James: 10-month Check-up

Yesterday, Caleb and I took James for his 9-month check-up that has been rescheduled so many times, it became his 10-month check-up. Caleb is very much a part of the process, as he feels that he is doing his part as the big brother to bring his little brother to the doctor. Since we have been going monthly for RSV shots, Caleb has gotten the routine down. But I was glad to tell him that James would not be getting a shot on this visit. (As a side note, the "RSV season" has ended, and we won't be getting the shots from now on. I don't know if they'll start back up next season or not.)

The visit was very productive, as Dr. R was more congenial than usual, and answered my many questions. But first, the stats!

Weight: 16 lbs, 6 oz  -  50%
Height: 28 in  -  75%
Head circ: 41.3 cm  -  45%

So my little man has gotten some length on him! I still haven't gotten around to moving him to 9-month clothes, but mostly because he's in shorts all the time. 6-month footies would probably not fit him very well.

Questions I asked:

1. Circumcision ok? James's circumcision doesn't look like a normal circumcision to me, and Dr. R said that he has adhesions, which my mom says is scar tissue that pulls skin together where it shouldn't. Dr. R said it should break up between ages 2 and 3 years, and if not, James will undergo another circumcision. Yikes. It doesn't seem uncomfortable to James, and it's not causing blockage or any other issues, so we'll just wait it out and make that decision when necessary.
2. Belly button ok? Ever since James's surgery, his innie belly button has been an outie. That's usually a sign of a hernia, but Dr. R said that if it was a hernia, it was a very small one, and that it should close up on its own. I have noticed the outie is not as much an outie as it used to be, so hopefully that's true.
3. Chest shape ok? Jame's rib cage is a bit of a mystery to me. It's concave at the top, flares at the bottom, and has a large bump over his heart. Dr. R says that the flare at the bottom is probably a result of his heavy breathing prior to surgery; his lungs pushed his ribs out. The bump over his heart is supposedly normal, and everyone's chest over their heart is larger than the rest of the area. I do not find this to be true in the rest of our family, but whatever. As with the other questions, James's chest shape is nothing to worry about, and should right itself with time.
4. Diet into his first year? Dr. R said it should be no problem to move James to cow's milk at his first birthday. We'll still thicken it, of course, but he should transition fine from formula. He also said that baby food would be fine, if James wasn't ready for table food. I guess I knew the answers to these questions, but I still wanted to ask to make sure I was on the right track. This is just one of those instances that shows how I feel like a new mom with James!



James and his therapist

5. Further therapies? I've asked our developmental therapist about starting other therapies with James--speech, physical, occupational--and he has been reticent to recommend it, feeling that what he was doing was sufficient. However, Dr. R feels there's no reason to delay, and I think I agree with him. A faith-based place for special needs children, called Hope Landing, is sending me a large packet of information and forms. Once I've gone through all that, James will be evaluated, and we'll be given a recommendation as to what therapies he currently needs. As a child with DS, he will probably qualify for all of the above therapies, and we could end up going to therapy every day of the week if we chose to. However, we have been cautioned by other families with special needs to not revolve the whole family around one child, and that we don't have to accept every therapy that is offered. Choose the ones that are important for James at the time. So that will take some prayer and wisdom from us when it comes time to make those choices. Hope Landing does not send therapists to the house (unlike the developmental therapist), but it is in town and not too far. It seems like a neat place that incorporates prayer and spiritual development into its plans, plus there are some programs that allow sibling involvement as well. So, I'll probably be writing more about them later.

Little Man loves his toes!

And that's it! That was the doctor's appointment. Very informative, and we don't go back until 12 months. Before that time, James has an appointment with the genetic clinic at Children's and a follow-up appointment with the cardiology department at Children's. I think his heart doctor will be happy to see how much he has grown, and how well he is doing!