Pediatrician visit went well, like I said before he said he has low muscle tone in his legs but I think in just a couple of weeks he is getting much stronger and we think he will begin walking on his own soon. He can now walk holding on to just one hand! :) Blood work came out all normal. Oh my gosh, getting blood from him was a nightmare. We had to go to the labs twice, the first time the nurses could not find his vein and both did not seem proficient in getting blood from infants. I even asked them before they tried and she said yes. Anyway, no blood on that day. We went back on a Tuesday after his cleft team visit since the first time was on a Saturday. We also went to the hospital to get it done not a satellite lab. Well, the first nurse did get some blood but couldn't get all that was needed. She called for a pediatric nurse and she was even worse than the nurses on Saturday. They said he has really small veins but that really isn't an excuse. He isn't the smallest baby. She tried both arms, both feet, and then finally went to the heel stick to get the rest. That blood flow from the heel was better than the vein! So she actually got everything that was needed. We were there for 2 hours just for the blood draw! Poor Lian was exhausted from crying, screaming, and getting poked at :( It was really frustrating watching the nurses be so unsuccessful (I know about getting blood, in a different way), so I sympathized with them, but it was just really hard to watch him go through that. They said if we needed to get anymore blood in the future to call down a pediatric anesthesiologist! We also submitted fecal samples and that came back positive for Giardia. If you don't know what Giardia is, it is associated with poor hygiene and sanitation and is usually contracted through contaminated water. It can only be caught if you handle the poop of an infected person. So don't worry everybody, lol! He just finished treatment of that which was 3 days (2 doses/day) of Nitazoxanide.
Cleft team visit was long but very positive. He saw the surgeon, geneticist, nutritionist, speech language pathologist, and ENT.
For his cleft lip and palate, the surgeon examined him and he only has a pre-maxillary cleft which affects the 4 front teeth. The rest of his palate is intact which is great! He will need a bone graft to fix the pre-maxillary cleft but that won't be until late elementary/middle school. His nose/lip revision is a wait and see. The surgeon said it is harmful to do too many surgeries early because the face changes/grows so much as they get older and if too many surgeries are done too early, the scar tissue that forms after surgery will prevent the face from growing normally (which makes sense).
The geneticist evaluated him and said his cleft is more likely an isolated event and is not associated with any syndromes. The speech language pathologist said he is 2-3 months behind on his speech development but for being home less than a month, he was doing really well. She said to apply for private speech therapy depending on what our insurance covers. And also to apply for Early Intervention. We did contact EI and someone will stop by in a couple of weeks to do a speech, language, and developmental assessment. He has to be at least 30% below the criteria of what he should be at normally in order to get assistance. She said she will double check to see if cleft lip/palate automatically qualifies him. If he doesn't need it, it's not a bad thing! So we'll see!
Lian's weight is on the low end of the scale (3%), so a nutritionist gave us some ideas, handouts on how to have him on a high calorie diet to increase his weight. We thought he was already pretty chubby but I guess not compared to other babies! We were already having him on several small meals a day and 3-4 bottles of formula (instead of 3 large meals). And to use higher calorie milk, cheeses when adding them to a meal instead of non-fat choices. Use butter or oils when cooking veggies, meats. Add jelly, honey to breads/rolls. It was interesting to hear that baby food actually is not that high in calorie, so we have him on regular food that is cut in small pieces to eat as well as formula. He still loves his fruits and yogurt. He is now getting picky on the foods that he likes! One day it will be all good, the next day it will be a spit-out fest. He had his first grilled cheese, mac n cheese, french toast, and PBJ which he liked!
At the ENT he had his ears cleared out of earwax, OMG there was alot of earwax lol!! No fluid in his ears so no need for ear tubes, yay! Had his hearing test and was normal. Nose and throat looked fine as well.
So all in all it was very positive. He has to go back to see his pediatrician and cleft team in 3 months, and ENT in 6 months. He will also have his circumcision in the next month or so. We wanted to get that done early, now that we know he won't need a palate or lip surgery in awhile just so that he doesn't remember it!
I finally had some time to go through Lian's baby book that we received from the orphanange. It had a photo of him when he was found and several others as he got older. I have to get it translated but it is so nice to have. There was also a CD of photos, some that we had already gotten and some that we didn't. Here are a few of the photos (everytime I see photos of him in the orphanage, I still can't believe he's home with us now):
