Little known fact about me: no matter how early the departure time, I will always, always take a shower before bringing Tessa to any doctor visit.
I’m not sure when this started, but I’ve determined that it acts like a security blanket for my nerves, like I’ve somehow decided that washing my hair and putting on make-up will somehow block us from anything bad happening. Because if I’m cleaned up and ready for the long haul, everything will go smoothly. You know how if you bring your umbrella on a cloudy day, it won’t rain? Kind of like that. If I’m prepared for the day, nothing can go wrong.
We had one of those appointments last Wednesday and since I now have all the information… here you go:
So there are several screening tests that we are to have with Tessa throughout her life. Thyroid, sleep study, monitoring white blood cell counts for leukemia, eyes checked, heart scanned, etc. The most recent test that we were to have done is the atlantoaxial instability neck X-ray.
Very very basically, the top two vertebrae on which the skull/brain sit are more likely to be unstable in individuals with Down syndrome. Rarely, this can cause nerve damage or more serious complications. Many times, certain therapies will require a child to be cleared of this instability (like to participate in equine therapy), as well as some extra-curricular activities (especially those that could involve head compression/injury like gymnastics). Our pediatrician wanted to have her screened at three. This was recommended by the American Academy of Pediatrics for some time, though I have been told that their most recent guidelines don’t require it.
In any case, we had the neck X-ray and at about 7 pm, I got a call from the pediatrician’s office and was greeted frantically with “are you still in the hospital? We really need to talk to you about your daughter’s results.”
Not exactly the words that we were anticipating.
Their instructions were essentially to put Tessa, our wild and independent little runner, into a bubble until we could see a neurosurgeon. What?? No PT, no physical education, no recess (what??)… do nothing until she is cleared by a neurosurgeon. They told us that there was a high risk of paralyzation if she were to have a head injury (as they say this, I remember the moment with startling clarity when she fell down the stairs just three days prior). The next day, the office made us an appointment to see a highly-recommended neurosurgeon within a couple of days.
To say that we were freaked out is probably the understatement of the year.
It was a long wait until that Monday, but I will say, within a minute of meeting this doctor, we were totally at ease… because he’s clearly brilliant, but also because he greeted us by asking “so tell me, why did they send you here?”
His concern was much more minor, quite thankfully. He didn’t see the severe instability that the initial radiologist must have. We weren’t totally in the clear – because Tessa can’t well communicate with us symptoms that she might be experiencing (numbness in her fingers, neck pain, etc), we still needed to have an MRI to make sure there is no damage to her nerves.
The problem with an MRI and a three year old is obvious. An adult can barely lie still for that long, let alone a child. We would have to go into Chicago to our Children’s Hospital so that she could have the imaging done under anesthesia. Unfortunately, in my family, there is some history of complications with anesthesia, so we get a little more antsy than people probably typically do.
We finally had her MRI done last Wednesday. A 5:15 departure time is not far off from my typical work day, but being on Spring Break… that alarm felt extra early. The hospital staff was lovely, really, and while navigating the city (especially on Lower Wacker Drive where GPS is useless) is not my favorite, we managed.
The history with anesthesia always brings lots of questions from the staff. Most people see one or two anesthesiologists before a procedure; we always meet the whole team. Tessa was a trooper, and charmed the heck out of all the doctors and nurses with her manners. She did take quite a bit longer than typical to come out of her daze, which made our time in the waiting room, waiting for answers, feel like an eternity. When she finally came around, she alternated between her dazed, lovey schmoozing and intense irritation with anyone who took her juice and goldfish crackers. It was hilarious.
I’ll cut to the chase here – on Friday afternoon, we got the call that her MRI was essentially “unremarkable” and that there are no concerns at this time. We will continue to see this neurosurgeon off and on over the next several years to continue monitoring, as AAI may not appear until later in life.
For now, I feel like my superstitious shower helped us out once again.