Check Ups: Emily's 12 Month and Sean's 5 year Endo

Sean and Emily both doctor appointments in the last 2 weeks. Sean was first. He had his yearly endo check up on the 11th. Endo conformed that even though Sean is way below the chart, he is still on his own curve. He wanted to do another bone age scan since it's easier to read the older Sean gets and he also wanted to look at the interval of change. I received the results on the 18th. Everything appears normal so he'll go back in a year.

On the 18th, Emily also had her belated 12 month check up. Not much to report as everything is looking good. Her stats are 17lbs 9oz, 28.5in. She's close to what Sean was at this age; just a pound heavier. The difference in the boy and girl charts is odd to me. At this size, Sean was well below the chart, Em is at the 5th percentile. Looks like we'll have 2 peanuts in the family. :)

Just for kicks I made charts to compare the kids' weights and lengths through out their first year (click to enlarge):

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4 Year Endo Checkup

Sean had an endo check up last Friday. It went very well. Doc was very pleased with how Sean has grown..it's been 8 months since he saw him. Again, he's keeping up with the curve and that's the important thing. The doc suggested that we go ahead and redo the bone age scan to confirm that Sean's just fine, just on the small side. As long as the scan comes back saying he has normal growth potential, we're good and we won't go back for a year. Sean made me very proud. Last time he sat on my lap for the xray. Obviously, I couldn't do that this time. The tech and I got him sitting in the chair, hand in place and then we walked behind the safety area. Even after almost starting to cry and fighting them when they tried to weight and measure him, Sean sat there all by himself like a big boy, kept still and didn't even fuss. Crazy how they decide when and what to fight!

Today we got the results. His bone age is the same as his age. That's a good thing! Last time it was slightly older than his age. Doc says that what we want to see is Sean's bone age get a little younger than his real age...which it seems like it's doing. That will mean he has more growth potential and is possibly just a late bloomer. We go back in a year.



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Doctor Appointments

Last week Sean had his endo followup and today Maddy had her 2 year check up.

Stats:
Sean - 3 years 5 months - 34in - 25lbs
Maddy - 2 year - 34in - 25lbs
No wonder people always assume they are twins!

I'll start with Sean's endo followup. While Sean is on the small side, he's now growing with the curve. The doc wants to still redo the bone age scan in November just to double check since it'll be more reliable than it was when it was done last time. I just have to say how happy I am with Dr Gyuricsko. He really does an awesome job explaining everything to me. He also works on gaining Sean's trust before he examines him.

Now to Maddy's check up. She's so funny. She lets the doctor examine her without a fight but she refuses to speak and gives him the death glare the whole time. I went in with a couple of things that I wanted to talk to the doctor about.

First was her poop issues. Back around Christmas she decided she didn't want to poop. She'd poop after a week because she couldn't hold it in anymore. I added more fiber and apple juice to her diet and gave her laxatives if she went more than a couple of days without pooping. It took awhile but it seemed to fix the problem. Then we worked on potty training. She could be potty trained if she wanted too. BUT she decided she would only stay dry in a diaper and just a couple weeks ago she started holding in poop again. Needless to say, she'll be potty trained when she decides to. I brought this up today. She's now going to be on Miralax or Milk of Magnesia daily to keep her regular. The doctor says it can take up to a month or so for her to realize that it's not suppose to hurt to poop and get her going on her own.

Second was her feet. I've noticed that when she walks her feet roll in and lose the arch. The doctor confirmed this but isn't concerned. It's not too uncommon at this age and could possibly fix itself. If it doesn't and her feet begin to bother her when she gets a little older, we'll have to get arch supports for her shoes.

And that is all. I take them both back in Oct/Nov for 2 1/2 year and 4 year check ups.



Not what I put them in this morning but hey, they're happy. ;)

Follow Up Endo Appointment

Sean had his follow up endo appointment this morning. (If you don't know about the first appointment read this: first endo appointment ) Today's appointment was so much better. We saw Dr Gyuricsko this time. First of all, the man has bedside manners!! He had Sean smiling and laughing in no time. Sean even gave him a high five at the end. This is big! Our last visit ended with 2 screaming kids and 2 frustrated parents. Dr G also did a very good job explaining things instead of assuming I understood why. He explained the bone age scan that was done a few months ago. He disagreed with the radiologist...but also said that it's b/c the radiologist doesn't read these as much as they read xrays for fractures and such. Sean's bone age is between 2 years 8 months and 3 years. Right on track. Dr G also mention how it's really not easy to pick up on things on the bone age scan at this age. At this age, there are still some bones in the wrist that haven't formed. It's more reliable at 5 years. So, if he's still having growth issues at 5 years old, they'll reorder the bone age.

As things would have it, Sean has had a big growth spurt. In the last 3 months he has grown 4 lbs and 1 1/4 in! That's the most he's ever grown! He's almost at the 5th percentile! The doctor is speculating that he may be trying to catch up because in the last 3 months he has grown faster than normal kids grow. On the growth rate chart, he's at the 90% mark for the past 3 months. This is a wonderful sign. Because he has no other problems right now and he has had this growth spurt, Dr G is not ordering any more tests for now. We are going to wait and see. We go back in 6 months.

Next week Sean has a follow up appointment with the G.I.

Peanut update

What a week it's been! Last Tuesday (June 15th) we finally had Sean's endo appointment. What a waste!! We saw Dr Kent Reifschneider. What an idiot! I left so frustrated and with no answers. Here's a break down of the appointment:

• Asked why we were there. We had to tell him Sean’s history. It seemed he hadn’t looked over Sean’s chart at all. He didn’t know about any of the testing that had been done. (Ped even wrote a nice long letter to Dr R about Sean.)
  
• Asked if we had seen a dietitian. We said we had but she said she couldn’t help us until Sean weaned.
• He asked if there was a reason I let him nurse that long or if it was just my “belief“. I said that there are many benefits for a toddler so there was no reason to make him wean. He said “oh yes there is!”
• Asked me about teeth and dismissed hormone problems b/c Sean got his first tooth at 9-10 months.
• Asked about pooping and dismissed absorption problems b/c Sean poops fine. He didn’t ask how often or about appearance, just if I thought he was pooping fine.
• The only family history taken was Richard’s and my height. He took them, found the average and told us that that is how tall Sean should be as an adult.
• Asked about his drinking and eating habits but cut me off after I told him about breakfast. He says that Sean is small b/c he doesn’t get enough calories.
• He said that if we don’t change Sean’s diet now, he’ll never meet the size he’s suppose to be. He told me many times that I needed to count his calories and it would prove that he is right. I felt he was talking down to us the whole time; like we are bad parents and it’s our fault Sean is small.
• His suggestions were: cut out all water and only give him milk to drink…milk with coffee creamer is better. And don’t let him drink too much. The way we know how much to give him…the things to look for that would mean we’re giving him too little are signs of dehydration…he said that Sean only needs to pee twice a day and if he pees more than that, to cut back on what he’s drinking
• I did not like the way he treated Sean. He wanted to see Sean run. He didn’t tell us this and never even told us why. Sean was sitting in my lap, crying b/c he’s shy and that’s typical at a doctor visit. Dr R was sitting in front of us in a chair with wheels. He had just finished checking Sean’s back, listening to his heart, breathing, etc. Without warning, he grabbed Sean, rolled across the room and let him go. Sean, of course came running back to me screaming and crying. He was terrified!

I did a calorie count for that day. Dr R claims he doubts Sean even gets 400 calories a day. He has 1070 that day...about a normal, maybe a little less than normal day. Dr. R said he should have 700-800 a day. AAP says 40 calories for every pound the child weighs, which would be 880 for Sean. USDA suggests 1000 calories a day for 2-3 year olds.


Wednesday I called the ped and got an appointment to talk to him the following day (Thurs). The ped (Dr Dean Cauley) is awesome! Thursday he spent 45 minutes talking to me about Dr R and what we can do now. Dr C completely agreed with me about Dr R and about his advise. He also told me that I wasn't the first to complain about him. We will be going back to the endo but not to Dr R. Sean's also going to see a GI to talk about food sensitivities. Dr C wrote a prescription for the bone age scan and Sean will also be tested for Cystic Fibrosis. There's hardly a chance that Sean has CF but it's an extremely simple test so we're doing it to rule it out.

Friday morning I got a call from Dr R. Dr C had called him and voiced my concerns! Man am I impressed. I was Dr C's last appointment the day before and Dr R called me pretty early. Dr C is on the ball! Dr R had lots of excuses, mainly that it was a long day. Not an excuse!!

Where we go from here: this week we will go for the bone scan...no appointment needed. July 13th is the CF test. July 30th is Sean's GI appointment (Dr Michael Konikoff). Oct. 7th is when Sean goes back to the endo (Dr Eric Gyuricsko)

Because I can't sit and do nothing, I'm doing calorie counts for Sean and adjusting his diet. Today is day 4 of the first set of calorie counts. I'm going to do about a week worth of calorie counts every few weeks. I'm doing a week at a time because you have to look at a toddler's diet a week at a time because it changed so much.

And just as a reference; Sean's updated growth chart:

Maddy's 12 month and Sean's weight check

Maddy had her 12 month check up and Sean had a weight check today.

Maddy- 31 1/4in 20lbs 15oz
Didn't shed a tear when she had her shot or when she had blood drawn for iron/lead testing. He mentioned that if she doesn't get teeth by 15 months, he'll send up to a dentist but he can see that teeth are right under the gums and the dentist really won't do anything. lol He didn't bat an eye when I told him that Maddy wouldn't be getting the MMR this time.

Sean- 33 1/4in 21lbs 15oz
He cried more than Maddy...with just the doctor talking to him. Doctor says he looks great and was very impressed with the potty training in 2 weeks. He grew a tad faster than last time but the doc agreed that he should go see an endocrinologist mainly to put our minds at ease. I have to wait till the end of the week to call to make the appointment to give them time to get the paperwork sent over.

AND I finally have kids over 20lbs/1yr...so what did the doctor say!? Keep them rear-facing as long as possible, but at least to 2 years if I can.