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Wednesday, May 1, 2013

Wellness Update

Lots of check-ups and appointments at our house! 

Over the past few months, Calvin has had another round of check-ups with all his medical specialists. They all said he's doing great! A couple of them want to see him again; a couple of them said they don't need to see him unless something comes up. He does need one more hernia surgery and there are a couple other possible surgeries in his future. His general health and development are looking good. 

Here's a breakdown of the specialists he saw:

Cardiology - His heart murmur seems unchanged. The VSD (tiny hole in the tissue between his ventricles) isn't closing on its own (boo), but it still could (fingers crossed!). It isn't affecting his heart functioning or anything else about his health (yay!). If it doesn't start to close within the next year or so, they will likely recommend surgery to close it. 

Endocrinology - Kids with Calvin's chromosome deletion often have thyroid problems or low calcium levels. They can also have low growth hormone. All Calvin's tests once again reassured us that his thyroid is functioning fine and his calcium levels are also fine. He is super tiny for his age (less than the 1st percentile!), but given that James and I are on the average-to-short side, the doc said it's not likely a growth hormone deficiency. She said she doesn't need to see Calvin anymore unless something concerning happens like a prolonged illness or a surgery complication related to thyroid function or calcium level. 

Immunology - Immunological problems are also associated with 22Q deletion. A new series of blood tests showed that his immune system is functioning fine! He was even cleared to receive live vaccines for the first time, just in time to get the MMR and Varicella shots at his 12-month check-up. Just like with endocrinology, the doc said he doesn't need to see Calvin anymore unless something concerning happens like a prolonged illness. 

Plastic Surgery - Calvin's previous doctors suspected that he had a submucosal cleft palate (which prevented him from being able to breastfeed), but until this check-up no one had actually confirmed it. His new doc was able to get a good look at his palate at last and confirm that he does actually have that type of cleft (it's not an open cleft, it's where the muscles of the palate are shaped differently and work differently from what you'd see in a "normal" person). The surgeon said it won't affect his eating from here on out but it may affect his speech. If his speech development is affected, they will recommend surgery but they don't make that determination until kids are 3 or 4. 

General Surgery - Calvin has one more hernia to be repaired that was missed in his first surgery last August. Frustrating. It's just above his belly button. It doesn't need urgent repair, but it won't close on its own so we decided to wait a little bit longer and let Calvin get bigger and stronger before another procedure. 

Audiology - Because palate muscles are connected to muscles in the inner ear pretty closely in tiny kiddos, Calvin had an extra hearing test. He passed with flying colors. His hearing is just fine!

 Nephrology - (Kidney doctor) Calvin had his kidneys checked when he was a newborn because his umbilical cord was a 2VC (2 vessel cord: 1 artery, 1 vein whereas there are usually 2 arteries and 1 vein) and that is sometimes associated with kidney problems because the kidneys develop at the same time as the umbilical vessels in utero (or something like that). Anyway, at that newborn kidney check the ultrasound showed that his kidneys were slightly enlarged. So they did another ultrasound to check the growth of his kidneys and sure enough they are still a little bit big for his tiny body but they are functioning fine so it doesn't seem to be a problem. They're going to check them again in a few months. 

Pediatrician - Last but not least, his pediatrician says he is doing great. He's tiny, but growing at the same rate as other kids. His development is looking good. He's ready to start weaning from the bottle and drinking cow milk instead of formula. And he got his 12 month vaccines. 

This week he woke up with a rash that came along with a low fever. We thought it was a reaction to one of the vaccines, but when we took him back to the pediatrician she said it was hives from an allergic reaction. Benadryl cleared it right up. Don't know what food triggered it, but the doc said not to stress about it unless it happens again.

James had his broken clavicle repaired with surgery last Friday. They re-set the bones and put in a plate to hold them together. He'll have his right arm in a sling for 6 weeks. He didn't need surgery on the wrist. They put him in a cast last week and the cast comes off next week to be replaced by a wrist brace for a couple of weeks. He's got appointments with both his shoulder and wrist doctors next week. 

He is recovering from the surgery well and needing his pain meds less and less which is a big relief. He says the worst thing is that the plastic bandages over the incision site are really uncomfortable. He'll have to put up with them until he sees the surgeon for the follow-up next week. 

And me? I'm doing fine :) Busy taking care of these boys, but trying not to take on too much so that I get some rest for myself. The pregnancy is progressing well. My midwife, Michelle,  is coming every other week to check on me and the new baby now that I am in my third trimester. Baby brother is kicking and moving around a lot, especially at night when I am trying to sleep! His heartbeat is always strong when we listen to it on Michelle's fetoscope and fetal doppler. I was having some problems with dehydration a couple of months ago, but I have been able to stay better hydrated by drinking a few electrolyte-rich drinks throughout the week in addition to water instead of just plain water like I'd been drinking (I stick with mostly coconut water to get my electrolytes). 

So Calvin's doing great and will have future chek-ups with some of his specialists. James is on the mend and should have the use of both arms again in time for baby brother's arrival. Baby brother seems to be doing well and I am feeling fine (if tired... but come on, I'm a mom! A mom to a baby and one more on the way! I can hardly complain about feeling tired - I'm pretty sure it's in the job description!). 

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