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Lyz
May 22, 2007

I AM A GIRL ON WOW GIVE ME ITAMS

Rupert Buttermilk posted:

That's what I keep thinking. A majorly scary thing is that the bulge/bump on his head could mean that his skull isn't going to form properly, which means, absolutely worst case scenario, his brain can't grow and develop because it won't have enough room. However, in looking that up, I see that most doctors recommend treating that (with surgery) between 6-12 months of age, so we're not late in that regard.

Thank you for your words. Reading that, and typing it all out in the first place has made me feel a bit better, but I'll breathe a huge sigh of relief if/when we find out that this is hopefully not serious.

My daughter was born with craniosynostosis (prematurely fused skull plates) and she had surgery to seperate them at two and a half months old. She wore a helmet until she was a year old and now you can't even tell that anything was ever abnormal with her head. It is scary as poo poo but totally worth it in the end. Just take it one doctor's appointment at a time.

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Papercut
Aug 24, 2005

Rupert Buttermilk posted:

I've never posted in this thread, but I need to just... I don't know, not 'vent', but type this out. I apologize if it's all over the place, I'm just kind of writing as it comes to me.

I'm worried about my son. I try and be positive and strong for my wife, since she's stressed as hell, but it's tough, and sometimes it comes off as I don't care. In short, he hasn't been eating well (100% breastfed). He had a lip tie, and ever since that was fixed, he won't take bottles whatsoever, and when he does feed, it's for a few minutes, and he's barely gaining weight. He's also got a bit of a bulge on the right side of his head, and he trembles every so often. Today, she brought him to one of our local hospitals that specializes in breastfeeding, and right away, within two minutes, the doctors there noticed not just his head, but also his tremble. They're sending off his records to the children's hospital in the city, and my wife's calling them to make an appointment tomorrow, because the doctors think he may have a central nerve system disorder.

Right before he was born, my wife and I went in to the hospital for a non-stress test, to check his heartrate, and every single time she had a contraction, his heart rate would drop off the charts. Because of this, they kept us in the hospital and carried out an emergency c-section. We were actually just 4 days away from our planned induction date (which was actually the LAST date they were going to allow him to stay in the womb, he was late), so it was good timing. When he was born, his lip would tremble like he was cold, and we were told that, because his nerve system wasn't fully developed yet, that was common.

However, 3+ months later, it's still happening, and the doctors at the hospital that we went to today were pissed that this wasn't noticed by anyone else earlier. Looking it up, it seems that this may have been caused by trauma during or right before birth, like from her contractions.

I've been reading some things about all of this, and some of it is REALLY scary, like him possibly growing up with a mental disorder, him having trouble with language, stuff like that. My wife is part of a pregancy group on FB of around 20 women who all gave birth in July, and all of their children are meeting milestones, but our son isn't. The doctor told us that, while me may not be grabbing for his toys while on his play mat, he IS grabbing for his hands and holding them, which counts for the same thing. I guess that's a positive, but another thing they said was that he's doing that to stop his hand from shaking so much, which is what happens. If he's shaking a bit, and puts his hands together (or focuses on something), he's absolutely still.

I don't know what else I can say about all of this, she went in today for help with breastfeeding and to see why he seems to barely want to eat, and now we're looking into him maybe having a serious problem, and I just feel so helpless, and it's killing me, because I just want my little son to be ok, and be like the rest of the children and to have a happy life, and I'm worried that he won't get any of that, and holy gently caress, I can't help but cry.

I listened to an interview recently with an author whose son is severely autistic (it may have been David Mitchell but I can't find the interview). He made a point that I found incredibly insightful and touching. When the interviewer asked him if given the opportunity, would he fix or take away his son's disability, his response was essentially, "no, because then he wouldn't be my son, he wouldn't be the same person." No matter what kind of child you have, they're still going to enlighten you, surprise you, and challenge you. They may not do it in the same ways you had envisioned, but the most important parts of the experience will still be there.

skeetied
Mar 10, 2011

Rupert Buttermilk posted:

That's what I keep thinking. A majorly scary thing is that the bulge/bump on his head could mean that his skull isn't going to form properly, which means, absolutely worst case scenario, his brain can't grow and develop because it won't have enough room. However, in looking that up, I see that most doctors recommend treating that (with surgery) between 6-12 months of age, so we're not late in that regard.

Thank you for your words. Reading that, and typing it all out in the first place has made me feel a bit better, but I'll breathe a huge sigh of relief if/when we find out that this is hopefully not serious.

My only advice is to try not to go down the Google rabbit hole quite yet. My older son had a couple of health scares (including one involving his head size) and Google only gave me gigantic anxiety attacks. Oh... and watch both yourself and your wife for signs of postpartum depression. It can happen in a situation with a perfectly normal newborn, but breastfeeding struggles and health issues can definitely compound it.

Hufflepuff or bust!
Jan 28, 2005

I should have known better.
You're doing exactly what you can do - get him the medical care he needs as early as possible. It is possible that it could be nothing - milestones have a way of loving with your head. My twins were premature, and so their milestones are all off and we have no idea how to calibrate our expectations. I've just had to put it out of my head.

Likewise, they have a little lip tremble too - babies are crazy things, and their nervous systems are still like WHOA WHAT IS LIFE. It could be something, I pray that it's nothing. In the meantime, snuggle time with dad will do a lot of good. Go talk to your doctors and DO NOT go WEB MD on this thing. I was convinced our twins had some terrible poo poo for a long time because I read it on the internet. Snorting while sleeping? OH GOD THEY'RE GONNA DIE OF SIDS. No, they're babies.

Good luck man, keep us posted. Try to find someone you can talk to, it's good of you to try to protect your wife but bottling it all up isn't good for you either.

His Divine Shadow
Aug 7, 2000

I'm not a fascist. I'm a priest. Fascists dress up in black and tell people what to do.
I hope everything goes well for you, do let us know how it goes!

Rupert Buttermilk
Apr 15, 2007

🚣RowboatMan: ❄️Freezing time🕰️ is an old P.I. 🥧trick...

Thank you so much, everyone. I'll definitely keep you all posted.

His Divine Shadow
Aug 7, 2000

I'm not a fascist. I'm a priest. Fascists dress up in black and tell people what to do.
It's not a fun position to be in and I completely empathize, also had premature twins like kaishek and they where born with health issues. One requiring open heart surgery, but it's been over a year now and they're both completely healthy and growing boys, but those where some worrisome days.

Midnight Sun
Jun 25, 2007

Good luck, Rupert Buttermilk! Fingers crossed.

Inudeku
Jul 13, 2008
Yeah, never Google stuff about babies and their illness/quirks.

My son had pretty bad jaundice and I was convinced he was going to have brain damage because of it. Little did I know that rarely, rarely happens. So rare that my pediatrician hadn't seen it happen in 20 plus year.

Don't worry about milestones either. You can't even tell what babies walked/crawled/sat up first after like, a year.

greatn
Nov 15, 2006

by Lowtax
You can have bad Jaundice into adulthood and become speaker of the house of representatives.

Volmarias
Dec 31, 2002

EMAIL... THE INTERNET... SEARCH ENGINES...

greatn posted:

You can have bad Jaundice into adulthood and become speaker of the house of representatives.

I think we all want more for our children than for them to become sociopathic power seekers.

Rupert Buttermilk
Apr 15, 2007

🚣RowboatMan: ❄️Freezing time🕰️ is an old P.I. 🥧trick...

My wife just texted me from the osteopath appointment she had for Arden (my son). She says that it's absolutely craniosynostosis and that he needs surgery ASAP and a helmet. She can't tell if there'll be any impairment.

I don't even know what to think right now.

gvibes
Jan 18, 2010

Leading us to the promised land (i.e., one tournament win in five years)

Rupert Buttermilk posted:

That's what I keep thinking. A majorly scary thing is that the bulge/bump on his head could mean that his skull isn't going to form properly, which means, absolutely worst case scenario, his brain can't grow and develop because it won't have enough room. However, in looking that up, I see that most doctors recommend treating that (with surgery) between 6-12 months of age, so we're not late in that regard.
This isn't a minor thing, of course, but they will cut the skull apart if they think there isn't room.

e: Beaten by your doctors and Lyz.

BonoMan
Feb 20, 2002

Jade Ear Joe

Rupert Buttermilk posted:

My wife just texted me from the osteopath appointment she had for Arden (my son). She says that it's absolutely craniosynostosis and that he needs surgery ASAP and a helmet. She can't tell if there'll be any impairment.

I don't even know what to think right now.

At the very least it's been detected and there is treatment available to you - so take some solace in that! Take it one step at a time!

edit: And now I'm going to take my daughter's head more seriously. She's 3 months and was in the 99th percentile for head growth at her 2 month checkup. The doctor said he didn't see any swelling though so he wasn't concerned. But still her head has got some pretty big bumps/ridges on it (most of which come from my wife...she has a pretty strongly ridged skull). But now I'm beginning to think it might be something else. She has hit most of her milestones though. Ugh. The anxiety rabbit hole begins.

BonoMan fucked around with this message at 18:16 on Nov 7, 2014

CelestialScribe
Jan 16, 2008
The lord has opened a portal to show me the fires of hell, and it took the form of a sick five month old.

Slo-Tek
Jun 8, 2001

WINDOWS 98 BEAT HIS FRIEND WITH A SHOVEL

BonoMan posted:

At the very least it's been detected and there is treatment available to you - so take some solace in that! Take it one step at a time!

edit: And now I'm going to take my daughter's head more seriously. She's 3 months and was in the 99th percentile for head growth at her 2 month checkup. The doctor said he didn't see any swelling though so he wasn't concerned. But still her head has got some pretty big bumps/ridges on it (most of which come from my wife...she has a pretty strongly ridged skull). But now I'm beginning to think it might be something else. She has hit most of her milestones though. Ugh. The anxiety rabbit hole begins.

The doctor tried to screen our big-head kid for hydrocephalus about three times, before we had her measure and plot the wife's head, and come up with a diagnosis of congenital big-headedness.

BonoMan
Feb 20, 2002

Jade Ear Joe

Slo-Tek posted:

The doctor tried to screen our big-head kid for hydrocephalus about three times, before we had her measure and plot the wife's head, and come up with a diagnosis of congenital big-headedness.

Ha! I'm sure that's all it is.


In other news, the other day, while changing our three month old, my wife shook a new rattle in front of her and she just BUSTED out laughing. Like two straight minutes of belly laughing and cackling at this rattle.

It took us by surprise because she hadn't laughed at all. There was no warmup, no weeks of "learning"..just BOOM laughter. We both started crying of course because it was such a milestone and ridiculously cute.

And then...two weeks of nothing. She hasn't laughed since. She's in a great mood and still smiling all the time, but it's like the laughing never happened. Kids are funny.

Thwomp
Apr 10, 2003

BA-DUHHH

Grimey Drawer

BonoMan posted:

And then...two weeks of nothing. She hasn't laughed since. She's in a great mood and still smiling all the time, but it's like the laughing never happened. Kids are funny.

My wife brought our son to work and, in the middle of a quiet cubical environment, he just looks at my wife and lets out one big chuckle.

She wasn't doing anything at all but that was enough to make everyone slowly rise to discover a baby was at work.

The Grumpy Snail
Feb 15, 2012

CelestialScribe posted:

The lord has opened a portal to show me the fires of hell, and it took the form of a sick five month old.

Everyone in your house will catch it. You've been warned.

visuvius
Sep 24, 2007
sta da moor
Lets talk hypospadias. This is basically a condition where your urethra is not exactly where it should be.

My boy is 8 months old now and utterly perfect except for his peehole. He has a relatively mild version of hypospadias where his urethra is maybe 3 or 4 millimeters "south" of where it should be. The doctors noticed it immediately and referred us to a pediatric urologist who we saw when the child was a few weeks old. The urologist said that hypospadias is not that rare and can be as mild as being barely noticeable to, like I said, having your urethra in the completely wrong spot. The surgery to correct it is about 4 hours and basically involves constructing a whole new urethra.

She told us that the type of hypospadias he has will not really affect him in any way other than cosmetic but that most parents do choose to correct it. Here is where the difficult decision comes in. We were told we could have the surgery done as early as 6 months, or wait till he is 3 years old. The main issue is anesthesia. Apparently, the studies they've done on the affects of anesthetizing children under 3 are inconclusive in regards to long term affects. This really freaked us out. She couldn't give us a recommendation either way and told us it was our choice. The pros of doing the surgery around 6 months are that because the child is not as mobile, recovery is easier since they won't have a catheter but then who knows what affect the anesthesia will have long term. At three months old, it can be very difficult on both the child and the parent but then you don't have to worry about the anesthesia issues as much.

We are kind of torn on what to do. At this point we're leaning more towards the wait until he is 3 months old camp. I mean he is already 8 months old and active as hell so I imagine post operative care would be a bitch either way.

The other thing is, to be honest, I'm wondering if he even needs the surgery. I mean, his urethra is definitely not where it should be but its not TOTALLY weird looking either. Like, if he held his tiny little pecker straight out and peed, it wouldn't go straight but maybe down at like a 30 or 40 degree angle. I don't want to put him through some poo poo he really doesn't need but on the other hand I really don't want him to be self conscious about his dick later in life. Dudes can be super weird about their dicks and I'd like to give him as few things as possible to be weirded out about. Plus as a guy there is the whole peeing in front of other dudes thing and I just don't it to be an issue for him.

Thought I'd post in here to see if anyone had a kid with hypospadias and what you chose to do. Also please chime in if you have any experiences with anesthesia on a child under a year old.

His Divine Shadow
Aug 7, 2000

I'm not a fascist. I'm a priest. Fascists dress up in black and tell people what to do.
Never heard that anesthesia could have such an impact, our son had open heart surgery at 3 months was under for many hours, and after that on strong pain killers and sedatives for days. I haven't seen that he's been affected negatively at all, he's like his brother except a month or so behind, which makes sense since his growth was retarded until they patched the VSD and ASD in his heart. Now they are 14 months and we're expecting surgery for both of them (hand surgeries) in a few months.

skeetied
Mar 10, 2011

visuvius posted:

Thought I'd post in here to see if anyone had a kid with hypospadias and what you chose to do. Also please chime in if you have any experiences with anesthesia on a child under a year old.

My five month old has mild hypospadias. His urethra exits right at the base of the head of his penis and his foreskin is incomplete as a result. I'm still pretty mixed on the repair since the pediatric urologist said it would mostly be cosmetic, but it's currently scheduled for when he is seven months old (right after Christmas). We were given a window of six months old to 18 months old as the optimal time, with six months being the minimum age they will do outpatient anesthesia at our hospital (Packard Children's) and 18 months old being when a catheter would become tough to deal with due to the child's activity/interest. We were told that the surgery will take two to two and a half hours and a catheter will be in place for two weeks after it so that everything can heal. The catheter is then removed at the urologist's office.

As far as anesthesia goes, we had a very long discussion with a pediatric anesthesiologist about it when my older son was nine months old, as he needed an MRI (incidentally, it was for his gigantic >99th percentile head). We decided the benefits outweighed the risks and he went on to have to have anesthesia twice more (ear tubes round one at 12 months and ear tubes round two and adenoids removal at 23 months).

From my experience with anesthesia at those ages, I would do it as young as possible. The last surgery was a living hell. He screamed for 24 hours after he woke up. For the younger two bouts of anesthesia, we were off doing something fun that afternoon after a nap.

Lyz
May 22, 2007

I AM A GIRL ON WOW GIVE ME ITAMS

Rupert Buttermilk posted:

My wife just texted me from the osteopath appointment she had for Arden (my son). She says that it's absolutely craniosynostosis and that he needs surgery ASAP and a helmet. She can't tell if there'll be any impairment.

I don't even know what to think right now.

On the plus side, the sooner they do it the less invasive it is. Emily has two little scars that show through her hair because that's all they needed to do to cut out the fused bone.

Here she is, helmeted 6 days after surgery.


This is what wearing her helmet did for her in 8 months.


So hang in there, it is scary as poo poo at first but then the surgery is done and they get their helmet and adapt and you have a completely normal, albeit armored baby.

Here she is at 17 months, you'd never even know she had a abnormally long, narrow head.


If you want any more pics spammed for reassurance let me know, I have some pretty funny ones of her looking like a Teletubbie while her head was getting scanned.

visuvius
Sep 24, 2007
sta da moor
The urologist really made it sound like anesthesia under 3 was like rolling dice or something. She kept mentioning how the long term effects are inconclusive. I heard the word inconclusive like 4 times. But I guess its way more common than I thought and not that big of a deal. She basically said either do it at 6 months or 3 years. A three year old with a catheter sounds like an absolute nightmare so if we do it, I probably won't wait that long.

Now its just, do I do this for the cosmetic reasons or not.

Rupert Buttermilk
Apr 15, 2007

🚣RowboatMan: ❄️Freezing time🕰️ is an old P.I. 🥧trick...

Lyz posted:

On the plus side, the sooner they do it the less invasive it is. Emily has two little scars that show through her hair because that's all they needed to do to cut out the fused bone.

Here she is, helmeted 6 days after surgery.


This is what wearing her helmet did for her in 8 months.


So hang in there, it is scary as poo poo at first but then the surgery is done and they get their helmet and adapt and you have a completely normal, albeit armored baby.

Here she is at 17 months, you'd never even know she had a abnormally long, narrow head.


If you want any more pics spammed for reassurance let me know, I have some pretty funny ones of her looking like a Teletubbie while her head was getting scanned.

Please, more pictures.

I'm very thankful that your daughter had no issues with the surgery or recovery. How long did she have to wear the helmet, was it 8 months?

Chickalicious
Apr 13, 2005

We are the ones we've been waiting for.
If I had to pick, I would definitely avoid surgery at 3 years old.

Marchegiana
Jan 31, 2006

. . . Bitch.
Basically my understanding is that they warn you about anesthesia on little kids because they just don't know for sure what (if any) the long-term developmental effects are. There could be nothing, or there could be risks but they just don't know because there's no way to safely test that on baby humans in a controlled trial. Obviously if the kid has something life-threatening they're going to put them under because any unknown risk from the anesthesia is lower than the known risk of foregoing a critically necessary procedure. But for an elective procedure, they warn you about any and all risks that may or may not occur because of the whole informed consent thing.

sullat
Jan 9, 2012
Our oldest has a bit of hypospadia, too. The doctors said to wait until he was at least 2 before correcting it, if we went that route. He's just turned 3 now and we haven't really looked much into treatment options. He seems to be peeing fairly normally, though.

Lyz
May 22, 2007

I AM A GIRL ON WOW GIVE ME ITAMS

Rupert Buttermilk posted:

Please, more pictures.

I'm very thankful that your daughter had no issues with the surgery or recovery. How long did she have to wear the helmet, was it 8 months?

I guess it was more like 9. The plan was to basically stop at her first birthday because that's when it's gone about as far as it can go and it's time to let the bones fuse (again) naturally. So she wore it full time (23 hours a day) up until 11 months of age and then wore it only at night until she turned a year. They said they shoot for about a 15% improvement and Emily managed 20+% because we did it so early. It's pretty amazing how malleable their little heads are.

Midnight Sun
Jun 25, 2007

Lyz, your daughter is sickeningly adorable. :3:

GoreJess
Aug 4, 2004

pretty in pink

Chickalicious posted:

If I had to pick, I would definitely avoid surgery at 3 years old.

This. If he has to have a catheter for a couple of weeks, I don't know how you'd keep a toddler from messing with it. My almost 2 year old spends so much time playing with his penis. Keeping him from touching himself for 2 weeks would be a nightmare.

ARCDad
Jul 22, 2007
Not to be confused with poptartin
Anyone have good tricks for getting toddlers to take medicine? My daughter has to take some medicine that she absolutely despises, so it's either holding her from behind and putting in that way, or trying to sneak it in on top of some of her food. She's caught on to trick #2 though with the cereal this morning.

gvibes
Jan 18, 2010

Leading us to the promised land (i.e., one tournament win in five years)
So this is kind of silly, but is there ever a point where you would take a kid to the doctor for eating too much? The eldest is about two and a half, and just eats an absurd amount of food. Maybe seven decent-sized meals a day. She will, for instance, eat an entire personal pizza (~350 calories) plus other stuff at a sitting without issue. She is pretty skinny (99th percentile height, and 50-60 weight), and no other stomach issues.

This has been going on for a couple weeks now. I assume it's just a growth spurt, but it seems kind of crazy.

Slo-Tek
Jun 8, 2001

WINDOWS 98 BEAT HIS FRIEND WITH A SHOVEL

gvibes posted:

So this is kind of silly, but is there ever a point where you would take a kid to the doctor for eating too much? The eldest is about two and a half, and just eats an absurd amount of food. Maybe seven decent-sized meals a day. She will, for instance, eat an entire personal pizza (~350 calories) plus other stuff at a sitting without issue. She is pretty skinny (99th percentile height, and 50-60 weight), and no other stomach issues.

This has been going on for a couple weeks now. I assume it's just a growth spurt, but it seems kind of crazy.

I'd probably be a bit worried about establishing a hosed up relationship with food, if you decide to medicalize it. If it were me, I'd probably make the volume available, but keep closer track of the content. "No, there are no more microwave pizzas, but there is ALL THIS BROCCOLI!!!" Getting convenience/garbage food out of the house is probably a good idea anyway. I put on an annoying amount of weight with kids aged 0-6, just because we had a bunch of convenience food to feed kids, and while you can feed a 5 year old toasted grease, if you're eating it along with them as often as is convenient, it'll show about the middle.

photomikey
Dec 30, 2012
My almost 5 y/o is 95+% in height and weight. She goes through stages where she eats a lot and stages where it's more normal. We have keyed on to a few things that are All You Can Eat at our house, so she eats meals (whatever we eat), then snacks (normal 5 y/o snack stuff), and if she's hungry after that she can have frozen corn kernels, frozen peas, frozen green beans (she eats all of the above straight out of the freezer, like a polar bear), broccoli (fresh or steamed), carrots, celery... some other stuff I can't think of right now, but whatever I have on hand that's vegetable-centric.

In fact, just tonight, we got home late and didn't have time for a pre-bedtime snack, and there was a near meltdown at my house because she couldn't have any frozen peas before bed.

The Grumpy Snail
Feb 15, 2012

momtartin posted:

Anyone have good tricks for getting toddlers to take medicine? My daughter has to take some medicine that she absolutely despises, so it's either holding her from behind and putting in that way, or trying to sneak it in on top of some of her food. She's caught on to trick #2 though with the cereal this morning.

Is there a reason you can't mix it in completely? I have been giving my daughter zantac since birth. She started clamping her mouth shut at the sight of the syringe months ago. I just mix it in with her food now. Just make sure it all gets eaten. Or if I forget to mix with the food, I use a different syringe. The gas drops syringe is working for now, I think because she actually likes the taste of the gas drops. We'll see how long that lasts. Hope that helps.

Edit: just realized you said toddler. Can you mix it in with some yogurt or pudding?

skeetied
Mar 10, 2011

momtartin posted:

Anyone have good tricks for getting toddlers to take medicine? My daughter has to take some medicine that she absolutely despises, so it's either holding her from behind and putting in that way, or trying to sneak it in on top of some of her food. She's caught on to trick #2 though with the cereal this morning.

Can you have the pharmacy flavor it? We were warned that Augmentin is disgusting so we had the pharmacy make it some sickeningly sweet fruit flavor and my son gobbled it right up.

The Nastier Nate
May 22, 2005

All aboard the corona bus!

HONK! HONK!


Yams Fan
Hello parenting thread, my wife and I are expecting the birth of our first child in December (boy) and I have not read all 127 pages so sorry if this has been brought up before but, has here ever been a petition for a parenting sub forum? It would fit right in under pet island (Kid Island: watch out for projectile vomit). The forums are getting older and I know that most of us who registered years ago are of prime childbearing age and would love to spam pictures of kids in between complaining about how much Xbone and dr who sucks.

jassi007
Aug 9, 2006

mmmmm.. burger...

The Nastier Nate posted:

Hello parenting thread, my wife and I are expecting the birth of our first child in December (boy) and I have not read all 127 pages so sorry if this has been brought up before but, has here ever been a petition for a parenting sub forum? It would fit right in under pet island (Kid Island: watch out for projectile vomit). The forums are getting older and I know that most of us who registered years ago are of prime childbearing age and would love to spam pictures of kids in between complaining about how much Xbone and dr who sucks.

This thread is over 2 years old and has 127 pages. No way that it justifies enough traffic for a whole subforum. There is this thread and the one for smaller kids, and they get a decent amount of traffic but ask/tell needs. most ask/tells burn out real quick, this is one of the better threads.

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Papercut
Aug 24, 2005

jassi007 posted:

This thread is over 2 years old and has 127 pages. No way that it justifies enough traffic for a whole subforum. There is this thread and the one for smaller kids, and they get a decent amount of traffic but ask/tell needs. most ask/tells burn out real quick, this is one of the better threads.

Also this thread just has the same 4 or 5 conversations over and over every 5 pages or so

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