Friday, May 12, 2017

Spring 2017

I'm bad at keeping this thing updated. So I've got a few things to cover here. 

Arron - Endocrinologist Visit

Back in the end of March we saw an endocrinologist at Children's to talk about Arron's tiny size & if he might have diabetes insipidus. We talked quite a bit about Arron's health history & the options for evaluating what's going on with him. Most involved blood & urine labs, so he put in the orders & we were able to get them drawn same day. Then we met with a nutritionist who said part of our issue might just be that he needs more calories. So we talked about ways to increase his calories without necessarily increasing the amount of food he eats. Things like making his oatmeal with half & half instead of water, giving him full-fat yogurt instead of non-fat, he LOVES avocados, so putting that on toast. That kind of stuff. 

I was able to get his lab results online a few days later & pretty much everything was within normal, but I recall at least a handful being at the VERY low end of normal. We should see them the end of July or beginning of August for follow up to see if he's gaining weight or getting taller. 

Bri's never ending knee problems. 

Right around Spring Break Bri told me she was out of Tylenol & needed more. We had given her a bottle of her own several months back (after make sure she had a firm understanding of safe dosing & all that jazz). So I asked her what was up & she said her knee had been bothering her pretty consistently for nearly a month. As I questioned her about the quality & severity of her pain, I quickly realized this was almost exactly what she described before her 2nd knee surgery. So I told her I thought we should get an MRI & then go see Dr Osgood about the results. She was disappointed but agreed it was best to get it dealt with. 

So I called to ask for the MRI order before we see the Dr. He was out on vacation but checking emails periodically, so the nurse put in a request to him. We got the green light to do MRI first, with a phone appointment the next day. So Bri will have her 4th MRI on her left knee on Monday, May 22. I'm anticipating she will have her 4th knee surgery over the summer. I assume he will just take the meniscus this time. More to come on this saga. 

Arron - otolaryngology 

Ok Tuesday, A2 & I headed to Children's to see his otolaryngologist (ear, nose, & throat Dr.) for follow up to see if his tubes are still in & to recheck his hearing. One tube was already out, but the other one appeared to still be in & open.  But on the side where it's out, there's already fluid building. So we need to watch for signs of an ear infection. Given the nasal congestion issues he has, I also wanted to revisit the timing of his septoplasty. I know they prefer to wait until the teen years, but felt if it could vastly improve his health now, I'd be willing to accept that it might have to be redone in 10-12 years. The doc said the first line of defense in kiddos with sinus issues is to take out the adenoids & since Arron needs new tubes, that's commonly done anyways. So that surgery is scheduled for June 20, 2017. 

Then we were off to see the hearing screener. Whose tests he failed miserably. Based on one of the tests, she's fairly certain the tube that's still in is blocked. He failed the main screening where we sit in a room, distract him with a cool toy straight ahead, then play sounds to one side, and see if he responds. So she put a bone conductor on him, and when the sounds were able to bypass the outer east, he passed with flying colors. So the good news is that means there's nothing wrong with the inner ear or brain. It's a problem getting the sound to the inner ear. 

We will have another hearing test at our follow up appointment on August 25th. If he still fails, then we will schedule a more formal exam with him under sedation & electrodes looking at how his brain responds. Then hopefully we can finally start speech therapy since they'll know what they're up against. 

If this surgery doesn't help him stay healthy and lessen his phlegm, then we will discuss other options for sinus surgery. 

Oh & he was wicked cute on the way north with his Brad Evans emoji stick. Occasionally, I would see Brad fly through my rearview mirror accompanied by chants of YAAAAY NOUNDERS!! 

I think that's all for now! Oh 

Sunday, January 22, 2017

Another specialist

Well I suppose it's about time for an update on our next medical adventure. Endocrinology!

I've always thought Arron drank a lot of fluids. Like, more than a typical kid. So much so, that I actually took him to the pediatrician about a year ago. Unfortunately, we didn't get to see Dr. Johnson, the best ped on the face of the planet. We saw one of the other folks at Group Health who wasn't as familiar with Arron's medical history & our family's knack for odd diagnoses. She wasn't overly concerned but ordered a few labs, which came back borderline, but unconcerning. So she said there was nothing to worry about & sent us on our way. 

It has continued as a nagging concern in the back of my mommy mind & a few weeks ago one of the teachers at daycare mentioned a relative's child with a similar issue who, once properly diagnosed caught up on the growth charts & has done so much better. She also said that Arron drinks & pees more than any other kid she's ever had in any of her classes. (And she's not new to daycare!) For reference, we've been monitoring his fluid intake this week & it's ranged from 45-76 oz per day. The average toddler is around 35 oz with the remainder of the fluids coming from the foods they eat. 

So I fired off a message to Dr. Johnson, who ordered some labs for before we would meet with him. At the appointment, his blood work was again borderline, but his urine was very diluted. As we talked, Dr. Johnson agreed that a formal evaluation for diabetes insipidus was appropriate. Thankfully, DI is not related to the blood sugar issues we think of when we hear diabetes. It's an electrolyte imbalance condition. DI is treated by an endocrinologist or a nephrologist depending on the type, but usually endocrine. So we've been referred to see them. If they suspect DI, we may need to do a test where he stays overnight at the hospital for them to control his intake & monitor his output. They can also try a dose of medication & see how he responds. 

As long as we are going to see an endocrinologist, Dr. Johnson is also going to have them evaluate Arron's thyroid & growth hormones to make sure they don't account for his peanut size. 

On the up side, we did a bone age study, which is an X-ray of the forearm & hand where they evaluate the growth plates & compare it to some standard. He has the skeleton of a 1 year old. Which is actually good news because it means he could continue to grow for nearly a year & a half after his peers stop growing. But if he's got any hormone issues, the sooner we find & correct it, the sooner he will start to catch up & the better chance we have of him not losing out on any of that growth potential. 

So March 28, we will see our new specialist & get lots of labs drawn & go from there.