Thursday, December 27, 2007

MMR Vaccination

They must have called Boxing Day for a reason coz this morning I really felt like BOXING someone!! I can't believe it! I made appointment at 10am for Ari's vaccination and 12 pm I am in the consultation room. I waited for 2 hours, so I wonder what's the use of making appointments!!!

Dr Tan asked if everything is alright with Aricia. So I filled her in with the 2 febrile fits incidents. (which comes to remind me, hubby did ask me to bring Ari to the PD when she had fever the second incident. But I told him "no way I'm going to wait for 2-3 hours to see a doctor)

I think there's something wrong with the height thing they use. They make Ari stand and they simply pull down the thing and that's it! She shrunk?!

Anyway, that's beside the point. So Dr Tan if I wanted her to refer us to an Endrocrinologist - wow! very chim word. But anyway it's from the word Endocrine, so it's some kind of hormonal doctor. Umm... maybe can fix this crazy mother who lost her hormones!!
Checked on hereditary grounds. I said yes, my hubby and his siblings were small but they all grew up tall and alright.
She did say that there are 3 types of growth and Aricia might fall into what they call the Constituitional Growth.
What the endrocrinologist will do is to observe her growth and then if there's a need give her hormonal injections. Hey! Am I qualified to do this. But then there's some arguments that this doesn't work much. So.....

Anyway, something to fill you in :

Growth Delay or Disorder
What is normal growth?
Growth patterns in children vary. For example, baby boys grow faster than girls until about 7 months. After that, girls grow faster until about age 4. The growth rate then becomes the same for both until puberty.
A child's size depends a great deal on their parents. Large parents usually have large children. Small parents, as a rule, have small children. A short child, who has short parents, does not necessarily have a growth problem. While these children will have growth spurts and enter puberty at normal ages, they will usually only reach a height similar to that of their parents.
Nutrition, genetics, and hormones can all affect growth patterns. When a child's growth seems to be lagging behind, the cause may be a natural growth delay or be caused by a growth disorder. A child with a growth delay may still go through all other development stages normally.

What is the cause?
There are several possible causes for growth problems.
Normal delayed growth: If your child is growing at a normal rate, yet is small for his or her age, it is called a constitutional growth delay. Your child may have a delayed bone age, which means your child's bones are a younger age than your child's age in years. Puberty may be delayed until bone growth catches up. Often one or both parents or a relative has experienced a similar late-bloomer type of growth pattern.
  • Failure to thrive: When children younger than age 3 show slower than expected weight gain and growth, it may be a condition known as failure to thrive. It is usually caused by a feeding problem or inadequate nutrition. Malnutrition is the most common cause of growth failure around the world. Failure to grow may also be a symptom of another problem, such as an infection, a digestive condition, or even child neglect or abuse.
  • Hormone problem: A condition that causes too much or too little of one or more hormones can cause growth problems during childhood and teen years. A failure of the thyroid gland to make enough thyroid hormone, which is essential for normal bone growth, is called hypothyroidism. If the pituitary gland is damaged or malfunctioning, it may not be able to produce enough hormones for normal growth.
  • Chronic illness: Chronic illnesses are another common cause of delayed or slower growth. Growth can be slowed by illnesses like asthma, congenital heart disorders, chronic kidney failure, and poorly controlled diabetes. Children with neuromuscular diseases, cleft palate, or some psychosocial problems may not get enough to eat. Some diseases such as diabetes, cystic fibrosis, heart failure, and HIV interfere with the body's use of nutrients.
  • Other problems: Other disorders that may cause slow growth include genetic disorders (for example, Turner Syndrome), infections during pregnancy, and use of certain medicines, alcohol or cigarettes during pregnancy.

    How is it diagnosed?
    Parents who suspect that their child has a growth problem should take their child to a health care provider for an exam. Regular recordings of the child's height and weight are used to check the child's growth rate.
    Your child may have blood test to check the functioning of many organs. Special tests may be ordered to check hormone levels. Your child may also need to have an x-ray of his or her wrist to measure bone growth and age. Occupational therapists may also watch your child's feeding behavior.

    How is it treated?
    Treatment for growth delay depends on the cause. Malnourished children may need high calorie supplements. Shots or pills of the hormone may help a hormone shortage. Children often compare themselves to their friends. This comparison can be a source of much distress to a child and his or her parents. It is important that a child's concern not be dismissed as unimportant.

    Read more about Constituitional Growth Delay (CGD) here

  • Oh, I just found out what squint means. All the while I was surprised when doctors don't raise alarm when they tick "NO" in the assesment charts. So I asked Dr Tan. "Shouldn't she be squinting and looking for the light when you turn off the light??" Squint in their medical terms means 'crossed eye' or not


    The Chengs said...

    Did Aricia NOT grow at all? (cannot be lost height, lah).

    In the Pre-school years, usually there's not too much concern. Anyway, for a preschool child, it would be too invasive to temper with their growth hormones, won't it? And growth hormones are not exactly natural either and we won't know how it impacts on a child's health in the future.

    Our eldest was on height-monitoring in primary school. We've got short genes from my hubby's side - what to do??!!! But she grows a few cm each year. She grew much significantly more as she hit puberty in Pri 6, so the School Health service was always quite happy to just put "continue monitoring next year".

    2nd child inherited my side of the height genes, so he's not raised the same concerns.

    The youngest. *haha* The shortest. The school health service had him referred and sent to SGH for Height-monitoring. But well, again, he grew more than the minimum rate in the 1 year they monitored him, although he's still very short. Oh well, I got sick of sending him to SGH, so I requested to take him off the programme and just have him monitored yearly during the annual school checks.

    I know someone who's girl is really quite short. They put her on hormonal treatment in Pri 6. Grew a little taller only though...

    Lily Ann said...

    The height thing the clinic did is not accurate! When she was hospitalised in KKH, I measured her on the bed after her bath. And she was above 70cm. 2nd admission, grew a little. And this time round in the clinic she "shrunk" from the height thing they did and my 2nd try in KKH during 2nd admission.

    We also think she's alright and might not be good for the child. Probably I see what the sinseh say.

    Wow! Must be really mentally tiring for you. Kudos to you for holding up so well