Wednesday, September 20, 2017

If You Give a Doctor an Appointment . . .

So the end of August I took Anna and Grace in for physicals because they needed forms signed so they could run cross country.  I'm pretty good about getting babies in for well-baby checkups, but once the kids turn 3, I'm a lot less consistent if they are healthy.  (Okay, we pretty much never go in for physicals anymore because who has time for that, and I've always been running smaller kids in for well-baby appointments.  You would think that would make it easier, but it is next to impossible to keep all my kids on the same "team" of pediatricians, so the upshot of it all is that the olders never get well child appointments.)  BUT we needed paperwork, so off we went.

Bethesda is a teaching hospital, so what that means is you always are seen by a resident, then the supervising doctor, and that is what happened that day.  Both ladies were super nice, and definitely super . . . thorough.  They both spent approximately forever listening to both girls' hearts--sitting up, lying down, over and over again.  Lots of murmuring and "Did you hear that? . . . How about now?"  Eventually the older doc said that they heard a murmur in both girls, which was perfectly normal, except that Grace's had a different sound to it.  Not "like a guitar string, and also not harsh, but different."  Okay . . . They asked Grace a bunch of questions about whether she has ever felt dizzy or faint while exercising, or ever felt her heart race or anything.  (No)  But they decided we needed to see cardiology for a consult.

So this morning was our consult with the pediatric cardiologist.  Before we were even seen, Grace had an EKG done.  Then the resident came in to say that looked just fine, and he took a listen to her heart.  He listened for awhile but didn't even hear a murmur, much less one that sounded weird.  Next the supervising doctor came in, and he also listened for awhile, but couldn't hear anything wrong at all.  He was actually a little irritated that they sent her over, although he did end that sentence with the obligatory "better safe than sorry," lol.  He said that every child probably has a murmur at some appointment--a murmur is just blood flow they can hear--and that they aren't anything to worry about.  If there are actual real structural problems with the heart, then those murmurs won't be here one day, gone the next, so a problem most likely wouldn't just all of a sudden show up at a routine physical at age 10 with no symptoms of a problem.  So Grace got a clean bill of health, and her heart is cleared to keep on being as physically active as it has been, which is good because she has another cross country meet coming up on Saturday!

The second issue the original doctors found with Grace is that she is really skinny.  This is not actually a new problem for her.  Although she was 8 lbs. 13 ounces at birth, she quickly fell off that, and has spent the rest of her life hugging the 5th percentile growth line for weight. Once when she was 18 months, she got really sick with a stomach bug over Christmas, and she dropped back below 20 pounds.  At that point everyone was concerned (even me!), and we had to give her cream on her cereal, lots of butter on bread, ice cream every night, etc.  This was while I was in my third trimester of pregnancy with Faith, battling gestational diabetes, so that was a challenging period for me, lol.

Anyway, she has always been skinny.  The problem here was that she did have a doctor appointment back in May, when she had strep throat, and since that time she had grown taller but lost some weight, so she was on the day of the physical 55 inches tall but only 59 pounds.  That puts her BMI at the 0th percentile.  So now we are supposed to go back for a weight check in November so they can make sure she is not losing anymore weight.  

Grace has put herself on a strict regimen of milkshakes almost every afternoon, and I am pleased to say that it is working!  When she was measured today, she was almost 56 inches--and 66 pounds!  She's really packing it on!  That puts her in the 11th percentile for BMI, and actually it makes me wonder if the scale over at the pediatric clinic was really accurate that day?  Weird.  No one looks at Grace and thinks she is wasting away, an unhealthy "skinny".  She looks strong and fit--just skinny!  Anyhow, I don't think I'll be bringing her back in for the weight check.  It's not like we can just pop over there for 15 minutes.  A 15 minute appointment takes me the entire morning, driving there and back plus navigating the parking garage.  And beside, we have to make other trips for Anna . . . 

Which brings me to Anna's issue.  She got out of the physical appointment unscathed and pronounced healthy.  But now there is a routine lipid scan for 10-12 year olds, so both girls had to have blood draws.  I got a call from the doctor a few days later saying that Anna's LDL had been very slightly elevated, so she needed to go back in for a fasting blood draw.  We did that before our weekend at WSS, but again, I got a phone call the next week.  Her levels are *just slightly* elevated, right at the top end of normal.  SO we need to go back in 2 more months for another fasting blood draw so they can keep an eye on these levels.

Well.  I quickly researched high LDL levels in kids, and all the articles talked about were obese kids.  Parents were supposed to encourage weight loss, healthy food choices, and more exercise.    Anna is 58 inches and 80 pounds, giving her a BMI of 17, which is completely healthy.  She is super fit, strong, and active.  She swims, runs, plays basketball, and was competing in gymnastics until this past spring.  She runs a 20 minute 4K, and at this point in her life, I don't actually think it would be healthy for her to exercise more, and she certainly doesn't need to lose weight!  She eats very healthily, and rarely eats any fried, fatty food.  We don't eat tons of red meat because it's expensive to feed all these kids steak and roast all the time, and I cook pretty much all the time, with very little processed food.  She doesn't even eat cereal most mornings, which is our most processed meal--she usually makes herself a fruit smoothie!  

I did ask around, and people suggested more oats, chia seeds, and fish oil.  So now we are making big batches of steel cut oats in the instant pot with chia seeds, and she is eating a bowl of that every morning.  I also got some chewable omega 3 pills from Costco, and she's eating 2 of those a day.  We'll see if any of this makes a difference.  I have had 2 other friends tell me that their very active and healthy teen sons also have slightly elevated cholesterol levels, per this blood test, and it makes me wonder.  How did doctors get these healthy-range numbers for growing tween/teen kids?  They are wanting to help obese kids, but it seems like maybe they are pulling in healthy kids with their wide net.  I don't think Anna is at risk for heart problems right now, and neither of our families have histories of kids/young adults with high cholesterol.  Once people get older (40's, and less fit), yes, but that seems pretty normal. I wonder if once she is through puberty and in her 20's, if she will still have any cholesterol issues (well, probably not because of all the oatmeal, lol!).  Maybe this is something that works itself out in healthy, non-obese kids, especially since she's not in a range that would indicate a need for medicine or anything.  Regardless, we'll be back at Bethesda for another fasting blood draw the end of October.  

And so now you see why I don't make annual well child appointments a priority for healthy kids of mine!  If you don't report a problem, they'll find some!   

Tuesday, September 19, 2017

Elementary Chemistry

Today and last Tuesday I taught chemistry to the 3rd and 4th graders ar our elementary co-op.  It was fun, although tiring.  I was having a hard time keeping all the different classes I'm teaching right now separate, since they are all sort of related to chemistry!  I'm glad this teaching is now over, and I can just focus on the other three, lol.

 Last Tuesday we talked about the periodic table.  When I was hanging up my periodic table posters (yes, plural) before we got started, one of the boys in the 3rd grade who was just walking in said, "I don't really understand what the periodic table is, or what it's good for." How about that for an introduction?  I told him I hoped he wouldn't be able to say that anymore after we finished!

I told them about Mendelev, who is credited with discovering it (although if you read other books like The Disappearing Spoon, which I highly recommend and have all my regular chemistry kids read, you'll find out that it is a complicated and very interesting story involving several other people as well . . .).  But Mendelev is a character, and he looks like the kind of person who you would find doing crazy experiments in a chemistry lab, lol.  Even though others had the general idea of how most of the elements were arranged, and what the patterns were, he gets the credit for discovering the table mainly because he was brilliant enough to leave holes where he predicted other elements would be discovered (and they were).

We spent a long time on what an element is, and more importantly, what an atom is and how it is structured.  We made these atom mobiles of a carbon atom (with 6 protons, 6 neutrons, and 6 electrons).  Although we talked a lot about the atomic number, I didn't go into atomic mass too much, which is a change from when I taught this 7 years ago to the 5th and 6th graders.  We also talked about the elements that have seemingly crazy chemical symbols that don't relate to what we call the elements (eg. Pb is lead, etc.).  They thought those were pretty interesting--well, maybe that was just me, lol.  Thank you, Latin!  And lastly we talked about each column of the periodic table, and how those elements all have similar properties.  I love the periodic table!  I even wore my "I wear this shirt periodically" t-shirt with the periodic table on it.

Here's a closer picture of Faith's paper plate carbon atom, complete with 2 outer shells for electrons.  I used pompoms for the atomic particles, which I bought from amazon.
For this Tuesday, we went a more experimental direction.  We talked about how to tell the difference between a chemical and physical change.  I gave them 4 main "clues" that a chemical reaction occurred:  it produces gas, it emits heat, light, or a new odor,  a new solid is formed, and it changes color (but this is tricky, because color change does not definitely mean a chemical reaction!).  Then we did some experiments to demonstrate those clues.

First was the classic "vinegar in a bottle, baking soda in a balloon" one.  When you put the balloon over the bottle mouth and shake the baking soda down, it reacts, forming sodium acetate, water, and carbon dioxide, which foams up, filling the balloon.  Most people had done this before, but hadn't thought of what was actually happening in the reaction or what the gas was.
 Secondly, we did a reaction with hydrogen peroxide and yeast in a beaker with a thermometer in it.  I had made up observation sheets so they could write down something about each experiment, and for this one, they had to mark the starting and ending temperatures.  It rose almost 30 degrees (F, although I made sure to tell them the C temperature too all the time), and it also foamed and bubbled, so they knew gas (oxygen in this case) was also being produced.  We talked about other exothermic reactions, like the ones used in those handwarmers, as well as endothermic ones, like the ones in those instant ice first aid ice packs.

Thirdly, we made slime, which was a big hit.  This was glue dissolved in water, with borax dissolved in water added to it.  This was definitely the big favorite as far as experiments go, because who doesn't like slime??  The 4th graders added green food coloring, which is why the slime below is tinted.  It was a good demonstration of a solid coming from 2 liquids.
 And lastly, I had 3 test tubes with water in them and a drop of green food coloring.  In the first one, I put a dropperful of vinegar, in the second a dropperful of hydrogen peroxide, and in the third (which is the first in this picture, because it's turned around, lol), I put bleach.  The bleach immediately turned the green blue, which impressed them, but it kept getting lighter until it was a very pale yellowish green.  We talked about the bleach you might put on white baseball pants actually having a chemical reaction with the green from the grass stains.
 Here was my table with a lot of my stuff on it.

After all the experiments, I gave them a handout with a ton of different chemistry lab equipment pictured, and then I showed them most of the pieces, thanks to my incredibly well-equipped science armoire here at home.  They liked seeing an erlenmeyer flask, volumetric flask, graduated cylinders, beakers, a ring stand with ring as well as the holder for burettes and thermometers, wire gauze, ceramic triangle, evaporating dish, crucible, various tongs, wire loop, 24 well reaction plate, and other stuff.  They were all pretty interested, and one girl said wistfully that she really wished she could come visit my lab, lol.  Maybe I'll inspire some future chemists!  After that, they all played with slime while I cleaned up.  It was fun, but I'm glad it's over!  

Sunday, September 10, 2017

Starting Up


A week ago, we had just gotten home from a wonderful retreat at WSS with my parents' chapel and Bible study group.  I had lots of time to visit with friends, which was so lovely.
 Bob and Anna got to try out the new high ropes course.  Bob was not a huge fan, although he completed it.  He did it with Anna, since she was younger than 13.  We may have to find someone else to go with Anna (and Grace too, since she'll be 11), as he wasn't sure he would do it again, and I am positive I'll never set foot up there!
 It was great to see my parents, of course, and the speaker, an active duty chaplain who used to be stationed there, was really good.

We left after the picnic Sunday evening and the bonfire.  Caleb drove us home so he could get in some night time driving hours, and he did a great job.  Usually we leave Monday after lunch, but we weren't all the way prepared for the start of Rivendell/TNT, and the house was a disaster area.  It was nice to have Monday to clean and finish preparing.

Tuesday was the TNT kick-off--Drew's first day!  This has been eagerly awaited for, well, as long as he has been conscious that Micah was going somewhere he wasn't, lol.  And it's definitely been awaited for since probably July, when he got his backpack out and filled up his pencil box.  He asked almost every night, "Is tomorrow TNT day?"  He is so happy to be going!  I totally should have taken a picture of everyone, but alas, taking first day pictures never became a tradition for me, and I'm not about to start now.  Maybe I'll think to take one this Tuesday--"second day of co-op"!

Usually I'll be doing chemistry lab Tuesday mornings, but the first day we had a moms' meeting, and then a picnic.  Since it was Drew's first day, it was nice that I could be there all morning, and I just worked the schedule so that we only had chem on Thursday afternoon, which is when we normally will have our chem class.

The 2 boys had some online classes on Wednesday, but Thursday was another busy day.  Last year Anna had German on Thursday morning, and I had signed her up again.  There was a conflict in that she and Jonathan both had to be different places at 9:00 (Jonathan at his math class), but I was able to work out a carpool to get Jonathan there. My morning was still going to involve a lot of running around, though, with dropping him off at 8:30, then Anna off at 9:00, then running home to try to accomplish something, then leaving at 9:45 to pick her up, coming home for another brief bit before runnign out to pick up Jonathan and his classmate, leaving at 11:45, and then coming home to teach chemistry from 1:30-3:00 followed by physical science from 3:00-4:30.  I was not looking forward to Thursdays at all.

But then we realized that Anna could take German with another friend who was going to be doing German with Joel Tuesday afternoons AT MY HOUSE!  Yay!  So that took care of some of the running around, and I have a bigger chunk of time to work with the girls on math and grammar especially Thursday morning!

Friday is AP chemistry lab in the morning.  The 2 kids who are taking this class are super self-motivated, exceptional kids, so they can pretty much run their own labs with just minimal input from me.  We're taking some time Friday mornings to go over questions they might have, but honestly, they know as much as I do.  My chemistry knowledge level is not longer AP level, so we are all working through this class together--I'm doing the chapter questions and everything too!  The upside is that will make teaching the regular chemistry class a total breeze.  I assigned the first 3 chapters of the AP book (Zumdahl, 9th Ed) for summer work--that covers the first 9 chapters of the high school book, lol (which is BJU, so pretty rigorous for high school!).  Side note:  I also assigned Alchemy of Air by Thomas Hager as summer reading, and I can absolutely recommend that book because it was so fascinating.  It detailed the development of the Haber Bosch apparatus that fixes the nitrogen in air into ammonia, which can then be turned into fertilizer--and also bad things, like poison gas.  I just tonight finished reading another book by the same man called Demon Under the Microscope, about the long road to developing sulfa drugs, the first antibiotics.  It too was absolutely fascinating!  I've decided I really like this author!

Saturday was the first cross country meet of the season for Anna and Grace, the only 2 kids of ours who are running this year.  It was down in Richmond, so the girls had a cheering section of Aunt Ann, Bob's sister!  Caleb went down with them and Bob so he could get in even more hours of driving (would that he were so diligent about the online portion, lol).  The girls ran in the middle school race, which was a 4k.  They did fine, although both of them felt like they did terribly.  But Anna ran a 20.30.5 4k, and Grace a 22:48, which is good for a 6th grader and a 5th grader in the first meet of the season!  There were only a handful of other 6th graders there, and no other 5th graders.  It was a beautiful day, weather-wise, for a cross-country meet!
Incidentally, the girls are running for the same team, different name.  The school they ran for last year folded, so the coach started her own private online homeschool academy so they could continue racing in meets against other schools and get into more competitive meets like this one.  She is a great coach, definitely going above and beyond for the team!

Now we're looking at the start of another week.  For the next 2 Tuesdays I'll be teaching chemistry at TNT.  (I am definitely all in for chemistry this year!)  I don't know that we'll totally get into a good weekly routine until that is over.  Tomorrow a few other classes start up that didn't happen last week with the Monday holiday.  Grace and Faith are taking a German class with Anna's teacher from last year, followed by an art class also with her.  Hopefully those will be fun!  The boys have some online classes tomorrow too.  This year is definitely the most complicated year yet, as far as schedules, outside classes, etc.  I'm trying to not stress about it.  One day at a time, right??  I'll be glad when the year is over and it's time for camping again, though!