Friday, August 12, 2005

Tenley Meets Dr. Mink

Yesterday was Tenley’s 1st doctor’s appointment in the US! Although we live in the Inland Empire, we drove to the Harbor UCLA Medical Center so Tenley could be seen by Dr. Mink who sees specialty pediatric cases- among them adopted children...which is great since Dr. Mink is also an adoptive Mom.

Ten’s last doctor’s appointment was in China on July 4th: she was pronounced healthy and weighed 16 lbs and was roughly 27 inches long. As of yesterday she is officially 17.9 lbs and 28.5 inches long. So she is continuing to grow and gain weight at an acceptable rate, and is in the 10th percentile for height, and the 5th percentile for weight. (For those who might not know percentiles: the 50th percentile would represent the “average” child. 100 is the top and 0 is the bottom. In Tenley’s case it means that 90% of children the same age are taller than she is, and 95% weigh more.) She had no fever, and we never did get a blood pressure reading because she wouldn’t sit still long enough for the auto cuff to get a reading!

We came to the appointment with a list of foods and drink Ten had consumed, and a 3 page list of questions. Everything she’s eaten was fine, and we were cleared to start cheese and yogurt, although whole milk, nuts, shellfish, and citrus remain on the “not yet” list. Since Tenley is happiest feeding herself, Dr. Mink told me to load up her highchair tray with anything she’ll eat and let her go for it! We are supposed to strive for 3 meals and 3 snacks a day, work to discontinue her middle of the night feeding (since it’s probably more for comfort and she should be eating enough during the day), and continue with formula since she’s small and it’s a good way to get iron & nutrition in her diet.

Since they tend to resemble bruises, notes were made about the Mongolian Spots on her back, hips and rear end so that should someone ever think we are beating her we have medical documentation that we’re not. The scar on her face is not severe and will fade as she ages, and we will be applying a topical cream to help the skin. The doctor was unconcerned about the way her feet pronate since they can be held straight, and Ten has no trouble getting to her feet and standing – she says most kid’s feet correct themselves as they start walking. The small lump we found under the skin on her left hip turns out to have a smaller one in the same location on the right and is most likely a calcium deposit from where she received injections in China...unless they suddenly grow or cause her pain, they are of no concern. (It was during this portion of the exam that we found out the hard way that we had left Tenley’s diaper off for too long as she peed all over her father and the exam table, and then promptly sat in it herself!)

The flat spot on her head is of concern. While it is likely that her hair will eventually hide it, one cheekbone juts further out and one ear is higher than the other...while these are aesthetically unpleasant and might dash her hopes of winning the Seventeen Magazine Cover Model contest, they aren’t really a problem....but if the flat spot is too big, it might prohibit her brain from growing properly, and that is a problem. So, we will have to visit a pediatric neurosurgeon to get the expert opinion, and Tenley might have to be a helmet baby...or have surgery if the bones in her head are too solid.

The doctor is very pleased with both her fine and gross motor skills, as well as with her mobility. Tenley happily demonstrated her ability to pick up and gnaw on objects large and small, and to scoot army style to a destination, stand up and sit down. She also got up on all fours and crawled in the traditional style, but the doctor said that her scooting was fine and that there was no problem with her walking as soon as she was ready to do it.

She wasn’t as happy with Tenley’s language development. Yesterday we learned that baby’s minds are “programmed” with their primary language by 6 months... so Tenley has been programmed with Cantonese and we’re going to have to un-do it and re-program her with English. Dr. Mink was pleased that she has continued to babble, but says that she isn’t babbling enough for a child of her age. We talk and read to her everyday, and I leave educational children’s programming like Sesame Street, Dora the Explorer and Between the Lions (all shows that emphasize language, speaking, sounds, and reading) on while we play so she continues to hear English. The doctor felt that that was a great start, said to talk and read more, the TV shows were great and get her more touch-and-feel books to hold her attention while we read to her. If she doesn’t see significant language improvement in the next couple months, she will refer us to a language specialist to help us jump start Ten’s English skills.

The last part of Tenley’s visit was the one I was dreading- vaccinations. I’ve read other parents horror stories, and I was prepared for the worst. A nice nurse held her feet and legs still (very important since they get their shots in the thigh), and Jeff held her torso down. I got to hang over her head and hold the one little hand that was free. Just as expected- there was alot of wailing... really loud angry guttural why-are-you-people-holding-me-down wailing, which began long before the needles came anywhere near her!! There was about 10 seconds of “ouch!” crying at the 2nd injection...and that was it! She was just mad about being restrained on her back (remember, to Tenley laying on back= no mobility), and as soon as it was over and Daddy picked her up and dried her tears she was smiling and holding Daddy’s hands and jumping up and down. Clearly, her thighs didn’t hurt, and she picked off one of her band-aids before we left the office.

All in all it was a good visit! We have to go to a lab to have some blood drawn for a baseline and to check for things like anemia, they’ll also take enough blood to re-check her to make 100% sure she is HIV and Hep negative. We also have to have a stool sample taken and a chest x-ray done: we know that she was vaccinated for TB (we have records, and she has the scar), but because of that she will test positive for it for up to 2 years; so the only way to be perfectly sure she doesn’t have it is by chest x-ray. She’ll also get more vaccinations at her next appointment after she has turned 1.

Our appointment was a great experience and I’m really glad we chose to take her to someone who has experience with adoptive children for her first few appointments. It was nice to have a physician who understands about issues like bonding, language delay, foreign vaccinations and the behaviors routinely seen with children who have been institutionalized, and has dealt with them previously.

Tenley came through her 1st doctor’s visit with flying colors, and for this moment I will cling to the unrealistic fantasy that all her future appointments will go so well!!


Bonnie, Clyde, Bubba Jr. & Charleigh-Jo said...

My son's head was flat and misshapen on one side b/c of the way I was holding him. (I *never* put that boy down!) Once I started letting him lay on his tummy or other things that kept the pressure of that side of his head it slowly began to correct itself. His pediatrician also talked about the helmet thing, but we were lucky to escape without needing that. I hope Tenley will react the same way. Given time it should (hopefully!) self correct. DS is almost 5 now and I have to really look to see any difference between the two sides.


One Lucky Mom said...

I am a little behind in reading, so sorry for the late post. I wouldn't worry about the language stuff until 2. Every kid really develops differently, and I know some doctors really freak adoptive parents out about it.

Also, so sorry for the posts you have had. I get ads on my blog, but never really nasty comments. How sad that you experienced that!