Well it is time to
wrap up 2009 . I figured this would be a good time for a run down of what has been happening lately with Austin's medical team. We have been busy with specialists since our
last medical update in September .
October:
Genetics: On a rainy October morning, we had nice, long {insert sarcasm here} visit with the Gene squad @ Cedars Sinai. We were referred to them because they are the same Genetics team that worked on my brother's case, back in the day. The team was excited to meet Austin, but long story short, nothing has changed. We were hoping some new tests would determine once and for all that Austin's genetic profile matches Branchio-Oto-Renal Syndrome. The
results are in, the answer is No . So we are still going on a "clinical" diagnosis. The important thing to note is that this changes absolutely nothing in his current treatment. The CSMC Gene squad are now attempting to have some researchers in Iowa take on Austin's case. It could be months, or even years, before they are able to give us any further answers.
November:
Gastroenterology: This is always a fairly quick and painless appointment as Austin has no ongoing GI issues - well unless you count the G-tube. It is more of a "Hey, How ya doing?" kind of appointment and often seems pointless, but we have to go in order to keep receiving his enteral (feeding) supplies. So in late November we went, he has gained some weight since we changed his feeding regimen and that is very good news.
The GI and I discussed some retching issues that had seem to resolve. The test to help determine a problem would be an upper GI. She felt that doing an upper GI would be just "more radiation" and we should avoid it whenever possible. I agreed and we decided to just watch the problem.
Then one fine Sunday in December blood come out of his G-tube during a routine venting procedure. Not good. So much for no ongoing GI issues. Our Nurse and I decided since it was Sunday and a small amount we would watch it and see what happened. It continued and the following day I was very worried for his tummy, but he seemed fine other than some slow motility (digestion). Along with the blood (which looks like coffee grounds) he had some delayed gastric emptying - which just means that his food was still in his stomach longer than normal. More information than you wanted? Sorry. So needless to say his GI doctor was going to get her opportunity to shine.
A quick call to Children's Hospital and a few hours later we had a new Rx for Austin. He is now taking Carafate to coat his tummy. And yes, by the time he started taking it the blood was already gone, but better safe than sorry. Carafate is a medication often given to people with stomach or intestinal ulcers. Does Austin have them? We don't know, but the blood came from somewhere and it would take Radiation and a LOT more blood to get to the bottom of it. As I mentioned we are trying to stay away from Radiation.
Pediatrician: In November Austin had his 2 year check up. And the good news is with the exception of his Expressive (spoken) language he is pretty much right on target with his peers. We don't need to go back to see her for another year. HA, HA. We were back two weeks later for the 2nd H1N1 shot. And then again, two weeks later for Thrush.
Ok yeah, my two year old who doesn't even drink a bottle got Thrush. From where? No clue. So now we have another lovely medication to treat that. Actually, I feel kind of bad because I had no idea he had it. It began the same weekend as the GI bleed. I am good at
diagnosing lung issues ; if you have pneumonia I am your gal, but a typical baby germ like Thrush and I am totally out of my element. Go Figure.
December:
Neurosurgery: Our appointment got cancelled twice, almost three times, before we actually got to see the Head dude. Just like the GI doc this appointment is ALWAYS quick and seems totally unnecessary. The long and short of it - Austin's head has slowed growth, good news. Dr. Neuro feels that Dr. Genetics overstepped his bounds a bit with the whole
"cervical spine issue" this summer and believes there is NOTHING to worry about. He said if I REALLY wanted him to he would order a CT scan, but again that is "more Radiation". Then he pretty much promised that even if Austin did have a congenital anomaly with his cervical spine, he will do nothing to correct it. Well that kind of sealed the deal, no CT and we go back to see him in a year. YAY one less doctor (for a year.)
Otolaryntology: Of course, the one appointment I dreaded the most went fairly well. Score! I
don't often see eye to eye with Austin's ENT , but he surprised me this time. He agreed to a DL&B (direct laryngoscopy & bronchoscopy) for Austin to be completed before his next sleep study. A DL&B requires sedation, but the procedure is done in outpatient surgery. What it comes down to is a scope in Austin's airway to determine any underlying issues *if* the Trach should be removed. If everything is clear and his chin has grown enough to support his airway we may be able to have the Trach removed sooner rather than later. BUT, and it is a
BIG one, we still have the issue of his Chronic Lung Disease and that needs to show some improvement as well, before the Trach goes anywhere.
So that's why it is important to get the DL&B done prior to the sleep study on February 8th. If all goes well, Dr. ENT will request for Austin's Trach to be capped during his sleep study. Being capped means that he would spend the night breathing through his mouth and nose for the first time in two years, he has had his Trach since February 1, 2008. Of course this all assumes that the stars align perfectly. Excited? Me, too.
Audiology: Austin was booth tested again. He still hears about the same as he did in June '09; with his BAHA
he has a normal/mild hearing loss on paper . The concern is that since his speech is not really improving rapidly he does need the 2nd BAHA. The insurance denied it this past year, but we will test him again in April '10 and then submit the paperwork again. This next time we will have three more tests behind him as evidence of his ability to hear, but not differentiate the sounds needed for words. We need to practice for the next booth test at home. In April he should be able to follow directions and place blocks on command.
Well that about wraps up the Medical portion of our program. Stay tuned for a
therapy update soon, boy this
end of the year stuff is really wordy, sorry.
Thanks for peeking,