Another Sign of Progress and Maturity

You know how when a baby is little, you have to take her to the pediatrician all the time? First every couple of days or weeks, then every few months, then at half year intervals, then annually to age 5, then it spreads out to every two or three years.

It hasn't exactly worked that way with Joy. We started out with that basic pattern, but things kept intervening. Like seizures, like autism. When we eventually switched pediatricians a little while back, ending up with Joy's current family doctor who is expert in special needs, he put her on a schedule of follow-up visits every four months. Lots of appointments.

I'm happy to report, though, that we've recently "graduated" to longer intervals with a couple of Joy's specialists.

First came the pediatric neurologist. We've been seeing him at least twice a year for quite a while now. The last three visits, though, we've been able to report that we've not seen any seizures since the prior visit. And when we saw him in May, he told us to schedule the next appointment a full year out. Woohoo!

Then yesterday we had to go back to the eye doctor. I blogged about this one last year; how I'd been sent back to the opthalmologist where we'd had the worst appointment experience EVAH, then managed with a lot of pre-planning to have a much smoother experience a year ago. Our follow-up appointment yesterday wasn't starting out so well -- even though we had the first appointment of the day, the waiting room was crowded, the lady at the desk didn't want to hear about Joy's needs ("you can tell the person who comes to get you"), and Joy was starting to get fussy in the 20 minutes it took for the person to come get us. As crowded as it was, I was fearing that we wouldn't get the private exam room to wait in low light for the dilation; plus the more people, the higher the chance of waiting delays. Arghh.

However, once we got into the exam room, people started to jump for us (jump for Joy?!) Joy was unhappy but at least willing to let her attention be directed enough to look where they wanted her to look. The doctor came in quickly -- and said that she really wasn't seeing the kind of strabismus/tracking-problems that had sent us there the year before. (We still see tracking issues, but I haven't been noticing them nearly as much). She didn't think it would be worth it to dilate Joy's eyes as we'd planned (YESSS!), and told us we wouldn't need to come back for two or three years unless the tracking got really bad, to the point that she was having trouble maybe half the time to pull her eyes back together.

Fewer appointments is always a fine thing. It's so good to have both the improvement and the maturity.

Will Squeak for Grease

Remember my agonized howls back in March, when Joy got referred for an appointment with the same pediatric opthalmologist at the same clinic where two years ago we'd had the worst clinic experience EVAH?!

We had the appointment this morning.

It went fine.

SO many things were different.

• Today we had the first appointment of the morning, so no crowded waiting room.
  
  
• This time I explained our situation up front to anyone who would listen.
  
  
• The waiting room itself was tidy and whole, as opposed to the construction that was underway in September 2007.
  
  
• We had a minimal wait before being called the first time (a short enough wait that Joy was entertained by the waiting-room goldfish the whole time.)
  
  
• The doctor came promptly after the tech was done.
  
  
• We knew in advance that Joy's eyes would need dilation so didn't have that element of surprise.
  
  
• We got to wait for the dilation to take effect in a private exam-room with low lights.
  
  
• They came for us in EXACTLY the 30 minutes allotted, rather than the hour-plus we suffered through last round.
  
  
• No seizures. As expected, but it helped so much! (We were so much in seizure-mode last time, it didn't even occur to me to TELL the doctor that it had happened. She was surprised not to find it in her notes when I recounted the experience this time around.)

We were outta there in an hour and a quarter. What a marvellously well-oiled visit!

The point of the visit was a concern on our part that we keep seeing episodes where Joy's eyes don't track well together. It seems worse when she's tired or out of sorts. Fortunately she performed for both the tech and the doc, so they could see what I was talking about! (Joy was, in fact, remarkably cooperative with the whole appointment.)

The diagnosis is strabismus, but not serious at this point. The key seems to be that she can pull her eyes back into focus on her own. Given that state of affairs, the doctor doesn't want to do anything beyond watching and waiting.

It's a brain thing rather than a physical-structure thing -- her eyes themselves look healthy -- and nothing that they have an easy reliable fix for. The next step up would be an eye-patching routine (yeah, she'd love that) and the escalation beyond that would be surgery on the eye muscles (about a 70% success rate, and I neglected to ask exactly what constituted "success").

We're to go back in a year, unless things get outta control and we have to go sooner. But for now, Joy's overcoming it all by herself. So very much this kiddo has to contend with. I'm very proud of her, and will gladly squeak on her behalf whenever necessary!

P.S. Tomorrow is the first blog-o-versary of Elvis Sightings. Hard to believe it's been a whole year since I first asked, "Is this thing on?"