Year four

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Year Four

In about two weeks Lokien will turn 4 years old, and Kajerik is a week under 7 months old. The last week has been mostly about Kajerik, but we need to go back a little before we can talk about that. Back when Kajerik was about 4 months old he was still very often cross-eyed. We brought this up with our local Doctor, who referred us to an expert at Keio University Hospital, in Sendagaya-ku Tokyo.

Ushka did this trip, which was a long morning with lots of dilating eye drops, waiting, more drops etc. Then various tests and eye photography. But the real expert only comes in on Tuesdays, so he had to go back the following week. I took this shift as Ushka had a cooking class at the time. No drops needed, mostly consultation and we were referred to the Kokuritsu Seiiku-iryo Hospital (National Research Institute for Child Health and Development) in Setagaya-ku. First we were to try some drops to see if it was a disease rather than a disorder.

The Kokuritsu Hospital is very nice, very new and caters very well to children. Has lots of play areas, very colourful and well lit. We saw the specialist there, female eye surgeon. After another bound of tests, mostly with prisms, we were informed that Kajerik had Infantile Esotropia and the normal procedure for this is corrective surgery. Luckily we are in Japan so it costs nothing.

As it is better to have the surgery sooner rather than later, it was scheduled for Aug 23rd, Wednesday. The procedure was to check-in on Tuesday before, have the surgery on Wednesday afternoon, stay all of Thursday and usually you can check-out on Friday morning. It is fine for parents to stay with the child, but they do try to discourage you. There is no accommodation for the adult. Although since we picked a private room, we could book a special chair that changed into a bed of sorts. If we had picked the public room (sleeps four kids) there would be no room, but to sleep in a chair. You can not bring in food, nor is there food for you in the room (there are both restaurants and shops of course, but your child can't leave the Ward after the operation).

Initially the plan was for Ushka to stay the 3 nights, and I shuttle Lokien to Daycare and work (to save holidays), but since Ushka's parents were here at the time, we modified it so that I stayed Wednesday afternoon/night and Thursday morning. That way Ushka did not have to do two nights in a row, and I generously offered to be there for the (presumably) hardest night.

So, Tuesday came. I took Lokien to Hoikuen/daycare as usual and went to work. Ushka and her parents left early for the Hospital, luckily it is on our train line (Odakyu, the Seijyo Gakkoen Mae stn). They went through the normal checks, and paperwork. They were a little worried about the /wobbly eye/ which can be a result of brain damage, or head trauma, so Kajerik also got a CT scan. Since that was clear, the surgery was still on.

In the end I think Ushka got the hardest time, namely Wednesday morning when Kajerik could only have a little formula, then had to go without food and drink until the surgery, scheduled at 15:00. Lots of work and stress there, in a way, quite lucky this was the second born, so we are already much less stressed in general. I took a half day that day, and showed up at 15:00 or so. [[1]]

The child before had a difficult surgery so it was quite late, but around 16:15 they came to the room to wheel him down to the OR. The OR is located on 4F, so we followed him down there, but were asked to wait in the waiting area. So here we got to experience the "parents waiting for news of their child's surgery" you see on TV so often. Naturally it was a little over-time too which did not help. We, and everyone else waiting, were all waiting for nurse or surgeon to come in, so anyone walking by resulted in everyone checking.

About 20 minutes later than expected the surgeon came out and explained everything went according to plan. About 6.5mm cut from the inside muscle (next to the nose). We were asked to wait while Kajerik was in the recovery room, and then he'd be wheeled out to us. This took quite a bit of waiting as well.

Eventually he was wheeled in, eyes covered [[2]] and sleeping. This part, and subsequent night, was quite uncertain to us, since he would have to sleep on his back (he's a front sleeper only), can't reach his face, eyes covered and could not drink immediately after surgery.

As it happens, he slept for the two hours that he could not drink anything. After that I could feed him sugar-water. As he kept that down, he could go off the IV. He didn't like the IV attachment, but the IV was not annoying him as much as the foot connection was. (pulse and oxygen percentage monitoring). An hour after than he could have formula which went down just fine.

He did not have to be tied down as he gave up trying to reach his eyes after I was blocking him for about 10 minutes. I slept off and on, the bed was a tight fit. Very narrow, you can have one arm by your side, not both. Kajerik woke up around 6 and had more formula, and slept a little more.

The surgeon popped in at around 8 in the morning, and she removed the bandages. [[3]] and after a little coaxing he opened his eyes. [[4]] A little red in the middle, but otherwise looking great. Thursday went well, and he could come home on Friday.


So, bigger picture... having a second child is quite different, much more relaxing and we leave Kajerik to himself a lot more than we would ever with Lokien. I would say this is better, as I suspect Lokien always being given the toy he was after, and so on, may have slowed down the need to learn to crawl. Kajerik is already getting close to crawling, about a month earlier. In a way it is a shame we can not have Lokien now, since you enjoy your children growing up more when relaxed. Lokien is doing well, speaks quite a bit more, 3-4 word sentences, and the same in Japanese. Already we had a situation where Lokien picked up something and said a word I did not know, which of course turned out the be the Japanese word. So already he has learned words I do not know myself.

But he does still have ways to go. Certainly when he is tired or hungry he reverts back quite badly, which is probably quite the norm for children his age. But he often seems to have little clue as to what is going on around him, for example when playing with a group of children. Sometimes the other children might be teasing him or deliberately trying to push him, to which Lokien seems blissfully unaware, and just think they want to run/chase, which he loves. Perhaps that is a protecting bonus for him. But it does mean we have yet to really move into higher playing. We can do "tag" now at least, but still miss other structured play, like, memory or such. Leaves going to the toilet to the absolute last split second, but does well with toilets during the day. Night time he unfortunately decided he did not want nappies anymore, so we frequently have night time accidents.

One noticeable difference between the two kids is food. Lokien still eats very little, and is very picky about what he eats. Kajerik recently started on solids, and after 2 weeks, absolutely loves it. Nearly stopped the bottles on his own accord, and will eat/try to eat everything. We got quite relaxed about "not having anything swallowable on the floor" since we knew Lokien would never ever try to eat it, and never did. But now, Kajerik will lunge for everything! Changes have to be implemented!

Both of them together is ok, Lokien mostly just ignores Kajerik but not in a bad way. Sometimes share, and sometimes worried about Kajerik touching his toys. (.. which luckily Kajerik mostly ignores).