Sunday, October 28, 2012

Bishops' Orchard

It was a cool, crisp Autumn day a couple of weeks ago after church, and we decided it was high time we checked out one of our local apple orchards.  Laura and Austin organized a picnic lunch, and drove out to the cute little town of Garfield, Washington.  We stopped at the little public park, and had our meal.

Chloë thoroughly enjoyed the merry-go-round.

And Elaina thoroughly enjoyed sitting in the grass and playing with the leaves.

Then we went to Bishops' Orchard.  And picked (and ate) lots of apples.

We ran into my dear friend Lynnessa and her family.  She had just arrived the previous day from her home in Maryland, so I was delighted at the chance to see her and meet her adorable baby Audrey.  Elaina, 8 1/2 months old, and Audrey, 2 1/2 months old, were just about the same size.

Then it was time to turn some apples into fresh cider!

I think we made about 12 gallons of cider.

We all had a grand time, but I think Chloë had the most fun.  I think we just might have to make this an annual tradition.

Monday, October 22, 2012

Hemangioma Update 2012

Chloë went to see her dermatologist, Dr. Dominey, over a week ago.  My parents were in town, so my mom came along for the ride, and she was very helpful with the girls (and took us out for a yummy Mexican lunch after the appointment!).

It had been a year since we last saw Dr. Dominey. Chloë has grown up considerably since last October, but her hemangioma is mostly unchanged.  I had hoped that we would see some fading or shrinking over this last year, but we really haven't.  I'm just grateful that it hasn't grown.

2010: 4 months old.  We had just started treating with Timolol.
2011: 16 months old.  No treatments since we ended the Timolol in February of 2011.
2012: 2 1/2 years old.  Still no treatment since February 2011. 

Since the hemangioma is in a "good" location behind her ear, we really don't have to be aggressive in treatment right now.  We can just leave it alone and not do anything until later, if we choose. Dr. Dominey talked about the presence of a hemangioma having some psycho-social affects on Chloë , especially a few years down the road.  I know that as she gets a little older and becomes more aware of the occasional stare, and more self-conscious of strangers' questions, I might not be content to sit back and do nothing.  I don't want her to be embarrassed to wear her hair up or in a ponytail.

So we talked about the possibility of a small surgery in a few years.  A surgeon would cut out as much of the hemangioma as he could, and since her right ear has been pushed forward a bit, he could remove a little extra flesh (and maybe cartilage) and "pin" her ear just a little to match the left side.  Since hemangiomas are highly vascular, sometimes skin grafts are required for things to heal properly. But because of the extra skin and tissue surrounding Chloë's hemangioma, Dr. Dominey thought that the edges of the skin would be able to be sutured together, and we wouldn't have to worry about any skin grafts. 

Then I asked Dr. Dominey about propranolol.  She laughed a little, and said "I knew you were going to ask me about that."  She said there hasn't been a lot of new research over the last year, but there are more stories of success of shrinking hemangiomas in infants or children taking oral propranolol. I asked Dr. Dominey if she had seen anything in her literature to suggest that there might be a difference in effectiveness depending on the age of the child.  She said she didn't think so, but that there were certainly more cases of infants using propranolol than toddlers or older children. 

Propranolol is a medication approved to treat hypertension, and I used to give it to patients to lower their blood pressure and heart rate.  So we weren't very keen on giving it to Chloë when she was an infant.  It just seemed too scary.  But now that she is a little older, I thought I might be okay with the idea of it, as long as we could closely monitor her heart rate and blood pressure.  So we talked about setting up an appointment with her primary local doctor, and having an initial baseline check of her heart rate, blood pressure, as well as her blood sugar.  Then we would start her on 5mg on Propranolol three times a day, and re-check those vital signs shortly after her initial dose.  Then every so often (a week maybe?), we would increase her dose by 5mg, and re-check her vitals.  So what were considering was: close monitoring of her vital signs initially and every time we increased her dose, and increasing the dose from 5mg three times a day, to 10mg three times a day, then to 15mg three times a day, to a total of 20mg three times a day.

Then we realized something.  Even if the hemangioma responds to the propranolol and shrinks, the cartilage and skin of her ear aren't going to shrink.  So we'd probably consider a small surgery to "pin" her ear so it matches her left ear.  And if we're likely planning on going to the trouble of a cosmetic surgery, why not just remove the hemangioma at the same time, and not worry about all of the monitoring and potential side effects of a strong medication.

So that's what we decided: to do nothing.  Even though the hemangioma hasn't really started to shrink, there's still some hope that it might, at some point in the next few years.  So we'll keep praying and watching it, and see what the next few years bring.

For the few of you that found this blog post by searching for hemangiomas, timolol, beta blockers, and before and after photos, you can see my older blog posts (with more information and statistics) on this subject tagged under the hemangioma label.

Wednesday, October 17, 2012

Elaina Signs

We have been using the sign for "more" for a couple of weeks now.  Last night at dinner, she did this for us.

Although Elaina's version isn't exact, it's close enough for us to understand! She is 8 1/2 months old now.

Just for some fun comparison, Chloë first signed when she was 8 1/2 months old, too!

Monday, October 15, 2012

Uncle Samuel

My brother Samuel called me a few weeks ago from Denver.  "Hey, can you pick me up at the airport on Wednesday?" he asked.  He had injured his collar bone and rib in a rugby game, and had to take a few weeks off to let things heal.  So the girls and I drove up to the Spokane airport.  Samuel's arm was in a sling, and his hair slightly resembled the Euro Rugby Mullet, but we were glad to see him.

Chloë was especially thrilled to have her Uncle Samuel around off and on for a few weeks.  He spent a lot of mornings and afternoons with the girls, napping, playing, tickling, and reading.

Last Tuesday, the night before Samuel's early flight back to Denver.  Chloë gave him lots of extra hugs and cuddles.

We miss you, Samuel.  Hope you don't get any (more) injuries this season.  Although we wouldn't complain if you came to visit again.

Saturday, October 13, 2012

Homecoming Parade

We bundled up and went to the U of I homecoming parade last weekend!  My sister was in town, and we figured it was a good a reason as any to take the girls to their first parade.  Both the girls enjoyed all of the marching bands, and Chloë was particularly fond of all the candy she collected.

As soon as we got downtown, I realized I'd forgotten my camera.  But the old iPhone pulled through for us once again.

The music was a big hit. Even Elaina liked it.

Chloë really liked the horses.

She thought the drums were the best part of the marching band.  She hasn't stopped talking about them and demonstrates how they worked by hitting her hands on her legs.


Wednesday, October 3, 2012

8 Months Old

Elaina is now mobile.  Three weeks ago, she would do her yoga routines, and maneuver into a half sitting, half side reclined position.  Particularly adorable when paired with this hilarious face.
Then she figured out how to army crawl.  Then she figured out how to push herself into a sitting position, and is getting better at her balance. (There have been a few tearful head bonks.)

Then last week she actually did a little bit of traditional crawling.

And she started pulling herself up on furniture.

A few weeks ago, we finally pulled out the rice cereal and introduced solids. I pureed some peas shortly thereafter, so she's been eating mashed peas and rice cereal every evening while we have dinner.  She thinks it's pretty important to sit in the highchair and join us for a meal.  When she's done with her mash, we put a few puffed cereal pieces on her tray.  She will slam her hand down over a piece, clench her fist around it, and sloppily attempt to get it into her mouth.  Then she'll happily slurp and gnaw on the thing until she swallows it and repeats the process.

Here she is the day we introduced rice cereal.

Since she is so great at putting things in her mouth, I'm trying to be extra good about keeping the floor swept.  If I leave one little cracker (or leaf or bark) crumb in a corner, she will find it.  Thank the Lord for audible gag reflexes to alert Mom.

Speaking of audible, this kid likes to talk.  And babble.  And shriek.  

She really likes all of her aunts and uncles and grandparents.

She just likes to eat.  She likes to nurse every 2 hours around the clock.  And she usually does, except for a 4 hour stretch when she goes to sleep around 9.  Which I really don't mind too much.  Selfishly, it would be nice to sleep for more than a couple of consecutive hours, but hey, I'll get to do that in 20 years right?

By the way, I'm eating dairy again!!  Glory, hallelujah.  No really.  I am so grateful for the little silly enjoyable things in life, like real cream in my coffee, and real cheese on my pizza. I re-introduced dairy a week and a half ago, and Elaina did fantastic. I would "cheat" here and there and have a tiny bit of dairy in something, and I wasn't seeing any of the usually dairy induced problems in Elaina.  So I just decided to go for it one Saturday morning, and started eating dairy.  She had a couple of little spit-ups, but nothing crazy or concerning.  And no trace of her dairy-sensitive rash, and zero signs of discomfort after nursing!  I am elated to be eating a full dairy diet again.  I missed milk, but man, I really missed cheese.  So it looks like she's over the dairy protein sensitivity, although I have to try giving her dairy directly, so we'll see how that goes.

Her eyes are still blue, although a good deal darker, and a little more gray.  We'll see what happens.
I sure do love this little girl.