Check up with Dr. Smith

Evan had his 3-year-old checkup with our local pediatrician, Dr. Smith today. It has been a while since we've had Evan weighed, so we guesstimated ahead of time that he would weigh about 23 pounds (he's been feeling heavier lately). We were close, he weighed 22 lbs. 2 oz. but he was 33 inches (so he is getting taller). He's still way off the charts, but a pretty perfectly sized 18-month old.

He was an absolute angel at his appointment...he even went to Dr. Smith and sat on his lap willingly. Evan got a clear bill of health. We don't have to come back to see Dr. Smith until he's 4 (unfortunately there will be shots at his 4 year old check-up).

Back to the Doc!

Evan had a doctor's appointment today (and ironically he has the crud also)...but his appointment wasn't for the crud, but to check on a problem he's been having at daycare. About 4-5 times over the past month, he's been having these passing out episodes where he stops breathing and turns blue. It takes his teachers about 15-20 seconds to get him back to normal by blowing in his face or splashing him with water. These episodes are usually brought on by extreme crying (usually someone stepped on his hand or knocked him over). We've never seen this happen at home, so it's really odd.

Dr. Smith was concerned about these episodes and wants to pursue all the options to make sure it's not something serious. He said it sounded like a case of breath-holding syndrome, which is what is sounds like. He is having Evan do a bunch of tests to rule out "Syncope" which is a more serious issue. We have to get blood draw to check to make sure metabolically everything is fine; a 12-line EKG; chest x-ray and MRI and EEG (at Tucson Medical Center). We're wating to hear from TMC when the EEG and MRI will be. Thank goodness he'll be sedated for those tests.

After the doctor's visit we went to the hospital to have Evan's blood drawn and EKG. The poor boy hadn't napped or ate anything all day, so he was miserable. We tried to get the EKG done first, the lady was able to get the stickers on his chest without too much fuss, but when she put the leads on, Evan lost his mind. We decided to wait until after he got blood drawn to do the EKG. Of course, the blood draw was terrible since Evan was so dehydrated. The poor lab tech had to use the top of Evan's hand to get a good vein. It took 2 lab techs and me holding him in the chair. After the blood draw, we tried the EKG one more time and of course, he was a no-go at that station again. We'll try again in a day or so.

On top of Evan feeling terrible today due to the onset of a bad cold, he got a flu shot. Dr. Smith was also concerned with Evan's chest congestion, so he prescribed Pulmicort 2 times a day in his nebulizer for the next 2 weeks. That should help open up his chest a bit more.

Weight check: 21 pounds 3 ounces (will the boy ever get heavier)??
Length: 31 inches.

2-Year Old Check-Up

Evan had his 2-year check-up today and we were hopeful to see him post a weight over 20 pounds. He made it with an extra 2 oz! So Evan at 2 years and 1 day, weighs 20 pounds 2 ounces. His height is now 30.25 inches, so he's gained a bit of height.

No significant things to report from the doctor's visit aside from Evan sounding a bit wheezy to the doc. Never fails that Evan gets congested right before going to the doc; so we'll try to give him an albuterol treatment to help clear him out.

Weight Check!

We had to get one of Evan's vaccinations done today since he missed getting it back in January. It had been a while since we had a weight check on Evan, so that's one good thing that comes out of visits to the doctor's office.

We put Evan on the scale and it read 19 lbs. 11 oz....still no 20 pounds yet! We didn't check his length but we are very sure he's gained a bit of height. Evan did so well for the shot; he barely cried. We think he's just so used to shots that it doesn't bother him as much. We set up his 2-year old appointment for next month and fingers crossed, no shots at that appointment.

Last Synagis Shot!

Today was Evan's last Synagis shot for he season. He won't have to get the monthly shots anymore since he'll be 2 by the next RSV season. Evan didn't gain much weight (3 oz.) since last month...he was 18 lbs. 14 ounces. That was to be expected since he hasn't been eating much.

Finally Seeing A Good Weight Gain

It was time for Evan's monthly Synagis shot today. The upside to it is that we get a weight check on him. Today he weighed 18 pounds 11 ounces, which is is 1 pound 5 ounce gain in one month. He still has a long way to go to get caught up on weight, but he's getting closer to that 20 pound milestone. The nurse told us he only has one more Synagis shot for this season at the end of April.

Dr. Hassan (the gastroenterologist) is keeping Evan on the Prevacid a bit longer. He wants us to wean him off of it (day on/day off) for 30 more doses (so 2 months longer). It will be nice not having to ambush Evan every morning to dump the granules into his mouth (he's getting good at anticipating it).

Weight Gain!

Today we had Evan weighed at the pediatrician (by Dr. Hassan's request). He weighed 17 pounds 14 ounces, which is about an 8 ounce gain since last week. Yea!! He's close to catching up to the weight he's was a while ago.

Check Up With Dr. Hassan and Upper GI

Today was the last minute appointment with Evan's Gastroenterologist (Dr. Hassan). We're fortunate that he comes down from Tucson about once a month now. Before Evan's 9:30 appointment, we had to get an Upper GI done on him at Sierra Diagnostics. Dr. Klein was the doctor who did the procedure, which didn't go as well as planned.

The x-ray technician who prepared the Barium drink made it really thin. I was prepared with one of Evan's bottles with a y-cut nipple for thick liquids. Of course Evan went crazy when it came time for him to lay on the x-ray table. When we gave him the bottle with the Barium, he was laying on his back and all the liquid rushed out through the nipple. Poor guy probably felt like he was drowning, so he didn't get enough good swallows for good pictures.

They also took a chest x-ray since Evan had a bout of pneumonia last fall. It was just a precautionary thing to make sure he didn't have any lung damage. Dr. Klein was able to see that all his digestive anatomy was in place; which we pretty much knew already.

Our appointment with Dr. Hassan was quick. He decided to give Evan a prescription for Prevacid; so we stop giving him Zantac and give him this instead. We have to get Evan re-weighed next Thursday at the pediatrician and if he is still losing weight, Dr. Hassan wants a call from the pediatrician. He weighed 8 kilograms when they checked his weight (about 17.6 pounds)

Monthly Synagis Shot

The dreaded monthly Synagis shot was today. The one good thing about the shot is that we always get a weight check on Evan. We were sad to see he has dropped a good bit of weight (he weighed about 17 pounds 6 ounces). Evan was up over 18 pounds; and we knew he would have a drop in weight since he's eating pretty much no solid food now (even on the Zantac).

The nurse was also concerned and was proactive in calling Dr. Hassan (Evan's Gastroenterologist) to see about getting him to see Evan ASAP. We were able to get him in the next day when Dr. Hassan would be in town. The doc wanted an Upper GI done on him before his appointment on Thursday.

18-Month Check-up

Can you believe...18 months??!! It was a relatively quick check-up with Dr. Smith...quick listen to his lungs, ears and teeth check. I think I forgot to mention one of his bottom molar teeth is coming in. He has all four top front teeth, two bottom and one bottom incisor tooth. He isn't very patient in letting us look in his mouth. ;-)

Of course Evan is still very much underweight and under-height for his age, but at least now he is gaining weight. Tomorrow we have an appointment with the speech therapist who will do a feeding assessment on him. We're still waiting to hear on the results of his sweat chloride test from Monday.

Weight check:

18 lbs. 2 oz.
28.5 inches tall
45 cm head circumference

If you open this image, you will see two circles connected by a line, the circle on the left represents his adjusted age and the right circle is his actual age:

Synagis Shot #3

Quick trip to the doctor's today for Evan's third Synagis shot of the season. He knew it was coming when we undressed him to get weighed. We were happy to see his weight went up, but it was sort-of a false reading since he had a poopy diaper. He weighed in at a heft 17 pounds, 15 ounces...but with the poop-weight, we are guessing it was more like 17 pounds 10 ounces. Luckily, the nurse who gives him his shot is really quick.

Synagis Shot #2

Evan had his second Synagis shot of the RSV season. We think only about 4-5 left to go. He shouldn't have to get them next fall since he'll be over 2 years of age.

Evan had an interesting eating week...now he seems to be eating more of the table food he is offered at daycare. I get notes from daycare annotated with what he eats and he's been eating things like burritos, pizza, crackers, french toast....ham salad! Ham salad!!?? Is this our same kid?? His teachers are still feeding him the "power-packed" food I send with him to get those extra calories in.

Weight check: 17 pounds 1 ounce

Synagis Shot #1

Ahhh, the fall weather and the onset of RSV season (again). Since Evan's weight is still low, he has to get the full series of Synagis shots (a shot every 28 days until the spring). It had been a while since he had a shot, and he knew it was coming (poor guy). The nurse also did his flu shot at the same time in the other leg (ouch).

When we weighed him, he was about 16 pounds 12 ounces, so he had a very little weight gain since the last doctor's appointment. I had the nurse do a quick look-over the test results from his blood test and she didn't see anything unusual (his thyroid levels were good); so at first glance it doesn't look like there's a metabolic issue of why he is so small.

Check up with the doc...and a video

We took Evan to see his local pediatrician for 2 reasons. The first was to get this bump on his foot looked at. We call it his "barnicle" since it sort of looks like one. The doc says it's probably a wart and the best way to heal it is to use (of all things)...duct tape. There's something with the fibers in the duct tape that helps to remove it. He says it will take up to 6 months (yikes)!

The second reason was a follow-up with what Evan's pulmunologist said about his lack of weight gain. We saw Dr. Smith instead of Dr. Ettinger since Dr. Smith is a bit more in tune with modern medicine. Not that Dr. E is a bad guy, but some of the advice he's given us in the past has been a bit antiquated. Dr. Smith did give us the dreaded diagnosis I had anticipated "Failure To Thrive" or FTT. You can read more by clicking that link. Basically, since Evan has not shown significant weight gain, he is classified as FTT.

Where we go from here is to get some lab work done on him to see if there is a metabolic reason. He's never been a big eater, but for the past month or so, we've been giving him PediaSure in his bottle instead of whole milk. PediaSure is packed with calories, so any normal kid would be porking out by drinking it all the time like Evan has been. On the doctor's scale, Evan weighed 16 pounds 5 oz and was 27 inches long...so that's a weight gain of like 0 over the past few months.

We also have to keep a detailed food log over the next month. We have a follow-up with the doctor in about 4 weeks. At that time, we'll go over the log and lab results to see what the next step is. He'll also get his 15-month shots (yuck) at that check-up. His Synagis shots are also on the horizon. Poor guy with all the shots!!

On a happier note...here is a vid of Evan from tonight. This is the first time he's used his walker with no assistance!

Check up with the pulmonologist

Today Evan had a check-up with the pulmonologist. This is that twice a year (or so) appointment he'll have probably for the next year or two. Figures that Evan had a little cold, cough and fever over the past weekend! We didn't want the doc to hear him all congested and wheezy, but alas (Murphy's Law I guess).

The doc wasn't overly concerned with his wheezing and congestion, but more with his lack of weight gain. Evan still is right around (or below) the 16 pound mark. He's now starting to really fall off the height/weight chart, even when it's adjusted for his prematurity. He looks like a perfectly proportioned 5 month old who can crawl and almost walk! He suggested we see a nutritionist; not sure if there is one down here in Sierra Vista, but he could refer us to one in Tucson.

We did get a stop-order on his home oxygen. So now we can return the tanks to Apria. They've been collecting dust since about January! Since he's been wheezy, we're giving him the albuterol treatments again.

**Weight Check:
- 16 lbs.
- 27 inches

7/17/07: 1 Year Check-up With the Doc

Evan had his well-baby check-up today. We knew that he had to get his shots updated, so we gave him baby Tylenol ahead of time to help with the pain. We thought he had gained a bit of weight, but when he got on the scale, he is still a bit shy of 16 pounds. He has gotten longer though, he's about 27 inches now. The doc wasn't too concerned since he is following a nice curve on the preemie growth scale (he is on the bottom arc of the scale).

He had to get 3 separate shots (Chicken Pox, MMR and I can't remember what the other was, Hep maybe)? He cried for just a bit, but with Dad there to comfort him afterward, he was a trooper. Mom got the mean job of holding him while they administered the shots. We anticipate having to continue the Synagis shots in the fall since Evan will probably still be underweight. Since he's in daycare, they suggest we keep getting the shots in the RSV season.

We got the green light to start weaning him off formula and give him whole milk instead. We also got a referral to see a local urologist for his mild hypospadia. We have a feeling he will have to get the circ after all. At least he won't remember the procedure at this age (hopefully).

The doc heard a bit of wheezing in his chest, but nothing to be alarmed about. We have an appointment to see the Tucson Pulmonologist in September anyway. We also have to get Evan's blood drawn for a basic metabolic screen. If that turns out fine, we won't have to see the doc for a while.

5/15/07: Day 304 (Tues.) Latest Vitals

Yesterday I forgot to post his latest vitals. Not much changed, just his weight (his head circumference and height were about the same as at the beginning of the month). Looking through a baby book I have, it says Evan's current weight/height are right on track for a 5-month old!

We started Evan on bananas this week. Last week was squash (which he wasn't too fond of). He seems to like the bananas much better. At daycare, they are also working with him on eating baby food. Today, he ate 1 tablespoon of rice cereal and 1 table spoon of squash.

Evan's evening sleeping music, Mazzy Star (I know that's a little eclectic, but it's mellow music).


-----------
Chronological age: 43 weeks and 4 days
Adjusted/developmental age: 7 months, 4 weeks and 1 days
----------

5/1/07: Day 291 (Tues.) 9-Month Check Up

Evan had his 9-Month Well Baby Checkup today. Since Dr. Ettinger is on sabbatical, a new younger doctor, Dr. Smith gave Evan the exam. Evan still is an ounce shy of 14 pounds, but he is getting longer (25.5 inches). When I inputted all his stats, he has fallen into the -2 standard deviation (you can see on the chart). Nothing huge to worry about, but he is small even for his adjusted age.

Evan still has that lingering cough with nasal congestion. Dr. Smith thinks it will take a while for him to kick it since he's been seeing perfectly healthy kids have it for 8-10 weeks. So the nasal sucking will continue (Evan just loves it)!;-)

Dr. Smith also put Evan back on the Albuterol treatments every four hours for the next 10 days. He thinks if we can get his airways wide open, it will help him expel a lot of that crap in his chest. There was definitely no pneumonia in his lungs, so that is a relief. He is having us stop the 3 times a day Dimetapp/Albuterol syrup that Dr. E had prescribed. Dr. Smith says research has come out showing that it really isn't effective. Which I can see in Evan's case since he has been taking that since the end of March and his cough and congestion hasn't improved.

We also got the green light to start him on rice cereal/solids. Yea! A step closer to getting him caught up with his peers!

Happy Anniversary to Jen's parents!!

** Stat Check:
Weight 13 pounds 15 ounces
Length 25.5 inches
Head circumference 42cm


-----------
Chronological age: 41 weeks and 4 days
Adjusted/developmental age: 7 months, 2 weeks and 1 day
----------

4/16/07: Day 276 (Mon.) Checking In With Dr. E

Since Evan still had that yucky sounding chest congestion, we took him to see Dr. Ettinger as a precaution to make sure it wasn't pnuemonia. Dr E had a medical student helping out in the office and we saw him first. Dr. E cam in later and reassured us that he was fine. We have to keep suctioning his nose out with saline drops and that bulb-sucking-thing. Evan hates when we do it, but I think he is happy afterwards since he can breathe a bit better. We don't get a whole lot of stuff out of his nose, but it must be enough. Dr. E is also not concerned with Evan's slow weight gain, so we'l keep doing what we've been doing. We're still continuing to give him the Dimetapp with Albuterol 3 times a day. Dr. E hopes that will keep asthma from developing. He also thinks that last Synagis shot will be it for this season. It depends on his weight if he will be eligible to get the Synagis shots this fall.

We found out Dr. E is taking a sabbatical to study marine biology down in Mexico. He has another doctor coming in (who used to practice in Gainesville) to cover him while he's gone. He said he isn't retiring...but will continue to work 3 or so days a week and golf the other days when he gets back.

**Weight check: 13 lbs. 15 oz.**
**Height: 24 inches**

-----------
Chronological age: 39 weeks and 3 days
Adjusted/developmental age: 6 months, 4 weeks and 3 days
-----------

4/13/07: Day 273 (Fri.) Last Synagis Shot (Hopefully)

Evan had his last Synagis shot of the season (fingers crossed). The appointment took a bit longer than we expected since it took a while to get a good pulse oximeter reading on him. The highest reading they could get was 95%...which isn't great, but enough. Evan is still wheezing a bit from that first sickness he had two weeks ago which may be the reason for his oxygen saturation level to be so low. We still have some leftover Albuterol ampules that we use in the nebulizer and have been giving him treatments once a day. The nurse told us to call for an appointment to see Dr. Ettinger on Monday if he is still sounding bad. I have a feeling with Evan's lung issues when he was born, the nebulizer treatments may be a daily thing through the spring allergy season.

**Weight Check: 14lbs. 0oz.** This is sort-of concerning to us since Evan hasn't gained a whole lot of weight in the last 2 months. He's only gained about 1/2 pound in 2 months.

-----------
Chronological age: 39 weeks and 0 days
Adjusted/developmental age: 6 months, 4 week and 0 days
-----------