Busy Friday Part 1: 4-Year Check-up

Last Friday afternoon, the kids and I spent a grueling 1 hour and 45 minutes at the pediatrician (Dr. H) for Gwyneth's 4 year "Wellness" check-up.  I'm starting to notice another difference between having a typical and non-typical kid.  Gwyn has a lot more medical appointments (at least 2 every month) and even the standard check-ups are much more involved.  When I took Ryker to his 1 year appointment, it was In & Out, Here's Some Shots, Bye-bye... but Gwyn gets some special treatment....

Here are Gwyn's 4 year measurements:
28 pounds, 13 ounces
35 inches
(A side note: she won't stand independently yet, so at EVERY single doctor appointment I have to tell the nurse: "Oh she can't stand yet, so you have to use the baby scale to weigh her." I can't wait to not have to say that anymore.)
She's below the 5th percentile on the typical growth charts, so the doctor and nurse had to fish for the Down syndrome chart.  They kindly made a copy for me since I only have the 0-36 month charts.  The new charts they gave me are for Girls with Down syndrome from age 2 to 18 years.  Gwyn is in about the 40th percentile for both weight and height.

They asked about Hearing and Vision screenings, which is probably standard for 4-year-olds starting kindergarten in a year or so.  I agreed we could try both.  The attempted Hearing test wasn't successful because Gwyn couldn't hold still enough.  We'll try it again at the Audiologist this year.  The Vision test was a pleasant surprise: she was very cooperative and passed 20/20.  The nurse held up pictures and pointed to each in turn, asking "What's this?"  I was so happy to hear Gwyn answer right away with the answers, even when the pictures were very tiny.  It made me so proud.

We had some new questions to answer this time, which I was hoping were the standard 4 year developmental questions because I was able to answer some of them with "Yes" or "Sometimes."  I remember filling out a 1-year-old developmental questionnaire that asked if she was pulling to stand, and she wasn't even sitting up yet.  I could have finally answered Yes this year to the pulling to stand question...hmm.  Dr. H also asked about how often Gwyn received Physical and Speech therapy.

We discussed again Gwyn starting the Therapeutic Listening program with her Occupational Therapist and she gave me a prescription for the Sennheiser headphones.  I don't know yet if Medicaid will reimburse us for this purchase, but I thought a prescription is the first place to start.  The doctor and I also talked about our upcoming Katie Beckett Medicaid Waiver renewal.  We have to reapply every year and the pediatrician has to write and sign in the application.  The pediatric group just decided to start charging a $25 fee to complete this paperwork.  Bummer, but it's worth it to get the Medicaid.  It has paid for medical appointments, adaptive equipment, and therapy for Gwyneth.

Then they did a CBC blood test, which I just had to look up to remember what it was... It stands for Complete Blood Count and it measures white blood cells, red blood cells, platelets, etc.  The pediatrician offered this test because there is a higher risk of leukemia for kids with Down syndrome.  They took blood from Gwyn's finger to do this test, which she screamed about and was even acting mad at the band-aid wrapped around her finger.  They had the results quickly and the pediatrician gave me a printout.  I really don't understand all of the numbers, but some were just below or just above the "normal range" and these items were highlighted.  Dr. H did not feel that there was anything to be concerned about because nothing was too far outside the normal range.  Out of 17 things measured, 4 came back "low" and 3 "high" but 10 are "normal."

We discussed another blood test which I have been avoiding: the Thyroid blood test.  I declined it again this year because it requires blood from a vein, and we had a bad experience with a pediatrician's office trying to find Gwyneth's veins.  It took 4 different people and many many pokes in both Gwyn's arms.  She just has very small veins and I don't want to put her through that again.  So I mentioned that she has an appointment with the Emory Down Syndrome Clinic in April and I could have them do the Thyroid test.  I'm hoping that they will be more practiced at taking blood from tiny veins...

Dr. H suggested that when we go to the Emory appointment I ask them about Gwyn having a pneumonia shot.  She has already had a flu shot this season.  She checked Gwyn's eye which we were treating with drops for pink eye, and since the eye looked fine, she said we could stop the drops.  Hurray!  I also told Dr. H that I had scheduled Gwyn's surgery to remove her tonsils and adenoids.  She thought it was likely that Gwyn would be kept overnight at the hospital after the surgery.

Gwyn had to then get 3 vaccine shots, one in each arm and one in her thigh.  She handled it better than the fingerstick blood draw.  And finally our appointment was done!