Tuesday, August 26, 2008

CT Scan--The Saga

I think I'll start by saying that we just got a call from the doctor saying that she and the radiologist looked at The Boy's CT scan results. The tumor in the right kidney has become more circumscribed, which mean that it is more of its own entity and less entrenched in the kidney, so they'd be able to go in and nab that sucker. Unfortunately, the surgeon has not finished looking at the scan, so we may not get a definite answer on when surgery will be until tomorrow, most likely.

So that's positive--it means that the chemotherapy is working. It was a genuine concern because we thought that the relative lack of symptoms (specifically the fact that The Boy still has his hair and grows more each day) meant that perhaps the chemotherapy was having no effect. Thankfully, that isn't the case.

The process of bringing a baby in for a CT scan is one that I wouldn't really wish on anyone. Remember that small children cannot follow the directions normally given "Okay...lie perfectly still. Now breathe in, and now breathe out." I don't think so. They need to be sedated (a "conscious sedation") so that they'll stay still. Which means that they can't eat before the procedure. Specifically, the guidelines are that 8 hours before is the last time they can have solid food, 6 hours before is the last time that they can have formula if that's what they're on, 4 hours for breastmilk, and 2 hours for clear liquids like water, apple juice, or Pedialyte. Look that up and remember it if, heaven forbid, your child has to go through such a thing.

The Boy loves his milk. You know that he doesn't sleep through the night so he never goes more than 4 hours without it and that's pushing it. The scan was scheduled for 7:30 AM, with a 6:00 AM arrival, so his last nursing was a little after 3 AM. Did it start at 7:30 AM? Nope. The possibility existed, but it was not meant to be. Here's why:

The doctors expected The Boy to drink the contrast solution. By itself, looked to be about...3 ounces. It needed to be mixed with something like apple juice to get him to drink it. I had to leave the room because he wanted nothing to do with apple juice; he wanted milk and he knows where to get it. My mother tried and tried, first with a sippy cup and then with a bottle. Then I tried the bottle. Forget it--he was batting it away and wanted nothing to do with it.

Here's the thing: The Boy has never been "forced" to eat or drink anything. He doesn't "get fed" his food. Never has. Moreover, he eats what he wants when he wants it. We serve him meals and he decides which items he would like first or second, and he decides how much water or juice he wants; there is no expectation that he finish the cup. I have no idea how much food or water/juice he takes in a meal. And The Boy hasn't had a bottle in about 6 weeks, when I was gone for more than 4 hours teaching lessons.

How about a little warning?

They ended up putting him out using a breathing mask and then placing an IV in his arm in order to inject the contrast solution. This isn't as effective of a method for this type of scan, apparently, but it worked. And why the IV in the arm when he has a medi-port? There is a clotting risk with this solution going through, so they don't run it through the port. It was really a no-win situation--chubby baby with no visible vains who also wants nothing to drink but mama milk, which he can't have until afterwards.

FINALLY they figured out what to do, as I said, and they did it. It didn't take very long at all, all told, and he started to wake up right away after it was all done, negating the need for a recovery room.

We went to his treatment center because they validate parking, and we were fortunate to see one of the oncologists and discuss everything with her. They had had to call her once The Boy decided that he wasn't drinking any of that contrast solution, so she knew that he had been an interesting patient. She explained that she'd have to look at the scan and consult with the surgeon, which brings us to the results that we got via the phone call.

Also, as an added nicety, we saw The Boy's pediatrician on the way in, at 6:00 AM. It was reassuring to see him and have him say that The Boy looked so good!

So...even though we know that the chemo is working, we still don't know when the surgery will be. Although we're pretty sure that the surgery will happen.

All in all, good news.


Sarah R said...

I'm so glad the chemo is working. That is great news. I hope everything goes speedy from here on out! It would be great if David could keep his hair! Hugs....and many well wishes.

Velvet said...

Sounds like a gruelling job getting the little one scanned - you have my admiration for your patience under trying circumstances. Glad it eventually got done though, and that David's reacting to well to treatment. It's wonderful that he's so far had the best (relatively speaking, of course) of both worlds - not too extreme an adverse reaction to the rigours of chemo, but a positive therapeutic effect on his cancer. Hope that continues!

Gill x