Thursday, November 17, 2011

MRI

Yesterday afternoon we arrived at the hospital for Maddy's MRI.  They weighed her and then brought us to an exam room.

Madeline is not waving at the camera here.  She's trying remove the ID bracelet on her wrist by waving it around wildly.

Then she pulled on it, still trying to GET IT OFF.  Maybe I should have put it on her ankle.

A nurse came to talk to us about what to expect.  He also told us that we'd be waiting awhile.  The schedulers I spoke to on the phone failed to tell me that our arrival time was at least an hour before the actual scan.  And they were running behind.  Because it's a hospital.  (By the way, those same schedulers both urged me to get Maddy a morning appointment because of the fasting requirements, then told me that there weren't any morning appointments for the next month.  Very helpful.)

Still waiting.  We were in that room for an hour.  At some point the anesthesiologist came in to answer our questions and explain what she was going to do.  This was the person I had been waiting and waiting to talk to.  Over the last few weeks, every time I asked any other hospital staff about what kind of anesthesia Maddy would need, everyone was really vague and told me I'd have to wait to talk to the anesthesiologist we had on the day of the MRI.  I found out from other parents that some kids just get sedation (meds taken orally).  Other kids have to have general anesthesia (meds given through an IV).  The ones who have anesthesia often have to be intubated to keep their airways open.  

When we first scheduled the MRI, we were told that Maddy would have to have general anesthesia instead of sedation because of her problems with vomiting; they didn't want to risk her throwing up the medicine during the scan.  They said we'd get more info on the day of the scan.  Since most people I talked to had kids who had general and intubation, and some of the hospital staff led me to believe she'd require intubation, I was preparing myself for the strong possibility that Maddy would be intubated.  But our anesthesiologist said they would try general anesthesia alone, and if she vomited during the procedure or there was some other problem with her airway, then they'd intubate.  (Intubation scares me because it's an intervention, and it comes with its own complications and risks.)

They told us that starting the anesthesia and performing the scan would take an hour, and that it might take up to 30 minutes or so for her to wake up afterward.  We walked down the hall and I got to put Maddy on the scanner table.  They led us away before they put the gas mask on her.  I'm grateful for that.  Hearing her cry for us was hard enough.

Mike and I waited for an hour.  The nurse called my cell phone to let us know we could come back to recovery.  She was already awake and alert.  Mike told her to say "cheese" for the camera and she smiled.  We weren't expecting her to listen!

She was hungry enough to drink Pedialyte.  That stuff's nasty, and Maddy doesn't even like to drink fruit juice.  She must have been starving.  The anesthesiologist assured us that everything went fine and that they didn't have to intubate (yay!).  The nurse (in the background here) said they were prepared for everything and therefore didn't have to do anything out of the ordinary.

It was 6 pm when we left the hospital and got to sit in Cincinnati traffic.  We stopped for a quick dinner and let Maddy have some juice because she was still quite hungry.  Here is Maddy looking shell-shocked at the sandwich shop.

Playing with the band-aid where the IV had been.  That pacifier was her best friend yesterday.  She was a little off her game like we expected.  Her eating and napping have been a bit weird today, but she's doing fine.  I know that she will probably have many more MRI scans during her childhood, that she will require anesthesia again, and that she might have to intubated at some point.  Plus she is having surgery soon and that will be much scarier than this MRI.  But I'm glad we are easing into all the scary things she's having to go through this fall.

I'm guessing that it will take a few days for the neurosurgeon (Dr. M) to get the results of the MRI.  Maddy also has a sleep study on Friday, and the results of that will take about two weeks.  We're not sure what happens next.  Dr. M might get the MRI results and put her on the surgery schedule right away.  Or the sleep study might reveal something obviously urgent and they plan surgery based on that.  Or Dr. M might wait until he has the complete sleep study results weeks from now before he decides on a plan of action.  The uncertainty and waiting is frustrating.  But regardless of what happens, I am so grateful that we have the ability to bring Maddy to such a great hospital.  I feel like she's in good hands.

Friday, November 11, 2011

Waiting...

Okay, here's an update on Madeline's latest medical stuff. Back in September I took her to a pediatric GI doctor to see if there's a reason for why she throws up so much and still eats such small amounts of food. The doctor did not have any answers. But he did order some diagnostic tests.

First was the modified barium swallow. Maddy did fine. The speech therapist who was there did give me some tips on feeding her to reduce the vomiting. Since then, her eating has slowly gotten better but still isn't great. Anyway, the speech therapist and radiologist could find nothing obviously wrong with her digestive system that would cause her the problems she's been having.

The second test was a CT scan of her head. The GI doc ordered it because vomiting can be a symptom of things going on with the brain or spinal cord, and achon kids are more prone to have those problems. My big fear with the CT was that they might have to sedate Maddy to get her to hold still. But she was an angel and they just had to strap her down. That's why I knew something was up when the CT tech needed more pictures, even though Maddy hadn't moved at all during the scan. Turns out the radiologist saw evidence of spinal cord compression. He saw that the foramen magnum (the opening at the base of the skull) was a little too narrow, but since a certain amount of narrowing is expected with achon kids, they couldn't tell if it was a problem. The GI doc called me to tell me all of this a day or two after the scan. He didn't want to freak me out, but we needed to see a neurosurgeon.

So even though we already had a scheduled appointment with a neurosurgeon in December, we got bumped up to the end of October. (When neurosurgery makes time in their packed schedule for you, you know it's kinda serious.) We headed to Cincinnati Children's. I was a little concerned when the intake nurse seemed to have no knowledge of what achondroplasia is. He was asking all these questions about her development, and I could not seem to get through to him that there is a totally different developmental growth chart for kids like her. But then we met Dr. M who does have experience with achondroplastic patients. He got to the point pretty quickly: he looked at the CT scan, and Maddy has cervical stenosis and spinal cord compression that warrants surgery. He emphasized that it's not an emergency, but that we don't want to wait many months. He said there's a 99% chance that he'll want to operate by the end of the year. But first he wants her to have an MRI to confirm that that's the right course of action. He also wants a sleep study to see if she has any central or obstructive sleep apnea. After he gets the results, they will find a spot for Maddy on the surgery schedule.

Getting these tests done has been slow and frustrating. She was supposed to have the MRI last week but came down with a cold. She has to have anesthesia during the MRI and they can't intubate her if she's congested, so we rescheduled for next week. Part of me was disappointed that we didn't just get the MRI over with last week. I've been so anxious about it, and I just wanted to get it over with.

Then there's the sleep study. I finally took her to the initial appointment at the sleep study clinic today. A nurse practitioner examined Maddy and took a look at the results of her sleep study done in Germany when she was only 2 months old. The NP said that she thought the sleep apnea had been more serious than the report indicated and that we definitely should do another sleep study. But of course they have a full schedule and they're trying to find a time to squeeze us in next week. Then it'll be another 2 weeks before they get the pulmonologist's report. At one point the neurosurgery department thought they might be able to get Maddy into the O.R. at the end of November, but I don't see that happening without these tests getting done quickly.

So there you have it. Now we wait - wait for tests, wait for results, wait for surgery. The word "neurosurgery" nauseates me. But like Maddy's pediatrician told us last week, this kind of surgery is easy compared with other procedures that neurosurgeons perform. It should only (haha, only) take about four hours, with a three- to five-day recovery time. It's still scary stuff. Finding other parents online who have already gone through this with their kids is helping a bit. This is a whole new world that I'm just not prepared for.

Thursday, November 10, 2011

Monday, November 7, 2011

Trick or Treat!

Halloween night.  Garfield eating lasagna.  (Yes, this was a planned photo-op.)

Ben insisted on wearing the "paws."

Getting ready to trick-or-treat for the first time in our new neighborhood.

Mike was just going to take Maddy along to a few houses, just to see some neighbors.  That was the plan, anway...

...until Ben found another group of kids and went up and down our street with them.  There were several parents there, so Mike tagged along with Maddy.  In this picture you can see Ben running across a neighbor's yard with some other kids.

Strawberry Shortcake was very chatty.

Our next-door neighbors took this picture at the end of the night.  They said that even though there were only something like seven kids that went door-to-door, it was the best turnout our street has gotten in five years.  There's only one other house on our street that has kids.  But there are plenty of residents who love to have trick-or-treaters.

Surveying his loot.  Over half of his candy was stuff he couldn't eat because it had peanuts or peanut butter in it.  So we let him swap that stuff out for the allergy-friendly candy we had leftover.  And then I made Mike take all the peanut butter candy to work.

So tired he can barely smile for this picture.

Saturday, November 5, 2011

Halloween Party

Mike's squadron had a Halloween party last week.  Ben got to dress up in the Garfield costume he'd been itching to wear.  Madeline tolerated the Strawberry Shortcake costume...well, mostly tolerated.  It was a family-friendly party, early enough for the kids to have some fun before bedtime.  And I finally got to meet some more adults!

Zach and Ben.  They still get excited every time they see each other.  Some people were surprised that Ben had a Garfield costume ("Is Garfield popular again?").  He picked it out at the costume store himself.  Ben got hooked on the CGI Garfield movie from a few years ago when he found the DVD at our friends' house.  Not my favorite movie by a long shot, but it made for a cute, non-violent, not-scary costume.

I found this costume at a consignment shop when we first moved here.  It's supposed to be a 3-piece outfit, so apparently we're missing a piece.  Worked anyway.  But I put tights and slippers on her and she was having none of that.  Shortly after this photo I changed her into pants.

He had a blast running around inside with all the other kids, and then he had some Daddy time in the awesomely decorated backyard.

We headed home a little after the kids' bedtime.  All the excitement was draining for Maddy.  She had more fun trick-or-treating (those pics are coming soon).

Friday, November 4, 2011

Friends & Adoption

If you know our friends Tim and Tina, then you know what great folks they are.  And if you don't know them, I'd like you to read just a little bit of their story.  They are in the process of overseas adoption.  Here's a blog they just set up to keep people updated:


If you skipped right over that link, let me tell you that Tim and Tina are looking to adopt siblings from Bulgaria.  Do you know how expensive adoption is?  HOLY GUACAMOLE.  It seems unfair to me, but that's the way things are.

Are you so excited to help this family that you don't even want to read their blog? Then click *here* to go straight to a fundraising page set up for them.  Give $10, or give $100.  Give anonymously.  Or sign your name and write a glowing letter of well-wishes.  But please consider supporting them in some way.  Thanks!

Thursday, November 3, 2011

The Kecks' Visit

A few weeks ago my sister Katie, her husband Brian, and their daughter Sophie fly up from sunny Florida to brave the Ohio cold, spend some time with us, and help us get settled in our house.  Madeline warmed up to Aunt Katie right away.

She was more suspicious of Uncle Brian.  He won her over after a few days.

We have no furniture for our formal living room yet so right now it's a play area.  It's a great space for Ben's tent and tunnel.  Here's Sophie checking it out.

The girls hanging out in the tunnel.

We also haven't furnished our Florida room so the kids had a blast running around in there, despite the really cold concrete floor.  Mike helped Maddy "chase" the other kids.

Tackling Katie.

They spent a lot of time running around out there.

The guys taking a well-deserved break to watch some football.  Brian was a huge help - he replaced our door locks, fixed a closet door, and addressed some electrical issues (including me not knowing we had two switches to the dining room light, oops).

Sophie with her Ernie doll and Madeline's Ernie, aka Double Ernies.  She carried them around pretty much the whole time she was here.

Maddy loved having another kid around.  Sophie loved having another kid's toys to play with.