(no subject)

[rivka]

Alex had her one-year pediatrician's appointment yesterday.

He heard a heart murmur.

This is probably no big deal. He says so ("If there were a serious cardiac abnormality, she would be weak and sickly - which she's obviously not."), my sister the pediatrician says so, and Dr. Google says so. Apparently, it is fairly common for children between the ages of 1 and 5 to have a heart murmur for a while. After I posted a plea for innocuous heart murmur stories to plan_survive yesterday, several people chimed in making them sound utterly unremarkable.

And yet.

We have an appointment with a pediatric cardiologist on the 26th of May. It's possible that she'll be able to diagnose what they call an "innocent murmur" just from listening to Alex's heart, and will send us on our merry way. If not, she'll need to have an echocardiogram, which is an ultrasound of the heart.

I am mostly succeeding in not freaking out about it, but it's definitely on my mind. I am relieved that the cardiologist's scheduler was able to find a cancellation, because originally she offered me an appointment in September. (Can you imagine? Boy, it's a good thing we don't live in Canada, where their evil socialized medicine has led to long waits for medical treatment.)

A heart murmur.

She's still in the 90th percentile for height; frankly, I'm starting to wonder whether she's really mine. Her weight curve has dropped a bit, from about the 75th percentile to the 60th. Her doctor thinks that's normal for the toddler era, when kids' exercise level increases and their interest in food decreases. We had a long, reassuring talk about the vagaries of the toddler appetite. Alex eats a good variety of food, but the quantities are often minute. His analysis essentially boiled down to this: toddlers don't starve to death, but we have no idea why not.

He said that we should just continue to offer a variety of healthy foods, and not stress about whether or not she eats them. Most of the toddler feeding problems he sees result from parents trying to compensate for poor intake, either by letting the child drink their meals (tons of juice or milk) or by filling them up with junk food because "at least she's eating something." I think we can avoid both of those traps.

He talked about accident prevention ("this is something that worries me far more than her heart murmur..."), the advisability of weaning her to a cup by fifteen months (already on my agenda), developmental milestones (he was impressed that she can feed herself if handed a spoonful of food), and discipline (he confirmed our opinion that it's time to start having some gentle expectations). He referred us to an ophthalmologist, because both Michael and I had strabismus as children, but said we didn't need to worry about seeing a dentist until she's three.

Then he sent us to the lab, where Alex had a blood draw (for a blood lead level, although they also do a CBC) and two vaccinations. That part was hard. When she was an infant, she'd stop crying as soon as I picked her up after her shots. Now it isn't like that. She fears, and then afterward she resents. The blood draw was particularly hard, because they stuck her finger and then had to keep squeezing and squeezing to pull blood up in the capillary tube. Yeesh. I was relieved that, in contrast to kcobweb's account of three extra staff people coming into the room to hold her baby down, Alex got to sit on my lap and be restrained by me and Michael. I wrapped my arms around her arms and chest and tucked her feet between my knees, and Michael held her legs still for the shots. Poor baby, she wore herself out with the effort of coping, and fell asleep in the car on the way home.

Comments

oh that Alex

[malibrarian.livejournal.com]

How frightening to hear about the heart murmur--I'm glad that you'll be able to get in to see the specialist quickly!

And it's true about toddler eating habits. She's going to go on food jags, when she only wants to eat one thing. And when she starts growth spurts she's going to want to shove everything she can get her hands on down her throat. Be calm and know that it will pass.

A friend of mine commented upon seeing Sarah graze from her plate, Kip's and mine--"You know toddlers really do know how to eat a balanced meal." Yeah, sometimes.

And Sarah's still ready to teach Alex any little skill she needs to learn. Cooking and handstands are high on the list these days.

[wcg.livejournal.com]

Boy, it's a good thing we don't live in Canada, where their evil socialized medicine has led to long waits for medical treatment.

Yep. It's so much better when the Invisible Hand(tm) takes care of everything for us.

[rivka.livejournal.com]

If we had had to wait five months to discover whether Alex had a significant heart problem, at least we could've been cheered by the fact that, because of our wait, a private corporation would be richer.

[filkerdave.livejournal.com]

Eep! Hugs!

[minnaleigh.livejournal.com]

I'm so glad you could get an earlier appointment with the cardiologist. I mean, I'm sure it's nothing but you certainly don't need to deal with the stress for that long. My sister and I and at least two of her kids all had heart murmurs that we outgrew. It does seem to be common non-problem.

I can't stand that squeezing and squeezing after a finger prick either- poor Alex!

[klwalton.livejournal.com]

Okay, breathe.

I had exactly the same thing happen at Megan's one-year checkup. I freaked out for a couple of weeks while we waited for our appointment at Children's Hospital and had her checked out by a Pediatric Cardiologist (who, by the way, was simply wonderful).

She had (and still has) a mild pulmonary stenosis. Because there is a slight danger of bacterial endocarditis due to roughening of the artery by the rush of blood through the narrower valve, she takes prophylactic antibiotics when having non-sterile surgery or dental procedures. Otherwise she is absolutely fine.

We were told at the time that most heart murmurs are nothing much. I know you can't help worrying. But she looks so good, so healthy, so happy, I'm betting it's going to be okay.

[jhetley.livejournal.com]

Elder Son had a heart murmur discovered in an early pediatric exam. Nothing ever developed, as far as I know he remains healthy at nearly 30 -- was still living when I saw him yesterday, anyhow.

Hope this offers a ray of sunshine.

[kate_nepveu]

Additional innocuous heart murmur story: I went until 25 or so before anyone noticed mine. Mitral valve prolapse, ditto with the preventative antibiotics, yearly EKG and every-two-years echo. No effects whatsoever.

If they have to do an echo, it might be a bit uncomfortable--I imagine that you had something like it during your pregnancy, but to get good views of the heart they need to press against the ribs, which I definitely feel, especially when they do it over breast tissue. So that might not be fun for Alex, but there's no bruising after or anything.

Hope all comes out well.

[rivka.livejournal.com]

I think probably they would give her a sedative for the procedure. They often do that for babies, even when the procedure is noninvasive, to relieve their fear and help them hold appropriately still.

[llnaughty.livejournal.com]

bob had a heart murmur around 20 months which was diagnosed at the same time as her reactive airways disease. we heard it mentioned a few more times in subsequent doctor visits, but there was never any treatment recommended and i had completely forgotten about it for the last few years until reading you post.

our doc called it an "innocent murmur".

[llnaughty.livejournal.com]

forgot the "too" at the end of the last sentence.

[eeyorerin]

Oh, that is scary just for the "what-if" factor, and I hope it is resolved soon. I got to watch Allan's echocardiogram today, and I can say that it was quick and painless. (He and I thought it was fascinating, but we are not children nor frazzled parents.)

I think that toddlers are able to eat as little as they do without starving to death because they are actually perpetual motion machines at that age, and thus most of their caloric needs are satisfied through that magical process. This would also explain how they can just keep going and going and going. If we can just figure out how they do it, we can solve all of our energy problems! :)

[iamjw.livejournal.com]

Just to add to the "Don't worry too much if you can possibly avoid it" anecdotes: my eldest nephew had/has a heart murmur. Currently 24 years old and healthy as a really healthy thing - and it's never once come up as an issue.

Also, I spend a lot of time working with mothers (almost exclusively, actually) and the one common thread of conversation when the children are young is the frustration of their eating habits. It appears to be completely normal for them to completely whacked out. Eldest Nephew went through a phase at roughly 2 when he refused to eat anything but peanut butter for several weeks. Kept it up until his mother gave in and bought several jars of the stuff just to keep up with him. He stopped cold soon thereafter :-)

As my own mother would say, "These are the things that are sent to try us."

[jmhm.livejournal.com]

I had a heart murmur as a child.

Really, I'm not nearly as frail as I look ;)

[rivka.livejournal.com]

You did wind up kind of stunted, didn't you?

[micheinnz.livejournal.com]

Augh, I owe you an apology. I didn't mean it to sound as if a heart murmur was inconsequential or unremarkable -- it obviously is, or they wouldn't bother checking it out.

What I really intended to say is that if the medical types aren't worried, then it will probably be OK.

[rivka.livejournal.com]

No, no! It was very reassuring to have all of these people chime in with, "oh, everyone I've ever met has a heart murmur, and they're all fine."

[kyra-ojosverdes.livejournal.com]

Just in case you'd like more "innocent murmur" stories, my oldest had a heart murmur as an infant. Nobody's been able to detect it since his third birthday. It's never caused any problems.

[erikted.livejournal.com]

FWIW, my sweetie was Dx'd with a heart murmur at birth. She's 40. Never a problem. I wish the same for Alex.

[redbird]

She's yours. Even if someone somehow proved they'd swapped in a changeling, by now she's yours.

I know nothing about heart murmurs, but can verify that echocardiograms are noninvasive and painless (having had one a few years ago).

I'm told that at some point in my toddlerhood, I refused all food except cucumbers and milk for several months. My mother was worried and asked the pediatrician. He said "if she gets sick, you can worry about it," and eventually I ate other things again, not having gotten sick in the interim.

[kalmn.livejournal.com]

okay, let's do this. we'll split the labor. you take care of alex on a daily basis. i'll worry about her heart murmur constantly until it turns out to be not serious, at which point i will only sporadically worry about it. deal?

[kcobweb.livejournal.com]

*hugs* to you. I'm definitely thinking of you all.

[lietya.livejournal.com]

I've got a not-innocent heart murmur that probably will still be reassuring.

After a doctor heard a heart murmur, I was diagnosed with a hole in my heart (patent ductus) at 18 months old. I weighed 16 pounds (less than Alex now!), I was barely able to stand, my lips were blue and I struggled to breathe.

I had surgery done, on a heart so small it was barely bigger than the surgeon's tools. I now have a scar that runs from the base of my left shoulder blade to the edge of my lower rib cage in front. And *absolutely nothing else is wrong.* I'm 100% strong and healthy. I visited a cardiologist at 20 who said he had to double-check my medical records to be certain I'd EVER had a problem.

It's scary as hell, I know - and my mother knows better than I do. But the chances are very, very good that she's absolutely fine, and even in the unlikely event that there *is* a problem, she's going to BE fine. I'll be thinking of both of you, of course, but I bet the worst part of this is going to be the worrying.

[signy1.livejournal.com]

I'll chime in with a reassuring story. When I was getting ready for college, there was a form with a list of health conditions. I was to check off any that applied to me, presumably so they'd know what to worry about before I got there, and it was not an interesting form. So I was singsonging the conditions and saying 'yes' or 'no' as I checked them off. I got to 'heart murmur', said 'no', and got the shock of my life as my mom looked over and said casually, "Yes you do."

Turned out that I had had one of those innocent murmurs since infancy. It was so unimportant and so minor that it took nearly two decades before anyone so much as mentioned it to me. They seem to be relatively common.

So fear not. All will be well.

[rivka.livejournal.com]

The American Academy of Pediatrics officially recommends lying on those forms (http://www.aap.org/pubed/ZZZA5IEFDDC.htm?&sub_cat=2):

You don't need to tell school officials. They might misinterpret the information, thinking your child has a heart problem, and they could try to keep him from being physically active. For the same reason, when you complete health forms for school or camp, you should write "normal" in the heart section if your child's murmur is innocent. If there's a specific question about a heart murmur, write "normal" in the space provided.

I thought that was interesting.

[journeywoman.livejournal.com]

I'm wondering why E didn't get a blood draw at his one-year checkup. Seems to be pretty standard. I'm still waiting for the toddler lack of appetite to kick in. He eats almost as much as I do, and has since he was about 10 or 11 months old.

Anyway, I have something that sounds like a heart murmur but isn't. My ribcage isn't very deep, so the heart is a little squished in there, causing the blood to make a sloshing sound that resembles a murmur. It's what my first cardiologist called a "pancake heart" though my more recent set of medical professionals had never heard of the term.

[raincitygirl.livejournal.com]

I'm sorry she had such a tough time with the vaccines and the blood test. *I* hate needles, and I'm a grown-up. It must be intensely scary for a one-year-old. And I'll cross my fingers that the heart murmur turns out to be nothing. I'm pretty sure if the pediatrician thought she were liable to keel over dead, he would've had you guys take her straight to the emergency room. Sounds from what he was saying that he's not too worried. But still, it'd probably be a lot more reassuring if she didn't have the murmur at all.

[sashajwolf.livejournal.com]

I had a heart murmur at my pre-school checkup at age 6 (in Germany), which resolved itself so thoroughly by the time we saw a specialist a couple of months later that my mother was convinced the first doctor had lied because he didn't like foreigners. These days, I prefer to think that I just grew out of it. 30 years later, my heart's as healthy as can be.

[saoba.livejournal.com]

My oldest, the 31 year old US Army veteran, has a heart murmur discovered at his 12 month well-baby checkup.

He was healthy enoigh to survive Army basic and infantry and artillery training and do 2 tours in the Army before bailing for the ivory towers of Germany's university system. So, almost certainly nothing to fret over, this murmur.

[ailbhe]

The only toddler I know who consistently eats like a horse is a month older than Linnea and about the same weight as Linnea was at 6 months. It's surreal.

(I hate holding Linnea down so people can hurt her. The only thing I hate more is letting other people do it.)

[epi-lj.livejournal.com]

On the one hand: I know what you mean (to a degree). I know some parents get upset at comparisons to pets, but I'm reminded of the other day when okoshun came home from Bean's trip to the vet with the news that the vet had heard an irregular heart rhythm that *may* have been nothing but him being nervous and freaking out (the cat, not the vet) but needed to be followed up on. My brain was immediately like "NO! NO! NO! NO! NO! NO! NO! (...)" (This was enhanced by having had a cat who had an actually-serious heart condition.)

On the other hand: Not only did the next visit to the vet confirm that his heart was fine, but I had a heart murmur when I was a child apparently that they said that they'd have to keep an eye on later but probably wasn't a big deal which my Mom forgot to tell me about until I was something like 30. She then mentioned it, I got it checked out, and they couldn't detect anything at all. So that's an anecdote to add to the statistics about it being common for young kids to have them and them sort of just growing out of them.