Every little bit counts...

Ava on the way into the hospital. It was still very early-6am-so she was in her jammies, snuggling her blanky and pillow, and watching Dora. Notice the lovely bib I had on her in case she got sick in the car-which she did not!

We made a trip into Boston Children's Hospital yesterday to see Ava's endocrinologist, Dr. Wolfsdorph. I was extremely anxious to see what her weight would be. I am happy to report that she gained 5 ounces in the last three weeks, making her 19lbs 9oz. To some, or many, 5 ounces does not sound like much, but for Ava this is a lot. I am not sure if it the rate at which she is gaining will be enough to keep her from having to get an NG tube, but I am encouraged at least that she is finally gaining something.
Her length is 32 1/2 inches, which was an improvement of an inch since we last saw him in July. He said that her height velocity (the speed with which she is getting taller) is within normal range so he is happy about that. Although, since her height overall is still so low for her age, we would like to see the velocity be even better so she can do some catch up. At this time, he does not recommend using growth hormone therapy, but said that we are going to keep a close eye on her growth, in case at some point we think it is something she should have.
The biggest problem with Ava's size is her weight for height. While we are wrapped up in the numbers, the reason is that we want Ava to be healthy. If her body is not getting what it needs to grow, it is probably not getting what it needs to develop and function properly. This is what scares me the most. The idea that Ava's body could be starving for what it needs and that we may not be doing everything that we can to ensure that it is. I basically told Dr.Wolfsdorph that this is my concern, and he said that for right now we need to concentrate on her caloric intake and that we are doing what we should be.
Overall, I would say that our trip and appointment went well. She gained some weight-woohoo! She also did not throw up in the car, which is a big deal since lately she has been vomiting whenever we are in the car for a period of time. I enjoyed spending the one on one time with her even if it was to go to the doctor. It is so funny being with Ava apart from her brothers and seeing how different her behavior and personality is. She was such a big girl holding my hand and walking into the hospital through the big revolving doors, marching up the big staircase and leading the way to Fegan 4 (this is the section of the hospital where her endocrinologist is). It is sad that my 2 1/2 year old knows her way around the hospital so well but at the same time it makes me proud to see her acting like such a big girl.

Ava on the way home. Sleepy but in good spirits.

Information on Dr.Wolfsdorph