Dear Callum,

I’m thrilled to say that you’ve been a healthy, energetic little guy lately. Your dad and I have both noticed that you’ve been full of pep, dancing all around the house and skipping and running home from school. You often ask to go out and ride your bike or Tobin’s skateboard, and you’re doing well on both. I don’t think you’ve attempted any ollies yet, but maybe Tobin can coach you on those this summer.

We had a GI specialist appointment for you last week, and your doctor was mildly concerned about some elevated calprotectin numbers you had on a recent test. That’s a measure of intestinal inflammation. Normal for a typical person is a level under 50. Before you started treatment for Crohn’s, your level was 1600. It had gone done to 108, which your doctor said was acceptable for a Crohn’s patient. We had labs done before your last appointment, and the good news was that your nutrition levels are looking great. You had previously been deficient in vitamin D and iron, and those levels are back in the normal range after adding supplements. Your doctor also pointed out some other nutritional and inflammatory markers, and she said those were all good too. The bad news was that your calprotectin was at 450. She wasn’t sure what was causing that, though it’s possible you had some blood draining into your digestive system either from your mouth or your nose. You’ve had a cold lately, which could have led to a nosebleed down your throat, and you’ve also had some gum tenderness. She had us repeat the calprotectin test, and it came back at only 38. That’s excellent, a good level even for a person without IBD. That means that your elevated levels must have been caused by something else that is now resolved. It also means that your treatment protocol is working. We don’t have to add any new drugs or send you for another colonoscopy. You probably will be getting an MRI at some point in the next couple of months, but that’s expected for all Crohn’s patients, and your doctor said there’s no big rush.

Even though worrying is a hobby of mine, I found it hard to be too het up even before we got your follow-up test results. You just seem to be doing so well, it was hard to imagine you were having internal problems. Your energy has been great, you haven’t had any GI pain or diarrhea, and your appetite has been good. Also, as I mentioned to your doctor, even your fingernails seem to be growing faster lately. She said that’s an indicator of good general health and nutrition. You’re still not gaining weight like she wants you to, so we’re giving you as many snacks as you want along with your regular meals. You are a fan of treats as well as a good helper in making them.

We got our Christmas tree not long after Thanksgiving. We had a slightly unsatisfying experience, as we didn’t get as good a look at the tree as we would have liked before we committed to it. Once we got it home, it looked kind of scrawny and deformed. You love to name our Christmas trees, and you accepted my suggestion of the name Olive Oyl. I’m sure you have no idea about the cultural context for that name, but trust me, she emulates the boniness and lumpiness of our tree. Fortunately I was able to buy some artificial greenery to fill in the meager areas, and now it looks pretty good. We had a good time festooning it with all our old favorite decorations, including the ornaments you and your siblings made at the Corning Museum of Glass over the summer. You’ve been relishing opening a little door on your Advent calendar each day, and you’re getting into the holiday spirit well.

It’s been unseasonably warm (climate change is real), so we haven’t had much of the fresh early winter snow we usually see. That has meant more outdoor time for you, which is good not only for your biking and skateboarding interests, but also for inspecting bugs. You and a couple of your school friends like to gather bugs at recess, and I’m pretty sure you follow your teacher’s rule of not bringing them inside. If we happen upon a box elder bug on the way home from school, you always want to sit outside and let it crawl on you for a while.  You’re kind and gentle to living things, from insects to cats. We don’t have many stray cats around our neighborhood, thank goodness, so I guess you’ll have to be the local bug guy.

Your reading skills have really taken off lately. You’ve read some thick chapter books, including one by an author you got to meet in person through the school district’s Visiting Author program. You do love using technological devices, but it only takes a little prodding for you to put the iPad down and pick up your book. You’ve even chosen to have ten extra silent reading minutes at bedtime instead of having me read to you a few times lately. You still like your bedtime cuddles, so I just lie there next to you while you read. Then we continue the ritual with a multi-stage series of goodnights to you and your stuffed animals (I make you choose two, since I would really like you to get to bed before midnight), a couple of games of Wordscapes and Best Fiends on my phone, and going to sleep. You always ask me to tell you before I leave to go to my own bed. I’m glad to do it, thought often enough I fall asleep for a while in your bed that you’re also asleep by the time I leave. You don’t need me to stay with you until you fall asleep anymore, but it’s awfully cozy in there with you, and sometimes it just happens.

Your current favorites: playing board games, including Sorry and Trouble that you got as a gift at the doctor’s office the other day; cookies and cream ice cream; our “lemons into lemonade” trips to Trader Joe’s after you have to get blood work done at the nearby medical lab; playing online games with your school friends; your ELP class at school, particularly the fourth graders in the class; reading; dancing; and lifting weights. You flex your tiny biceps at me and ask if they’ve improved. I always tell you yes. Maybe I shouldn’t blow smoke up your butt, but you’re so darn cute.

I love you, my dear Callum. Have a wonderful last month of being eight.

Love,

Mom