Wednesday, November 16, 2011

MRI/neuro visit

Rhys had an MRI last week... the one the neurologist mentioned way back in April. I was a little nervous about the anesthesia for the test, given the reaction Rhys had after his adenoids were removed. I'm still not sure if Rhys's increased oxygen needs were related to the actual surgery, the drugs they used to knock him out, or possibly the intubation, so I was really hoping he didn't have the same reaction after the MRI. I expressed my concerns to the anesthesia team, but (obviously) they still had to sedate him. They did explain that they don't actually use a breathing tube and instead do something just at the back of the mouth to help keep air moving. Other than being a total grouch for two days he did great with it all.

Today was our follow up with the neurologist. After comparing the first images (from when Rhys was in the NICU) to this MRI the neurologist is comfortable knowing that Rhys's damage was related to his prematurity and is not progressive. Not that we were worried really, but any brain damage can cause things like seizures, etc. And depending on where the damage is located, and what the scar tissue looks like, they can get a good idea of who may be more at risk for these other issues. As of now Rhys is not at risk and other than a yearly follow up we should be good. The only interesting thing that the doctor did find was where damage had occurred.

Rhys's brain bleed was on the left side of his brain. On the very first head ultrasound, done in the NICU when he was only a few days old showed, everything was normal. The second ultrasound is what revealed the brain bleed. All the damage Rhys has now is related to that event three years ago. However, in addition to damaged tissue on the left side of his brain, Rhys also has damage on the right side of his brain. Again, based on the scar tissue the doctor can tell it isn't from a recent event. So, the doctor was a little perplexed given that Rhys was initially diagnosed with only a grade III brain bleed on his left side. He did have an MRI in the NICU right before he was discharged, and that study was supposed to be delivered to our doctor several months ago, but we only viewed the old head ultrasounds today which is something entirely different. I meant to ask about that first MRI, but we'd had a very long day and I was running very late to let Courtney leave and I just forgot to ask about it. Regardless, we got a good report! And even though he can't really give us any insight into what the future may hold for Rhys he is very optimistic given Rhys's behavior and current abilities and just told us to keep trying as hard as we can right now because it will pay off in the long run. We've been told a million times that these kids' brains develop entirely differently than an average baby, and reroute pathways around the damaged areas.

Incidentally, the doctor and all (four) of his medical students got a huge kick out of Rhys constantly telling them "all done". He was giving high fives and even got a little upset when the medical students walked out of the exam room. He's quite the charmer when he wants to be.


Alicia said...

LOL at him telling them "all done" wish I could tell dr.'s that when I have an appt!

Only the Sheppards said...

The brain is such a strange, amazing thing! Dax never had any signs of brain bleeds on any of the head ultrasounds, which was quite a miracle considering he was a 23 weeker. He gets an MRI at 8 months, and, WHAM, his brain was all jacked up (my term, not the neuro's ;) He's missing most of his cerebellum and pons, there's atrophy in his brainstem, loads of PVLs, and, for lack of a better term, his ventricles are so large his brain image looks like a slice of swiss cheese.

When did it happen? We don't know. We have to assume the cerebellar atrophy, etc, was from a stroke or bleed but we have absolutely no idea.

Here's to a good MRI report and continued progress to you guys! And for the day you can be "all done" with doctors :)