Ricky was home again today. He was lethargic, but seemed better than he was yesterday. MUCH better. So I am hoping against hope that he can go to school tomorrow since I have five days of work to do in two days. (Ack!)
This afternoon, I hauled all three kids up to Stanford for Ricky's every-six-months (I guess that would be twice-yearly) appointment with the endocrinology clinic. They've been monitoring him for CF-related diabetes, which is a sort of a hybrid of types 1 and 2 that happens in most people with CF eventually; basically the pancreas gets clogged up with that thick CF mucus and stops secreting insulin. But with CF, sometimes the insulin gets through once in a while so basically the pancreas is just imperfect. It is complicated because people with CF really shouldn't limit their calories; yet of course if they have diabetes they need to.
Anyway, Ricky's meter showed very few surprises, and the endocrinologist was unconcerned about it. He had one very low number, but this was not surprising because he had been fasting. And he had one pretty high number (around 200) but he had just eaten.
But... The big concern was Ricky's growth. As I've documented, he has grown very little in about three years... Most noticeably in the past two years his growth curves, in both height and weight, have flattened out. Before that, his height was increasing at least. Something I didn't know, is that boys' growth curves do flatten out for a period of time right before they enter puberty. 2-3 years is a bit long for that, but we could be seeing something like that.
Ricky had his physical exam and, I'll be delicate here and respect his privacy, was found to have one sign of possibly entering puberty soon, and one other questionable sign. I did mention his recent need for deodorant (Andrew and him both recently needed to start using it, though they frequently forget).
His stat blood tests today were normal. The resident and attending decided to ask for a bunch of blood tests to be run along with his CF ones next month, including thyroid function, growth hormone, etc. They want to have the Stanford neurologist look at Ricky's MRI from February 2007 to see if there are any clues there, so I am going to send them a copy of the CD ASAP. We go back to the endocrine clinic in four months, and if he has not grown by then they'll start talking about a more specific MRI of his pituitary gland and possibly supplemental growth hormone. I just don't want to wait too long for the growth hormone, but I also know that these doctors know what they are doing.
Oh, this is also significant... A lot of males with CF have stunted growth because of their CF exacerbations, but it is not felt that this is a problem with Ricky as he has always been at least in the 50th percentile for height and his illness has not seemed to affect that. And he has not been a lot sicker until the past year or so. The doctors are of the opinion that this growth stunting does not have to do with his CF. That was interesting to hear.
The resident also asked if he had had genetic testing. Doctors often ask that about Ricky because of a few unique things about him -- he is slender and double-jointed, and has thin, velvety skin. She also measured his arm span versus height, which either has something to do with puberty (I should Google that) or meant she was checking for Marfan's. Hmm. She did say the results were normal.
That's about it for now... Just wanted to document it before I forget!
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