Saturday, February 26, 2011

The second opinion

Our pediatrician was eager to give us a new referral for an ENT for Caroline. Adam and I were relieved to hear that she was also not pleased with our first ENT visit.

Thankfully, we got in very quickly. Our new ENT appointment was this past Wednesday. Dr. V examined Caroline and began to talk to us about our options. He did mention surgery - an adenoidectomy, but also discussed some steps we could take prior to surgery.

The first thing he wants to try is a regiment of Singulair and Flonase. Both of these normally treat allergies. It is possible that Caroline is having an underlying sinus infection due to allergies, but I'm skeptical. Dr. V's main reason for this treatment is that he has seen several studies where these 2 drugs shrink the adenoid. Dr. V was also ok with us waiting this out until the summer. Kids' adenoids shrink a little each year until they are school aged. So our thinking is that maybe next year, Caroline will have fewer sinus issues - and the next year, even fewer. Dr. V said it would not be harmful to wait and see. However, I did get the feeling that he would want to do surgery next year if we don't see improvement. We go back to see Dr. V in 4 weeks.

So on Thursday, I took the prescriptions of Singulair and Flonase to the pharmacy. That afternoon, when I picked Caroline up at my aunt's house, my aunt told me that she had only wiped Caroline's nose once after lunch! This is truly unbelievable. She has been a green fountain like the one in Five Points on St Patrick's Day for over 4 weeks. Thursday night she slept great and on Friday I didn't wipe her nose once - all day! Saturday was the same story. She's been in a much better mood the last 2 days and has taken great naps. So I haven't given her the Singulair and Flonase yet.

What happened? I really don't think I can attribute this to the antibiotic she is currently on. Thursday was day 8 of that antibiotic. It should have worked by Day 3 or 4 (according to MD Ashley). I am currently attributing this to answered prayer. We are still finishing off the 3rd antibiotic. And Caroline is still on a pretty extreme diet of no milk and no fruits/veggies (except bananas) to help her tummy cope with the strong antibiotic. So we still need prayer, but I think we are on our way to recovery. Having such a great last 2-3 days, has made me so thankful that we didn't go with the first ENT's recommendation and have surgery this past Wednesday!!

Side notes:
- I have now had 3 doctors (Our pediatrician, ER doctor #2, and ENT #1) tell me how surprised they are Caroline didn't have an ear infection with how bad her sinus infection was. They've told me that she must really have great Eustachian tubes. What a blessing!

- Caroline has now been to a doctor 7 times in the last 4 weeks for one single sinus infection. She is getting pretty good at saying "Ahhhh" for them to look down her throat.

- Adam started to feel sick on Wednesday of this week. By Thursday evening, the fever was setting in. And then on Friday, it peaked at 102.6. I made him go to the doctor on Friday to make sure it wasn't the flu. They also checked him for strep. It is neither. Caroline and I are staying far away to make sure we don't get it - whatever "it" is.

Tuesday, February 22, 2011

The nose that just won't stop

I mentioned in Caroline's 21 month post that she has been continuously sick this last month and on one antibiotic after another. Our pediatrician had pulled all the tricks up her sleeve and last Thursday she decided to refer us to an ENT. Our appointment was Monday - same day as my big ultrasound (talk about an emotional day for a pregnant lady).

Adam and I were both disappointed in the appointment. The doctor basically read Caroline's chart and decided she needed an adenoidectomy before he even walked in the room to meet us.  He was in the room with us all of 10 minutes discussing the surgery and how we would see results immediately. He was ready to schedule the surgery for this Wednesday or next. Adam and I told the doctor we would think about it. We both left the room stunned. That night we decided we wanted another opinion.

I called our pediatrician and gave her the highlights of our ENT visit. She was not pleased with the results either and readily referred us to a new ENT for a second opinion. We go to see the new ENT tomorrow. I'm so glad we are getting into these places so quickly. Dr. G told me that sometimes getting into an ENT can take a couple of weeks.

It may be that an adenoidectomy is the right thing to do, but we just want to make sure. Please pray for us as we make these decisions for Caroline. Please pray for Caroline to just get well and to feel good again. And please pray for the doctors who are advising us - that they would be interested in Caroline's well being for life. 

Little Bit is a little bit PINK =)

Today we found out that Little Bit is a girl. We are thrilled to welcome another sweet girl into our family. The tech took all her measurements and she looks great. She's currently tipping the scales at an estimated 10 ounces. We aren't completely settled on a name, but I think we are getting close so I'll fill you in as soon as we decide.

The ultrasound was interesting to say the least. Little Bit is currently completely breech and the placenta is anterior (meaning it is in front of her). All of that is fine for now, but this made the ultrasound a bit challenging. All of the pictures from the ultrasound are very blurry because the signal was traveling through the placenta =( That part was kind of sad. I was looking forward to some good pictures of our little girl, but we really don't have any good ones.

I was very proud because I predicted that the placenta was in front a few days ago. About a week ago, I noticed that the pronounced big kicks Adam and I had been feeling on the outside my tummy were suddenly all inside. I can only feel them on the outside if it is a huge kick, but I feel plenty on the inside. So I told Adam a few nights ago that I thought the placenta had moved closest to my tummy now and that I thought it would make the ultrasound difficult - I was right. See...ready to be an MD =)

The tech had an especially hard time getting the gender. She seemed to take it personally that Little Bit was not disclosing the information. She told us she had never had one where she couldn't tell. After trying and trying, she stood up from her chair and said that this was getting serious! She had me move into different positions and had me try things like laughing and coughing to get the baby to move. She then told me that if she couldn't figure it out in the next few minutes, she was going to have me standing on my head. Finally she felt comfortable enough to tell us it was a girl =)

Saturday, February 19, 2011

Monday's a big day

On Monday I'll be 20 weeks along - half way there. And...on Monday, we will find out if Little Bit is a girl or a boy -yay! I can't wait to see Little Bit again. We are praying for a healthy little baby. So stay tuned...

Me and Little Bit at 17 weeks.

P.S. Little Bit and I are feeling much better these days =)

Thursday, February 17, 2011

Another trip to the ER and me getting my MD

So we had another trip to the Emergency Room with Caroline. I briefly described the situation in her 21 month post, but now I will divulge a little more.

The Saturday of Adam's half marathon, Caroline woke up with one of her eyes matted shut with yuck. She had also coughed all night. I assumed pink eye and kept cleaning her eye all day. That night we were back home and at dinner Adam and I noticed a distinct red line just below her eye. It was very strange. The next morning I took her to the doctor. Since it was a Sunday, we saw the on call doctor and not Caroline's normal doctor. Dr. D was great. He said it wasn't pink eye, but just a bad sinus infection and he put Caroline on an amoxicillin. He was, however, concerned about the red line. He told me to call the office immediately if I saw the redness again. He said it could be cellulitis.

The next Thursday, I arrived at my aunt's house to pick up Caroline after work. Caroline had just woken up from her nap and my aunt had noticed her very red - raccoon like eyes. They were red all around - hence "raccoon like". It was the first thing I noticed as well when I saw her. So I loaded Caroline in the car and called the doctor. Because of poor communication between the nurses, my information didn't get passed to an actual doctor until 5:00 on the dot. At 5:02, the nurse told me the doctors wanted us to go to the ER - it was too late to go into the office. I was beyond frustrated about this and drafted a letter the next day to our doctor's office - this is still in the works.

We went to the Palmetto Richland Children's Emergency Center. We were triaged and taken back to see a doctor very quickly - about 1 hour - pretty good for an ER. The doctor's saw us and did a simple physical examination to diagnose Caroline with Blepharitis - much less scary than Cellulitis. We were out of there all in about 2 hours. I was very impressed.

Caroline waiting to see the doctor.

Caroline's Blepharitis. You can see the redness under her eye and in the corner. You can also tell how swollen her eyes are. Her eyes actually looked much better at this point. This was taken about 5.5 hours after they looked their worst, but they were never an "angry red". The ER doctor said that Cellulitis would be an "angry red".

So I feel that I have learned sooo much from Caroline's doctor visits and medicines in the last couple of months. I'm already making my own theories and conjectures. Adam told the last ER doctor that I have "lots of theories" =)

Here are some of the things I have learned:
  • We all have 4 sinuses.
  • When you are born, only 2 sinuses are completely developed: maxillary (below the eyes) and the ethmoid (in the nose).
  • The frontal (above the eyebrows) and the sphenoid (also in the nose) sinuses don't develop until much later.
  • Sinus infections are often over-diagnosed in small children because it is more challenging to get sinus infections in the maxillary and ethmoid sinuses. (I learned this fact because are ER doctor on this last trip said that it was impossible for Caroline to have a sinus infection. I got angry and did some research and talking to our pediatrician.)
  • Sinus infections can be accurately diagnosed to a small child in one of 2 cases: 1) blood test, 2) child has a cold that is getting worse after 10 days. Caroline's first sinus infection at Christmas was officially diagnosed after a blood test - Check meets #1! Caroline's second sinus infection (the one we are currently treating) was officially diagnosed when I took her to the doctor 9 days after a previous appointment for the same sickness that was getting worse - Check meets #2!
  • You should typically expect a turn around of 3-4 days when giving an antibiotic. Doctors typically prescribe antibiotics for 10 days because the AAPA suggests taking an antibiotic for 7 days while you are well. So 3 days of sick and 7 days of well = 10 days. If the sickness is more severe antibiotics are typically prescribed as follows: 14 days, 21 days, and 28 days. 
  • A child Caroline's age can take up to 2 packets or Culturelle (probiotic) packets a day with 2 cups of yogurt - this is to help the tummy keep good bacteria for digestion purposes.
  • Azithromax does not have a good history of working for ear infections or sinus infections. It works best on respiratory type infections.
  • Amoxicillin and cefdinir are typically prescribed for ear infections and sinus infections. In our case, we have tried both and we are now moving on to clindamycin. All of these are difficult on the tummy =(
  • Cellulitis is a very dangerous infection of the eye. It is caused by bacteria that gets trapped in there. There are 2 forms. Orbital cellulitis is the most scary. Periorbital cellulitis is less scary. If not treated in a few hours, blindness can occur in the affected eye. If not treated soon after that, the infection can cause death. Orbital cellulitis requires immediate hospitalization and an IV of antibiotics. 
  • Blepharitis is irritation of the eye caused by sinus infections, viruses and the like. Blepharitis is treated with a little love and warm washcloths. 
So if you would like for me to diagnose your child - bring 'em on - unfortunately the pharmacies won't accept my signature for a prescription. I'll be glad to tell you all my theories too =)

Adam's Birthday and his 1/2 marathon

Adam turned 28 on the January 24th. Both of our families came down from the upstate to eat dinner and cake with us. We loved having them down and Caroline talked about all of them so much the next week. Adam and I went out the next Monday night to see The King's Speech. We both really enjoyed the movie. Someday I'll remember to take pictures =(

On February 5th, Adam ran the Tybee Half Marathon in the pouring down rain. Caroline and I attempted to be supportive and we were able to see Adam a few times towards the end when the rain let up. Adam completed the half in 1:47....8 minutes slower than his best half marathon 1:39....not bad for running through a bad rain storm.

Enjoying a post-race burger.

Playing Outside part 2

At one point in this video, Caroline calls me "Alice". This is my aunt's name. This video is blackmail for when I mix up my children's names. I can show her this and say "see you do it too!" I'm so glad Caroline adores my aunt.

Playing outside - Part 1

I took this video on one of the days when Caroline was feeling good and the weather was nice.

Notice that she counts all they way to 10 before she slides down the slide. She used to just count to 3, but apparently she has to count all the way to 10. Also, she has started skipping the number 2 recently - I'm not sure why. Maybe she is as anxious about turning 2 as I am =) When she reaches the bottom of the slide, she counts to 11. She cracks me up =)

21 months

Caroline is 21 months now. These days you may find her doing any of the following:

- Grocery shopping with her toy grocery cart

- Coloring
- Pointing at items and declaring who they belong to. Things often belong to our family members - Grandma, Grandpa, Audry, Nana, and so on. But actually, all of these things belong to Adam or I. According to Caroline, Adam's sunglasses are "Nana's", many of her own hair clips or toys are "Audry's", food and various furniture are usually "Grandma's" or "Grandpa's."
- Riding in her Cozy Coupe
- Saying "You ok, ?" Usually it starts with people - "You ok, Mommy?" and I say "Yes. I'm ok." But it quickly moves to inanimate objects - "You ok, ground?....You ok, rice?..."
- Playing on the playground
- Doing her makeup or hair
- Singing nursery rhymes or lullabies - her newest one is "Where is Pointer?"
- "Rest 'a mommy" or "Rest 'a daddy". This started because there were many days of my pregnancy when I did not feel good. I would lay on the couch and tell Caroline I was resting. She would always want to come and cuddle close to me and rest with me. Even though I'm feeling much better, she loves to point at the couch and ask if I will rest with her. And now she's even asking Adam to rest with her. She's a big cuddler =)

The whole family cuddling in the Daddy's recliner

- Listing what things are not. For example her milk is "not water" and early this month Aunt Amber was "not Grandma". She does this many times a day with various objects.
- And To Adam's (the journalist) dismay, Caroline has added her own word to the Beam dictionary "No-kay." It means "No, I'm ok." If you ask her if she needs to go to the bathroom, she is likely to reply "No-kay." Adam gets flustered and says "That is not a word! I don't know what that means" in classic Adam style =)

But one thing is for sure, wherever you find Caroline, you will surely find Bubby. Bubby seems to have booted out Nommy for the time being. I'm not too disappointed - Bubby fits better in the diaper bag if so needed. It's so funny to hear her talk about/to Bubby. If you ask Caroline if she is hungry, she will turn to Bubby and say "Bubby, you hungry?" She does this for just about all daily activities. So far we don't have to take Bubby everywhere we go. Most of the time, we just tell Bubby "night-night", we lay her in the crib and we "cover up blanket". Then we are ok to leave the house without Bubby. As soon as we get home, Caroline says "Bubby, time get up!"

Bubby - wearing pajamas because Caroline was putting on her pajamas.

With the nice weather, we've had several opportunities to run around on the playground that is about 2 blocks from our house. I'm so amazed at how much she can do by herself. I remember thinking last year that there was no way this playground was going to be age appropriate until Caroline was 3 or so, but I was wrong - she's an expert. She climbs the steps and slides down the slide all by herself. And she's confident enough to do so. She's also started going down the slides on her belly (feet first). I don't know where she learned how to do this. She just turned around and did it one day. I guess this is her adventurous side.

Caroline's has been really sick this month. I'm so sick of her being sick =( My healthy little girl who didn't have an antibiotic until 18 months old - is now on her 6th antibiotic. All 6 in the last 3 months =( She is currently dealing with a sinus infection and I'm learning that her infections tend to settle in her eyes. We've even had another emergency room trip in the last week. It's a long story - worthy of another post. In short, the doctors have us watching her eyes very closely to make sure cellulitis doesn't develop. We had a scare one evening that it had actually progressed to that and since the pediatrician's office was closing the pediatrician told us to go to the ER. The ER doctors very quickly assessed her and told us it was not cellulits and we went home. Caroline is currently on a 3rd antibiotic for one single sinus infection. Today, 2/17, is day 12 of antibiotics. Her little tummy is barely hanging on with all this medication and we are doing all kinds of things to help it. Our pediatrician has also referred us to an ENT to hopefully get this figured out once and for all. Our pediatrician mentioned that we may be in for a head CT soon, which would mean sedation. Please keep Caroline in your prayers as we talk to the doctors and try to make the best decision for her. I really just want my little girl healthy and back to her old self.

Caroline is loving wrapping blankets around herself and wearing them like a cape - she gets this from me. I do it all the time =)

With all of Caroline's sickness, we have been extremely lenient with TV and movies. We, as a family, have fallen in love with The Little Mermaid and Beauty and the Beast. We spend lots of time cuddling on the couch and watching bits and pieces of these 2 movies. It has been sweet cuddling time, but it sure makes me sad that she doesn't feel like playing.

At one of our sick visits I went ahead and asked our doctor what she thought about Caroline not feeding herself. The doctor just laughed and said that obviously she has the motor skills, it's just Caroline's personality. And while I couldn't agree more, it was nice to hear that she is not concerned either.

In other news, we turned Caroline around to forward-facing this month. I was hoping to make it to 2 years old, but our car seat only goes to 30 pounds rear-facing. And at her last sick appointment, she was 29 pounds 13 ounces. She is still under the car seat's limit, but the car seat did not look like it was handling the 29 pounds well. Every time we rode somewhere it would end up all tilted and funny looking. I would have to adjust it before I put her in every time. Caroline doesn't seem to notice a difference. I definitely noticed that she had a harder time falling asleep on our trip to Georgia.

Many of the 18 month, 24 month and some 2T clothes are leaving Caroline's closet to be replaced by 3Ts. Seems crazy that my 1 year old is wearing clothes for 3 year olds. Her shirts were just seeming to small and sleeves seeming too short. She's also in some 3T sleepers at night, but all of her pants are still 2T. 3T pants are way too long. I really thought she might drop a size when we dropped the diaper, but her current pants just seem to fit better =)

Caroline just sings all the time. When we went to Georgia for the 1/2 marathon and we all shared a hotel room, we heard Caroline whispering something. When we went closer, she was whispering "Twinkle, twinkle little star" in her sleep =) Such a sweet sound for a mommy who loves to sing.

We took Caroline to a basketball game this month. My aunt and uncle couldn't use their tickets that day so we got to enjoy them. Caroline seemed to enjoy it and have fun.

I love this face. She is frustrated because the Gamecocks are losing so bad.

And finally, we are getting a glimpse of the terrible twos this month. We have seen our fair share of tantrums. I do think that this is related to all the sickness she has been through. Hopefully my next monthly post will say that Caroline is very healthy and all is well with the world again.