Thursday, May 29, 2008

15 Month Appointment

The boys had their 15 month well baby check last week. Overall, they are doing great with just a few concerns. Developmentally, they are also right on track. I was really worried about their speech. I had heard recently that a 15 month old should have 10-15 "meaningful" words; say "mama" and "dada" specifically to mom and dad; "uh-oh" and "oh-no" should also be part of their vocabulary. When I told our doctor of our concerns, he said they are right on track and not to worry about it. Noah says "mama" and "dada" but not specifically (and we were told that's all he should be able to do...say it). Ethan rarely says it and Nathanial almost never. They all shake their heads "no" and "yes" and will put their hands on their head for "Oh, No!" or "Oh, my aching head." So they do mimic that. They also all point and make fantastic eye contact. These are important milestones for us as they can be early indicators of autism.

Nathanial's stats were as follows:
Height: 30 3/4"
Weight: 21 pounds
Head: 18"

Ethan's stats:
Height: 30 1/2"
Weight: 21 pounds
Head: 18"

Noah's stats:
Height: 30 1/4"
Weight: 21 pounds
Head: 18 1/4"

They all weighed exactly 21 pounds and their lengths were within 1/4 with Nathanial being tallest and Noah being shortest...not a big shock. Even though Noah's head looks so much bigger than Ethan and Nathanial's, it's only 1/4" bigger and does put him in a slightly higher percentage, but he is still on the little side (I think 20th %tile).

Now for the concerns. Nathanial doesn't respond to his name at all, doesn't flinch hugely at loud noises, doesn't turn when I enter his bedroom if his back is to me, and is extremely quiet. While I think some of the quietness is just his little personality, he doesn't "say" much at all. Ethan will generally respond to his name, but also appears to "ignore" us quite often and also doesn't say much at all. Noah is very chattery and seems to respond to his name and do pretty well with everything. I mentioned their lack of speech and my concerns that Nathanial wasn't hearing. They all passed their newborn screening, with Noah actually having the worst one. She did his several times over until she finally got something. Our next step was to check their ears to see if Dr. B could see anything wrong. If not, we would take a wait and see approach. He did the tampanogram (?) (Aidan's had it done several times) and nobody produced a spike. Not a single one of them, they all had flat lines. We were originally just going to check Nathanial and Ethan, but then decided to do them all, just to see. I was most surprised at Noah because he seems to hear pretty well. And he may be fine after all. We are now getting all three in to have their hearing checked next week and will go from there with whatever those results show. To fix it, most likely, they will only need tubes and that's not a big deal, so I feel OK with that. I'm just relieved to know there is fluid build up behind the drums because I was really worried something more was wrong with Nathanial. Steve has tried clapping his hands loudly right behind their heads to see if they react....they don't. Nathanial will sometimes turn around and smile, but never jumps, flinches, nothing. Ethan will sometimes flinch a little bit but doesn't jump or anything else and will also turn and smile. Noah will turn and respond with a smile also. So I guess we'll see what happens next week.

Our other concern was Nathanial's leg. When he was probably 6 weeks old, he developed a "birthmark" behind his left knee. That "birthmark" started cycling through a little system. It starts out looking like a birthmark, then gets a blister on it, then it pops, heals, then starts all over with the birthmark stage lasting at maximum a week. I mentioned it at his 2 month appointment and we started using hydrocordisone (sp?) and Aquaphillic on it three times a day. We have kept an eye on it and continued to do this for the last 13 months, with no change at all in the cycling or appearance. It does itch terribly, I have realized since Nathanial has been in shorts. And now there is another spot about 1-2 inches above the first spot that looks exactly the same and is doing the same thing. It is now time for him to see a dermatologist to figure out what it is.

Nathanial is definitely allergic to strawberries, so we are assuming Ethan is also. Noah will not get them until he is at least three and maybe not even then. Not sure I want to have them in the house ever again.

They recieved catch up Pediarix and Prevnar shots and will not recieve the MMR until after the new baby is born, due to the risk to the baby.

All in all, a great appointment!

Nathanial's update:

We went to the dermatologist today. Nathanial's spots are more than likely (90% sure) mastocytoma. Which is essentially a mass of cells on the skin, which blister and burst and when they burst they produce histamine which causes them to itch (hence all the scratching). He said he was ruling out eczema because it wasn't rough and patching and ruling out herpes simplex (what?!?!?!) because it is only one small bump and not several littler ones. The only way to know for absolute sure if this is what it is is to do a biopsy and, thankfully, he doesn't want to do that on someone so little. We are going to start with a super potent hydrocordisone cream once a day that will hopefully stop the cycling and eventually, he will outgrow it (as an adolescent or adult). If this doesn't work, then he may do the biopsy. We also may follow up with an allergist to check on all possible allergies Nathanial has because that "might" be contributing to the cycling. We're not thinking about any of that at this point, though...we're just hoping this cream does the trick to stop the cycling!

Next stop.....hearing checks!


Anonymous said...

Trista, Herpes simplex is nothing to be alarmed about- that is the bug that causes cold sores - NOT like herpes complex, that is the STD, --

I don't want you to worry any more than you do.


Ash said...

Hey Trista, Just got over to reading your blog from the message Jen sent to the MOPS group. I am gonna book mark you on my blog so that I can get back to you easily. What an amazing family and I pray that I can be 1/6th of the mom you are!!! You seem to be truly an amazing woman and I look forward to getting to know you more through MOPS next year!