Wednesday, May 16, 2007

New Paediatrician Update

Wednesday, May 16, 2007

Today we saw our Paed again. We haven't seen him in a very long time. Isla was so good when we saw him, although she didn't take too well to him giving her a stamp on her hand and made him wash it off LOL

The things we discussed:

*Walking - He had only met with Michael that morning, and Michael was telling him how well she's doing. Isla can now walk unaided for about 10 or so metres, it depends on what's in front of her. The more excited she is, the more likely she is to fall over. Isla is also able to stand unassisted with bare feet and can even take a few wobbly steps without her AFO's :)

*Toilet Training - He asked where we were at with it. He's of the same thinking as me, we need to get her balance sorted out before we can contemplate a potty. She won't be able to handle it if she's uncomfortable. We'll get there :)

*Weight - He's convinced that she's just petite, she's only just reached 11kgs so it's taken her about 18 months to gain 1.5kgs. He's not concerned about her weight.

*Seizures - We were given a referral for Liverpool Hospital for Clinical Neurophysiology. There she'll have a "Sleep Deprived EEG" to see whether these "episodes" are infact seizures or simply Isla just zoning out. He seems to think the latter as there's no convulsions etc associated with them. I do hope he's right.

and finally
*MRI results - I informed him that we'd been waiting since October for the results, so after a quick phone call to the Sydney Children's, his receptionist appears with the report in her hands :) It reads as follows:

Spastic Diplegia. Born at 35weeks gestation. Second Trimester antepartum haemmorhage.

The following sequences were performed through the brain:
T1-weighter sagittals
T2, FLAIR and gradient-echo axials
Diffusion on weighted imaging
Axial true IR

There is excessive abnormal signal (hyperintense on T2 and FLAIR and relatively hypointense on T1) in the peritrigonal periventricular white matter and centrum semi ovule bilaterally. There is also a reduction in the volume of the peritrigonal white matter bilaterally. Ventricular size is normal but there is a slightly wavy contour to the lateral wall of the trigone of the right lateral ventricle. The surface CSF spaces are normal in size and appearance. There is no shift of midline structures or other evidence of mass-effect. There is no structural abnormality. Myelination is appropriate for age. There is no evidence of space occupying lesion, extra-axial coillection or past parenchymal haemmorhage.

The appearance are consistent with periventricular leucomalacia.

So there you go.

From the way Dr F explained it to me, it basically means that parts of the brain that supply the spinal column with fluid aren't perfect in Isla's brain. She has some tissue missing. It is most often found in children born prematurely (Below 37wks), with birth weight under 2.5kgs (Isla was 2585g). It could have been caused by those two factors. I may be because of a virus I had while I was pregnant (which I had while in hospital). It may have been caused by the placenta praevia - or a combination of all of the above...we'll never know.

Anyway, good news is that it won't get any worse. Also, if there are to be any more little people in this family, we are at the same risk level as the rest of the population :) He also said that I was a slight risk of PP again, although some other OB's have said that I'm at a 90% - who knows!