Thursday, April 9, 2009

No Spicies!

{scene: mexican restaurant, early this evening}
Dad: Maya, would you like another bite of my burrito?
Maya (loudly and dramatically, as she pitches herself backward onto the booth seat as if shot): Nooo! THIS Indian doesn't like SPICIES or MUSHROOMS!

So, prior to our Mexican restaurant outing (where Maya ate fish sticks and fries btw.. nothing spicey or mushroom-y).. we took Devika to a post-adoption medical and developmental evaluation at the International Adoption Clinic which is located in a nearby children's hospital.
First of all, let me say that it was a GREAT experience. There were six (or 7?) doctors/therapists who evaluated her.. held a quick meeting together.. and then presented their results to us. They were all very good.. Devika had a great time charming everyone that she met! They worked well with her and there were no meltdowns of any kind.
The most interesting results: all of the med personnel believe that she has a vision issue. We had never really thought anything of her eyes. We have noted that, at times, they don't look like they are aligned.. but it has seemed to be a rare occurrence and not something we were sure enough to even discuss with each other (and I mean Aj and I of course). The signs that lead to this: they noted that during certain exercises, her eyes looked to not be 100% aligned; she had problems putting a peg in a hole; she had problems putting small blocks in a cup; she tried to grab items off the floor occasionally and missed; she 'rakes' rather than grasps with a pincher-grasp; and most importantly: she walks into things and hits her head CONSTANTLY. We had attributed this to just a 'learning to walk' issue.. but it did seem fairly obvious by the end of our visit that it is not normal. We spent ~2 hrs in the same small exam room and she hit her head on EVERYTHING possible - more than once. Each time she hit her head, everyone seemed more and more certain that there is some type of vision issue. Of course, we don't know.. we had to make an appmt with an ophthalmologist and wait to find out.
She also 'tested' developmentaly with most motor skills at a 15-month level. With a few gross skills she is more like 18 months, with a few fine motor skills she is at 9-10 months, but overall they felt she was at 15 months. We were not surprised or overly concerned by this. We were happy to find out that she will qualify for OT (occupational therapy) for the fine motor skills.. and possibly for gross. We are going to be making some calls to get started on this also. They do feel like if she has a vision issue, it is the main contributor to the delays.
One other wierd thing .. she has a split uvula. Now my question is.. why has her pediatrician not noticed this? Odd eh? The doctor at the clinic told us that sometimes this is a sign of a type of cleft palate issue.. but the main sign of this would be an odd voice (did he say froggy? I cannot recall). He did not hear anything worrisome from Devi's voice. I also looked this up in Wikipedia - just to check the spelling of 'uvula' actually.. and this is interesting (keep in mind that she continually has ear infections):

A bifid uvula is a split or cleft uvula. Newborns with cleft palate also have a split uvula. The bifid uvula results from failure of complete fusion of the medial nasal and maxillary processes. Bifid uvulas have less muscle in them than a normal uvula, this may cause recurring problems with middle ear infections. While swallowing, the soft palate is pushed backwards. This prevents food and drink from entering the nasal cavity; if the soft palate cannot touch the back of the throat while swallowing, food and drink can enter the nasal cavity. Splitting of the uvula occurs infrequently but is the most common form of mouth and nose area cleavage among newborns (roughly 2% of infants have this bifid or split uvula). Bifid uvula occurs in about 1% of Caucasians and 10% of Native Americans.

Statistics have been presented in the New England Journal of Medicine suggesting a correlation between bifid uvula and aortic aneurysm.

Oh how I love reading medical items online. Don't they ALWAYS include some lovely note.. OH and btw.. there MAY be a correlation b/t this seemingly non-concerning issue and a life-threatening aortic aneurysm. {eye roll} I did think it was pretty cool that the doctor quoted his statistics correctly. When he saw the uvula and told us about it, he pretty much quoted the last 2 lines of the main paragraph (with numbers). Maybe he wrote this wikipedia entry.

Btw.. a couple other small items that came out of this meeting: we set up an evaluation for Maya (early June) due to our slight worries about her gross motor skills and some behavioral issues (we talked about most of this during todays meeting and they thought it would be a good idea). We also found out that Devi's screaming tantrums (our reason for scheduling this evaluation really) were normal. They saw many great signs of good attachment with us.. and they do see her always turning to 'mommy' for reassurance and care.. so they suggested some things that dad can do to try to boost his place in her priorities. They also agreed that we should pick her up and care for her needs/concerns when she screams as she is basically at 15-month level. She is too young for any type of 'manipulation'.. too young and very developmentally lacking at cognitive skills. They felt that if we did any type of damage by 'picking her up too much' or 'being too attentive'.. it would be very much the lesser of two evils (much more damaging to do the opposite). They were more concerned by the effects of my having to give this attention while Maya is needing my attention also. They gave some ideas to help this and want to check on Maya in June to ensure we aren't scarring her. ;) Ok, they didn't SAY that.. but they did warn me to be very careful and mentioned that we will revisit this in June.