International Clinic follow-up

We had an interesting appointment at the international clinic this morning...

The nurse asked us what, if any, therapies had been initiated for Nicholas since we were there 6 weeks ago, so Matt told her about PT & DT and that we're heading over to OH next month to address some attachment red flags. She wrote it all down.

Shortly thereafter, Dr. Escobar who is a developmental pediatrician, met with us (this is a standard part of the St. Vincent IA clinic follow-up) to discuss any developmental concerns we have about Nicholas. We really don't have a ton of developmental concerns for Nicholas, but ended up talking about his PT and our attachment struggles. He basically said that because I'm a psychologist, I'm probably over thinking things and need to relax so I don't miss out on the joy of parenthood. Wow, right? He told us that Nicholas is just fine and seems well bonded to both of us - clearly demonstrating that he knows we're his parents. He also told us that PT cannot fix Nicholas' pronating problem and showed us how the heels of his own shoes are worn because he pronates - noting that we should just get Nicholas some inserts if he's going to play sports some day.

Hmmm...Needless to say, I was pretty annoyed with him and just wanted him to exit the room - stat. I was so blown away by his COMPLETE and TOTAL dismissal of our concerns, I didn't even consider confronting him about it. Amazingly, he was able to size up Nicholas' bond and awareness that we're his parents in a matter of 5 minutes while our child appropriately acted like a 2-year-old standing across the room from us opening and closing, opening and closing, opening and closing the cabinet doors. We will not be following up with him.

Dr. Belcher walked in a couple minutes later, plopped down and said, "I hear you have an appointment with an attachment clinic." Then he gave us two thumbs up and continued on - "I'm glad you're not sticking your heads in the sand about how important this is. I'm just a microbiology geek. I don't know anything about the psychological side. But, I strongly recommend early intervention. It's the only way to go."

Validation.

He left the room in the middle of the appointment to see if our lab had faxed Nicholas' results over yet and said, "Let's see if he'll go with me." He opened the door, put his hand out to Nicholas and Little Man grabbed his hand and trotted right out the door. One very cool moment in this exchange was that after a few steps down the hall, Nicholas turned around and looked as us. That's definitely progress (and definitely frightening that our almost-2-year-old will walk off with any 'ole random who interacts with him)!

This is what we learned medically:
1. He will take isoniazid for 9 months because of his +TB test. He's been exposed at some point (according to his chest x-ray), but is definitely not active nor is he contagious.
2. He has giardia! Poor little guy. So, he's being treated for that as well.
3. He had some lead exposure, but not enough to be concerned about. His level was 2.5 and they don't do anything unless it's 10 or above.
4. His thyroid is just fine - Dr. B wanted to make sure because he's so 'shrimpy'.
5. Apparently he's only gained 2 lbs since arriving home 3 months ago. I'm bummed about this, but am trying to keep it all in perspective - especially given he has grown an inch! Dr. B didn't think the giardia was contributing to his slow weight gain.

We'll follow up in a month re: the isoniazid tx - to make sure he's not having liver issues. After that we'll follow up every 2 months through July when he's completed this course of treatment.

Good times!

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