Poor Pookie

This morning Emrick and I drove up to Salt Lake City to see the pediatric endocrinologist to whom we were referred by our regular pediatrician. This is the appointment I made more than 3 months ago, after our regular doctor thought maybe we should look into the fact that Emrick has such a small body with such a large head.

The endocrinologist is a lady who’s been practicing for 30 years, and I think she also teaches classes at the University of Utah Medical School. In fact, at one point during our visit, she called in three women, whom I took to be med students or something, and had them look at Emrick and chat with me. Hmm.

Anyway, here’s the blow by blow. Grab a drink, sit back, mute the TV.

First, I undressed Emrick so they could take height and weight measurements. They measured him at 27.5 inches. At his regular check up a week ago (with his normal pediatrician), they measured him at 27.75. But I trust the 27.5 measurement instead, for two simple reasons: 1. It’s the measurement I came up with myself when I measured Pookie on his birthday (and I am just that good) and 2. They placed Emrick in some super-duper, fancy-shmancy, hoity-toity measuring machine to come up with that figure. The Baby Measuring Thingy 4000, I believe it was called. And while it lacked lights and buttons, it did consist of a flat board with measuring lines already marked, and movable bookend-like panels (babyends?) to enclose the baby at the head and foot, so there is no mistaking where his body begins and ends.

Second, we met the doctor. When she came into the exam room, Emrick happened to be standing next to, and touching, a small child’s chair that was in the room. It quickly became apparent that the doc thought Emrick needed that chair for support.

“I see he’s pulling himself up,” she said, as she made some notes. And before I could clarify for her that Emrick is in fact a seasoned walker now, she turned to him and said, “You’re cruising.”

For those who don’t know or don’t remember, “cruising” is the term used for the phase that babies go through when they have to hold onto furniture in order to walk around. In other words, the phase Emrick entered a good four months ago.

“Actually, he’s walking on his own,” I said.

She was surprised to hear that, made some notes, and then admitted that she had assumed, based on his small stature, that he wouldn’t be walking yet. Then she said something about how the fact that Emrick is walking is a good reminder for her not to have low expectations.

Then I stormed out of her office in a huff.

(Just kidding.)

Anyway, then she proceeded to ask me questions about my height, Marcus’ height, and the heights of our parents and siblings. I wasn’t sure, so I told her that everyone in both of our families was four foot nothin’, with the exception of Marcus’ mom whose height I estimated at 7 feet.

(Just kidding. I gave her real estimates. If you’d like to know how I reported your height, just ask! ;))

Then she asked if my husband has a big head. Before I could answer, she looked at me and said, “You have a big head.” I wish I could say Just kidding now, but I can’t! ‘Cuz she really said that!!

So I said, “YOUR MOM has a big head, lady!”

Then I stormed out of her office in a huff…

(jk)

Next, she examined Emrick. She quickly ruled out an endocrine problem because she said he looked too healthy for that. I asked her what the chances are that Emrick just takes after his parents’ shortness/bigheadedness and that there’s nothing really wrong, and she said, “Very high.” And though that seemed reassuring, she did say toward the end of the appointment that she could not rule out hypochondroplasia. That’s the term that was initially uttered by our regular ped, and it’s a rare and mild form of dwarfism. She noted that there is a certain swoop in Emrick’s lower back when he stands and walks, and that this could be normal for him, but it is also a symptom of the hypo-thing.

She assured me that if Emrick has it, it’s probably a “very, very mild” case of it. It’s also genetic which means that if Pookie has it, Marcus or I have it (or the gene for it) as well. I asked her if it was possible to go your whole life without knowing you have it and she said yes, because most patients’ symptoms are so mild that they do not interfere with a normal life. She told me to disregard any scary info I may come across about it, because those are extreme cases.

While Pookie’s case (IF he has it) may indeed seem mild, though, that’s no guarantee that it will always be mild. When I first looked up info about this condition three months ago, I didn’t come across anything really scary, but I did read (and the doctor today said this as well) that the condition is usually not obvious until much later in childhood. So, that could mean anything for Pookie’s future (IF he has it, again).

Anyway, since she could not rule out hypochondroplasia, OR growth hormone issues, she ordered some bloodwork and a “skeletal survey” (x-rays) for Pookie. So next, we loaded up and drove up the street to Primary Children’s Medical Center and had his blood drawn and x-rays of all his bones taken. Pookie was not happy with any of this. I expected him to cry during the blood draw, which he did, but that was over pretty quickly. The x-rays on the other hand, though not painful, took a long time and Pookie was very upset. All he knew was that he was lying on a table and being handled by two strangers who kept forcing his legs and hands and head into various positions. The staff were all very nice, of course, but it was still distressing to a one-year-old who has no way of understanding what’s happening or why. I mean, he screamed during the entire 20 minute x-ray process. Screamed.

Then something happened that has me just a little concerned. After the x-rays, they told me to go ahead and get Emrick’s clothes back on, but not to leave yet because they needed the main radiologist person (whom I never saw) to look at the images taken so far and determine if it was necessary to take an image of Pookie’s spine (which they did not do initially). So I dressed Pookie, got him all calmed down with my hugs and kisses and Cheerios, only to have this girl come back and say that as a matter of fact, YES, they want to take an image of his spine. So I undressed him, took him back to the table, and watched as he screamed and writhed again.I wondered later why they didn’t just take the spinal image to begin with, and all I could figure was that they don’t want to subject the major organs to radiation if they don’t have to.

As I was undressing the screaming Pookie on the x-ray table, for the second time, one of the girls who had been helping with the x-rays apologized, and said that she had told me earlier to get Pookie’s clothes back on because it “hardly ever happens” that the radiologist wants that spinal image.

Hardly ever happens? Oy. So what was it about the images taken before then that made the radiologist say, “Boy howdy! I gotta see this kid’s spine!”???? Hypochondroplasia is evident mostly in the hips, or so I hear. Was something off about his hip x-rays? I guess I will find out soon enough!

But listen to THIS: after the spine x-ray, they once again tell me to dress Pookie, but don’t leave yet. This time I had to stick around until the phantom radiologist Master determined that the spinal image was good enough/clear enough/whatever. So I dressed Pookie again, fed him Cheerios again, showered him with hugs and kisses again, the whole time thinking to myself that if they came back and said, “Oops. We need another image. Undress him again, please,” that I was going to have to say, “OH HEEEEY-EELLLLLLLLLLLLLLLLLLLLLLLLLL NO!”

Luckily, when the girl came back,she smiled and said, “You can leave!”

I said, “YOUR MOM can leave!”

Then I stormed out of the x-ray office in a huff.

The nearly nekkid Pookie waits eagerly to meet the endocrinologist.

After the blood draw, waiting to be called for x-rays. Pookie rocks the play kitchen.

Pookie can't seem to make any water come out of that faucet. Nobody's perfect!

While I was taking pics of Pookie, a boy of about 6 walked in with his mom. I heard his mom encourage him to go play with the toys, and the boy replied angstily, "But there's a boy over there!" His mom said, "Oh he's just a little baby. I promise he can't hurt you." But Pookie's mom can promise no such thing!

The faucet is still dry.