Allergy Testing and Bedside Manner

Hi everyone, just wanted to let you know how Liam's allergy appointment went today.  We had to take Liam off of his Zyrtec for a few days so it did not affect his allergy testing. Over the past few days we have gotten a chance to really see the difference it makes, and its really amazing! Within 24 hours of not taking Zyrtec, Liam had a terrible runny nose and eye buggies around the clock, and became very congested. Over the past few days, he hasn't been sleeping well and has been much more fussy than usual. I was happy when I woke up this morning to get this testing out of the way! So we went on our way to meet Dr. Isreal, although the staff was organized and polite- there was something....sterile about the office. I felt as though there was not one person that was enjoying their job, and I know it sounds silly but it's important to me that you at least try! Granted, our appointment was at 9 am on Thursday...but still, everything had such a generic feel to it. Overall, I was not impressed with Dr. Isreal. As a nurse, it bothers me when doctors have terrible bedside manner. I mean I wasn't trying to dress to the nine's this morning, I threw my hair back, grabbed a sippy cup and off we went. But when you can't even fake a sympathetic smile after hearing what Liam has been through??.... it gets to me. I mean LOOK AT HIM! ... here is he - sitting on the floor of your office, playing with the baby laptop and giggling.....and I am in the middle of telling you that he was born NOT BREATHING with apgar scores of 1,3,6, experienced neonatal seizures and underwent a breakthrough treatment (the FIRST) in the Lehigh Valley....and you don't even blink -- seriously? As a nurse, this is such an insult. In every job we have, compassion pours out of us. It may not look the same, but each of us has our own unique way of connecting with our patient. This is why we continue to be one of the most trusted professions, and I firmly believe that it is not recognized how hard that is..even if it does come completely natural to us. In one day, we can celebrate birthdays, congratulate victories over disease/medical conditions, fight with the toughest cancer patient we have met thus far, and hold a hand for a dying family member- it is exhausting...but no matter what we are always 100% present in the moment. I have had patients come back and visit on the floor just because they missed a few of us that took such good care of them ...I had a patient ask me once when I was working my last shift, "what am I going to do without you, I mean I know they are good - but they are not you.." I told my patient that she would be okay, I didn't perform miracles, all I did do ... was my job. I look you in the eye, I am honest with you. If I don't have the answer I tell you- I don't pretend to know or tiptoe around it, if you ask me a question I am going to give you the answer that will best benefit you- whether it is what you want to hear or not, but I am gentle about it. I pour my heart and soul into every moment with my patients, whomever they may be, dying sick or young surgical prison inmate on a med surg floor. Honestly, today it was hilarious once I told Dr. Isreal (right before the appt was over) I was a nurse - he really perked up! I wanted to say, oh! now maybe we can have a real conversation? UGH! In my opinion, the highest quality in a doctor is one that can interpret the same information to people in all different levels of understanding....and in my career it has been rare to find. Still, I have to say I agree with Dr. Israel's plan for treatment, given that Liam's testing came back NEGATIVE! That's right, he is currently NOT allergic to dust, mold, CHLOE, or milk/nuts/ eggs etc. You are probably asking yourself the same question I did-- then why is the Zyrtec helping? Dr. Isreal explained that Zyrtec can treat non allergic rhinitis......so now the next thing to rule out is immunologic disorders. My plan is to take Liam  to see Dr.  Ververeli on 4/7 for a second opinion, who is a respected pediatric allergist I have heard wonderful things about. I want a doctor who looks at my son for the miracle that he is. I know that might sound crazy, but hey- that's where I am at....if you are in the medical profession you should consider yourself lucky to work with this little man, and I want....no, no I DEMAND a doctor with half decent bedside manner. My child is not just like every other pediatric patient you see, and no parent should EVER feel that way. This child is there for an appointment because they are sick, they have a story, and you should be interested in every detail....in my opinion, if your not - it's a waste of time! I am adding in a picture of the little munchkin's back tonight before his bath -- no welts, but you can see they tested him for a number of things. I have to say, it was horrid having to restrain him on my lap, it broke my heart- no it shattered my heart into a bazillion pieces. He couldn't understand why Mama would hold him down like that and he was getting pricked -- oh the tears flowed for a bit. Luckily, the office had a lollipop and the sugar quickly made the experience worth the trip! I am glad it is over with and ecstatic that Liam was able to take Zyrtec tonight! Tomorrow, we sadly will be saying goodbye to Liam's caregiver in the young toddler classroom. Miss Alexis is leaving for another position in Olympus, I am so happy for her since she is such a bright girl -but I have a heavy heart since I am not ready to lose her. Liam absolutely lights up when he sees Miss Alexis, and we have built such a great relationship that it is going to be hard to change - whoever takes her place will have huge shoes to fill. I guess that is just one of the trivial trials of mommy hood that I have yet to fully accept. I have been insanely busy but will try to update as much as possible on our upcoming appointments. Love to all and Happy Spring!

Incident reports and sweet potatoe fries

Hi everyone! The good news is that we think the Zyrtec is helping a lot! The bad news is that Liam has another ear infection. This time Dr. V put him on Ciprodex ear drops since he feels the tubes are open. Little man is very fussy with this one, so Dr. V did a very thorough check on his tummy, throat and diaper area to see what else could be bothering him.... even Dr. V has come to learn that "Liam isn't a big complainer."  I know it cannot help that molars are making their way on in! Dr. V also instructed us to make an appointment with an allergist as soon as possible, since a 4 week wait is not ideal, Dr. V told us to contact Dr. Isreal, who was able to schedule us for next Thursday. I am excited to see how it goes since we will get the results right after the testing. I was hesitant to have Liam get skin testing, when I had this done as an adult I remember it being particularly uncomfortable, however, I was assured that the skin testing on babies is barely felt. More on this to come!

Liam had his second speech therapy appointment today at daycare. I was excited to hear how it went. When Liam was having problems nursing we were told he may be “tongue tied.” Babies that are tongue tied sometimes struggle to stick their tongue out, and often have trouble nursing. There is a surgical procedure to correct the condition, but Liam did not need to have this done. Kristen assured us that Liam can stick his tongue out, and she doesn’t feel this will present an obstacle to his speech development. Overall, we feel that Liam’s babbling is heading in the right direction. We LOVE when he says “UT-OH” when something falls on the floor.

Liam’s caregiver had to fill out an incident report today. Liam has had several of these since starting daycare, and none have been serious. The funniest one I can remember is when Liam was playing with a xylophone and poked himself in the eye with the drum stick! I was not too concerned at first, but when I was told Liam fell and hit his face on a chair leg I was a bit alarmed. I was told he had a nice bruise above his eye….but when he came through the door and I saw his big smile along with the swollen lump above his eye, all I could feel was pride for our little warrior. This evening after dinner we took Liam out to enjoy the warm weather – of course during this adventure Liam fell on the blacktop and landed on his palms….without even a wince our little man got up and just kept going. In just 14 months, he has enlightened me, and taught me lessons about life that I never would have learned without all of our experiences together. I am so proud to be his momma!

In the last few weeks, we have been having trouble getting Liam to eat any vegetables. Even if I mix them in with other food, he will find a way to spit them out! We were excited to discover that Liam LOVES sweet potato fries! I know – it doesn’t replace veggies- but, it’s a nice option for variety between the crackers/cheese, spaghetti/meatballs, raviolis, yogurt and other snacks!

We found Liam an adorable outfit for the butterfly ball which he will also wear for Easter, and we can’t wait to show him off! Love to all!

Latest on Liam

Hi Everyone! I just wanted to give a quick update on how Liam is...the good news is that he didn't have another ear infection! Unfortunately, he was running fevers and the doctor checked him for strep....the rapid swab came back negative, but given his symptoms and fever the doctor started him on amoxicillin. Luckily, whatever it was that he had was treated with the antibiotics, thank goodness since his Tmax was 103.8! The little man was pretty miserable for a few days, but now fevers are gone and he is back to daycare. His first day of speech therapy was supposed to be 2/25, but we had to postpone, so more on that to come later. As far as his physical therapy is concerned, Liam is going to be monitored on a monthly basis for now, which we are thrilled with! Even better, Dr. V. agreed to trial Liam on Zyrtec since we won't be able to get to the allergist until 4/7, we think we may even have noticed a little bit of improvement already with less runny noses etc. On the other hand, Liam's asthma has been acting up over the last few days....it felt like once his fever came down....his wheezing acted up- or vice versa! I always listen to his lungs myself now to be sure, which originally I vowed never to do! I originally had a ton of mixed feelings regarding weather my background as a nurse ultimately affected how everything turned out with Liam's birth.....was I over or underdiagnosing myself, was I trying not to act like the "crazy patient?"....was I trying to steer my own healthcare and made bad decisions? I could go round and round for hours.....so when Liam came home and then had trouble breathing I decided to just be a mom and not get out the stethoscope, I had never listened to little baby lungs anyway right? Well.... this feeling SOON wore off as every doctor would say something different and every time we went to the ER we were given different information. I remember one time when we were sent home from the ER I even called ABC's triage nurse (on the weekend) and told her what happened with our visit to the ER, and how Liam looked to me, and then I even held the phone up to him so she could hear how loud and fast he was breathing and how terrible it sounded! She agreed with me that we shouldn't have been sent home too- we were getting mixed directions about how much albuterol to give etc. Then, I have the on call doctor contact me (as we are driving BACK to the ER) only to be told that as long as his oxygen levels were good they would probably not admit him! Eventually I came to the conclusion that the stethoscope would come out- and really I am quite comfortable listening to him and I actually feel SO much better when his lungs are clear after his albuterol nebs. We are still super hopeful little man will grow out of this and it is just baby asthma! In other news, we are really hoping that the weather clears up soon so mommy can get out and start fundraising for the march for babies walk on April 27th, and also exercise! I am super excited to get the little man outside to enjoy the park across the street, I am hoping to invest in a bike trailer the little man can ride in! We are really looking forward to spring! I recently was asked to precept a new health coach at work which will require some commuting into the office 1-2 days a week until mid April, so if you don't hear from me for a bit that is why! Love to all of our family and friends, and here's to staying warm with snow on the way!