Showing posts with label infantile scoliosis. Show all posts
Showing posts with label infantile scoliosis. Show all posts

Monday, October 13, 2014

Cast #2 and the dreaded MRI

For more background information, please see: What is going on with Addison?

October 13, 2014

When we last left you we were heading into the removal of cast 1 and our weekend of freedom.  IT. WAS. GLORIOUS. The weather cooperated and it was a perfect warm but not to hot and a little windy cape cod weekend in late August. 

CAST OFF AND THE MRI
We started out Friday getting the cast off in Boston at 8am followed by the dreaded MRI at 10:30am. Remember, this MRI would let us know if there are any underlying issues driving Addison’s curve. First stop at the “cast room” to saw this thing off! Naturally Addison is very scared but Joe the cast tech does his best to calm her and make her laugh. We are reminded that cast saws don’t spin; they vibrate, so there is never a danger of her being cut. Two quick saws and she is free. Her skin looks profoundly damaged and irritated. One of the biggest casualties in this casting process is the damage to the skin. A nurse comes to examine it and see if Addison is in good shape for her re-cast on Monday. The good news is she is (no broken skin or lesions).


We head to the MRI room. By the time we get there the air has had enough time to let Addison’s skin know it is ANGRY. She is itching like crazy and just getting more and more red. They’ve told us this is normal and actually she is in better shape than most kids. We do what we can to distract her. The wait for the MRI is long, sitting in the tiny room giving all of her medical history again. This time they want to give her the IV while she is awake (no fun).  One parent can stay with Addison through this. We decide it’s Dad’s turn to hold her hand through the scary stuff. So he is suited up and off they go for what will be a very long hour. The MRI tech will painstakingly go through every vertebrae in A’s spine to look for abnormalities. Also, they will check for a tethered spinal cord or any other possible damage to it.
Off to the waiting room I go, alone. I’ve decided MRI’s suck. I feel while they could deliver good news, it seems its never just ok news. Its good or it’s devastating. So while I wait I am having that moment when you think, “it can’t happen to me”, but there you are waiting for your 2 year old to come out of an MRI and realize it very damn well could happen to me!  As I hang on to the edge of a black hole of bad thoughts trying not to get sucked in, the Children’s Hospital clowns arrive. “Ugh, not now. No clowns.”, I think diverting my eyes to the floor. This room has no children in it. Just long faced parents sitting silently. The clowns launch into a gentle, age appropriate, elevated level of humor that you cannot help but laugh. Suddenly I was gently lifted out of my funk, and was smirking along with all of the other parents. It was impossible not to. Today the clowns were for the moms and dads. Excellent.
Addison is in recovery now and it takes her a little longer than usual to come out of the anesthesia. She has only had the gas before today and this was an IV sedative. When she finally wakes up she is absolutely loopy, laughing, talking about Elsa and Anna from Frozen and making zero sense. It was pretty funny to see my 2-year old like this. Then that wore of and she cried hysterically for a while. Finally that wore off and we were ready to head home.

INTO THE WATER
First book of business once we get home is a bath! It’s been 2 months since she was had a full body bath. Tub full of bubbles and warm water, then the several lotions and potions I have found to try to help that red skin heal in two days. I used Damascus rose with lavender and chamomile oil as well as “Emily Skin Soother” which is an all natural balm containing olive oil, beeswax and herbs. They were helpful although I am not sure anything could have fixed that skin in 2 days.

We met friends at the beach both days. Her skin was in such tough shape that I cancelled plans to meet friends at their pool. The chlorine seemed like a bad idea. Even the sunblock was too drying. Addison only had one bathing suit this year that was a gift. Once we knew about the cast I didn’t bother getting swimsuits. So, here she is in her brothers UV safe one piece.  TWINS!


CAST #2 GOES ON & THE MRI IS NORMAL!
The weekend went by way too fast and here it is 4:30am and we are driving back to Boston for our 6am pre-op time. Again only apple juice for Addison until after the cast is on. We are all getting used to the drill: wake up ungodly early, 1.5 hour drive, park, check in, wait, wait, wait. 


It’s my turn to head to the OR with Addison. Unfortunately we did not luck out this time with her falling asleep ahead of time. So she was screaming and crying as I held the anesthesia mask over her. I doubt this part will get easier.  A quick 45 minutes later and her surgeon emerges to tell us she did very well and he was happy with the results he got getting her straight in the cast. He also delivered the news that her MRI was normal!! YAHOO. So Addison officially is diagnosed with Idiopathic Infantile Scoliosis. Which means we don’t know why it’s curving. This is one of those times where no news is good news. If there were something else going on in her body, the battle to straighten her out would be significantly harder. We have a very good chance that this cast process will retrain her spine to grow straight.  Naturally we stared at her back all weekend debating, “does it look better?” The moment she came out of the cast she appeared totally straight! However as the weekend went on we could see the bump at her ribcage grow as her body settled into not having the cast to hold it straight. We asked Dr. G. when we would re-xray to find out how she was doing, because it’s entirely possible that this is doing nothing. It’s not probable but its possible. He informs us that there is no reason to re-xray until we have been doing this for 10-12 months. Then based on that we decide if we move to a brace or if we should continue with the casts.

We head down to recovery to see Addison and she is pretty hysterical. These drugs send her into a tizzy when she is coming out of them. So for 45 minutes she screamed. Unfortunately, we were also pretty stressed out ourselves. We had been up since 3:30am and it was now noon, our conversation with the Dr. did not deliver the totally unrealistic expectations I had (that she’s miraculously cured and no more casts), seeing her back in the cast and her screaming bloody murder was also depressing and very stressful. 

We go over every edge of the cast to make sure nothing is sharp or digging into her skin. Everything looks great; thank god no extra cutting is needed. John the hippie nurse stocks us up with extra moleskin for the cast’s edges as well as some apple juice for the road. He was so calming, slow moving and kind.  He slowly attended to Addison’s IV and heart monitor wires, which made her scream more. He slowly removed her IV that splashed blood onto her new white t-shirt that we can only change once a month. He told stories about his own family. He is a saint. However for any type A people out there, you may understand, in these overtired, stressful situations we like fast moving, take charge types that are actually abrupt and maybe a little rude. Just get it done! AHHHHH. John was chamomile tea in a tequila shot moment. I hope we see him again through this process when Addison is not screaming her lungs out. He was interesting to talk to. Finally the screaming stopped and we got A dressed and headed to the car.  Back to life in the cast. Total bummer.

Thanks to all for reading about Addison's curve and following us along our journey.
xo


Saturday, May 31, 2014

Pre Op Day

For more background information, please see: What is going on with Addison?

May 30, 2014
Pre Op Appointment

We left home very early to get to Children's for our 9am pre-op appointment. Not having any restrictions on Addison's (22-mos) eating or drinking made this a fun ride filled with little traffic (thank you HOV) and several rounds of her favorite songs from Frozen. Brother Matthew (almost 3 yrs) happily stayed home with Nana.

Our first appointment was 2 hours of family medical history as well as discussion about Addison's present health.  A new snoopy doll from the nurse as well as a princess castle in the room kept Addison occupied as we answered a zillion family medical history questions. For anyone who knows how last fall was for my dad, I had a lot of ailments to add to the history. Luckily none of them were pertinent to Ms. Addison's upcoming procedure. We are very fortunate as well that Addison's health and growth is all very good. Often scoliosis in infants is indicative of a larger congenital or neurological disorder. We will be required to get an MRI to confirm that neither of these situations are present.  So far Miss A appears to be developing right on time.

The nurse who took the medical history was wonderful and for Addison, the oxygen monitor was more fun than the princess castle. We then met with the anesthesiologist. She was very helpful in calming our fears about long term exposure to anesthesia in toddlers. She also gave us a full description of what "casting day" will look like and what to expect. For me, knowing what's coming up is calming.



2 hours of that...and we are off to Orthopedics. We are greeted by clowns in the lobby. Creepy they may be, but suddenly I do feel a little less anxious about how scary this experience will be for Addison. So far she has scored a Snoopy doll, a pin wheel, and seen countless fish tanks and bubbles. For any 2 year old this was a good day!! We met with Dr. G, the physician's assistant and a PA student about what will happen the day Addison gets her first cast.


Addison is too tired to go for lunch, she was asleep before we got out of the parking garage. A well deserved pinwheel and nap for her brave efforts today. She never cried and I think made everyone she met smile. Goodbye for today Children's, we will see you June 10 for her first cast.





What is going on with Addison????

Some background....

When Addison was 8-months old Mike (her Dad) noticed that her rib cage was not symmetrical. When she sat, she tilted to one side and we could see her ribcage on the right side was protruding. We quickly made an appointment to see the pediatrician.

As much as I love all of the nurses and staff in our pediatricians office, I do want to share that my phone call about this mysterious bump was met with a bit of disbelief. "Babies are still very floppy at this age" was the response to my concerns about my 8-month old not sitting up straight. I am a pretty bold person so I just pushed past the "you're kind of being a neurotic mom" tone and said "well I guess if it's nothing, a quick visit won't hurt anyone". Which she kindly agreed and we went right in. I encourage you to push and advocate for your children if ever met with doubt. There is a lot to be said for parental instinct. And in the case of infantile scoliosis, early detection is the best chance for a non-surgical cure.

Our pediatrician felt and saw the same thing we did and sent us that day for X-rays.  The images confirmed, Addison had a significant to severe right turning 'C' curve in her thoracic spine. Scoliosis usually appears in adolescents and rarely in infants.  The realization that my child has a rare spine disorder known as Early Onset Infantile Scoliosis was devastating. I had so many questions and no patience to wait for answers.

This is where living in/near Boston is truly incredible. We had an appointment with an orthopedic surgeon who specializes in infantile scoliosis within the week. Many families have to travel across several states to a hospital that know how to treat infants with scoliosis. We felt lucky to be so close to Boston Children's Hospital.  Our first x-ray at Children's revealed that the curve was less than initially recorded.  While still significant, it was not severe and met the "watch and wait" category of curves. Addison's curve was 20-degrees. In some instances these smaller curves will self correct. Over the next year we met with the Dr. every other month and took new images, each time revealing no movement. Unfortunately on May 15, 2014 the x-ray revealed that Addison's curve had progressed to 33-degrees and her rib cage was beginning to twist to accommodate the bending spine. It is time to intervene.

The recommended course of action is a series of plaster casts over a 1-year period. Due to her age, the cast will be changed every 2 months under anesthesia to accommodate her quickly growing body. While the cast is on we cannot get it wet, so that means no baths, no pools, beach, etc. It also means we have to watch carefully what falls down the cast so nothing gets stuck and causes a skin irritation. This means, no sand boxes or playgrounds with mulch.  Addison is almost 2 and has an almost 3 year old brother. My head is spinning about how my daughter will live happily in this cast, and if she will fight scoliosis for the rest of her life. The only certainty is that we will be a strong family for her and I know she is getting the best care in the world.

Follow us as we go through this journey with Addison.