Two-year checkup.

[rivka]

Alex had her two-year-old well child visit today, and she is indeed a well child.

She's refusing a lot of foods lately (typical two-year-old stuff), so it was a bit of a relief to see that she's continuing steady on the 25th percentile line for weight, at 24.5 pounds. Her height is still near the top of the charts - she's just a half-inch shy of three feet.

She still has a heart murmur.

Her doctor gave us the go-ahead to introduce nuts and shellfish, the last two things we were abstaining from for fear that she'd develop food allergies. The nursery school she'll be starting at in June is not peanut-free, so I really want to test her out on peanut butter at home and make sure there's no reaction.

She needed the chicken pox vaccine to start nursery school, so we went ahead and got it. I am disappointed that we didn't have the opportunity to expose her to the natural disease, because I still have reservations about how effective the vaccine is likely to be in producing lifelong immunity.

She was a little hero about getting the shot! While we were waiting for the lab tech, we reminded her of a little video clip she'd watched in which her favorite TV character got a shot. She sat on my lap to have it done, legs tucked between my knees and each of us holding one of her hands. I told her, "The lady is going to give you a shot with some medicine to help you stay healthy. It will hurt a little bit, and then it will be all done." She didn't make a sound when the needle went in, or afterward - she was just interested in having a "sticky bandaid" and also getting to pick out a sticker to take home. Her bravery was much admired by all.

(While we were waiting, a kid who looked about five came out sobbing. His mother said cheerfully, "You're okay. It probably didn't even hurt." WTF?! Did she actually think she could convince him that he was mistaken about feeling pain?)

Comments

[ewein2412]

While we were waiting, a kid who looked about five came out sobbing. His mother said cheerfully, "You're okay. It probably didn't even hurt." WTF?! Did she actually think she could convince him that he was mistaken about feeling pain?

When Sara had her MMR booster at 4, the health visitor who gave her the shot told her, "This will be a little tickle." Sara spent the next 20 minutes screeching in outrage: "SHE LIED TO ME!!! MUMMY, SHE TOLD A LIE!!! SHE LIED!! THAT WAS NOT A TICKLE, SHE'S A LIAR!!!"

[hobbitbabe.livejournal.com]

Good for her!

When I was about 14, my youngest brother broke his collarbone while he was in my charge. After the family doctor had determined the problem and discovered he didn't have the right kind of bandage, we were waiting in his office for our parents to drive us to the hospital. At this point, G's patience ran out and he began to bellow "Can't we get some service around here? Why do they call this a doctor's office! Don't they know there's people in pain around here?" and I could see people in the waiting room craning their heads down the hall to figure out what had prompted this odd outburst of mature language in a small child's voice.

[ewein2412]

excellent boy.

[rivka.livejournal.com]

Ugh. Poor Sara. The funny thing is, if you asked that health visitor I'm sure she would tell you that it's very important to teach your child to be truthful.

I've been explaining that shots hurt since Alex was about six months old. I'm matter-of-fact about it, but I want her to be able to trust that I'm going to give her accurate information.

[ewein2412]

if you asked that health visitor I'm sure she would tell you that it's very important to teach your child to be truthful.

which brings me to another rant... The Santa Claus Rant. Every single child in V. Primary School believes in Santa up until about the age of 10 at LEAST. My take on this is.... How many of these parents are teaching their children to be truthful, while perpetuating this ENORMOUS piece of fakery?

Consistency required in all parenting!

(don't get me started.)

[mjlayman.livejournal.com]

My parents were very fundamentalist Christians and we were taught that there was Jesus and no Santa Claus or Easter Bunny, etc., but that other people lied to their children about those and we shouldn't tell them the truth because then they'd know their parents lied to them.

[ewein2412]

the perpetuators of the Santa myth around here have got all kinds of safety nets in place. It really is freaky. If you don't believe in Santa, for example, Santa won't deliver to your house, thus forcing you to give each other presents... so unbelievers like ourselves are punished.

The problem they run into, and I know a self-professed atheist who dates her disbelief to this very topic, is that when they learn the truth about santa, they also doubt god. But I would guess that a more immediate problem is how they view their parents when they discover this tissue of lies.

grumble grumble grumble!!!!!

sorry to spam your lj with my santa rant, rivka!

[janetmiles.livejournal.com]

I have a vague idea that I knew, even as a young child, that it was fun to pretend Santa, just like it was fun to pretend other things. I certainly don't ever remember being traumatized by the discovery that Santa wasn't real.

[mjlayman.livejournal.com]

Many many years ago, I worked for neurosurgeons in DC. They always had me tell people that EMGs were painless. Years later, I had one myself and I was so angry that I'd lied to all those people. I think doctors should have to have most of the common procedures so they can describe them accurately.

[ewein2412]

appendectomies for all!

[mjlayman.livejournal.com]

Yes! Well, I was thinking of non-invasive procedures. There's enough risk in surgery that I wouldn't insist on that.

[ewein2412]

sara would insist on it! (she had her appendix out last year, at 8. She thought they were all morons in their approach to pain. Actually, I thought they were very efficient and have no complaints.)

[janetmiles.livejournal.com]

Is an EMG the same thing as a nerve conduction study? Because my one experience with the latter instantly became my "10" on the pain scale (up to the point where I broke three ribs in a car accident).

[mjlayman.livejournal.com]

No, it's an electromyogram (http://en.wikipedia.org/wiki/Electromyography) which measures electrical potential of muscle cells. I wouldn't call it a "10," but maybe a "5" and here I'd been telling patients for years that it was painless!

[hobbitbabe.livejournal.com]

Oh, yeah, it's May. When does she start nursery school?

[rivka.livejournal.com]

It turns out, not until June 11th. We originally thought it would be the end of May, but that's just when the old class ends - the new one doesn't start until June.

We've been talking about it a little. Alex can tell you that she's going to go to school and be in the Bluebird Room, but I'm not sure how much she understands about what that means. It's probably time to get some books about going to nursery school from the library. Using picture books for preparation helped so much with learning not to be afraid of medical exams.

Chicken Pox vaccine

[tammylc.livejournal.com]

I'm waffling about the chicken pox vaccine. We've had a couple of opportunities to expose Liam to the real thing recently, and not followed through on them. I read about a study recently that indicates that children who get chicken pox naturally have a higher likelihood of getting shingles later in life (http://www.prweb.com/releases/2003/10/prweb83848.php) because they don't get the boosts to their immune system caused by re-exposure since chicken pox is so rare now.

On the other hand, there's that whole thing with the chicken pox vaccine wearing off right when it becomes most dangerous to get the disease...

Damned if you do, damned if you don't.

Re: Chicken Pox vaccine

[kcobweb.livejournal.com]

One of our pediatricians told me the thing about the shingles - basically as the main reason why it would be important to get vaccinated. But she didn't push it.

I feel like you do - damned either way. I keep hoping there will be some more studies that either show it works, or that boosters are required at X interval or whatever - so that by the time we get it (before kindergarten, at the latest) we have some *clue* of what's going on.

Re: Chicken Pox vaccine

[dmk.livejournal.com]

My mom was in the trial for the shingles vaccine. They said it was a great success, and they've released it for public use, but they only recommend it for people over 50 or so. I plan to ask for it anyway (I'm 44) next time I have an annual physical.

It seems to me that the vaccine would be better than getting chicken pox. I remember when I got chicken pox at age five; I was miserable for a very long time (a week or two?).

I've also heard that getting chicken pox does not provide life-long immunity.

Re: Chicken Pox vaccine

[kcobweb.livejournal.com]

Someone else might have citations, but I don't. I just know that *most* people who've had chicken pox don't get it again. Whereas, with the vaccine, there are still too many unanswered questions - they don't know how long it will last, how effective it is, etc. As rivka just said elsewhere on this thread, their doc predicts that there will undoubtedly be boosters required by the time Alex - and my daughter Elena - are teenagers. The fact that they don't really know puts me off a bit, and I'd like them to figure that out before getting it, if possible.

I should note that I'm totally pro-vaccination. But I just want to know that the vaccination will *work* as advertised.

Re: Chicken Pox vaccine

[glinda-w.livejournal.com]

No statistical info here, but... had chicken pox as a child, back in the '50s. Had shingles in my early 30s; hope to hell I never have it again. Nerve pain is not a fun thing.

(That's all; back to your regularly scheduled mayhem...)

Re: Chicken Pox vaccine

[rivka.livejournal.com]

On the other hand, there's that whole thing with the chicken pox vaccine wearing off right when it becomes most dangerous to get the disease...

I raised that question with our pediatrician back when we originally delayed vaccination. He said that he was 100% certain that, by the time that Alex is a teenager, a second booster of varicella vax will be required.

Re: Chicken Pox vaccine

[rivka.livejournal.com]

From that press release, it doesn't look like the determining factor is whether children have natural exposure or are vaccinated, though - it looks like, on a population-wide level, the decrease in cases of chicken pox is leading to an increased incidence of shingles.

Varicella is a live-virus vaccine, so vaccinated kids can have latent infection just as natural-exposure kids can. And vaccinated children aren't going to get natural re-exposure boosts either, given the population decrease.

I guess I wouldn't make the decision based on shingles alone.

Re: Chicken Pox vaccine

[ewein2412]

They don't offer the vaccine here in the UK. Both my kids (and every other kid in their school) has had the disease. I don't know what the policy is in other European countries, but if you have any intention of travelling outside the US with your child, I'd probably go for the vaccination first.

[wcg.livejournal.com]

Yay Alex! That was very brave of her.

[janetmiles.livejournal.com]

Good for you -- for being honest with Alex -- and good for Alex, for being mighty!

[rivka.livejournal.com]

Good for you -- for being honest with Alex

I can't imagine doing it any other way. As you know, I had tons of medical procedures as a kid. "This won't hurt" isn't for the benefit of the child at all - it's for the adult. Medical procedures are scary enough without also having to worry about people giving you false information.

good for Alex, for being mighty!

I know, we were impressed! She also let the doctor look in her mouth with a tongue depressor, which has previously been very scary for her.

[jinian.livejournal.com]

The "didn't hurt" mom was probably told the same thing when she was a kid. I sure was, by any doctor I ever saw. Invalidate the kid's feelings so they'll shut up; done systematically, it works great.

Re: Chicken Pox vaccine

[johnpalmer.livejournal.com]

I'm reading up on a newish branch of psychotherapy (ACT) and its claim is that one of the better indicators for how well you'll weather unpleasantness is how willing you are to accept the unpleasantness. "It'll hurt, but it will be over soon" would be a heck of a lot better than "It doesn't hurt". (Plus, with "it doesn't hurt", hey, now you can also shame the kid for feeling pain!)

[marici.livejournal.com]

Speaking as one exposed to chicken pox on purpose, who's had one episode of shingles? The vaccine is better. Me, I'm not much upset, my mom made the best medical decision at the time, but my mom continues hugely guilty.

[rivka.livejournal.com]

Let your mom know that, given that the varicella vaccine contains live virus, it's entirely possible for vaccinated kids to have latent infection and then develop shingles later on. It appears that the risk is lower in vaccinated kids, but the vaccine hasn't been on the market long enough for them to really be sure.

[minnehaha.livejournal.com]

"(While we were waiting, a kid who looked about five came out sobbing. His mother said cheerfully, 'You're okay. It probably didn't even hurt.' WTF?! Did she actually think she could convince him that he was mistaken about feeling pain?)"

He might have been crying from fear and not pain. Maybe she was trying to remind him that it wasn't painful like he feared it would be.

B

[nolly.livejournal.com]

Second that -- if whatever was done really dud hurt, of course she shouldn't have denied his pain, but I know some of my biggest childhood doctor's-office meltdowns were from fear, and before anything had been done at all. The most memorable to me was the year he had a finger-stick gadget that looked rather like a stapler; I'd accidentally stapled my finger once and knew how much that hurt, and so the sight of that device sent me into hysterics. I'm sure my mother has more tales.

[writingortyping.livejournal.com]

Heh. When I was little, my grandmother's cat bit me, and when she examined my finger, she responded to my sobs by saying, "Honey, she didn't even break the skin!"

"No," I wailed, "She hurt my feelings!"

[zanawake.livejournal.com]

That reminds me: those growth charts are due for revision.
www.newscientist.com/channel/health/mg19426014.100-babies-overfed-to-meet-flawed-ideal.html