O-yeh and turkey samiches: An update on the kids

Emmeline had her fifteen-month appointment at the doctor's office on Friday.  She is doing great, just as I thought, and got back to her normal growth curve after falling well below it at one year (probably because of her surgery and subsequent illnesses).  She's now 21 lbs., 14 oz. (55th percentile), 31 inches (70th percentile), and has a head circumference of 17 3/4" (35th percentile).  Dr. Rauth could clearly tell from her time in the room that Emmeline is very active.  I assured her that she's getting plenty of protein (I've never seen another kid this age like meat so much!), though fruits and vegetables are a struggle (we're still giving her pouches of baby food with fruit and vegetable purees to make up for this).  She's communicating so well these days.  It's really amazing to see.  Oliver's speech developed more slowly, in part because of his hearing problems, but with Emme it's much more than just words.  She really is trying to tell us things, using a combination of baby sign language, pointing, and grunting/fussing/words.  For example, when she wants picked up, she'll say the word "up" with her arms in the air and push up on her toes.  When she's in her room and tired, she'll sign for sleep and then point to her crib.  Yesterday (when she was home with a low, but too-high-for-daycare fever), she pointed to the tupperware of cookies, signed for food, and then threw a tantrum when I said "no."

And that is the other way Emmeline communicates -- with tantrums.  They aren't elaborate.  They don't last long.  But she gets mad easily and isn't afraid to show it.  She stomps her feet, falls on the floor, cries and throws her head back, and when something is in reach (like her cup), throws it.  She gets over it fairly quickly, but our ignoring it has thus far not dissuaded her from throwing the tantrum to begin with.  It's been clear since early on that she is a strong-willed child with very specific wants.  It seems like she's going to use any tactic available to get them.  Here's hoping we all survive her toddler years.

And she is getting some real words, too.  She says "ball" very clearly and uses it for different kinds of balls.  She's starting to get "book" and tries "dog" and "shoes," but it's only the beginning sound.  She also seems to be trying to say Oliver's name.  The word (sound?) comes out at different times, so I don't know if it's used exclusively for him, but there does seem to be a connection.  About a week ago I went to pick her up from daycare, and when she saw me out in the courtyard, she immediately stood up, turned towards the door to Oliver's room, pointed, and said in kind of a singsongy voice, "O-yeh."  She didn't want picked up; she wanted to go get her brother from the playground, where he usually is when it's time to go home.  If I take her to the car without him there, she'll point at his empty seat with a look of concern on her face and say, "O-yeh?"  Yesterday afternoon, when we left to go get him from daycare, I told her we were going to get Oliver from school.  She kept going to the stairs and pointing up them saying his name.  I guess she thought he was in his room.  So I don't know for sure if she's really attempting his name, but she definitely knows him as a person now and wants to know where he is, too.

Oliver is really into Emmeline these days, too.  He fusses if he doesn't get to eat breakfast with her (because he's spent, I don't know, twenty minutes upstairs putting his clothes on -- or not -- and so missed the chance to join his hungry-as-soon-as-she-wakes-up little sister).  He fusses if they have to take baths separately.  At bedtime, he gives her a hug and a kiss.  They make each other laugh in the car.  They really, actually like each other.  I don't say that to mean they always get along and will have this relationship forever.  But they're finally at the age that there's some kind of legitimate attachment to one another, from both sides.  And it's fun to see them together.  Oliver has always liked to sing, and now Emme really responds to either one of us singing a song she knows.  Favorites include: The Itsy-Bitsy Spider (she'll start trying to do the hand motions) and Ring-around-the-Rosie (only she doesn't realize you're supposed to hold hands and just turns in a circle herself).  Oliver will also do the alphabet song for her, and she obligingly claps when he's done.  It's adorable.

Oliver's language has also otherwise developed.  He likes to try out new words -- with lots of inflection.  Like when he told me Emme was making a complete mess with her milk one day.  Or recently he's talked about he likes gerdening with Grammy Kay.  This weekend they planted some azaleas, and he has a very unique pronunciation for this word.  On Sunday evening, I asked him if he wanted to anything else to eat.  He thought for a moment and then said, "Do you have any more of those turkey samiches?" (since we'd had them for lunch).  Ollie's general knowledge of letters and sounds has gotten better.  He can pretty consistently identify the beginning sounds of words now and I think would do well with some basic phonics instruction.  He can count and does simple math "problems" with Wes using food items or fingers to help him add and subtract.  His hand-eye coordination is improving, though it's not clear whether it will end up closer to mine (broken nose from a softball) or Wes's (semi-pro baseball player).  The thing that I will never totally get over, though, is his memory.  It is sharp.  He has on more than one occasion corrected (politely) something I said, talked about an obscure incident from months past, or made connections between seemingly small details in two very dissimilar situations.  Whereas Emme seems "bright" in her communication, Oliver's smarts stand out the most in how his mind operates to remember things and put them together.

Without question, I am loving this time watching the kids develop.  The un-fun things -- Oliver's unbelievably slow-moving nature, Emme's demanding one -- are but small blips on the fun we have most days.  I'm really looking forward to this summer, when I'll have more time to spend with them and, in the words of Bravo, just watch what happens next.

Big girl

And so it happened once again that a child in my house turned one.  Emme's first birthday came and went with less fanfare that I would probably have liked, but she's one and won't remember any of it.  (Maybe I should have thought of that before I started documenting every detail of my kids' lives here...).  The big birthday started on Friday with her one-year checkup at the pediatrician's office.  Oliver came with us, both because it was an early appointment and I didn't want to take him to daycare before it, but also because I wanted to have his ears checked.  He so often has ear infections without me knowing it, and if he continues to have them over the next six months, we may have to think about a second set of tubes (since the first has now completely fallen out).  Emme measured in at 18 lbs., 9 oz. (15th percentile), 29 1/4" (55th percentile), and head circumference of 17 1/2" (30th percentile).  She's little compared with Oliver's 23+ pounds at his first birthday (and tiny compared to his current 36 pounds!), but I love it.  The nurse actually measured her twice because she hadn't gained any weight since her last appointment.  I pointed out that her December weight included a 2-3 pound cast, but regardless she did fall in her percentile.  Her surgery, the subsequent infection, and her general business probably account for the slowed growth, but there's no doubt she's overall healthy and developing right on schedule.

It turns out that both the kids had an infection in one ear (opposite the ears that were infected at Oliver's three-year checkup).  They're both on amoxicillin.  It baffles me because neither usually shows any indication that they're in any discomfort.  Dr. Rauth is repeatedly shocked at how bad Oliver's ears can look (and yes, she does know what his ears look like healthy as a comparison) without him running a fever or complaining.

They both went to daycare after the appointment so that I could get some work done.  Emme wore her first birthday onesie that Aunt Laura gifted her at Christmas.  Before I picked them up in the afternoon, I stopped by Harris Teeter and got two helium birthday balloons that I knew they would like.  I also put back up the multi-man tent in the living room, thinking that would be a big hit.  The kids' enjoyed both he balloons and the tent (while Lucy liked neither).

Wes had an evening shift on Friday, so we waited to do cupcakes and such until Saturday.  I did make Emme's mark in the doorway that night -- I thought it was more important that it was "official" than that Wes was there for it.  Consequently, though, I couldn't get any really good pictures of Emme standing next to it.  Oliver somehow helped me get the mark made, but that was about it.  Both kids were in bed a little early, and I wasn't far behind.

Saturday morning the kids and I did a bunch of errands (it becomes a "bunch" when you go to both Target and Wal-Mart and Costco in the same morning).  It ended, as I had repeatedly promised Oliver, with a trip to The Painted Cupcake for Emme's birthday cupcakes.  Emme wore her "1" shirt that day, though it didn't make it all the way until dinner time.  When evening finally came, Emme was fussy, Oliver wouldn't eat any of the dinner, and Wes and I were both in foul moods.  But I didn't want to wait another night to celebrate, so I relented and let Oliver have half a cupcake, even though he didn't have any real dinner.  He and Emme split a strawberry one with pink frosting.  We did the one candle, we sang the song, and I think Emme went to bed thirty minutes later.  We finished the mixed half dozen of cupcakes (some kind of chocolate, peanut butter, pumpkin, and others) over the next few days, and they were the best I've had in Nashville.  Very moist, just enough icing, not sickeningly sweet.

There were no presents this year.  I will be sure in future years, when she's old enough to remember, to have a birthday present for her, even so soon after Christmas.  Wes's birthday (and my sister's) is right around Christmas, so I've heard enough to know that there has to be a distinct celebration for it to feel real.

So the day is done.  I wish there had been something that felt a little more special.  I wish I had better pictures to remember it all.  But regardless, it happened, and I now once again have a one-year-old in my house.  Oliver keeps asking if Emme is still a baby now that she's one and kind of walking.  I don't know that I have an answer for him.

Vaccinated

Ollie and Emme had a pediatrician's appointment today.  This was Oliver's 3-year well-child visit and Emme's 9-month well-child visit, but it just so happened that both have had recent health complications.  Oliver had a red, swollen...boy part last week.  It has since gone away, though Oliver mentioned several times last week that it was "still bothering him."  Wes and I figured he had just picked up the language we had used to ask him if it was, in fact, still bothering him, as there were no symptoms to suggest that anything was still wrong.  But, since he is uncircumcised, we wanted to make sure there were no issues (there weren't).  Emme has been sick for almost a week -- a higher fever that kept her out of daycare last week, followed by a low-grade fever and horrible nights of sleep since Saturday.  So here's what we found out:

• Oliver can pee in a specimen cup if necessary.  He thought is was hilarious.
• Ollie is 35 lbs., 4 oz. (80th %tile) and 39" (85th %tile).  The pediatrician thinks he'll be about 6 feet tall.
• Emme is 17 lbs., 5 oz. (25th %tile -- my little girl!) and 27 5/8" (60th %tile).  Her head circumference is 17 1/8" (up to the 40th %tile -- whew!).
• Oliver's right ear tube has dislodged and -- shock! -- he has a nasty ear infection in it (with nary a symptom of one).  The doctor pulled a glob of black, nasty earwax out before diagnosing him.  
• Emme's left ear is infected.  I'm hoping this is an explanation for the persistent low fever and night wakings.  Hoping...hoping.  Both kids are on amoxicillin.
• Kids don't like shots.  Oliver got his flu vaccine and a PCV booster.  The last time he got a shot, probably around 18 months, he didn't even cry, so I thought he'd be okay.  Wrong.  Cried and cried.  And even more when the nurse realized that the doctor had forgotten to tell her about the PCV booster, which meant Ollie had two separate shots and freak-outs rather than two quick shots in one freak-out.  He calmed down when I mentioned the stickers by the sign-out desk.  He said later -- several times -- "Mom, I don't like shots."  Emme, suffice it to say, also did not enjoy her flu vaccine.  Since she didn't get one last year, she'll get a booster in one month.  Lucky her.

So overall, smart, (mostly) healthy, happy children.  

Wes and I also happen to have gotten our flu vaccine's today.  VUMC had "Flulapalooza," during which time, they vaccinated more than 12,000 Vanderbilt faculty, staff, and students and set a world record for most vaccinations given in an 8-hour period.  I felt a little like a cow being herded, but it was fast, free, and relatively painless.  Here's hoping the vaccines keep us flu-free all winter!

Inching along

Emme had her six-month pediatrician's appointment today.  She is 26 3/4 inches long (75th percentile), 15 lbs., 9oz., (35th percentile), and has a 16 3/8 inch head circumference (25th percentile).  She is still almost a full pound smaller than Oliver was at four months, but she's growing right in line with her growth curve, so all is well.

She is also nearly crawling, if not actually so.  She gets on her belly and uses some combination of her arms, knees, and feet to inch forward (and sometimes backwards), along with rolling to get where she wants to go.  And now it is all intentional.  She sees something, she wants it, and she goes after it.  Often to include Oliver's toys.  Fortunately, he finds that funny right now.  I'm not sure how long that will last, though.  Her postures look a little like the three-point stance of football players on the line as she reaches for things.  She's also started making some new noises that include the "b" and "m" consonants.  She has several times in the last two days said something that sounds like "mama," and even though it's not really and she's certainly not directing it at me, it's hilarious (and wonderful) to hear her say it.

Ollie came to the doctor's appointment, too, this morning.  It was early, so I didn't want to drop him at daycare beforehand, and he's been asking to go to the hospital or the doctor since Emme was born.  I told him that Emme would get some shots and that he could hold her hand and make her feel better when she got them.  He then kept talking about the "shots store" and that we were going to pick up some shots for Emme ("not for me," he would remind me).  She did a really great job -- didn't even cry from the first one and just a few seconds after the others.  Ollie found the whole thing strange but interesting and really liked that he got a sticker (a Lego construction sticker at that) at the end, even though he wasn't the patient!

Back in three more months and off to the plastic surgeon in a few weeks to make plans for the next surgery.  With any luck, she'll be walking (or close) before that happens so that the surgery and cast don't delay her.

Cast away

Emme went to her follow-up appointment with the plastic surgeon yesterday.  She removed the splint, said everything looked like it was healing well, and told us to come see her at the end of the summer.  She doesn't want to do the next surgery until Emme is almost one and plans to do the graft to the top of the foot next.  Emme still has a stitch at her knee, and the Dermabond at the scar on her ankle is still peeling away.  The skin is a little taut, so we're massaging it every day to help it relax and soften.  She doesn't seem bothered by any of it at this point, and she really enjoyed her full bath last night.  Wes thinks she just likes to be able to squirm more thoroughly.

They did run a pathology on the skin that was removed (something I hadn't even thought about), and there was no sign of melanoma or other concerning changes in the skin cells.  We also received our hospital bill for the surgery yesterday (note this does not include the surgeon's fee or anesthesiologist's fee): just under $19,000.  

Beetlejuice

Emmeline had her 2 month checkup with her pediatrician yesterday.  She is doing great, of course, but it's always nice to get her official measurements.  She's grown almost 2 inches since her 4-week appointment, but she's only gained about a pound a half (from 8 lbs. 13 oz. to 10 lbs. 8 oz.), despite her excellent eating. She is around the 80th percentile for length (a highly interpretative measurement with a baby), 40th percentile for weight, and continues to be around the 20th percentile for head circumference.  Her pediatrician was very impressed with her neck and shoulder strength.  When she saw Emme push her arms and head up when lying on her belly, she commented that was a four-month milestone.  Perhaps it's because of her small head or because she can see that she'll have to be strong to survive in house with Oliver, but it's fun to see such a little person trying to be so big.  She even likes to stand and push up on her legs when held.

Emme's doctor assured us that the fussy evening period usually peaks between 6 and 9 weeks, but I'm not sure anyone's told Emme that.  I did get a swing today (though I'm leaving it in the box and keeping the receipt), so if the troublesome evening period continues, we might try that.  She is stretching out her nights more.  I've seen a few 5-hour and even one 7-hour sleep stretch.  Of course, I'm not always in bed when that happens, but it's a move in the right direction.  I also read somewhere and had another mom mention to me that we should try to put her down earlier, like 6 or 7 o'clock, to help her sleep better (though, as Wes pointed out, it's not like we're keeping her up).  She sleeps fine once she's down, but helping her settle for that first stretch of sleep has been a real challenge the last few nights.  But as they say, this too shall pass -- and all too soon, I dare say.

Emme got her vaccinations yesterday, too.  I knew what to expect, having watched Oliver bump her head often enough to evoke her greatest rage.  She was pretty easily consoled, though.  We did end up giving her some acetaminophen last night, when her crying got even louder than the normal fussing.  She's been down for a big long nap today, too, but hasn't been especially cranky.  Next appointment with the pediatrician in two months -- and hopefully not before!

*To understand Wes's reference in the title, view this video clip. 

A leg up

It's not every little girl who has her first plastic surgery at around 2+ months, but that's exactly what Emmeline's going to do.  After preliminary consultations with two plastic surgeons in Nashville, it seems clear that she's going to need a series of surgeries to remove the larger nevus, and both suggested that we start soon, so as to take advantage of the great skin elasticity she has right now.

Our first consultation was with a surgeon at Vanderbilt.  He was a surgery resident at UVA when Wes was in medical school there, and they actually recognized each other.  He seemed nice, very knowledgeable, and pretty confident in his recommendation that we should remove the large nevus.  He disagreed with the dermatologist, though, in how to go about it.  He recommended a series of 10-15 surgeries, starting at the end of February, to excise the nevus in stages, possibly with a graft at the end.  He didn't think the location of the nevus would support the tissue expander without running a high risk of erupting, which requires emergency surgery.  Wes and I left the surgery a little overwhelmed by the prospect of so many surgeries and such an early start date and decided that, though we trusted this surgeon's opinion, we wanted a second opinion before making a decision.

A few weeks ago, Wes took Emme to meet with the other plastic surgeon the dermatologist had recommended.  She is based out of Centennial but does her surgeries at Vanderbilt (the only hospital in Nashville with a pediatric anesthesiologist).  Whereas the doctor at Vanderbilt is only a few years older than Wes, this surgeon, Dr. Chester, is much later in her career and has spent much of her career dealing with nevi removal.  She agreed with the other physician that a tissue expander was not a good idea, but she thinks she can do the excision in four surgeries, the final being a graft with the skin coming from Emme's tummy.  Wes felt more comfortable with this surgeon, a little more confident in her experience, and we both prefer the idea of four surgeries versus ten or more.  Emme will still have surgery soon -- the first one is set for March 30, with plans to do the subsequent spaced six months apart.  She has another appointment on March 21, when I will get to meet the surgeon and hear about the first procedure, the hospital stay, recuperation, and follow-up care.  The excision will leave her ankle pretty scarred, but her young age should minimize the scarring from removal of the various other smaller nevi and the graft site.

I should mention that Wes's position at the hospital has really helped us get these appointments.  Both surgeons were booked for months out (much like the dermatologist), but the fact that he's on faculty got us in almost immediately.  We're not people to play our connections -- frankly, we just don't have any -- but the doctor's offices who make the appointments for us don't seem to mind, and well, we let them.  There's not the same kind of "professional courtesy" among doctors these days that there used to be -- people don't just treat each other for free -- but if we can get in to see specialists sooner because of it, we'll take it gratefully.

I'm still not thrilled with the prospect of having to do all this, but everyone seems to agree that it's medically necessary and that it can be done safely.  I have to think the later surgeries will be a little harder when she's crawling and walking and more likely to be affected by the recuperation, but the first one will hopefully give me a sense of what this will be like.  And hopefully, by the time she's two, we'll be all done with this -- a little girl with a scarred ankle who wears lots of sunscreen, but one with a much better prognosis.

Stats

Emmeline had her 4 week appointment with the pediatrician today.

Height: 21.5" (75th percentile)
Weight: 8 lbs., 13 oz. (45th percentile)
Head circumference: 14 1/8" (25th percentile)

Next appointment in four weeks, when it's time for her next immunizations.

  

Now or later

When Oliver was born with congenital cutis aplasia, Wes read a lot about the condition so that he would know more about its causes and treatment.  Ollie spent two days in the NICU getting antibiotics because I was GBS positive and didn't get the meds in labor, and the doctors were worried that the combination of open skin lesions and lack of antibiotics put him at higher risk for contracting Strep B.  Fortunately, he was just fine, and a series of ultrasounds and visits from pediatric neurologists and even a neurosurgeon confirmed that his head was completely normal -- he was just missing the skin in two places.  Today, he has two thick scars on the back of his head, hardly noticeable at quick glance because of his white-blonde hair.  He wears a hat in all weather when he's outside to protect the scars -- and his super-fair complexion -- from the sun.  A month or so ago, we saw the ENT for a follow-up on his tubes, and the surgeon helpfully referred us to -- and scheduled an appointment for us with -- a plastic surgeon who specializes in cranio-facial and other scalp malformations.  (Clearly within the realm of what an ENT should concern himself with.)  I cancelled the appointment as Wes and I had previously decided to wait to do anything about the scars until Ollie was a bit older.

When Emme was born two weeks ago, Wes and I immediately looked at the back of her head (and laughed at each other for doing so).  And very quickly, Wes noticed the lesion -- only one, much smaller, and already half formed over.  Another week or so in the womb, and she might have been born with almost nothing noticeable there.  We both were and weren't surprised.  Nothing we'd read suggested that this condition would repeat in subsequent children.  No one in either of our families has had this or anything like it.  But clearly, there's something in the mix of our DNA that causes this.  Fortunately, it's subcutaneous only.  Emme, however, was born with her own additional skin deformation.  She has several congenital nevi on her body -- one small but dark spot on her left shoulder, a very large, dark and mottled band on the top of her right foot and around her right ankle, and several satellite spots, much lighter, on her right calf.  We learned a little about them from the neonatologist who saw her right after her birth, and yesterday, upon a referral from her pediatrician, she saw a pediatric dermatologist, who told us a lot more.  (Random side note: Turns out the dermatologist (Class of '77), plus his resident (Class of '02 or '03), also went to Davidson.  Four adults in a dermatology clinic in Nashville, TN, and they all went to the same, very small college.  Strange, but less so when you consider how many academic physicians Davidson turns out.)

The biggest concern with the nevi is that they can become melanoma.  The incidence of melanoma among Caucasians is 1-2%.  Small cases of congenital nevi carry a risk of 3-5% by adulthood, with most cases occurring in adulthood.  Large cases carry a risk of 5-10% with 3-5% occurring before the age of ten.  This time, it seems, we won't be able to wait.  We've been referred to a plastic surgeon, whom we'll see next Friday, to talk about doing a procedure to remove at least the large nevus on her right foot and ankle, which is the area that poses the greater risk.  The dermatologist described the procedure generally.  She'll be put under some anesthesia and have a balloon implanted in the healthy skin just above the nevus.  It will then be filled with saline every week for several weeks to stretch the healthy skin, just like what happens when a woman's pregnant belly stretches for a growing baby.  Once there is enough healthy tissue available, she'll have a surgery to remove the nevus and replace it with the healthy skin.  I hate to think of her going through this, but from a medical standpoint, it's pretty straightforward and relatively low-risk and low-pain.  It also minimizes the scarring.  The small nevi we can either treat at the same time or just watch over the years to make sure there's no change in the texture or thickness, which would be an indication of melanoma forming.  Wes and I are hoping it can be done this summer, when I'm home with her full time, so that no other caregiver has to monitor her during the process.

Dr. Smith also talked to us a little about our options for Oliver's head.  He said that it's probably best to wait until 3 or 4 years old, when the skull is fully formed and the fontanel is completely closed.  He can then undergo a straight excision and suture of the two spots, which will leave him with tiny scars that will be hidden by hair.  (Right now, the hair grows around the scars, which are each about the size of a nickel, but doesn't cover them.  It make a really interesting hair pattern in back!).  The dermatologist said it's a good age to get it taken care of, before kids start to really pick up on those kinds of differences and tease each other.  So it's something we'll consider in a year or so.  Emmeline likely won't need anything at all done, as her spot is much smaller and won't scar as thickly because it was already forming in at birth.

I think it goes without saying that I think my kids are beautiful and don't think they need to do anything at all, now or later.  I hope that my children are secure enough to wear their differences proudly and see how amazing they are, inside and out.  However, I know what kids can be like and how difficult it can be on a child to have such noticeable differences.  I'm probably more attune to it for Emmeline as a girl, knowing how, at some age, she's likely to be embarrassed or not want to wear certain clothes or shoes because of what it shows.  Part of me wishes we could wait on all of this until later, when my kids could choose for themselves what they want done.  But realistically, Emme's nevi pose some health risks that we need to consider.  And Ollie's scars are probably better dealt with before he's really aware of them and at an age when kids heal so much faster.  Wes and I feel lucky that both Ollie and Em are so healthy, despite these strange congenital issues.  I hate the thought of either of them suffering to have them fixed, especially if only for aesthetic reasons, but then, I guess that's part of motherhood.

Tympanostomy

Oliver had an unexpectedly eventful week last week with his ears. He has been having ear infections on and off since last September when he started daycare. At first, we knew when he got them because he ran a fever that got him sent home from daycare and sometimes was concurrent with other viruses or infections. His ears were completely clear at his 15-month checkup in December but were "thick," as the pediatrician described them, at his 18-month appointment. No fever, no tugging at his ears, no crying at night -- but two nasty ears -- and, as time went on, somewhat delayed language development. He did a of antibiotics, then went back to the doctor. One ear was clear and the other was not. We decided to wait a few weeks to see if the other would clear on its own (as we were reticent to give him antibiotics with no fever or pain present). We finally went back on Tuesday, with Wes in tow, and both ears were again "thick." The pediatrician did a tympanometry test, which showed that his ear drums were not moving very much, and we all agreed it was time to see an ENT.

The pediatrician recommended using the ENT practice at Vanderbilt, but said they were often hard to get an appointment with. Her nurse called the next morning and told us that the ENT clinic -- the nurse practitioner there, in fact -- could see us on June 14. She had mentioned, though, that Wes was a faculty member at Vanderbilt, and the clinic was trying to see if they could fit us in sooner. The nurse called back an hour later -- Oliver had an appointment that afternoon at 2:00pm for hearing tests, with a 2:40 appointment with the pediatric ENT himself. I had class, but fortunately Wes was able to take Oliver to his appointment. He said the hearing tests were kind of sad. They had Oliver sit in Wes's lap and played a series of tones to in different directions. When Oliver looked at the tone, he was rewarded with a picture of something he liked (Wes chose a dog as his reward picture, and Ollie spent the entire time saying "dog," "dog"). Wes said it became quickly obvious that he could hear much better than Ollie could. So the ENT, not surprisingly, suggested having tubes put in. What was surprising, though, was the timing. They would add us to the schedule any morning, so Wes took Friday to give us at least a one day lapse to get things in order.

Wes had two classes on Friday, so I was alone with Oliver. I was up at 5am and got Ollie up around 5:30am or so to head to the hospital. He wasn't allowed to eat or drink after midnight, and this was my greatest worry. Anyone who knows my kid knows he likes to eat, and I couldn't imagine him going several hours awake without food. I changed his diaper and clothes when we got up and then bustled him to the car, got to the Children's Hospital in less than 5 minutes, and parked by 5:55am. We signed in at 6am and finally were registered (confirmed that all of the information provided two days prior was correct) an hour later. People slowly trickled into the waiting room, and it quickly became full. There didn't seem to be a relationship between when you signed in and when you registered. I don't really know how that works. I assumed we went later because he had such a simple procedure and didn't have much that needed to happen pre-operatively. But who knows. I was irritated with the parents who were sitting in the waiting room with coffee and fruit under signs that said "no food or drink" (since none of the kids there could have anything to eat or drink). I just hoped that Oliver didn't notice and ask for anything, and in the end he was a real trooper. He and I played in the waiting room and read books, and he didn't really fuss at all. We went back to holding around 8:15am and waited there until probably 9:15am. He got into his hospital outfit for the procedure and got his band on (and played with it periodically). There was a glider back there, so when he seemed to get kind of crazy I would rock with him, and he'd rest his head on my shoulder and calm down, almost drift off to sleep. At least five different people asked if he was on medications or had any known allergies (also included on the sheet I filled out the night before). Two nurses carried him off at 9:10am, and I talked with the doctor post-procedure ten or fifteen minutes later. He said they cleared a lot of very thick fluid from both ears, and he has to use drops this week to get the rest cleared out. I was back with Oliver ten minutes later, a little groggy and very thirsty. They let us leave right away, and he was home having breakfast at 10am.

Unfortunately, he didn't take a nap that day. I put him down around 11:30am, thinking he would nap soundly, but 90 minutes later he was still upstairs talking to himself. So I let him get up and play. I was trying to finish a paper due at 5pm, and right around 4 he got really fussy and cranky and wanted to be held. Fortunately, Wes came home around then so that I could proofread my paper and get it submitted. I rocked with Ollie on the porch swing while Wes mowed (thank goodness, before all this rain came). He fell asleep immediately, and I moved us to the couch, where he slept soundly on my chest. We woke him up for dinner, then put him quickly to bed where he slept until almost 9am the next morning.

We don't go back to the ENT until mid-June for a repeat hearing test, but we can already tell he's hearing better. We've stood across the room and whispered his name, and he turned and looked at us. When the rain started yesterday morning, he stood gaping at it at the back door. He's certainly seen rain before (though this is a new level of rain), but it occurred to us that he's possibly never heard the sound of it coming down very clearly. It's hard to know exactly what the before and after was like for him, but it's nice to know that our boy is finally enjoying the world in full surround sound.

At fifteen months

Well, fifteen-and-a-half months, to be fair. Oliver had his 15-month well-child visit with the pediatrician last Tuesday. He is 31 1/4" and 23 lbs. 5 oz., and his ears were clear for the first time in months. He's grown about an inch and gained three pounds in the last three months. He's now about as heavy as the dog. He continues to be in about the same percentile -- except in weight, which went up from 55%tile to 75%tile. It shows, too. His tummy keeps peeking out of his shirt, the way mine did towards the end of my pregnancy. I have actually worried a bit about this, but everyone keeps telling me that all toddlers get the belly. I'm wondering if it's because he walked later and hasn't been burning off the calories.

The last few months have been lots of fun with him. I say it at every stage, but it's true! He's finally walking, is interested and into everything. Yesterday he learned how to climb the side table next to the couch and, as of today, face dive onto the couch -- where, fortunately or unfortunately I'm not sure, I'm sitting. He loves to climb up the step stool, which is only out when in use. Inevitably Wes and I got up it only to find when we try to come down that Oliver is right behind us. His newly daring nature is showing, too. He bobbled in the bathroom last week and got a gash next to his eye. He fell hard on his butt and back yesterday and got a bloody nose. Then he crashed off the couch but has his fall broken by the dog, who was not happy to do so. Oliver has started playing a lot on Lucy's bed, which concerns me a little. She needs a place to be apart, if she so chooses, especially as he gets more rowdy. We're having to say no to him or redirect a lot, and he's not always happy about it. He usually gets over it pretty quickly though, and it's certainly necessary if he's going to make it to two. He loves to push his truck, stack the blocks, and put the shapes through their respective holes on the one toy. He still likes all kinds of non-toys, including the remote control. He can reach almost every surfact in the house now, at least the end towards him. I learned this today as I watched him start to pick up a very sharp Henkels chopping knife from the kitchen counter. Lesson learned.

Since Thanksgiving and more recently my parents' visit, he loves to hold his arms in the air to be picked up. This is not something he did before the trip to my parents' at Thanksgiving, and I blame my family members personally for encouraging this behavior. Last week I took him and the dog to the park, and I let Oliver out of his stroller to walk to the playground. A lady walked up with her dog to say hello, and Oliver marched right over and held his arms up to her! I can see we need to talk about stranger danger.

The only thing he seems delayed in, to me, is talking. I don't recognize really any words. Sometimes some things he says sound a little like an actual word, but it's then applied to sundry other things. He says "mama" and "dada," but not really to us. The pediatrician told me to focus on receptive language -- like asking him for the ball or to point to the truck. I started doing this when I got home from the appointment. Sometimes he does it, and sometimes he doesn't. And usually I can't tell if he knew what I was saying or just happened upon the right item, or if he didn't understand or did but chose to ignore me. He communicates well through physical action and does a little signing, and we're trying to add to his signs. I don't want to be the worried mother, and I'm not too worried, but I'd rather ask now than have problems later. The pediatrician said if we don't see improvement by his 18-month appointment, she'll think about speech therapy for him. He's such a good kid, I hate to think there's anything seriously wrong with him, but I'm also a teacher and know some kids need more help. We'll figure it out, though!

Nine months

Oliver had his nine-month checkup on Monday, thankfully our last one with this woe-begotten pediatrician's office. We were actually seen on time for once -- like some kind of parting gift. Oliver smiled and babbled at all of the nurses on the way in and refused to sit in my lap while we waited for the doctor. He's started standing, though, so I propped him to keep him from trying to crawl around the floor. I left the nice growth charts at the office, but I remember him being just over 22 lbs. (75th %tile) and almost 30 inches (90th %tile), right on track for where he's been all along. The doctor noted that some babies drop percentiles in weight at this age because of their increased activity. Evidently, Ollie has kept up his food intake to match his exercise. He's doing everything he's supposed to be and more. He got two shots, an MMR test (a Children's Memorial resident had TB, so all kids seen in these offices have to have one), plus they drew blood because the doctor thought he looked yellow. It took two nurses and me to hold him still enough to draw it, him screaming all the while. Wes was unimpressed when I told him she's ordered these tests; he argued they were unwarranted -- his eyes aren't yellow, and he's otherwise completely healthy. I got a call today that all the labs were normal, so that's good.

At nine months, Ollie is pulling himself up into a kneeling positions and thinking about trying to pull to standing. He likes to be stood up next to things so that he can hold on and stand up, but then he gets upset because he wants down but is afraid to let go. He doesn't like falling. I don't think it's so much the bump at the end as the falling itself (he's never been one to like getting tossed in the air, hence his hesitancy with the swings, I think), but I'm sure he'll get used to it. His top two teeth are about a third in and moving slowly down, and I can even see two new spots next to his front teeth where more are heading in. He's been very easy with the teething process and just mainly seems to drool more. He's still a strict two-nap guy, though he skips that afternoon nap if the schedule gets too far off (sleeping in late or too long for the morning nap) and then gets cranky toward evening. We haven't had a lot more complete nights of sleep, but I think Nashville will make a difference with this with him upstairs and us down. I've found on nights when I wait it out that he often falls asleep after a few minutes of even somewhat intensen crying. He loves playing with Lucy -- they share her toys. Oliver will play with one, then Lucy takes it from him. Oliver gets the other toy, then Lucy switches. They'll play up to half an hour like this without any problems, but, of course, continued oversight on our part. He likes to take movies and books off the shelf but is fortunately drawn to his books and not ours. He constantly wants in the front bathroom so he can splash in the dog's water bowl and push the stroller back and forth. He is patient in the stroller and very observant. And he's warmed back up to other people -- not necessarily smiley right away, but he'll play with them and giggle as time passes.

Tomorrow is Oliver's last day with our sitter and her son. I've honestly thought about how important it will be to find some new little people for him to play with in Nashville. I think he's grown really attached to having Jack around, and I don't want him to lose that interaction. I'm thinking the playground in the nearby park will provide some possibilities.

You big baby

Oliver had his four-month check-up on Monday. He is 16 lbs., 3 ozs. (75th %tile, which is consistent from birth), 26 inches long (90th %tile, which is a leap from his 2 month apopintment). He has a big head -- a lot bigger than before, in fact -- his percentile went from 25th to 75th, which Wes says it's not supposed to do, but the pediatrician insists in normal at this age. It all seems proportional to me.

After checking out the pediatrician, Oliver flashed some of his best smiles to win her over. It wasn't enough, however, to keep her from sending in the nurse with another rotovirus oral vaccine and four shots. He screamed, as expected, but was pretty easily consoled with hugs and kisses from mom.

Two months

Ollie had his 8-week appointment at the pediatrician's office yesterday. Our new (but same office) highly animated pediatrician informed us that he is 13 lbs. (up from 7 lb. 5 oz. at birth) and 24 inches (up from 21.5" at birth) and all else is well, too. He got four -- four! -- shots, two in each leg, plus the rotovirus immunization, which is oral. He bellowed and turned red when it happened but was easily consoled thereafter.

Tears at the doctor's office

I have, in the past two days, had to take Oliver to the pediatrician for two separate appointments. Mind you, there's nothing wrong with him. It seems all our appointments thus far have been for a "well baby," and for that we are thankful. But, like with his 48 hours in the NICU, there are downsides to taking a "well baby" to a doctor's office.

The two-week appointment on Monday was a follow-up to the one-week appointment. The doctor wanted to see that the aplasia was healing well, which it is -- indeed, surpassing our expectations for how well and how quickly the spots would cover over. The doctor and her resident confirmed this in about three minutes. I also wanted to see the lactation consultant, who turned out to be hugely unhelpful and for whom I paid a second copay. A few hours after getting home from the doctor's office on Monday, I got a call to let me know that Ollie's newborn screening tests, as mandated by the state, had been done too early at the hospital and had to be repeated. So back we went on Tuesday. Wes was working or out of town for both appointments, so I schlepped the baby up on my own, which is fine though a little daunting the first time. The second appointment involved pricking Ollie's heel -- in this case three times by a nurse who seemed somewhat incompetent -- and squeezing out blood into five neat little circles on a sheet of paper. Surely someone can come up with a better way to do these newborn screening tests. Do you know what happens when you prick a newborn on his heel -- three times -- and then squeeze the blood out? He cries. He screams and then he cries. And there's nothing you can do to console him, though you try anyway.

But the tears I reference aren't Ollie's. They're mine. While I don't mind taking a healthy baby to the doctor's office for these "well baby" checkups, I do mind -- terribly -- waiting an hour or more at both appointments. If you can't see me at 1pm, don't give me an appointment for 1pm. I know doctors get behind, have sick patients who need seen on a last-minute basis, or whatever, but an hour-long wait two days in a row is inexcusable. Especially when I'm sitting there with a newborn, exposing him to every germ coming through the waiting room. On Tuesday as I sat, I heard a nurse mention that a family waiting in one of the rooms had two cases of strep throat and one of scarlet fever. Just what a three-week-old should be around, right?

So I found myself there on Tuesday, after an hour and the second hour of waiting in two days, watching family after family go back before me when all I needed was a nurse to redo the screening tests. At an hour, I gathered my nerve and asked the receptionist how much longer it would be. The problem, of course, was that I couldn't just ask. I couldn't be angry and frustrated and even indignant. I asked -- as I teared up. I'd like to blame it on postpartum hormones or the lack of sleep I was suffering from at that point, but mostly it's just me -- I cry when I get frustrated like that. I was just so mad that these people were forcing me to sit there with a healthy baby surrounded by sick kids.

So while I don't have to learn how to change diapers or give a bath or rock a baby to sleep -- those I learned on other people's kids -- the one thing I do need to learn as a new mom is how to advocate for myself and my child -- without crying. And I'll do that first by finding a new pediatrician.

Ollie's Journal, Days 7 and 8

Things I did:

1. Learned to nurse! We still have some work to do, but mom is very happy about this.
2. Met my pediatrician. I weighed 7 lbs. 15 oz., and I am 20.5" long. Oh, and I can hear.
3. Visited some of mom's and dad's friends at and near the hospital. They were nice and thought I was really cute.
4. Went shopping. Dad got a shirt for his interviews coming up, and today Lucy got some treats that are supposed to make her smell better.
5. Tried tummy time again. I liked it a little more.

Right now: Waking up.