Wednesday, September 10, 2008

Nine Month Checkup

River had his nine-month checkup today. I’m less than thrilled with our pediatric practice because it seems to me they go too much by the book. We go to the scheduled check-ups just because we are supposed to.

This one was slightly more useful than past appointments because they did a blood test for lead without my having to ask for it. I’d read that kids should be tested at a year or two old and I’d planned on asking for it at our 12-month appointment. There are a lot of older homes in our community and many of them, including ours, have lead. The inspector who came last fall said we have lead paint about ten layers of paint back on the walls. It’s only a danger if the paint chips off and then River puts it in his mouth.

At the time, we thought we’d be moving by the time River was 6-months old. As long as he couldn’t crawl, it wasn’t a risk. But now we’re staying another year and River is crawling, so we’re concerned. If his levels are elevated we’ll take action, moving if necessary. Hopefully they will be OK and Mark and I will both feel better to be reassured.

We also learned that River has moved up from the 75th percentile to the 90th for height and weight. I was expecting that because he does seem larger than many of his age-mates and frequently receives comments about being a big boy. Even the doctor called him “muscle-man.” Mirena, his new playmate, is half an inch taller than him though. She must be at the 100 percentile-plus range for girls.

He still only has one tooth, which I think is a bit less than average for his age. The doctor’s assistant asked if we have him hard things to chew on. I said no, not often, because he doesn’t experience pain very often.

“But chewing on them will help the teeth to come in faster.”

I told her we weren’t in a hurry, especially after I read that baby teeth don’t aid in chewing until the molars come in. Until then, they don’t serve any purpose but to make breastfeeding a little more complicated.

River had to get his finger pricked for the lead test and a hemoglobin test. I’m afraid he’s inherited my poor bleeding skills. I used to walk out of the doctor’s office with six bandages on a typical blood draw. When I tried to donate blood in my 20s I was told to not come back because it was like taking blood from a 90-year-old. The lab worker couldn’t get enough blood from River’s first prick and many squeezes (which River took like a muscle-man, without crying), so the worker pricked his other thumb.

It’s really horrible to watch pain inflicted on your child. I knew my presence was probably comforting to him, but at the same time, I feel he must wonder why I’m letting it happen. From the finger pricks, I had to take him to immunizations, where he got the last Hep-B shot. I would have come back in six weeks for the last polio shot (which was also scheduled for today), but the doctor said it could be given as late as 18 months, so no hurry. That was the first time he actually supported my delaying a shot.

At the same time, he did urge me to get (two!) flu shots, even while he admitted the low efficacy. I’m pretty sure I’m not going to. Not because I have anything against the shot – I get it for myself almost every year. But because River is already getting too many things injected into his young immune system this year. The doctor commented that despite the low efficacy, it’s worth it because of the serious effects the flu can have on a baby. I do understand that, but River has less exposure than others by not being in daycare and he really is a big, healthy guy for a baby. If anyone can make it through a bout of illness, I think he has a very strong chance.

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