The doctors, again.

Here's Rudy, undergoing her latest eye exam.  The last time the pediatric ophthalmologist saw her, in the fall, he noticed that even when her glasses were on and her eyesight was therefore corrected with prescriptive lenses, her eyes were still turning inward.  He suggested that this slight wonk (my word, not his) could be an indication that poor eyesight was not the only thing causing her esotropia.  He thought that she might need surgery on her teeny-tiny eye muscles in the future, and wanted to see her again sooner rather than later.  So we made the trip in last week, and thankfully, when he played around with additional lenses and inadvertently made my three-year-old resemble an Evil Genius reclining in the chair from which she controls her minions, what he saw made him retract the surgery recommendation.  For now.  It may just be that she needs a stronger prescription, and when she's dilated in the spring for her next exam, we'll be more certain.

In the meantime, I also made three trips to UMASS in the past couple of weeks, first to get updated ultrasounds of Marley's and Rudy's kidneys as well as new blood and urine samples, and then to see the pediatric nephrologist so that we could go over the findings of all that testing at our annual appointment.  And it turns out that now Rudy is officially a patient of this nephrologist instead of just her big sister's sidekick who maybe needed a look or two in the future.  Both of my daughters have nephrocalcinosis, basically, calcium deposits in their cute little kidneys as a result of the supplemental phosphorus and vitamin D (in the form of calcitriol) that they take every day in order to strengthen their bones.  They need the supplements because they have x-linked hypophosphetemia, or hypophosphetemic rickets, and their bodies need to be continually flooded with phosphorus since they naturally don't hold on to it long enough for proper absorption.  It's been a while since I've explained that in writing, and it's good for me to practice, because every so often I have to explain this obscure condition to someone who hears "rickets" and wonders why I don't give my kids enough milk.

My third trip to the University Campus of UMASS Memorial, by the way, I was by myself, headed to my third meeting as a member of the Children's Medical Center Family Advisory Council.  Our pediatric endocrinologist asked whether I'd like to get involved because we see three specialists at UMASS, and spend a lot of additional time there getting labs, ultrasounds, and x-rays.  This last meeting started with a tour of the hospital's inpatient floor, including the soon-to-be-remodelled palliative rooms for children with terminal illnesses.  And standing in those rooms, and later sitting at a conference table with mothers who are on this committee because their children have cystic fibrosis or are in remission from cancer or are no longer living, as you might imagine, puts everything in extremely clear-sighted perspective.