Tuesday, April 17, 2012

I worry too . . .

You may have noticed that the blog posts are less frequent than before. That is for a few reasons. As you know, I had Child2, moved, went back to work, had Passover, and a delay in getting our Internet service back. We also had to let go of both of our dogs - one died and one finding a new home. Even more, we are also having health issues with Child1 and Child2.

So you thought pediatricians didn't go through this type of thing? We do. In some ways we have an even harder time because the burden of knowledge is so crushing.

Child1 is behind on his gross motor (not walking) and verbal skills (babbling, not talking). He's also the bottom of the growth curve. We are scheduled for an early intervention evaluation from the local infant services group. They'll come to our house to evaluate him and determine if he needs additional therapy. I sit around and wonder if I've failed him in some way that all three of these things are going wrong.

Did I fail to stimulate him enough? Did exposing him to 2 languages by visiting Israel and speaking Hebrew for the first few months of life mess up his verbal acquisition? Did I feed him too little from birth onward? (All of his food is now spiked with olive oil or carnation instant breakfast.) Should I get him sweat tested for cystic fibrosis? He coughs every once in a while - does he have occult pneumonia from cystic fibrosis or inhaled foreign body? Should I get him retested for lead - even though his level was fine at 12 months? Was our apartment too small?

Child2 has a patent urachus - a connection between his bladder and belly button that oozes fluid and pee out of his bellybutton. If left untreated, it could lead to multiple damaging UTIs and cancer. Correction is surgical. The radiologist told us it wasn't too severe so I should wait for my urology appointment to make any decisions as they are often observed. I stare at his bellybutton obsessively now looking for signs of infection.

Should I have gotten the ultrasound sooner? Should this have been caught on prenatal ultrasound? Did the time I mistakenly ate some chicken that I thought was hot ended up being cold contribute to this? Was thirty feet not far enough away from the portable x-ray machine they use in the hospital - even though radiation doesn't cause this? What will I do if he needs surgery? Should I have insisted on an immediate appointment? He's cried for 10 minutes - am I missing an infection?

Then I ask myself what I would tell a patient. "Child1 is above average in his fine motor skills and has great eye contact. Kids develop at different rates, so see if early intervention as an unbiased observer, thinks anything needs to be done. You have plenty of time to step in and someone is going to be the 3rd percentile. Child2 has a relatively common well known generally uncomplicated abnormality. It was even a regular question on board certification testing. You got your testing done by the head of pediatric radiology and he recommended observation with pediatric urology. You have an appointment with the best pediatric radiologist in 300 miles."

It's comforting to know, but as a parent you'll still worry, no matter what.

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