ENT Appointment (Or, Finally: A Routine Appointment)

I am so thankful our trips to Buffalo have decreased this winter: spending less time in the car and more time doing our regular routine has been absolutely wonderful. We did have to pop in to the ENT for a quick (routine) check yesterday. For the first time ever, it was an entirely painless and procedure-free visit.

Despite having influenza recently, Nolan's nose and ears looked pretty good. No excessive wax, no infection, no congestion. Did I ever mention how much I love those "permanent" T-tubes? I love them. Love, love, love them. This is the longest he's ever gone without an ear infection, and these tubes are much less likely to fall out.

His breathing sounded pretty good to the doc, so there was no need to scope his upper airways to check on the laryngomalacia. We'll see what his sleep study on May 3 shows: if apnea is still present, we'll probably have to do another scope to see if the reflux is causing an inflammation of the tissue around his voice box. Until then, however, we're free to go about our daily business with no worries.

I'm not all that optimistic about the sleep study, primarily because I have heard some stridor and Nolan still doesn't sleep through the night. Not even close: he wakes multiple times to climb back into our bed. It is possible that is a habitual behavior, though, so we'll see what the sleep study shows.

She did increase his Nexium dosage to 20mg, twice per day. His reflux is barely controlled on the 10mg (2x per day) and Zantac, so we want to head off any increasing reflux before the sleep study. She faxed in the scripts for the medication, and we were free to leave. Nolan was over the moon that there were no "tubies" involved. So was I.

The one interesting thing I noticed while going through his medical binder was that his vision screening packet actually does include the data regarding his vision results. It is interesting for several reasons (nearsighted in one eye, farsighted in the other eye), but I'll write about that in a different post. His ophthalmologist appointment is only one week from Friday, so we'll find out if the screening machine was accurate.

Influenza

Nolan has managed to catch influenza: it is rather ironic since he's the only one in the house who actually got the flu vaccine this year. He has had a high fever and cough (and threw up once, but it was due to extreme coughing and not really an upset stomach). Unfortunately, I have also caught the flu: I forgot how miserable it is to have a high fever as an adult. He finally seems to be over the worst of it, though I am keeping his hearing aids out much of the time. I'm terrified that the congestion will create another ear infection with his earmolds in place. He should be back to wearing them full-time by tomorrow.

In other news, Casey is the Best. Dog. Ever. Not only is he brilliant, but he knows that Nolan is a little afraid of him. When Nolan is around, Casey tends to lay still and let Nolan pet him. Nolan spent much of yesterday morning petting Casey, giving Casey toys, and putting a blanket on Casey (because Casey might be cold, according to Nolan).


I am really, really looking forward to the arrival of Spring. Technically, the calendar has changed over to Spring, but we had 4" of snow last night. It is also supposed to be in the teens for the next few nights: a low of 10 degrees is not appreciated in late March (-12C, for our friends that live outside of the States).

Here's to the end of the "sick season" and the arrival of warmer days!

The New Addition

We got home late tonight with our new addition: Casey the Golden Retriever. He's adorable. He's also brilliant (and I'm not biased in any way). He's already partially house-trained, and has figured out how to strategize his chasing technique to double back on Matt: the puppy beats the boy every time.

Nolan fell asleep in the car on the way home, so he'll get to socialize with Casey tomorrow. In the meantime, Matt and the puppy have become inseparable. The dog whimpers when Matt gets out of sight.

Right now, dog and boys are all happily asleep. I'm headed in that direction, too.

Gotta love a new baby that already sleeps through the night!

Preschool Art Show

It's a bear. Obviously.

Nolan had his preschool art show a couple of weeks ago. He was so proud to show us his artwork - his preschool is really wonderful at letting the kids create art entirely on their own. There are no "parent-pleasers" here: the kids create whatever they desire with the materials given.

Crushed Fruit Loops on Paper

This is Nolan's last year at his preschool. We debated long and hard, but decided to apply for the universal pre-kindergarten program through our local school district. "Universal" is really a misnomer: the program has a certain number of slots, and children are selected by lottery. If Nolan is selected (by lottery) to attend the local elementary school, then he will ride the bus with Matt next year. Our local elementary school is absolutely fabulous, has sound-field systems in every room, and dedicated, experienced staff. If he does not make the lottery for our local elementary school (alternate sites are allowed for the universal pre-k program), then we will keep him at his current preschool.

For all the worry regarding how well he would do in preschool, he is thriving now. He still doesn't preferentially interact with his peers, but he is learning to socialize more and he is academically more than ready for pre-kindergarten.

Nolan at his current preschool (Open House)

Playing School (Nolan's Crazy Math Skills)

I have been playing "school" with the boys occasionally, since both boys love this pretend game. We all get a turn as teacher, and I've been having to up the ante with various skills lately.

Tonight, we were playing "Math Class," and Matthew is getting bored with basic addition. I threw a wrinkle in it and had him guess at what the missing number would be - it takes a little thought, but he eventually gets most of them. This didn't surprise me very much: he's five and addition isn't too far beyond his ken.

Nolan, however, is kind of freaky with his math skills. Not only can he add smaller numbers, but he also had these nailed without even thinking about the answer. If you listen carefully, he gives the answer to the final problem long before Matt comes up with the answer, at about 1:05 in the video (transcript provided below):



Nolan has done this several times. I'm not quite sure how well he can add, but he's been spot-on every time I ask Matt a question. His teacher of the deaf was over the other day, and had him put cheerios next to the numbers. He did fine until he got to the number seven, when he smiled slyly and placed four cheerios by the number. Thinking he had reached the "ceiling" of his counting abilities, the TOD said, "Nolan, is that seven?"

He looked aghast and told her, "No! I need three more to make seven!"

The good news is that he'll be very ready for kindergarten by the time he gets there. The bad news (for me) is that he may surpass my mathematical skills at a very early age!


Video transcript:

Me: What do you think the first one is?
Matt: Three!
Me: You're right! What do you think the next one is?
Matt: A three!
Me: Mmm..Two plus "X" equals four...
Matt: Uh, that's a two.
Me: Yes, a two. What do you think the next one is?
Matt: Four!
Me: Mmm.. three plus "X" equals five.
Matt: (mumbling)
Me: If you have three, how many more do you need to get five?
Matt: TWO!... uh, ONE!
Me: You're right... no, two.
Me: And two plus "X" equals seven. How many more do you need... if you have two, how many more do you need to get seven?
Nolan: Um, Mom, Matthew needs five.
Matt: Um, we don't need to get to ten or eleven, so that's a higher number.
Me: No. You're only going to seven. You have seven, and you already have two..
Matt: So I need five more.
Me: You need five more - that's good.
Matt: I couldn't think of the X on that one. Five X.

Another "Refer"

I'm really starting to dislike the word "refer." The last time we saw the word, it was with regard to Nolan's ears. This time, the referral comes complimentary of our local Lion's Club vision screening program.

When Nolan was a baby, I took him to a free InfantSee checkup at our optometrist. We just wanted to make sure that his eyes were relatively fine, since his hearing is affected. He passed the test with flying colors, with the small exception of some very mild myopia (near-sightedness) that needed no correction.

Last year, he had a vision screening from the Lion's Club at his preschool. They ran the test twice, and he passed with flying colors (his myopia was mild enough not to trigger the referral).

This year, Nolan came home with his big Lion's Club screening sticker, and I asked him if they checked his eyes. He said (with great enthusiasm), "No, Mommy, they checked my eyes THREE TIMES!"

Uh-oh.

Sure enough, his teacher handed me his results. Instead of a nice, thin sheet of paper with a check beside the "PASS" statement, it contained a thick packet.

Double uh-oh.

Sure enough, there was a check-mark beside the dreaded "refer" word.

"Refer"- a word I despise.

At first I thought they had marked off "anisometropia," (a difference in seeing ability between the two eyes, which can lead to amblyopia), but when I looked at the paperwork again, I realized they had marked astigmatism. They also marked the myopia box, which we already knew about.

I've also noticed one eye wandering outward on occasion - I've caught it on camera a few times, so I think I'll print one out to take to the eye doctor. Dr. Google says this is intermittent exotropia - not a big deal, but something that needs to be addressed.

Nolan's left eye wandering outward.

I called one of the ophthamologists recommended on the Lion's Club list, and secured an appointment for June 1. I managed to get the little guy on the cancellation list, so hopefully he'll get in a little earlier than June.

Our Lion's Club uses the Welch-Allyn Suresight for vision screening, and the screening criteria for Myopia is <-1.0 OD and >1.0 for astigmatism. We know is vision is (at best) 20/50 for distance (the minimum screening trigger), so there is a very high probability he needs glasses. Using a vision simulator, the best vision Nolan could have is shown on the right in the picture below (using a sphere value of -1.0 and a cylinder value of 1.0, the minimum referral requirements for myopia and astigmatism). It's not too bad, but definitely would inhibit reading anything at a distance.


Fortunately, his vision is fine for close-up work, but I'm anxious to get him in for a full exam. A part of me is hoping that we can hold off on glasses until kindergarten, but I know they usually recommend glasses for kids with vision worse than 20/50. If he needs glasses, we'll look for thin wire-frames to fit alongside his hearing aids.

The best news is that Nolan will look very scholarly in glasses, which will only add to his irresistible cuteness!

A Very Nice Vacation

Our Little Skier

I promise to blog more regularly, but the "blog-cation" was rather nice. With no medical appointments, hearing appointments, and a week in Park City, Utah, we have had a rather nice February.

Last week, we flew to Park City and registered both boys for ski school. I don't have very many pictures of Matthew in ski school, because he "graduated" to the chair lift on the first day and we rarely saw him until school let out for the day. Nolan, however, remained in the "Magic Carpet" area with the smaller children, and did quite well.

Riding the Magic Carpet

I was so impressed with Park City's "Signature 3" program. They were attentive to his hearing needs, and supplied an amazing instructor, who always got down on Nolan's level and made sure Nolan was facing him before giving instructions. The ski helmet, thankfully, fit wonderfully over Nolan's hearing aids, and our little guy did amazing with the attention Park City gave to him. He actually passed every skill required to graduate to the chair lift, save one. He's simply not heavy enough to click his ski boots into his own bindings!

Andrew the Amazing Ski Instructor, talking to Nolan

Nolan does have (yet another) upper respiratory infection, but that is par for the course. We all have gotten this bug, probably from the airplane on the way to Park City. His permanent ear tubes ("T-Tubes") are functioning well, and seem to be the best thing we ever did for him. With the standard tubes, every upper respiratory infection resulted in a clogged tube and often a perforated ear drum. This winter, his T-tubes are staying put and his ears are infection-free. His ears are, however, full of wax - I'm trying to hold off on going to the ENT, since we already have an appointment on March 23rd.

For now, we are trying to get back into the routine. For Nolan and Matt, this involves returning to school. For me, it involves large quantities of Dayquil and coffee. Spring, come quickly!