Developmental evaluation

Maria had her semi-annual developmental evaluation yesterday. It wasn't the usual soul-crushing "she can't do this, she can't do that" thing that it usually is.

Her head circumference is, as always, quite low on the chart. It's something like the 4th percentile, just above officially being called "microcephaly", but she's following the growth curve so the doctor wasn't concerned. Her weight and height are pretty normal for her age. She didn't perform well for the doctor since she was tired and had already had a long day having seen the dentist and her vision/hearing therapist (not to be confused with her vision therapist or her hearing therapist). Luckily the doctor wasn't one of those "if I don't see it then it isn't real" types and believed us when we told her all the great things Maria has been doing lately.

The doctor said the two things that are really important right now are standing and communication. The standing is important because they are still concerned that her hip joints aren't going to form right which will lead to problems later. Communication is important for so many reasons and Maria seems to be right on the brink of starting some kind of communication. That doesn't necessarily mean speech or sign. It might be as simple as having her point to things.

But, as Cathy said after we left, we'll add that to all the other things we absolutely have to do right now. Hot packs on her eyes so she doesn't have to have surgery again. Eye patch so she doesn't get lazy eye. Eating and drinking so she'll pack on the weight. Holding the bottle and self feeding to give her independence and free up our time. And on and on and on.

This is also the doctor who previously suggested using melatonin to help Maria sleep. Cathy and I have each used it once and it worked very quickly both times, but it's a little disconcerting that she sleeps so deeply. I think we are having phenobarbitol flashbacks. She suggested using the melatonin just one or two nights a week. Not only is sleep important for development, but Cathy is on the ragged edge all the time as well. I think it's a good idea - hint, hint Cathy ;)

We talked a little about Maria's poor spit management, particularly that she tends to choke. She's nowhere near as bad as she used to be, but there is the danger of aspiration, and it's just as dangerous to aspirate on saliva as on milk or juice. Her first suggestion was some drug that has very few side effects. Her other one was to use botox injections to paralyze half of Maria's salivary glands. Um, let's not do that one. But Maria's spit-choking is pretty rare now so we're going to ignore the possibility of drugging her up for that.

All in all, not a bad visit.