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Weight 6.6 kg (14.5lbs)
Length 25 ¼ “
Next Appt: June 2nd 9:40am
Dr. Gottleib felt there was no need for the ambulatory EEG, b/c there isn’t a question of whether or not the spells are happening. Based on Jamie’s description of the episodes, along with the original EEG data, he felt increasing Siena’s medication is the best course of action, since she is still having seizures. She is currently on the lowest dosage possible. For the next 2 weeks, he would like the morning dosage the same, but the evening dose needs to be 1 full ml. Jamie needs to call the office in 2 weeks to let him know if they’re better. If not, then he will increase the morning dose to 1 full ml. CALL THEM MAY 16TH
ENT appt at duPont needs to be set up ASAP (CALL THEM TODAY). When you talk to the ENT, ask them to coordinate a visit with an Endocrinologist while you’re there, so you can discuss GH and the overall plan with the adenoid removal and GH administration. This is assuming that the adenoid removal would take care of the sleep apnea, and that the Endocrinologist would agree that Siena is a candidate for GH.
After the discussion about using specialists at duPont, we asked if he thought Siena should have a pediatrician there who can coordinate the various treatments. Dr. Gottleib was in favor of that (though he was careful to say she could also stay with Telford-Wren if that is what you decide). Here is a list of the developmental pediatricians at duPont: http://www.nemours.org/patientfamily/findadoctor.html?fn=&ln=&loc=delaware&spc=developmental-pediatrics Here is a link that better explains Developmental Pediatrics http://www.nemours.org/service/medical/developmental.html
Overall it seems like it will be necessary to have a primary care physician at duPont, but Andy and Jamie can discuss that with them when they’re there.
Final points – Overall Dr. Gottleib was encouraged by how far Siena has come. While he did say her tone is still low, he said she’s ‘come a very long way’ and was happy with her improvements in head control and her improved core strength.
THANK YOU FOR THE AWESOME NOTE TAKING TRISHA!! : )
Siena Eve 
>Excellent explanation. I think the Developmental pediatrician would be a great idea.
>I am so happy to hear that the doctor was encouraged by Siena's progress. Nice note-taking Trisha.