Saturday, September 25, 2010

2.5 year well check

I had no idea there was a well check at 2.5.  The nurse said it was a relatively new trend and not all pediatricians do it.

Randy's check was uneventful.  It was the first time I did not have a long list of questions.  His pediatrician was pleased to see him walking.  He spent a lot of time flexing his ankle and checking his reflexes.  He noted that the tightness is still there, but that his range of motion is still good.  He asked if he was in orthotics.  I told him that the orthopedic doctor said that they were not needed medically, but they may be helpful for balance if the PT likes.  His PT says that she wants to hold off and see what development does for his flat feet and for his ankles that pronate (lean in).  She says the orthotic will feel awkward and wants him to be a committed walker before adding orthotics (if at all).

His ped remarked that his head looked good for the number of surgeries he's had.  He was pleased with his eyes and very pleased with his growth.  His stats are:

Length - 35.75 inches
Weight - 27 lbs
Head circumference - 45.5 cm

Despite all our feeding woes, he continues to grow well.  He is now 25th-50th percentile for height (up from 10th-25th) and 10th-25th percentile for weight (up from 5th-10th).  His head circumference is still not on the charts, but the growth is following the same curve.  The ped is going to email his head circumference to the neurosurgeon.  Neither of them are overly concerned about his slow head growth, especially since he is developing cognitively.  I could not believe that he grew 3 inches, gained 3 pounds, and his head grew 1 cm in six months!

Sunday, September 19, 2010

Long overdue update

I have not posted a real update about Randy in quite a while.  It is long overdue.

Developmental Toddler program:
Randy started "pre-school" August 24th.  He attends Monday-Thursday for 2.5 hours a day.  He rides the bus to and from daycare.  Two of his "friends" from daycare also attend (they both ride the bus), but are not in his class.  I visited the school last spring and was fortunate to get the exact class that I wanted (without even asking).  There are 7 kids (all special needs), 1 teacher, and 1.5 para's (one is a floater).  Some of the kids attend two days a week and the others attend 4 days per week.  The number of days is dependent on their needs.  So the kids in the class range from those with mild speech delays or mild OT delays (2 days per week) to children wheelchair bound and non verbal.  Randy began the year as one of two children not walking.  Randy has group PT, OT and speech each week and the vision teacher works with him individually or in conjunction with another therapist (this week she saw him with the PT to work on mobility).

Randy is soooo happy to be back at daycare.  He has been dubbed the "class leader" by his teachers and the therapists.  He is one of the older kids in the class.  He is certainly the most verbal and is resisting being a big boy in class at times.  He can now say all the teachers names still greets every person there.  He is going to be featured in their annual report this year.  I will scan his article when I get it.

PT-Randy is WALKING!!!! He has been independently walking for 3 weeks.  He has been so close for months.  He just decided that he did not need any help and just stood and walked.  He has improved so much in 3 short weeks.  He can now stand (without moving).  He can turn around without getting on his knees.  His therapist has already began working on stairs and have given him a new goal of walking backwards.

OT-He is only being checked until we get new visits next year.  His OT is also his feeding therapist, so she just "checks" with him occasionally.  He gets lots of fine motor work in daycare and in pre-school.

Feeding-Still the bane of my existence.  His therapists says he's making great progress.  I am having a hard time seeing it.  It just feels so slow.  He now eats cereal bars and is eating thicker purees.  I make a batch of "baby food" every weekend and freeze it in small containers.  I have to send it to daycare or he would starve.

Speech-His speech therapist is on maternity leave.  I opted to put his therapy on hold since she is only out 6 weeks and he's in daycare and pre-school.  I am working on getting him to tell me about his day.  I ask him about things I know and prompt him to give me a response.  I'll say, "What did you do today?" He'll say, "Mmmmmm I don't know." I'll ask, "Did you ride the bus?"  He'll say, "Yes."  I'll tell him to say, "I rode the bus."  He won't say anything.  I figure at some point he will start to respond.

Gymnastics & swimming:
Both of these are Mommy & Me.  Mommy is getting quite the workout. LOL.  He loves gymnastics and likes swimming.  In gymnastics I lift him through all these circuits.  He has gone three weeks and I see and improvement.  He will now step up onto the balance beam (week one he screamed when I put his foot on it).  He goes through the tunnel (she switched the navy blue tunnel to a lime green one and now he loves it).  He will allow me to move him through a forward roll.  Although he is not helping at all, at least he is not arching his back and flailing his arms like week one.  Swimming is only OK.  He likes to be able to splash around and play in the water and this lady girl has us doing stuff like rescue breathing and showing us the fire exits.  My baby just wants to swim.

Patching has decreased from 4 hours per day to 2-2.5 hours five days per week.  His eyes look great!  He will probably have surgery next summer to straighten them more.


Doctor appointments:
They have really slowed down this third year of life.  He sees his pediatrician on Tuesday for a well check.  Is there a 2.5 year well check?  My friends daughter went at two and does not go back until age three.  He sees neurosurgery yearly now.  His next appointment with and MRI is June 2011.  He sees the ENT yearly with a hearing exam.  That appointment is May 2011.  The feeding team appointment is next month.  I am going to discuss discontinuing these appointments.  His growth is great and his reflux is controlled.  I will just see his pediatrician for his reflux and allow the CP clinic to chart his growth and nutrition.  We'll see.  His next CP appointment is in January 2011; he sees them every 3-6 months.  He still sees his eye doctor every three months.  These appointments are a piece a cake compared to the monthly appointments with almost all these specialists that he had at one point.

This is a really good time for us right now.  I have the days when I'm super stressed out over feeding or when I begin to worry about his IEP that is just around the corner; but overall, things are good.