Sunday, January 30, 2011

Hello all. Sorry it has been a while since my last post. I was going to update you on Friday after the appointment with Dr. Singhal, but we had to take some time to let all the information settle in.

They had a scheduling error and for some reason we were not on the books. They kindly squeezed us in and still ended up spending an hour and a half answering our questions. We really liked Dr. Singhal, he seemed to be a very accomplished plastic surgeon. We asked him many questions just as we did Dr. Igbase and he was patient and answered all of them. Dr. Singhal is adamantly against the endoscopic procedure for several reasons. One being he said he sees patients all the time that had the endo procedure that need second surgeries due to inadequate results. After getting home we called the nurse back and asked how many patients is "all the time", we needed some clarification. Secondly, he did not perform or recommend the endoscopic procedure because he does not believe in doing a procedure that forces the brain to conform to a specific defined area instead of on its own. He says there isn't enough research and follow up later on in life to prove that it works. He had many other reasons, but these were the main concerns. He has been performing the traditional surgery for about 20 years (if my memory serves me correctly) and last year he did 60. Last year Dr. Igbase did 12 endoscopic procedures.

He said if we went with the traditional (big surgery) it would take about 4 hours, 3 nights in the hospital, and 3 weeks post op recovery at home. This is quite significant compared to the endoscopic procedure of 1.5 hours, 1 night in the hospital, and 1 week post op. The risk of a second surgery is at greater risk with the endoscopic surgery. A helmet would need to be worn after the endoscopic procedure for at least 9 months to remold the head. With the traditional surgery, a soft helmet (only worn for protection of the scar) would need to be worn for 3 months. The endoscopic procedure would need to be done by 6 months of age and the traditional would be done between 9 months to a year of age. Dr. Singhal believes that patients are better equipped to handle a major surgery at an older age.

That being said, you can probably imagine why we have been so overwhelmed. We have went back and forth between wanting one surgery over the other for weeks. This weekend we took some time we have decided (unless the CT scan shows something and it is medically necessary to change our minds) to go with the traditional surgery. For us, the endoscopic procedure is just too experimental, without enough proven results. We do not feel that Dr. Igbase has done enough procedures for us to feel comfortable with our little angel. We are still planning on having the CT done on Thursday to ensure there isn't any pressure on his brain or any reason to push up the surgery. We are suppose to hear back from Dr. Singhal's office this week to schedule the surgery and I will let you know what I find out, but more than likely it will be at least 7 months from now.

An update on Sophia.... She is not doing so hot. Every day she shakes in pain when her meds wear off and she yelps when walking around. It is very, very sad. We are going to go see the vet tomorrow and Sophia is getting acupuncture done (I know it sounds crazy, but we just want our little Sophia back). Hopefully this makes her feel a little better.

Thank you again for all your prayers and support. We love you all!

Wednesday, January 26, 2011

Ben's appointment with Dr. Igbase

Today we met with Dr. Igbase at Children's Mercy. He is the neurosurgeon that preforms the endoscopic procedure for craniosynostosis. He confirmed our fears that Ben does have metopic craniosynostosis and he will need surgery to correct it. His procedure would take about 1 1/2 hours to perform, he would be in recovery overnight in the ICU and then the next day he would be able to go home. He recommends I take at least a week off work for Ben's post op recovery. We have a CT scan and an appointment to meet with the craniofacial surgeon that would be working with Dr. Igbase on the surgery. These appointments are both scheduled for February 3rd. The CT scan would be performed in order to map the route for his operation. Ben also has an appointment with an opthamologist on Feb 4th for his lazy left eye. I'm not sure why Dr. Igbase wants this done before the surgery, but he does. We are thinking it is to protect himself from a liability if Ben has eye problems down the road. We are waiting to hear back from the scheduling department, but we are thinking that Ben will have surgery on February 8th. About a week after surgery, Ben would have to start wearing a helmet to reshape of head. This would have to be worn for 9 months to a year depending on the results.

That being said, we are still meeting with Dr. Singhal (a craniofacial surgeon) this Friday. This appointment is for a second opinion and to hear his thoughts on why we should do the more invasive surgery vs. the one that Dr. Igbase suggests. Honestly, Seth and I feel that Dr. Singhal would have to have some pretty compelling evidence of why we should do the more invasive route in order to change our minds. With Dr. Singhal's surgery we would have to wait until he was 9 months to a year old to get the surgery. No helmet would need to be worn with this surgery but there is a lot more blood loss during surgery and the surgery is much more complicated.

We want to thank each and every one of you for your support and prayers. We are so blessed to have such wonderful people in our lives. Seth and I are ready to move forward and past this hurdle so we can focus our energy on the wonderful gift God has given us. Ben is such a wonderful baby and has already brought so much joy to our lives and those around him. I will continue to keep you updated on his progress as the days go by and let you know how the appointment goes on Friday with Dr. Singhal.

Monday, January 24, 2011

Two appointments this week

Hello all! Wanted to give you some updated info. Sophia is doing okay; we are managing her pain with medication still. Friday night when we got home from a date night and she was in severe pain and wouldn't let either of us touch her. She hid in the corner for a while and finally came out and came to bed with us. The next day she was feeling better. We are kenneling her each time we leave the house now so she doesn't get into mischief and hurt herself worse.

Ben is doing well also. He is growing like a weed! After talking to a friend of ours (not naming names on purpose, but you know who you are-and thanks!) that works at Children's Mercy, she mentioned if it were her kid she would want all the information and would want to know about all the procedures that are possible. When I spoke with her she told me about another doctor that treats craniosynostosis very differently. He does an endoscopic procedure that can only be preformed with children at a young age (I forget what age this was) and it is minimally invasive. They cut about a 2 inch opening at the soft spot on the head compared to a incision that is all the way across the top of the head. There is less blood loss, the procedure only lasts about 1 hour vs 3-7 hours with the other procedure, and he could go home the next day vs 3-7 days. To Seth and I it sounds fantastic!!!! We now have an appointment with the doctor that preforms the endoscopic surgery to see if Ben is a good candidate and to get an official diagnosis on Wednesday at 11:30. I will update you with the info afterwards.

We still have an appointment with Dr. Singhal, which it sounds like he is the best in the area for the surgery that he preforms. This is the surgery that is more invasive, etc.

So, for now, the Olson's are just waiting for the doctor appointments and feel a little more at ease because it is all moving forward. Our only concern is that the doctors will try to persuade us to have one surgery over the other and then we will be on information overload and will have a hard time making a decision (not a strong suit for either of us). Of course, we are still hoping that nothing needs to be done at all and that this was all an unnecessary worry... But, at least we have options which I am thankful for and we feel so blessed to have friends and family that support us. Thank you all for all your kind words and prayers. Soon we will be on the other side of all of this! :)

Wednesday, January 19, 2011

Ben's appointment with the craniofacial surgeon and news about Sophia

Ben's doctor was able to get the appointment for the craniofacial surgeon moved up to January 28th (of course the day I go back to work) at 9:30. I really don't know what all to expect from this appointment besides the doctor evaluating him and seeing if he thinks a CT scan or MRI is necessary to confirm or rule out craniosynososis. After this appointment I will update you all.

Although this blog is set up for Ben's story, I'm sure he wouldn't mind sharing due to the amount of people we can reach with this avenue of contact. Last week we took our dog Sophia into the vet because she acted in pain and was yelping when she would walk or get up on furniture. The doctor thinks (he can only speculate without x-trays) that she has intervertabral disc disease, a fancy term for reptured disc. She seems to be in quite a bit of pain when walking or even to go to the bathroom. The vet has her on anti-inflamatories and pain meds for now. We are hopeful that this will go away on its own but he said if it doesn't and she becomes paralyzed, there isn't much they can do. Please keep her in your prayers also.

Damn, when it rains it pours, right?

Tuesday, January 18, 2011

The Good, the Bad, and the Ugly

I will first start by telling you some of the information that many of you already know. My life changed on Thursday, December 2, 2010 when I gave birth to our handsome little boy. He weighed seven pounds and five ounces and was nineteen and a half inches long. His APGAR scores when he was born were very high (8's and 9's) and we were very happy to be blessed with a happy, healthy baby boy. Ben got a hearing test and scared Mommy and Daddy to death. When he was tested, his left ear passed right away but his right ear was another story. In order to pass the test, they measure brain activity while introducing sounds and you have to pass the test by the time the stopwatch gets to 400. He passed on his right ear at 399! Seriously??? The lady administering the test said she thought he had some fluid in his ear and that is why it took so long. I cried when I heard the sound go off saying he passed and the lady hugged me because she understood the way my heart felt because she has a baby of her own that is deaf. She had already listened to my story of my own hardships of losing my hearing in my right ear from bacterial spinal meningitis as a baby. So, the good news, he passed!!!!

Day 2 of Ben's life he developed jaundice and breastfeeding him had to put on hold and he needed to be supplemented with formula in order to get rid of the jaundice and to get his blood sugar to a healthy level. He was not getting enough milk from me and was losing enough weight for the doctors to worry. By the end of the second day his jaundice score was appropriate enough that he was discharged from the hospital without any treatment needed and at this time weighing 6 lbs 13.2 ounces. We couldn't have been more happy or ready to take our baby boy home.

Daddy was so nervous driving home from the hospital with our little angel. He drove like a grandpa but eventually we made it home safely to introduce Baby Ben to our home, and our dogs (Shamus and Sophia). I was thankful I was not the one that had to drive us home. Sophia was curious right away and soon she became very protective and was given the nickname of Nurse Sophia because of the way she reacted to him each time he would cry or make any kind of noise. Shamus on the other hand wasn't as thrilled to have Ben home. He tried to ignore him possibly thinking he would maybe just go away soon (same way he reacted to Sophia when we brought her into our lives), but after a short amount of time, he took on the same curiosity and protective nature as Sophia did early on.

After getting home on Saturday, the pediatrician wanted to see us on Monday to make sure his jaundice was gone. He was gaining back some weight already and the jaundice was no longer a worry. His next appointment was set for Thursday, 3 days later for his 1 week check up. Ben did the unthinkable on day five of his life by rolling over from his tummy to back. As naive new parents, we had no idea this was a very advanced milestone for him. When we told his pediatrician, she was shocked and told us wee should child proof our house now!! We went home and got his milestone on videotape because we figured no one would believe it unless we did so. His one and two week check up came and went without any issues and we were starting to adjust to our new schedule at home nicely. I was on top of the world, I had so much love in my heart for Ben, Seth and everyone in my life and I was recovering and losing weight from giving birth and pregnancy nicely. By week one I had lost 20 pounds and by week two a whopping 30 pounds!! The only set back for me was a bladder infection.

By Ben's two week appointment he had gained back his weight plus a few ounces (7 lbs, 9 ounces and 20 1/4 inches long). The doctor said that he could go one feeding of waiting for 5 hours if he would. We were looking forward to this since we were lacking in our usual amount o f sleep, but as of today (6 weeks, 5 days) he has yet to do this, but I hear this is pretty normal for his age. Things were settling in well at our house. Shamus had accepted Ben as a new addition to the family and Sophia continued to welcome him. I loved staying home with him and watching his every move. The first two weeks were very emotional with all the hormones, but it seemed like, as soon as the two week mark came and went, so did the tears. Also at the two week point I had to make a decision to stop trying to force breastfeeding on him. Each time I tried he would get angry ad push me away. I would try for ten minutes as directed and each time when he pushed it away, and then I would end up pumping and feeding it to him. Seth saw my frustration over it and told me it was time to make a decision. I made the decision to no longer force breastfeeding on him since he clearly was not a fan and continued to pump and bottle feed him exclusively. This went well. I was able to offer him breast milk which offered all the benefits and also allowed Seth to enjoy the feeding times.

Ben's first month check up went well, now weighing 9 pounds, 9 ounces and 22 1/2 inches long. This put him in the 25th percentile for his weight and 50 percentile for his height. His pediatrician informed us that she believed his soft spot on the top of his head was closing prematurely and noticed his head was a bit triangular shaped with a ridge on his forehead. She wanted to re-evaluate it at his two month appointment. She mentioned that if it was more closed, she would have some tests run. She informed us that surgery would be the remedy of this condition. We didn't think much about it and scheduled our two month appointment.

On Thursday, January 6th, Seth noticed when changing his diaper that it had blood in it. Again, we didn't think much of it, but monitored the following diapers. On Friday, he had another bloody diaper and we immediately called the doctor and they requested we bring him right in. They tested his stool and it tested positive for blood. The doctor believed he may have an allergy to milk and recommended I restrict my diet (since I was still pumping and bottle feeding him) and then drop off a sample on Monday after having no dairy in my system and his. Since we were seeing a different doctor because his pediatrician was out of the office, and to get a second opinion, I asked the doctor about his soft spot growing together too quickly and asked if she noticed anything. She indeed confirmed that he had a triangular shaped head and a ridge on his forehead. She said to follow up with his regular pediatrician the next time we see her. She also believed he had a lazy left eye and advised we get it looked and so it can be corrected early. I thought, "Great, sorry I asked." Ben had developed a diaper rash around the one week mark and just would not go away. We tried three different diaper rash creams with no sign of improvement. At this appointment the doctor also prescribed a compound rash cream that proved to work within a day or two. Saturday he became colicky and was cramping up every time he ate and his sleep patterns were affected from waking up from two to three times a night to several times. On Monday we took a stool sample to the doctor's office and it tested negative for blood which lead the doctor to further believe it was a milk allergy. She explained to us that most babies that are allergic to milk are also allergic to soy therefore we needed to either continue to remove milk and soy out of my diet while feeding him with my current method or put him on hypoallergenic formula. With a hard decision to make and the anxiety of not being able to eat very many things, (I found the two ingredients are in almost everything), with a heavy heart I made the decision to put him on formula. I was surprised by the sadness I felt by not giving him "special mommy's milk", but over time got over it. The colicky behavior lasted from Saturday through Tuesday and by Wednesday we saw some improvement. The dairy must have begun to work its way out of his system. We were so relieved because it was so hard to see him scream at the top of his lungs and know that there was nothing we could do to soothe him. As of today the formula was a great choice and he no longer has the cramping during and after feedings. The only downside of it is it is a very expensive option, but we'll make it work.

I had my six week checkup with my OB doctor and in order to get a third opinion I asked her if she noticed anything wrong with his head. She said "Unfortunately, yes, he has craniosynotosis, doesn't he?" I think my reaction was a foul word followed by "maybe". So this being our third doctor to evaluate him and see what we hoped was nothing, was a realization that our fear might be coming true. I began to do some research on craniosynotosis and I have gone from knowing nothing about it to knowing alot and have also found a great support group online called Cranio Kids. I will give you some information (below) so you can understand what might be going on.

According to the Mayo Clinics website,

"Craniosynostosis is a birth defect in which one more of the joints between the bones of your infant's skull close prematurely, before you infant's brain is fully formed. When your baby has craniosynostosis, his or her brain can't grow in its natural shape and the head is misshapen. Craniosynostosis can affect one or more of the joints in your infant's skull. In some cases, crainosynotosis is associated with an underlying brain abnormality that prevents the brain from growing properly. Treating craniosynostosis usually means your infant needs surgery to separate the fused bones. If there's no underlying brain abnormality, the surgery allows the brain adequate space to grow and develop. Your infant's skull has seven bones. Normally, these bones don't fuse until around age 2, giving your baby's brain time to grow. Joints called cranial sutures, made of strong, fibrous tissue, hold these bones together. In the front of your baby's skull, these sutures intersect in the large soft spot (fontanel) on the top of your baby's head. Normally, the sutures remain flexible until the bones fuse.

Craniosynostosis signs in general include:

-A misshapen skull, with the shape depending on which of the cranial sutures are affected
-Abnormal feeling "soft spot" (fontanel) on your baby's skull
-Early disappearance of the fontanel
-Slow or no growth of head as your baby grows
-Development of a raised, hard ridge along affected sutures
-Increased pressure within the skull (intracranial pressure)

The signs of craniosynostosis may not be noticeable at birth, but they will become apparent during the first few months of your baby's life.

Common types and characteristics are Sagittal synostosis, Coronal synostosis (anterior plagiocephaly), and Bicoronal synostosis (brachycephaly).

Rare cases and characteristics include Metopic synostosis (trigonocephaly) and Lambdoid synostosis (posterior plagiocephaly). Ben's pediatrician thinks he may have Metopic Synostosis.

The metopic suture runs from the baby's nose to t he sagittal suture. Premature fusion gives the scalp a triangular appearance.

The cause of craniosynostosis is unknown. However, there's a heredity component to craniosynostosis when it occurs with certain genetic syndromes such as Apert's syndrome and Crouzon syndrome. Besides misshapen heads, infants with these syndromes often have seizures, blindness, developmental delays and mental retardation.

If untreated, increased intracranial pressure can cause these conditions:
-Brain damage
-Death, in rare instances

In addition, facial deformities that affect the middle of your child's face may case:
-Upper airway obstructions, compromising your baby's ability to breathe
-Permanent head deformity

For other infants, surgery, usually during infancy, is the primary treatment for craniosynostosis. However, the type and timing of surgery depend o the type of synostosis and whether there's an underlying syndrome.

The purpose of surgery is to relieve pressure on the brain, create room for the brain to grow normally and improve your child's appearance. A team that includes a specialist in surgery of the head and face (craniofacial surgeon) and a specialist in brain surgery (neurosurgeon) often preforms the surgery.

Traditional surgery. The surgeon makes an incision in your infant's scalp and cranial bones, then reshapes the affected portion of the skull. Sometimes plates and screws, often made of material that is absorbed over time, are used to hold the bones in place. Surgery, which is performed during general anesthesia, may take up to seven hours.

After surgery, your infant remains in the hospital for at least three days. Some temporary facial swelling is common after surgery. Complications are rare. Some children may require a second surgery later because the synostosis recurs. Also, children with facial deformities often require future surgeries to reshape their faces."

After reading this, you are probably:
A) Very tired
B) Are as concerned as we are
C) You now know the reason I have created this blog

Today, Ben's pediatrician gave us a referral to a specialist and we are in the process of setting this appointment up. The earliest the craniofacial sugeun at Children's Mercy said they could see us was February 23rd and Ben's doctor was not satisfied with that and so she has a call into the doctor's office to see if she can move the date up. Writing all of this brings me great sorrow, but is also somewhat therapeutic to write (talk) about it. I have my good days and my bad...

I will keep you all informed via this blog. For now, please pray for our little angel.

See pictures below.

With love,
Breanne & Seth