his curve is flattening out and may even be reaching a plateau. She said she'd be really concerned if it began to drop. He's been healthy and is on target for milestones but she did want to do some testing to rule out abnormalities just to be sure. She assured me that she really doesn't have any strong suspicions of anything being off but thought it was best to test just to be sure. Blood draw today to check CBC, liver function, kidney function. The blood draw was tough. His veins don't cooperate and he got stuck a lot in both arms. Poor guy was howling and worked up quite the sweat protesting. The nurse is supposed to call me to set up a "sweat test" to check for cystic fibrosis. The test is noninvasive and shouldn't be a big deal. While I am pretty sure neither Charlie or I had any genetic link to CF when we went through all of our infertility testing, the recent coughing and state of his poop make me a tad nervous (mucousy stools are associated with CF).

Next steps:

• Tomorrow afternoon: Phone call from Dr. J to discuss lab results
• Sweat test: Will update here once I get scheduled Wednesday, April 14th, 9am
  

Yogurt?

This post is about poop. Sorry. Gotta document.

Freddie has had some questionable diapers for some time now. His stools are never ever solid. The consistency varies from runny to pasty.

He had a period of perfect, round, solid turds when he first started solid food but since January I have seen few of those. I wondered if it was because he was teething. Dr. J suspected it was due to his increase in fluids when he was sick around the new year and she thought it was firm up as his mucus decreased and his milk consumption increased.

This past week his stools returned to solid until today. The only thing I can think of is that he hadn't had any yogurt the past week until breakfast this morning.

He loves the Brown Cow and Stonyfield whole milk yogurts. Can they really be the cause if whole milk, ice cream, and milk shakes aren't doing the same? Planning on running this by Dr. J at his weigh in tomorrow.

Lead Level

Freddie's lead level is down to 4.

It had been 3 at six months and 6 at nine months. I'm relieved to see it dropping. I imagine this is mostly due to the reduction of mouthing objects although he is still pretty fond of chewing on most everything he picks up.

We'll continue to monitor it.

Thanks for the tip, Ford!

That chocolate chip cake my mama made was pretty good.


I wish I had some milk to wash it down but I suppose I'll try this milkshake she gave me in my Tommie Tippee sippy.

Delish!

12 month well visit

Freddie's Stats:

Weight: 18 lbs 1 oz. (Below the 5th percentile)
Length: 27.5 inches (5-10th percentile)
Head Circumference: 46.75 cm (65th percentile)

Vaccinations:

• PCV (Dose 4)
• Varicella
• MMR
  

My concerns:

• Lead: We did another test. Should have results early next week. This time it was a blood draw from a vein and not a finger prick. This should lead to more accurate results because there is less chance of contamination.
  
• Scrawny: He's tiny. Really tiny. Dr. J says he should be getting about 20-24 oz milk per day. He has recently dropped to 1 nursing a day so she estimates he's getting about 6 oz in that feeding, leaving 18 oz that should be coming from milk. He is not there yet, but she said I could continue the milk in a cup rather than try to entice him with warm milk in a bottle. We're doing everything right, sitting down for meals 3-4 times a day even if it is just a ritual because he tosses everything on the floor, offer him a variety of foods even if he tosses everything on the floor, and opt for high calorie foods. She wants him back in a month to track his weight gain. I didn't ask what actions we'd take if he wasn't gaining, but I imagine it to be some high calorie supplement. We'll see.
• Breathing: She could hear a little crud in his chest still but nothing of great concern. We talked about his constant congestion of varying degrees over the last few weeks. His ears were clear and everything looked ok, so she said it's tricky to determine if it is allergies or just a lingering cold. She seemed to hint at the definite possibilities of allergies and recommended testing when he's two.
  

Dr. J said he is *so* 1, with all of his development being spot on. She indulged in lots and lots of tickle time because the kid has got this great laugh.

He made sweet eyes at the nurse even while pinned to the table. Once he caught site of the needle the lip quivered and he howled. Tears didn't last long though. He actually handled the blood draw for the lead test rather well. Definitely some tears, but mild compared to the shots.

Next appointment: Weight check, April 2010 and then another well visit at 15 months.

Still sick

My two sickies, watching movies in bed...


Freddie had his first sick visit with Dr. J today. He had some fever weekend before last, and has been battling congestion all week. When his temperature shot up this weekend I figured a secondary infection was at work.

Yep, says Dr. J. Right ear is infected. His chest sounded clear enough to her, although his congestion is definitely migrating from his head to his chest. She said his lungs were fine and thought some antibiotic for the ear should take care of it. She said the congestion from a virus (cold) typically lingers for 10-14 days so hopefully we'll be seeing the inside of his nostrils without having to pin him down one day real soon.

Amoxicillin twice a day for ten days. The kid slurped that pink stuff out of the syringe. Yuck!

And the little peanut weighed in at 17 lbs 11 oz today.

After coming home early from work today, Charlie's headed to the doctor first thing tomorrow. He's been congested for a while too. I'm predicting a sinus infection, although his symptoms are a bit flu-y.

The Mama had one sick day, complete with some fever at bedtime, but I am feeling pretty run down at the end of each day. Thankfully I am managing to stay relatively healthy. Hoping we get these germs out of our systems before the weekend, as things are about to get pretty exciting around here.

A Note about Fever

Freddie's sick. He was bit stuffy when I put him to bed last night. He was restless all night, letting out a little whimper here and there and finally at 2.00am I went to him and discovered his fever to be about 100 degrees. After some Tylenol we rocked for about an hour and a half and he was finally content to be back in his crib. He slept until 5.00am, nursed, and then more sleep until 6.30am. Fever was near 100, so another Tylenol dose.

By 10.30 am his temperature was up to 103.5 and he was just so pitiful. After 45 minutes and no change I talked to the on call nurse.

Instructions as follows:

• If temperature is 102.5 or above, then alternate Tylenol and Motrin every 3 hours. If fever remains under 102.5 then every 4 hours is fine. Nothing if under 100.
• Lots of cold fluids and only a diaper on his body.

She was very helpful and reassuring. It was good to hear that I can make an after hours appointment at any time, 24 hours a day, and going to the emergency room is not necessary.

Poor guy. His fever is currently down to about 101 and he's flashing those pearly whites again. He has his first babysitter tonight, who insisted that we still go out as planned. Any bets on how many times I text her from the game?