Saturday, February 14, 2009

Motzai Shabbos

I just put sitemeter back on here, after a few years of having it off. I discovered that I have an average of 25 visits per day, which is nice; I'm surprised that many people read this. I also discovered that on Saturday, I get ten readers. Which, I guess, says something about my readership.

So... where to begin?

Avtalyon had his birthday last week. That was fun. He got chocolate cake and ice cream, which he ate, of course, with his hands, and while I'm sure some of it made it into his mouth (he was singing the happy food song, so it must have) the rest wound up evenly distributed over his face, pajamas, and high chair. Also last week was Avtalyon's introduction to spaghetti and meatballs. Eating spaghetti and meatballs is fun, but nothing like as fun as seeing them eaten by a pair of one-year-olds (we had some very small guests that night too).

In other news, all the boys are now sleeping in the same room. I tried this a couple of weeks ago and it didn't work out very well, because when Barak woke up screaming (which doesn't happen every night, but often enough) I ended up with a lot of screaming, and Avtalyon got relocated back to the pack and play in my office pretty quickly. I have cribs in every bedroom right now; the regular crib in the kids' room and pack and plays in both our bedroom and my office. The walls are thin and the kids are loud, and Avtalyon is a light sleeper, so he frequently gets moved from one crib to the next, often in the middle of the night. Anyway, I just put him down in the kids' room for the first time, and it's still quiet there. The night is, of course, still young.

And as for the Iyyar medical saga... well, it continues. The GI doctor, as you may remember from our last thrilling episode, ordered a bunch of tests, including stool samples for parasites and some blood work. Early last week, I noticed Barak sticking his hands in his underwear and scratching his bottom. "Barak! Don't do that!" He withdrew his hands, guiltily. The next day we were at CVS for something and I saw him doing it again. "Barak!" This time he didn't stop. "It's so itchy."

Hang on. Did I blog about this already? I did, didn't I?

I need to sleep more...

Anyway, yes, so, Barak had pinworms, which meant dosing both him and Iyyar, which I did, and now Barak is no longer itchy Iyyar is doing way better, so much so that I reintroduced dairy gradually last week and he is now back to his usual diet and seems fine. He occasionally complains that his tushy hurts him, but not in a major way, and he's been going every day. So, that's good.

Thursday, I took him to the ENT, fully expecting to be told he needed his tonsils out. I was rather taken aback, however, to hear that the doctor first wanted to do a sleep study, because otherwise my insurance would not approve doing the surgery at the local children's hospital, and he wanted to do it there because they had a PICU, and Iyyar might need one, and they wanted to be cautious.


I do think Iyyar needs his tonsils out. I don't think he breathes easily, I don't think he sleeps well, and I am pretty sure his enormous tonsils are a cause of that. I also think that his tonsils are part of how prone he is to choke on food--I still feed him like I would feed an 18-month-old, with nothing hard and no chokeable pieces. I think the tonsils should come out. But, hello, NOT IF IT'S GOING TO LAND HIM IN PEDIATRIC INTENSIVE CARE!!

I think what happened--and I told this to my pediatrician on the phone late on Friday--is that I started giving the ENT doctor the abbreviated saga of Iyyar's GI woes, and the doctor heard this and immediately thought that he was looking at some kind of medically complicated child, and decided to be really cautious. I am all for caution. I applaud caution, especially in people who are considering performing surgery on my child. But I thought the communication might have been a little lacking there.

I asked him to explain to me exactly why he was being so cautious--whether it was something he was seeing in Iyyar, or something I had said. He said it was what he'd heard from me. Fair enough. He also said that Iyyar's ears were packed with gunk--I can't see anything, but clearly he did--and that he had no motility in his eardrum, his ears were full of fluid and he couldn't hear (he also wanted an audiogram). I have no problem with an audiogram but I'm really sure Iyyar can hear--maybe just in the other ear, which he couldn't look at because of the gunk, but he doesn't have any hearing loss that's affecting his communication with me, at least. (I told this to the doctor and got the body language loud and clear in reply. "You don't believe me. That's okay. You see what you see in his ear, which is that it's full of gunk. I'm telling you what I see, which is that he communicates fine. Now you have more information.")

Barak could not hear at all, which is why we got the ear tubes. Iyyar hears fine. I don't have a problem with doing a sleep study, which is at worst an inconvenience--okay, a fairly major one, being that we have no car and a nursing baby--but we'll manage. I don't know why I came out of the appointment so mightily freaked--maybe it was that I felt I wasn't communicating, or that the doctor wasn't listening, or maybe I was just flipping out from having heard the phrase "pediatric ICU" uttered in conjunction with MY CHILD.

The next morning I called my regular pediatrician and left a message saying I wanted to talk to her. She called back right before Shabbos and I communicated my freaked-dom to her; I also said that I was worried because the ENT was making clinical decisions based on things I had said about Iyyar's health, and I didn't know what the heck was going on with him myself. I think it's pinworms, but am I really sure? No. She was reassuring; do the sleep study anyway, she said, because it can't hurt. Go to the followup, and take it from there. Your insurance will cover a second opinion, especially if it's for a surgery, because they'll be hoping they won't have to cover the surgery. So, that's the plan. And open enrolment is coming up soon at work--I'm going to look into switching to the PPO.

Anyway. Sleep study scheduled for Wednesday night. I'm supposed to make a followup appointment two weeks later, for an audiogram and another checkup with the ENT. Stay tuned, as always, to this exciting channel.


Deborah said...

Oh you poor dear. Isn't the medical community difficult to navigate? And you are a highly educated woman!
Keep being proactive for your boys. No one else will see to their best interest.

Yasmin said...

Oh, my. Nice to see they're making it easy, isn't it? As Deborah says, you are an educated woman. Imagine how the less-educated would feel. (Or maybe they would just accept the gospel of the doc and not worry, hmmm.)

Sounds like your pediatrician is being sensible, though, so you may as well put up with the great inconvenience of the sleep study. Might learn something interesting. And keep being a terrier w/ the doc who may or may not be listening completely to what you, who are only a mom, are telling him.

There's also always that 2nd opinion, which will at least give you a chance at another doc.

Ellen said...

I hear you about the inconvenience, but, if it's any consolation, I have advocated for years to anyone who will listen that kids should not have a tonsillectomy without a sleep study. (My idea being that the risks of surgery are not worth it unless we're pretty darn sure that the problem has a good chance of being fixed!).

I like the idea of a second opinion, too :)

umm, can I be glad it was pinworm and not a milk sensitivity?! If so, I'm glad!

Hang in there, Uber!!!!!!

uberimma said...

I think there is a milk sensitivity. He had milk in a cup on Sunday and threw up; he's also gone back to not being able to poop, after about a week of eating his old levels of dairy. So, we'll try it with yogurt but no milk or cheese. I am really uncomfortable with his caloric intake if he's really not eating any dairy at all. He's down to 30.5.