Wednesday, September 30, 2009

Bloodwork at 2nd Year Pediatrician Appointment

Matthew is turning 2 next week. We're looking forward to celebrating his birthday. However, I'm not looking forward to his pediatrician appointment next week. I'm not worried about the scheduled vaccines. I'm fretting over the bloodwork needed to check on a few things. Does every kid go through this at the 2nd year appointment?

Just the thought of holding him down and keeping him still breaks my heart. Memories of previous bloodwork are etched in my mind and his screams break my heart over and over. They will need to stick his arm. Hopefully it will only take one try this time. When he was a baby, there was one visit that made me so mad. The nurse ended up sticking him 4 or 5 times and ended up drawing blood from his heel. After that I made sure we never got that particular nurse again. But it doesn't help that Matthew's veins are hard to find.

Matthew has had blood drawn when he was born, when he was 1 month old, 2 months old, 6 months old, 9 months old, and 12 months old. Various things were checked at these past laboratory visits including:
- Bilirubin levels
- CBC w/ differential
- Comprehensive Metabolic Panel
- Comprehensive Metabolic Panel
- Full Thyroid Panel
- Lead

I've been looking up the possible things to check at 2nd year visit through bloodwork. The long list below drains the color from my face. I'm hoping it's not as much as it seems. I realize that some things on the list may be necessary if Matthew were on a vitamin therapy such as Nutrivene. He isn't on Nutrivene right now so maybe there are a few things we don't need to include for bloodwork.
- Full thyroid panel - TSH, T3, T4, free T3, free T4
- Celiac panel
- Leukemia
- zinc
- selenium
- ferritin
- iron
- Vitamin A
- Homocysteine
- Magnesium
- Copper
- B12
- Vitamin D
- Amino Acid profile
- Glucose
- urea nitrogen
- creatinine
- calcium
- sodium
- potassium
- chloride
- total CO2

I'm wondering - is this too much? What are absolute must-checks? What can we do without?

Maybe the less we have to check, the less heartache I will have over this bloodwork. In the back of my mind though, I know that any bloodwork at all will be agonizing for me, wishing the nurse can stick me instead of Matthew.


Unknown said...

It seems like a lot, but it really is not. He will likely have 2 viles of blood possibly a 3rd one. These tests are fairly routine. The poke is always worse than the actual tests. Plus, its good to know that he's being followed so closely. Our kids with Ds can have so many issues arise.
I really hope you get a good nurse. That makes all the difference.
He'll be fine. So will you. :o)

Beverly said...

I hate taking Noah for blood work too. He is hard to get and it just gets so ugly and awful!

Angie Willey said...

Best of luck for the blood draw. As long as they can get enough blood, test it for all you can. The draw is the worst part.

Jennie said...

Can you ask that the blood be drawn at the hospital lab, perhaps? I like a particular phlebotomist at Children's (who does a great job with Micah's itty bitty veins), and if I know he's going to have a visit there close to a checkup, I'll ask the pediatrician to send the orders for bloodwork to the hospital lab instead of having it done at the pediatrician's office.

Violette's Mom said...

Violette turned two the end of June, and I haven't made myself take her yet...I will...I just keep putting it off...this post is a good kick in the rear for me...once we kick this H1N1!!!

Julie said...

We have to go for 3 yr check-up. Where did you get the list of tests?

The Cooking Ninja said...

Just wondering if distracting him with toys or reading him his favourite book would do the trick. Hope u get a good nurse who is kid friendly - that helps a lot.

Lance Boldt said...

I remember it taking 4 of us to hold Josh down for blood work as he got older.

Do check for everything. We've uncovered a serious thyroid condition, diabetes and even leukemia over the years. Better to be safe.

Life with a child who has Down syndrome is the best.

6 months after Josh was born with Down syndrome, I attended my first parent group. I was touched by the struggle people were having with “why?” I went to bed with a heavy heart and awoke with this story. I hope you enjoy it.

Debbie said...

Oh....oh.....oh......I just read the other post.....YAY!!!! CONGRATULATIONS!!!! I'm sooooo excited for you guys!!!!!

Happy BABY!!!!!!

Beth said...

The last time Hannah had hers done she had 8 vials...and she's a big girl! Some of the tests need to be in different kinds of vials. You can ask for Emla cream which numbs the skin. We've never used it, but know lots who do.

No, not every kid has labs done. Every kid with Ds should have most of these, but usually just end up with basic thyroid and a CBC. :{

I highly recommend that you get the script for the labs and then call the hospital and ask about blood draws. Tell them Matthew has special needs and is hard to stick (make sure he's well hydrated--it's much easier to stick when hydrated). Ask when a NICU or PICU phlebotomist will be available. Make sure they use a butterfly needle (probably they would anyhow) that way the needle won't wiggle when they change vials.

I'm sure the doctor will delete things from your list.

Things you don't really need, IMO, are:
Leukemia (they check that with the CBC)
urea nitrogen
Vit A
total CO2

Give him a chance to recover from his vaccines (spread them out too, if there are several). Or, get the labs first, then the vaccines.

Austyn said...

Along with keeping him hydrated, if you can put a warm pack (pad, towel, compress) on his arm --that is, if it doesn't bother him too much --will help make Matthew's veins easier to stick also. This may not be at all convenient for you during an office visit, but I thought it might be worth suggesting ;o)

I'm sorry that he has to have the bloodwork. That's no fun for either of you, but it's likely that all of those tests will be run from 2 or 3 vials, and just one stick.

Michelle said...

Yikes that is quite a list! Did you find a recommendation somewhere to check all those levels? I'm feeling like a bad mom cause Kayla has never had a full blood panel like that before. The only thing I regularly had checked was the celiac screening and thyroid. I didn't realize about all this other stuff! She has an appt next month with Dr Capone at Kennedy Kreiger - it's the only Down syndrome clinic she's ever had an appt with so I'm planning on asking about all the bloodwork!

Beth said...

What did you end up doing with the blood labs? I'm just curious! (Or nosy, as the case may be!)