Today was a good day. Today was a great day!
This is the first doctor appointment in 6 months that seems promising.
The appointment started off great to begin with. Dr. Mahr came in and introduced himself, let us voice our concerns and went on to explain his thoughts on Harrison's first year of life. Dr. Mahr has probably the best bed side manner of any physician we have ever had, even better that his primary physician. Mr. Mahr tells you like it is, yet he he adds humor and caring into his mannerisms. At one point during our appointment he told us (jokingly) that Harrison is a great contraceptive. We assured him that he is. Sorry Grandma and Grandpa, there will not be a baby number two for quite sometime (in the meanwhile keeping spoiling Harrison). As we told the doctor this he told us (again jokingly), "Well, I don't think you so procreate...this is quite a mess." Then he went on to say that that didn't stop him.... he has one child with food allergies and the other one with asthma and allergies---you never know what you will be dealt.
Dr. Mahr was very knowledgeable on his prematurity and sicknesses. It was AMAZING to have someone say to us, "Wow, you really have had a rough year, all you want is a healthy child, is that too much to ask?" I think Dr. Mahr WON my heart right then and there.
Looking over Harrison's labs and a preemie... The state of WI does additional newborn screening for major autoimmune disorders that the state of Minnesota does not. Since Harrison was technically born in the state of WI, he had those autoimmune test done in the first few days of birth. Those labs came back normal---which is nothing but good news.
Dr. Mahr went on to explain that he feels the immunity issues Harrison is facing can be likely caused from his prematurity (but this may not be the only cause) and his immune system is not yet matured. This wasn't new news to us, this is something we have heard before, in fact several times. However, Dr. Mahr went on to explain that this is only a presumption as his condition could very well be something more. He said that Harrison's medical history suggest he may also have T. IgG Subclass Deficiency and Specific Antibody Deficiency. (If you remember from my blog entry below---this is a immunity issue that I researched the other night). IgG is a immunity disorder that is treated aggressively with antibiotics. There has been no replacement approved deficiency, but the awareness to treat the disorder with lead to faster recovery and longer stretches of being healthy. Sometimes children can outgrow this deficiency or essentially become symptom free, but carry the deficiency their whole lives.
Doug and I opted out of blood work to further pursue this diagnosis today. We did this for a few of reasons. At 19 months (16 months corrected) the immune system is immature, very immature, so the results are often hard read and clearly diagnose. Secondly the Dr. Mahr suggested we try a asthma/allergy medication Singular to help treat the daily symptoms. He said that over the past year we have just been treating the episodes and not treating the ongoing congestion that has been following for months and months. This medication should help clear up the congestion in his chest that leads to frequent vomiting from his coughing as well as clear up his nose that never seems to stop running (and is the greatest contributor to the past 12 ear infections). And lastly we chose not to do that lab work because the diagnosis of IgG deficiency doesn't have have replacement therapy for the condition. Beginning the medication made the most sense to us.
Something else Dr. Mahr said that he was confident is saying is that Harrison had
Respiratory syncytial virus (RSV)
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002531/ prior to his diagnosis of Pnemonia back in March of 2011. He said RSV leads to pneumonia and ear infections and the symptoms and the deep congested cough can last months after having the virus. In the spring of 2010 Harrison was protected from RSV with the vaccine (which cost more that $1,000 each injection). In 2011 Harrison prematurity no longer qualified us for the vaccine, our insurance wouldn't cover it. (Damn you Blue Cross Blue Shield----quit being so damn cheap). Well back to the RSV---this is a very probable cause to why Harrison still sick today.
We are going to give the new medication 3 weeks to start working before we conclude if it's helping or not. So far Harrison gobbled up the chewable tablet on the ride home from the appointment today. If after the 3 weeks has passed and we aren't seeing any improvement Harrison will be started on a inhaled steroid and a nasal steroid. If after continued daily treatment of the steroids doesn't provide any relief Harrison will need to undergo labs to dig deeper into and a clearer diagnosis. What's so good about this whole situation is that there is a plan of action... The coarse of treatment just doesn't stop. Dr. Mahr already talked about treating Harrison next fall, thinking we may need to take a more aggressive approach to his treatment plan.
I can't keep saying how good it feels to be heard and that we didn't have to hear another doctor conclusion is that it's been a hard winter and things will get better when the weather gets warmer and sends us on our way or my absolute favorite---maybe it's his teeth!
Our next appointment is September 16th with Dr. Mahr (who also comes to Winona--yeah). However, if we aren't seeing relief in 3 weeks we will follow up sooner.
Tomorrow morning Harrison has a audiology appointment and following his hearing test we meet with his ENT doctor, Dr. Case. I am expecting he passes the hearing test as he has in the past, that is, if he even lets the audiologist test him. Harrison hasn't been the good little patient that he once had been. Appointments are ever so challenging (today he refused to sit or stand for a weight and length check) and tomorrow it's just Mommy and Harrison...WISH US (ME) LUCK!