Friday, March 21

Update on Boy's Endocrinologist Appointment

The boys had their endocrinologist appointment Tuesday and xrays again. Good news, mostly, for Tris. Not so great on Trace, but still chugging along.

 

More about it below-

Tris is actually sneaking up past that 5% mark on the chart. Great news after his pulminologist appointment had given us bad news on his lungs. He isn't gaining weight the way the doctor would like (actually hasn't gained any since the last apt 3 months ago- which isn't good). Weren't too surprised on that end, we've had several 'sit at the dinner table til bedtime' nights lately. The kid just doesn't want to eat. We'll work on that.

Trace just isn't growing enough. He has grown some (which is better then the flatlining he was doing) but it's just not enough. His weight was up appropriately for his height increase, so that was ok. The problem is that Trace is getting significantly too small for his age group. The height difference of an almost four year old who isn't even the average height of a 2 year old yet is just too great. The endocrinologist talked about maybe putting him on growth hormone now, even though it hasn't been the prerequisite year since we first learned about the abnormality in his pituitary gland. No blood work or any other tests has suggested that the abnormality is anything more then a cyst, and not an aggressively growing cyst that might still be concerning. All his blood work and even his growth still mirrors Tristian's at the same age. Even the slight increase in growth after more then a year of flatlining right before turning four is identical to Tris, except Tris flatlined longer. The difference is that Tristian started out in the upper percent on the growth chart and had much farther to fall. At 2 when Tris flatlined he was already the average size of a 3+year old. Trace was never more then at 50% to begin with, so the year of falling off the curve and then the year+ of flatlining put him much farther behind his contemporaries on size then Tristian ever was.

The size difference combined with Tristian's bone growth having always been 6months to a year behind his real age gave Tristian the advantage of time. Waiting until he was four to start him was a reasonable choice as far as making sure we got him to a normal or above height at the end of the day. Trace's bone growth has never been behind, consistently being at his real age. With Trace we are loosing time to safely catch him up. Realistically we are starting all this young enough (thankfully) that it should be fine still. Children started much later are often still caught up and end at a normal height. However time lost is still time lost, so it nags at the back of your mind while making the decisions. Waiting until four to start him is something being forced because of a possible worst case scenario with the abnormality found during his last mri. The more pressing concern is the disparity between his height and others of his age. The fact that said height is starting to interfere with his development. Tris was a little small at four, but the concern for catching him up was that combined with his motor delays and autism symptoms made the height difference more significant then if his motor skills had been normal. Trace has no motor delays to be blamed,  the issue is entirely in the lack of size.

Dr. Gardener suggested speeding things up, redoing the testing and getting Trace started now on growth hormone. Trevor and I do not feel comfortable with that. We understand that the abnormality is probably nothing, especially with an brother with identical labs and symptoms. However, we just aren't comfortable taking the risk when the normal wait period is just on the other end of summer. Don't get me wrong, I'm torn. Part of me wanted to jump at the offer and get him on growth hormone now. However, another part of me is saying avoiding the possible worst case scenario is worth half a year of being too small. In the end we decided to wait and watch a little longer.

The biggest issue is probably going to come down to if we can catch him up in time for school Autumn of 2015. I homeschooled Tristian for a slew of reasons that made homeschool just the obvious answer in the end when compared to public or private school. The height, the autism (sensory episodes and breakdowns), the motor delays, the June birthday making him among or the youngest, already reading chapter books, doing addition, subtraction and starting multiplication. Public school had the drawback of possible traumatic scenarios Tris just wouldn't be ready for and the fact that intellectually he would be beyond bored. With little to offer besides socialization, which we could and do provide in other venues. Trace is different. I honestly feel that Trace could, and would, thrive in a school system. He has the right personality and learning approach; while being in the right stage and pace of development intellectually. There is always the choice of putting him in late. With his July 15th birthday there would be nothing odd about waiting until Autumn of 2016 to put him in Kindergarten and give him that extra year to grow. As always, if public school turns out to be the wrong place for him I can pull him out and homeschool him with Tristian if needed.
Either way we have another year before we need to start really worrying about school.

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