Medical Update - 11/25/08

UPDATE POSTED BELOW 2:51pm

I pumped the wee one full of moo-juice and we bundled off to the Pediatrician for our 3:15 appointment yesterday.

The waiting room was full and we had to wait about an hour to be seen by the doc. As we were waiting, I noticed that the area around the base of Annabelle's shut was swollen. My heart began to race.

"Calm down", I had to tell myself. "You are sitting in the waiting room of your pediatrician, across the street from Children's hospital. Everything will be fine." Five minutes later and we were still waiting in the lobby.

My magical black binder was in the car so I didn't have the phone number to our neurologist. I asked the receptionist if she could look up the number for me and 5 minutes later, when we were ushered to our exam room, the receptionist still hadn't located the number.

One of the doctor's assistants came in first to check out the basics. I gave him the run down and pointed out the swelling. "So is this spot usually flat?" he asked.

"No. She has a shunt. There is always a bump behind her left ear - but this is the first time it has gotten swollen."

I was rapidly losing confidence and patience.

I began leaving messages for friends that might be able to pick up the wife from work and shuttle her up to the hospital . . .

The receptionist brought in the correct number and I immediately dialed it even though the assistant was still running through the standard 25 or so questions . . .

The receptionist at the neurologist's office put me on hold while she tried to contact the doctor. She came back on the line and stated flatly, "If you have a concern about the shunt, you should take her to the emergency room . ." Which is medical-speak for "I have no idea where the doctor is - he is not returning his pages and I am just a receptionist and I am going to cover my hindparts and lay the responsibility on you, dad."

Fine.

The Pediatrician's assistant finished up and said he thought every thing looked fine but he wanted the "boss" to take a look at her. Again, doctor-speak for, "I have no idea what is wrong so I am going to smile, nod, and get someone who knows what they are talking about . . ."

With that, Annabelle and I were left to wait in the exam room. Annie was asleep on the exam table so there was nothing for me to do but sit. And wait.

There was one of those big clocks on the wall - the kind that "ticks" with each second. I swear it was just like the movies. The silence was deafening with the exception of the ticking of that damn clock. Every tick sounding like a gong or Tiphany drum.

BANG. BANG. BANG. BANG.

"Calm down," I kept telling myself. "This is probably something that is critical in a space of hours . . not minutes . . . not seconds . . . I hope."

It was now 4:45 and we had been there an hour and a half. Emergency rooms are not always known for their speediness and who knows how long it would take for someone to see us once I got us checked in??

I resolved to wait 5 more minutes.

At 4:50, I scooped up the little one, grabbed the diaper bag and headed for the door. As I was getting Annie in her stroller, I told the receptionist that I never did see the doctor, that I wasn't waiting any longer and that I was headed to the emergency room.

Mouth agape, she reached for her phone and punched in an extension . . .I was out the door before she reached anyone.

So in the car - drive around the block - into the parking structure- back into the stroller - across the street and into the ER . .

"Have you folks ever been to this hospital before?" the receptionist asked . . . .

I reached the wife and gave her the run-down and our dear friend Wendy dropped what she was doing to shuttle her up to Childrens.

After the standard poking and prodding, the doctor on shift agreed that there was some swelling at the base of Annabelle's shunt and ordered a series of Xrays.

The wife arrived and we all got to review the images together.

The doctor pronounced the shunt in good working order but still wanted an okay from the neurologist on call before they allowed us to leave.

It was now 7pm and Annabelle (who typically eats every three hours) had not eaten since 2pm. The doctors would not let her eat or drink anything until they knew exactly what the situation was.

Little Annabelle was exhausted from not sleeping and hungry from not eating. The wife and I took turns holding and rocking her all the while waiting for an infant meltdown of Biblical proportions that never came.

Annie was amazing. Nary a peep or complaint so long as we were holding and rocking her.

We put out the prayer alert to as many people as we could and the swelling actually went down as we waited to hear from the neurologist.

We finally got the okay to go home around 9:30pm or so with a return trip planned for today so that they can do a CT Scan to take a closer look.

So that is where we are this morning.

Annabelle is doing fine. Acting, eating and sleeping normally. Some of the swelling has returned this morning so we are concerned about that.

We will be calling the neurologist first thing this morning to find out when we should come in for the Scan today.

Updates to follow . . . .

UPDATE:

Just got back from the neurologist. They said this type of swelling is not uncommon.

When they inserted the shunt, they had to drill a hole in Annabelle's skull to insert the tubing. While excess fluid should drain out through the shunt itself, the hole and the tubing it passes through do not form a super tight seal. Sometimes fluid will actually leak out through the hole around the tubing which causes some minor swelling.

The important thing to watch for is changes in behaviour:

- Inconsolable irritability
- Sluggishness
- Vomiting
- Loss of appetite
- Swelling of the head / soft spot
- Excess swelling around the shunt (insert subjective and arbitrary definition of "excess" here . . .)

You know, most of the basic symptoms that would indicate your common flu . . . Don't get me started . . .

They opted against the CT scan as they can't really justify it without one of the above symptoms. The docs said they would continue to work with our insurance company to get approval for a scan in the near future though.

So the upshot is that everyone is just fine if not sick of hospitals, co-pays and paying three $$ for parking twice a day . . .

I had the presence of mind to ask to see an actual shunt system and the nurse went and grabbed one for me to inspect. Amazingly simple, really. Here is an image I found on google. The shunt in the lower left is the kind I looked at today.


While looking for that image, I stumbled across this cool diagram as well.

Thank you for your continued prayers and support!