Wednesday, October 29, 2014

15 Month Well Check

I put off scheduling the trio's 15 month well check. I was waiting to schedule it when Jesse would be able to go with me. Because we schedule all three kids at the same time, it's tricky finding back-to-back time slots. Ideally we would have taken the trio to the doctor on Monday when Jesse had a workday, but the clinic didn't have any openings.

Since we go to a children's clinic, we don't have to see the same pediatrician. I try to schedule it with the same woman, but they are especially busy with sick visits this time of year. I called last week and requested the first available appointment. The first time they could get everyone in was at 10:30 this morning, which meant I didn't have to bring Jackson with us.

Even though I take the kids out alone every day and I've taken all four to the pediatrician when one was sick, I was still nervous about taking the triplets to the well-check by myself. It's a juggling act trying to get everyone in, undressed, weighed, measured, entertained, talk to the pediatrician, comfort hysterical kids after shots, etc.

The highlight of our well check was the waiting room. The trio explored all of the toys while I filled out questionnaires on each child.

Some nurses go out of the way to help, other nurses do not. Our nurse today was among the latter. She did not even open the door when I wheeled the stroller through to the exam room. She watched me undress all three and waited for me to place each child on the exam table one at a time.

The most stressful part of the entire check up was weighing everyone. This is stressful for three reasons:
1. The scale is located in the check out area, which is a high traffic area.
2. At our practice, under 2 are weighed naked. No diaper.
3. The babies are mobile...and fast!

After the nurse got everyone's lengths in our room, I had to load James and Amelia back in the stroller and carry Maddie. The nurse didn't offer to push the stroller or hold Maddie, so I did both down the hall to the scale. I put Maddie on the ground while I took James' diaper off and placed him on the scale. While she weighed James, I took Amelia's diaper off. I had to put James on the ground in order to get Amelia on the scale. A naked James crawled halfway down the hallway. I chased him, put his diaper on, and buckled him in the stroller. Maddie walked into the bathroom while Amelia was being weighed. I picked her up and took her diaper off mid-air. I switched the girls on the scales, put Amelia's diaper back on, buckled her in the stroller, picked up Maddie, put her diaper back on, and walked back to the exam room. Of course, parents and children passed by throughout this ordeal, making the same comments I've heard a hundred times before (i.e. "You sure have your hands full!" "Triplets? Wow!" "Are they all yours?" etc)

The waiting time for the doctor was fairly entertaining. Of course the trio was all over the place. Amelia was the first to discover the ability to roll more paper onto the table. James was immediately drawn to the trashcan. Maddie was elated to push the rolling doctor's stool around. Then they would switch places.

The pediatrician was a bit more relaxed than I preferred, but he addressed each of my concerns. (Sidenote: He has a 15 month old son who is two days older than the trio. They also cloth diaper.)

The quick recap for everyone is:
-James still has loose stool, but not every day. I was told to continue regular probiotics. As far as his diaper rash, we are to let him air out in between diaper changes. The pediatrician even suggested using a hair dryer on cool setting. (Because that's practical!)
-I've been concerned about possible cognitive and speech delays with James. I gave a variety of examples such as how he continues to go head first down a step instead of reverse, refuse to let go of an object if I'm trying to buckle him in the car seat or get him dressed, etc. The pediatrician felt confident that James is more stubborn than delayed. Just while the pediatrician was there, James had moved the stroller to get to the trashcan, and go through my purse to find my phone that I had put away.

-I didn't have any concerns with Amelia. The only thing suggested was using hydrocortisone occasionally on her feet for eczema.

-He wrote a prescription for stronger steroid cream since Maddie is bothered by her dry skin and regularly scratches at the folds of her arms and ankle.
-He said, "According to our notes the neurologist was pleased last week." I bragged about Maddie's progress and let him know she would be using shoe inserts soon.
-After listening to her heart, he detected a heart murmur, specifically a VSD. He suggested we see a cardiologist again when she turns two. I didn't think much about it at the time, but after reviewing blog posts at home, I am quite confused.  Maddie was born with a PDA, but it had closed by 6 months. We saw a cardiologist at that time and found out via ultrasound that she had a PFO. However, no doctor has heard a heart murmur with a stethoscope since she was 4 months old. I sent a message to the doctor through Patient Portal and am a bit anxious about his response.

Here are their updated measurements:

6 lbs, 12 oz
20.5 in
6 lbs, 2 oz
20 in
5 lbs, 9 oz
18 in
4 Months
13 lbs, 5 oz
12 lbs
9 lbs
23.75 in
6 Months
15 lbs, 7 oz

14 lbs, 9 oz
11 lbs
9 Months
17 lbs, 6 oz
16 lbs, 11 oz
13 lbs, 5 oz
12 Months
21 lbs, 15 oz
20 lbs, 9 oz
17 lbs, 4 oz
15 Months
24 lbs, 13 oz
22 lbs, 14 oz
20 lbs, 9 oz

From the time the doctor left to the time the nurse returned with shots was an excruciating wait. The exam room is no bigger than a walk-in closet. Two chairs, an exam table, and a double stroller fill up most of the room without adding three toddlers. It was noon, which meant we had been at the clinic for over an hour and a half. The triplets were hot, tired, and hungry. 

The nurse was painfully slow giving the shots. Each child had three vaccines (DTaP, flu, Hib). She gave each vaccine one at a time, then applied a band-aid. And, she didn't wear gloves!

The triplets were finally loaded in the van by 12:30, which just barely gave us enough time to go pick up Jackson from preschool. What a morning!

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