Annabelle had her 3 year checkup with Dr. Calk this afternoon. Yes, it was a few months late, but I waited to book it until early November, and I couldn't get in with Dr. Calk until January. Since he's seen her for all her well visits since birth, I preferred to stick with him even though he probably does not remember either of us. But, for the most part, I've been very happy with him.
Here were her stats for the visit at her age of 3 years, 2.5 months:
Height: 37 3/4" (50-75%)
Weight: 35 lbs (90%)
Blood Pressure: 92/58
Heart Rate: 104
Two nurses walked in with us to the exam room. I thought, "Oh great! We get another nurse in training!" It turned out to be a very pleasant experience though.
One nurse took Annabelle to weigh, measure and take her blood pressure and heart rate while Lauren, the other nurse, reviewed her list of questions with me and discussed any concerns I had to discuss with the doctor. It actually made me a little sad that Annabelle was so quickly to follow the other nurse without me there to tag along. I just like to watch everything my sweet girl does, and I missed out on how she acted when they took her blood pressure and heart rate for the very first time. I don't think they've taken it in the past.
Then, after Annabelle had returned and while I was still speaking with Nurse Lauren, another nurse showed up to take her for her vision test. Vision test! I never dreamed they would check her vision at 3 years. But, apparently, she did well, and she was so proud because they gave her a sticker with a tiger on it wearing glasses that said, "Lookin' Good!"
Yet again, she followed that nurse without any problem at all. She's growing up so fast! My baby no longer needs me for everything in her life any more. It is definitely bitter sweet!
As for her wellness visit with Dr. Calk, I came prepared with my list of questions. He always takes the time to explain most everything to me. And, today, it seemed as if he took an extraordinary amount of time. But, he didn't act rushed at all, and he answered all of my questions in full detail.
And, Annabelle was awesome! She wasn't scared at all. I had told her that I didn't think she would need any shots today because they had told me that she wouldn't, but I warned her that I could be wrong and they may need to insert a needle to give her a shot. She seemed okay with it, but fortunately, I was right. She had no shots!
Here are details regarding my list of questions for Dr. Calk.
EczemaSince Annabelle was a baby, she has always dealt with problems with eczema, but this winter has been to the extreme for her. I believe one of her wakings last night was related to this eczema.
Poor baby has splotches of the raised, bright red nastiness all over her body. It has been bothering her for a good 2 months, but I've been able to tame it with fewer baths, lots of Eucerin and Calydryl on the really bad spots. Honestly, the Calydryl and fewer baths has seemed to help the most.
She had another bath last night though, and that seemed to set off another bad case of it. Her little legs turned red while in the tub, and she started itching and scratching before she was even out.
Dr. Calk said that the eczema is generally worse when it is cold outside. I already knew that though. He also said that I really didn't need to cut back on the number of baths, but instead may try a little salt in the bath water. He said that some people believe salt helps to heal the sores, but he believes the eczema is a direct result of the humidity levels.
He did say she would need a steroid cream to heal those sores, so he prescribed Cutivate cream. He said to apply it once daily for 7-10 days. I just wonder how much that cream is going to cost me since our health insurance changed to a high deductible health plan, and we no longer have copays, so the cost is ours up to our deductible. But, the good news is that we will most definitely meet our deductible this year with the birth of our second child, so I'm not too worried with the excessive cost of a prescription. You know me though, I will still try to find the cheapest option.
Labial AdhesionYet again, she had a slight labial adhesion. I already knew it though because I've been watching that one like a hawk since she's struggled with that since she was only a few months old.
And, honestly, she hasn't had a problem with it in months, but I noticed it again at the beginning of this week. Naturally! Just in time for another checkup!
SpeechAnd, my biggest concern for Dr. Calk was her speech. Most people have a very hard time understanding Annabelle, and I have to repeat everything for her. But, once she started talking, she has NOT shut up. She talks non-stop! Some people don't realize she talks so much though because she tends to be quiet and shy around those that she doesn't know or doesn't know very well. Get her alone, and you cannot get a word in otherwise.
Thankfully, she did open up to Dr. Calk immediately. He mentioned something about the Hello Kitty socks she was wearing, and she said, "Yes, I like dose Hello ditty dat socks. I have another pair at home with, with, with, only one Hello ditty dat on it. Dose are my best favorite."
His response: "She's a little chatterbox, isn't she?"
You think!?!?! Is it a girl thing?
He did immediately ask if she had seen a speech therapist though, and he recommended that she see one. He was very positive about it though, which made me feel much better. He said that some people believe in early intervention with speech, but he didn't feel like it would have made much of a difference in Annabelle. He said that a 3 year old is much more cooperative than a 2 year old, and she's going to get a lot more out of it now than she would have a year ago.
I cannot even tell you how good that made me feel because I have really been beating myself up for not acting sooner.
And, he also mentioned that he isn't concerned about her developmentally at all with her speech. He said that she just needs to work on her articulation. He recommended that I write down all of the sounds she has trouble with before we meet with the speech therapist. He said that 2 out of 3 kids her age that he sees have problems with L's.
He said that her vocabulary and ability to process her words into complete sentences was actually very advanced for her age. He said that was actually a 4 year milestone. Whew! Again, it helped ease my feelings as I've really been blaming myself for her speech problems. Maybe I am doing something right! Too often I feel like I am doing everything wrong.
As for easing the cost, Dr. Calk mentioned that speech therapy is no rocket science. He recommended that I take her for a few sessions and really listen to the speech therapist and ask a lot of questions. He said that I am the best person to help Annabelle since I am with her every day. Of course, he doesn't know my daughter, does he?
I have really been trying to work with her to teach her to sound out all of the syllables and sounds, but she gets tired of me, and she'll say, "I don't want to say dat any more!" But, working together, she has transformed "Bookie" into "Cookie" and "Dannabelle" into "Annabelle." So, I know she can do it.
In all honesty, I do know her speech problems are directly related to me. I think she cannot articulate the words because she has "heard" me say a word one way for so long that she cannot change her thought process to say the word correctly. I talk so fast that she has always heard me differently. I mentioned this to Dr. Calk, and he said that a lot of children with speech problems have parents that talk very fast.
As for speech therapy, I am hoping it will be covered by our health insurance. As I mentioned, we will most definitely meet our deductible this year, so if speech therapy is covered, then this is the year for Annabelle to get the most appointments in as we will then only be responsible for 10% of the cost. If it isn't covered, whoa be unto us!
DietMy next biggest concern is Annabelle's diet as I don't feel like she eats a well balanced meal. And, it isn't always because I don't feed it to her. But, I've felt for a long time that her attachment to apple juice has become the problem. She used to be such a great eater too, until she got closer to 2.5 years of age. I'm not sure what happened. Independence on her part maybe?
She's had issues with constipation since she started eating solids at 6 months of age, and at that time, the doctors we saw all recommended apple juice to help with the constipation. I think it used to work, but it has gradually become a habit for her. So much that if you offer Annabelle water instead of apple juice, she will completely refuse it and go without anything to drink all day.
But, I have been refusing any apple juice or milk until she eats her meals first. If she drinks anything, she just will not eat. Then, she is starving and a pill to be around within just a few hours.
Dr. Calk mentioned the Rule of 2's: We can go 2 days without fluids, 2 weeks without food and 2 months without something else, but I cannot remember what he said.
He said that the apple juice was acting as a high glycemic food. He mentioned that high glycemic foods (including fruits) makes us feel good immediately, but then sends us down and we get hungrier sooner. However, if I stick to feeding her leans and greens, it may take longer for her to feel better, but she will stay fuller longer. He recommended snack foods such as yellow bell peppers, carrots and sugar snap peas.
Dr. Calk also mentioned that she needed 3 square meals a day with a snack in the afternoon. He said that all of her meals and her snack should include a high protein which could be milk or a dairy product. He said she needs 10-15 ounces of dairy per day to meet her calcium needs.
As for her refusing to eat, he said to only offer her water, no apple juice. And, provide her with her meal, and if she doesn't eat it, don't give in and give her any snacks. He said she will eventually eat when she is hungry. And, just for the record, I am actually not big into giving her snacks. And, I am a big proponent of "she'll eat when she's hungry." The apple juice has been my weakness because I hate when she gets so constipated because it hurts her so much. But, she is at an age where I can explain this to her.
Reason, reason, reason: This is one thing I love about this age! You cannot reason with a 2 year old, no matter how hard you try. I still think it is important to "try" at age 2 even though they'll never get it, but eventually, when they get closer to 3 years old, they truly do understand, and you can reason with them. And everyone says 3 is harder than 2! The problems I have with my 3 year old are a direct result of my parenting at age 2...such as rocking her to sleep every single night after she gave up naps!
So, tomorrow is another day. I know she heard everything Dr. Calk said, and I know she understood it too. So, she may start hating visiting the doctor for fear of him changing my parenting style! Forget the shots!
Growth and DevelopmentI was a little alarmed that her percentile for her height had jumped down while her percentile for her weight had jumped up. I did mention to Dr. Calk, but he said that he isn't worried about it right now. He said that they typically don't see signs of obesity until a child is between 4 and 6 years old.
However, he did mention that when they look back, the higher percentile in weight compared to the lower percentile in height is common among obese children.
But, he said that she is just built "thick." He said that she doesn't have any fat in her belly that is not normal, so that is why he isn't concerned right now. And, I brought this issue up with him. He didn't even mention it to me.
As for her being "thick," please, please, please, if you know someone who has a child that you consider "thick," please do not refer to that child as "thick" in the presence of that child (or the child's parents for that matter), especially if the child is a girl. Just keep your comments to yourself! Of course, I am not upset with Dr. Calk for calling her "thick" because he had no other way to explain it to me since I had asked. But, girls are self conscious enough during their adolescent and teenage years, so don't add to the drama by calling them "thick." They pick up on this stuff much earlier than you would think, and "thick" in a girl's eyes refers to "fat."
VitaminsDr. Calk recommended she start taking a multi-vitamin once daily such as Centrum Junior Chewables or Flintstone's. He did mention to stay away from the Gummi ones though. He said the dentist hate those as they aren't good for the teeth.
MiralaxPer Dr. Calk, I can continue to give Annabelle the Miralax once a day, if necessary. However, once every 2-3 days is sufficient enough for her (going on experience alone). Otherwise, it is very runny and she doesn't even realize she's gone poopy sometimes. Not a good thing!
He also mentioned that she should start getting a bowel movement once a day once she starts eating more balanced meals. I beg to differ with him on this one as she used to eat very well balanced meals, and she still had problems with constipation.
DentistAnd, per Dr. Calk, she is now ready to start seeing a dentist. He did recommend a pediatric dentist so that her dentists experiences would be pleasant.
4 Year CheckupIt will consist of another round of shots including the following: MMR, Vericella, Dtap and Polio. And, of course the flu shots if I opt for them, but she hasn't had a flu shot yet, and I plan to keep with that trend. I just don't find them necessary, personally.
Don't most kids hate going to the doctor? For some reason, Annabelle has never been scared of going. Maybe because we rarely go, because (knock on wood) she is rarely sick. She did such an awesome job, and I was so proud of her.
She told me later, "When da doctor put dose tangs in my ears, it didn't hurt, it hurt just a ittle bit." She's a trooper, isn't she?!?! She didn't cry one bit.
Of course, she felt the need to empty my entire purse right in front of the doctor and pulled out my gum which the doctor could have mistakened for medicine.
My favorite part...as we were leaving, she pulled me towards the lab where she had a strep culture done back in August or September. The lab tech saw her, smiled and said, "Do you want something?" I laughed and said, "Yes, she's been asking for a band-aid." Annabelle said, "Yes, a sticker." So, the lab tech let her pick out a sticker. She picked a princess sticker. She apparently forgot that she had asked for a band-aid.