MRI Results

We had the MRI today. Lucas had to be sedated for the procedure, so it was a long, fairly stressful day. Before I get to the results, I should tell you about the week leading up to today.... The blood tests last week all came back ok, so we've been very nervous about what the MRI would reveal (because with the bloodwork checking out, it confirmed that the apnea was definitely neurological). It was the first time I was disappointed to hear them say everything was "normal." The neurosurgeon told us last week they were looking for a "chiari" in the MRI, which scared the hell out of us. Chiari's are many times associated with brain injuries and hydrocephalus, where the cerebellum and brainstem are pushed downward, and the pressure causes problems with basic vital functions... they can be very bad news with painful surgeries to correct. Of course, I heard this and went immediately to the Internet because I have this bad habit of self-inflicting pain by looking for information. You'd think I would have learned my lesson by now...NOT to go looking online for answers or hope, because you read a lot of scary medical stuff out there (I can't tell you how many times Bran has walked in to find me crying and says "Oh, Angie, have you been online again? You've got to stop!") In addition to hearing about the chiari possibility, Lucas dropped his eating in half last week and was sleeping notably longer than most days (pointing also to a neurological issue). So we've been pretty freaked out, scared of it being a shunt malfunction or chiari--both would require surgeries.

The great news is we learned today that he does not have a chiari! I can't tell you how much relief we feel! The MRI did show, however, that the 4th ventricle has expanded significantly since January and is most likely the culprit to his apnea spells and loss of appetite. That ventricle is now bulging with fluid to the point that it is putting pressure against the brain stem. This 4th ventricle has a line of scar tissue separating it into two areas, causing only half of it to drain (this most likely happened as a result of the meningitis). The existing shunt is not able to drain the walled off portion. She is recommending surgery to place another catheter into that part of the ventricle and will splice it into the existing line. In other words, he will still have the same shunt, but it will be spliced to drain two separate areas.

Instead of being upset about this, we are actually very relieved (since we've spent the last two weeks worried about other problems). It is nice to have an answer, or something to blame for the apnea. We certainly don't want him to have another surgery, but if we can push through and just get this over with, he should start feeling better and hopefully sleep better without all the apnea spells (and maybe we can get rid of the oxygen tanks)! Plus, by relieving this last bit of pressure, it can give the brain even more capacity to expand. You have to wonder how much this last bit of compression on the left side is impacting his development...it will be good to get it fixed.

Dr. Yaun says the procedure should be pretty simple (as simple as brain surgery can be, I guess). It should only take about 20 minutes once she begins, and he should spend only one night in the hospital. She said she would not expect him to take more than a couple days for him to feel like himself again. Seems too good to be true, but she assured us that it is not nearly as invasive to add this line as it was to install the shunt. We are looking at scheduling it next week. Please keep him in your prayers.

I'll end on a good note regarding an appointment we had last week... Lucas had a hernia while he was in the NICU and we were told to have it surgically corrected when he was bigger, at 6-months ocrrected age. This would have been in January. We noticed the intestine had not been dropping down the last couple months (as it used to every day when he first came home from the hospital). I asked our pediatrician last month if it could have resolved on its own and he said it is possible, but said it was very unlikely -- and deferred us to the surgeon at Children's. So Lucas was seen last week, and guess what -- it DID resolve on its own! How 'bout that? There's our boy again... I guess they just didn't know who they were dealing with!