We waited almost two hours for our appointment, so here is Wyatt's nurse entertaining him in the Dr. office.
This is my favorite picture. Here you can see the cat scan of his brain done in September 08 during his last repair surgery (left side) and the same picture done in April 08 on the right side. Looking at the picture you can see four ventricles. The most recent scan in Sept. (left side) shows the ventricles almost normal size and the April scan (right scan) the ventricles are much larger.
Just for fun, Dr. Carson showed us the Cat Scan of his chest when he reherniated in Sept. during labor day. Here you can see Wyatt's ribs, scapula, and heart. Pretty cool!!
Here is a picture of his lungs. His right lung is clearly larger. His left lung is smaller because of CDH, but also because left lungs are always a little smaller because the heart is slightly on that side. Wyatt's lungs will grow until about age 5. It's amazing to think that before his orginal repair surgery, his heart was pressed all the way on the right side of his body and then after surgery, it natural moves back to the correct position on it's own. I love the human body!!
After Wyatt's repair surgery when he was about 15 days old, Wyatt suffered a brain bleed in his ventricles which leaked into his right temporal lobe due to heperin and the trauma of surgery. These bleeds are graded from a scale from 1-4 (1 being the least damage). It was devastating to find the news out after a successful surgery but we were relieved to find out it was a grade 1. Doctors advised that nothing be done, and we just sit and watch Wyatt. His head was measured everyday to check for hydrocephalus and to feel his soft spot to make sure it's still soft. Wyatt was then moved to the NICU and then to the 6th floor and with all the moves and new doctors, his head status was put on the back burner. At one point, the doctor said, this is the least of my worries and you can get it checked out after he is home. Well... a brain bleed is the MOST of my worries and I would rather prevent any damage from occurring before it actually happens. You can't play around with a head bleed. So I pressed on for Neurology to follow him while he was in the hospital as well as general pediatric surgery for his CDH. I felt very nervous about sitting and watching him. After a cat scan and head exams, his IVH grade 1 escalated to an IVH grade 4 (the worst). I remember thinking, "will we ever get a break!" I did tons of research on the Internet which made it sound very scary. Wyatt was still heavily sedated at this time in the NICU so I was not sure of the outcome. Dr. Ben Carson who is the neurosurgeon following Wyatt since he was in the NICU suggested it was time for a VP shunt since he was showing signs of hydrocephalus. If you look at the Dec. 07 pics, his head does look bigger and he was showing signs of it like rolling his eyes back. Initially, the shunt was going to be drained to his chest because Wyatt did not receive his g-tube yet and draining in the abdomen after g-tube surgery could cause infection. Draining to the heart and lungs was not on the top of my list. Wyatt already has a lot of fluid in his chest and I did not want an added source. Plus if he would reherniate (which he did three times) it could be a source of infection. So after Dr. Carson consulted with General Pediatric Surgery, he decided to drain it on the right side of his abdomen away from the g-tube. I was happy:)) Shunts get infected very easily. Wyatt's shunt was coated with antibiotics to last three months to help prevent infection. The shunt can be adjusted by placing a special magnet on his head. So far, his shunt has not given us any trouble and is working properly. It drains at a speed of 1.5 (whatever that means- it's actually a medium flow).
Today, Dr. Carson brought us good news. He is such a wonderful doctor, who sat down with us and took his time showing us all the pictures of Wyatt's x-rays and explaining it to us in detail. He said that Wyatt's ventricles are almost normal size! At the current size, he would not place a shunt in. So I asked if it would ever get removed and he advised against it. It's doing it's job of draining spinal fluid and removing it 20 years from now would mean brain surgery which would be risky and plus he said the shunt would probably be "grown" into brain tissue and he would have to pick it out. So it looks like Wyatt will have a shunt for the rest of his life. I remember when Wyatt was sedated and not knowing how he would interact, I asked Dr. Carson what would happen to Wyatt. He told me to pray and that God is Good and you know what... God is Good. Dr. Carson will be protrayed in a TNT Movie played by Cuba Gooding Jr. in his book Gifted Hands.
side story- On Thurs. while Infants and Toddler were here, Wyatt did something he never did before. While in his Jumperoo, he "zoned out" and his heart rate dropped to 50 according to the pulse ox. The therapists said it was sensory overload. Today Dr. Carson said that it's not sensory overload, that Wyatt was probably tired, and that the pulse ox was not picking up accurately. It was nap time and if it happens again to let him know.
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