I glanced back and forth between June, sleeping deeply on the bed, and the clock. It was 9:45 a.m., our target leaving time for our 11:00 pediatrician appointment. We’d managed, though an extraordinary stroke of luck, to schedule Noah’s belated six-year appointment back to back with June’s fifteen-month one. The diaper bag was packed; Beth and Noah were ready. All I needed to do was wake June, change her and go. I hesitated a moment, watching her peaceful face and her chubby little arms and legs sprawled on the sheets. I hate waking sleeping babies. Then Noah’s screams pierced the air and I didn’t have to. June’s eyes popped open and she immediately sat up, looking confused. I wondered, briefly, what he’d done this time as I set to work changing June’s diaper. It turned out he’d scraped his leg jumping from the radiator.

Despite an unexpected street closure we got to the pediatrician’s office in plenty of time so we stopped at Starbucks to fortify ourselves for the potentially long visit with iced lemon pound cake (Noah’s favorite), a vanilla frappe (for Beth who had a sore throat) and an iced almond latte (for me). In a last-minute bid to fatten June up, we fed her bits of Noah’s cake and the whipped cream from Beth’s frappe. I saved my ice for her sore and swollen gums.

We were called in quickly and nurse came to weigh and measure the kids. I lay June on the scale and we watched the numbers flash by while it averaged the data from our unhappily writhing child. Finally it stopped at 17 pounds, 11 ounces. “Yes!” I yelped. I knew she would still be off the charts at that weight, but she’d gained a pound and a half in three months, more than she had in the previous three, at an age when most children’s growth is slowing. For her, it counts as a growth spurt.

Noah was weighed in another room while I got June back into her diaper. “Fifty two pounds,” Beth reported when they came back into the examining room. I nodded. We already had a rough idea of what both kids weighed because we’d just come back from a long weekend in Wheeling, visiting Beth’s parents and celebrating her father’s birthday. We don’t have a scale at home, but they do and Noah loves to weigh himself there. Whenever we’re there he does it several times a day, announcing with equal enthusiasm any losses or gains of weight over the course of the day. I’d also weighed June—just once—by stepping on the scale with and without her.

Noah has gained nine pounds in the past year, six in the past six months. He has seemed big to me recently, but I thought it was just from being with June all day and using her as my frame of reference. He has only grown two and a half inches taller in that time, but he doesn’t seem fatter, rather more muscular. His body feels harder and his hands in particular seem bigger and more sinewy. Andrea, Beth and I discussed whether this growth spurt could at least partially account for the clumsiness and lack of body awareness that seemed to worsen for Noah this spring. Of course it can’t account for all his troubles. Crashing into people and using too much force on crayons and glue bottles maybe. Pulling hair and stealing goat masks? Probably not. Like every other explanation we’ve tried on (Is it a six-year-old thing? A boy thing? A sensory processing deficit?) it makes some sense but doesn’t explain the totality of his difficulties, although it does answer the “Why now?” question that is always tugging at my mind.

The sensory issues are part of the picture, too. In late May we had Noah evaluated by an occupational therapist. We just received her report and she found mild dysfunction in his vestibular, tactile and proprioceptive sensory processing. In plain English, that means he has problems with balance and needs to move frequently to regulate this sense. He is sometimes over-responsive and sometime under-responsive to touch and he seeks the sensation of deep pressure on his muscles and joints (by jumping or bouncing) to regulate that sense. He also has some trouble knowing where his body is relation to objects and other people. A lot of these observations ring true to us, but they still don’t explain why he functioned well in day care and school settings prior to the middle of this school year and so much worse after that. Even if it was something about his kindergarten environment, I don’t understand why problems didn’t crop up at once.

After the nurse left and the nurse practitioner examined both kids and conducted the interview portion of the appointment, it was time for shots. Three vaccinations for June and a TB test for Noah. He was nervous about it and wanted to know if it would hurt. Beth said in her experience it stung a little but his experience might be different. The nurse came in and asked who was first. Noah, Beth said, since he wouldn’t scream as long. But when the nurse came at him with the needle, he cried “No!” and jerked his arm away. Beth put her arm around him and tried to talk him into it. The gruff nurse lost patience and headed over to June, who was in my lap. June did not cry at the first shot, but mildly regarded the thin trickle of blood running down her thigh. By the second one, however, she’d decided enough was enough and began to wail. The nurse worked quickly and soon all three shots were administered and Loony Tunes Band-Aids covered the pricks. June continued to sob. As the nurse turned back to Noah, Beth said she didn’t want to have to hold him down, but in the end, she did just that. His eyes, red with tears, wide and terrified, sought mine. I wanted to look away, but I held his gaze with what I hoped was a more sympathetic than stricken look until the nurse had finished.

“Have a nice day,” she said, as she left us, each holding a screaming child. Beth’s prediction was wrong. Noah screamed longer. I think he actually startled June into quieting down as he thrashed on the floor and gave Beth an angry push. She told him to use his words. He had none, but he stopped pushing. Eventually he was calm enough to leave the room and soon after he was happily chatting as if nothing had happened.

I don’t know why this scene took us by surprise. After all, we have an official document from a licensed professional telling us our son is sometimes over-responsive to touch, and of course, we didn’t need to read it to know it was true. He has always had unpredictable responses to injuries, sometimes shrugging off hard falls, other times going to pieces over a minor bump. But the truth is, for whatever reason, shots have never been much of a problem. There was a blood draw at his four-year appointment that ended in screams and struggles, but the nurse had repeatedly botched it and it came after several shots and getting a plantar’s wart frozen off his foot. His last shot, a flu shot in November, was without incident. One thought kept running through my mind: “He’s changed.” Something about Noah is different, some part of him that keeps him physically and emotionally under control has deteriorated recently and I don’t know why. I hope the therapist can help, but my worry for him almost spoiled my happiness at June’s weight gain.

The afternoon was busy. Beth took the kids out to lunch, grocery shopping and to get Noah’s hair cut. I asked her if she still wanted to do it on what seemed to be a tactile-sensitive day for Noah. She said yes, his hair was getting long enough to tangle and she didn’t want to struggle with him over brushing it. Plus she’d taken a personal day to go to the appointment and get caught up on weekend chores we didn’t do since we were out of town. She just wanted to get it done. They dropped me off at home so I could clean house and do laundry from our trip.

It was late afternoon before they returned. The haircut went fine, Beth reported and though the nurse practitioner had warned June might be feverish and cranky from her shots, she’d been cheerful and pleasant. Beth had become sicker over the course of the day, however, so she went to bed, where she stayed most of the rest of the day, emerging for short intervals to inflate the wading pool, eat dinner and get Noah ready for bed. I don’t know how much rest she got, though, since June—feeling the effects of the shots, or her sore gums, or the oppressive heat, or some unknown existential angst– began to fall apart quite loudly in the early evening, and Noah was, well, Noah.

There were some quiet moments, however. Noah, June and I played in the wading pool for a while, and then Noah watched television from 5:00 to 6:00. As he watched, there was an occasional hiatus in June’s hysterics. During one of these, she escaped from me as I was getting her out of her wet bathing suit and she climbed naked onto the couch. She sat next to Noah, who was sitting on towels in his damp trunks and swim top, sucking his thumb, already absorbed in Cyberchase. I came to fetch her and paused again, as I had that morning, hating to interrupt a moment of peace. They sat cuddled up against each other, sixty-nine and three-quarters pounds of damp, momentarily still children. They were in parallel positions and June’s hair, curly from the recent humidity, increased their resemblance. Finally, I scooped her up, diapered her and put her in her hand-me-down dolphin pajamas. I deposited her on the same spot on the couch, but the moment was broken. She stood, and a few minutes later, having forgotten her recently mastered couch dismount technique, fell off onto the rug. I picked her up and brought her to the kitchen where I started dinner, with her either on my hip, or when I tired, clinging to my legs and screaming.

At dinner, Noah crankily rejected his tofu because it had a slightly different texture the tofu we normally buy and went out on the porch to bounce on his Hop!55. (For those of you who were or had children in the 1970s, think Hippity Hop.) I let him go. We bought the hopping ball on the therapist’s recommendation and at the moment he seemed to be using it for its intended purpose, to help regulate his emotions when he gets out of sync. Beth was still resting, so June and I ate in relative quiet, until Beth came out of our room and Noah returned from the porch and politely asked for bread and butter. How about bread and peanut butter, I suggested, wanting to get some protein in him. He is, after all, a growing boy. Peanut butter and jelly, he countered. I agreed and made it for him and we ate, growing boy, growing girl and tired moms.