The Results

Friday after work I went by Vanderbilt and picked up the CD of images to bring to her appointment Monday. I brought the CD over to my mom's on Saturday to look at the images the report was also included on the CD. Mom and I read it over and honestly became quite concerned. The two main items of concern were the statements "substantially incomplete myelin" and "possible lesion or artifact on the t2". Of course I googled the crap out of it and began freaking out - yes I know Dr. Google is ALWAYS wrong but I just couldn't help myself.

A few items to note so that you can fully understand the above terms.

Myelin is the white matter of the brain and surrounds the exterior of the brain. The purpose of the myelin sheath is to allow impulses to transmit quickly and efficiently along the nerve cells. If myelin is damaged, the impulses slow down. This can cause diseases such as multiple sclerosis and most children with delayed myelination are severely delayed.

An image artifact is any feature which appears in an image which is not present in the original imaged object. An image artifact is sometime the result of improper operation of the imager, and other times a consequence of natural processes or properties of the human body. It is important to be familiar with the appearance of artifacts because artifacts can obscure, and be mistaken for, pathology. Therefore, image artifacts can result in false negatives and false positives.

I picked Todd up from the office and we went to Dr. Cruz's office. As always we went straight back (they are wonderful like that) I gave the nurse the CD of images. Dr. Cruz came in and stated that the MRI results were pretty insignificant which had me baffled. As we discussed he said that the statement "substantially incomplete myelin" was typical for her age because it shouldn't be complete at this age and that there is a huge difference between DELAYED myelination and INCOMPLETE myelination and that we will do another MRI at age 3 to see if it has fully developed as it should. Then we spoke about the lesion/artifact he said on the images that he looked at it was a very small dark spot deep in the brain - think the inner most part of the brain behind the right ear. This could be a cortical dysplasia or it could be nothing - it is still hard to tell since her brain still hasn't fully developed. We then discussed the original EEG and how it showed the spike at the front line of the brain. And then discussed the fact that we believe she had a seizure the other weekend I described how she hadn't napped all day and at dinner she became unresponsive for around 20 seconds. Then she slept horribly that night was extremely cranky and slept all day the next day. He said everything I described sounded spot on for a seizure but he was going to let it slide. The next seizure she has we will have to do labs to see how quickly she is metabolizing the medicine then up her medicine dosage and then do more labs. And we will also have to repeat the EEG this time doing it at Vanderbilt instead of Centennial. Over all it was a great visit and I walked away feeling much better. Out ultimate goal is for her to become completely seizure free and secondly to figure out why she is having the seizures.

MRI day

History: In May 2011 Olivia went in for an EEG at Centennial Hospital just as a precaution for some jerky motions at 9 months. The results showed and abnormality in brain waves coming from the front of her brainn between the two spheres. We were referred to Dr Cruz a neurologist who had us go in for an MRI in July 2011 at Vanderbilt Children's the MRI showed a small amount of delayed myelination behind her right eat and we were told that she had Cortical Dysplasia. But because the MRI and EEG showed issues in different parts of the brain the doctor didn't want to put her on medication. However a few weeks later after more seizures we decided to put her on Keppra. In January 2012 Olivia began to blink continuously for 10-30 seconds at random times so we preformed an eye exam which showed normal vision and then upped her medication dosage which has stopped the blinking.

Today: Olivia slept GREAT last night and got up at 6am (as always) and we got up and showered and watched movies she only asked for a snack once (no food allowed after 2am) and was pacified with a cup of apple juice and wasn't too upset when I took away her juice at 8am. At 9am we left to pick up my mom (who we haven't seen in over 2 weeks) from work and then went to the hospital. Olivia was in a great mood in the car but did ask for crackers, candy, and juice and was upset when she didn't get any. Once at the hospital we fed the fish and played outside (LOVE Vanderbilt Children's) we then went back and weighed her - 29lbs dressed! - took her oxygen levels, temp, etc and played toys and such talked to nurses and the anesthesiologist they were all so great with her - they had toys for her and Mickey Mouse Clubhouse on. We sent her back with them and we were told it would be 1.5-2 hours before we were called back. Mom and I went to the cafeteria and had lunch and then went and sat in the park and chatted waiting for the call. It only took an hour and 20 minutes! But on the call I could hear her crying in the background. Mom and I went back to the recovery room where Liv was laying down crying and coughing with nurses around her. They stepped back and let me pick her up she kept coughing like she was choking and crying like she didn't want to be awake and her eyes were swollen and face was all red from the tape on her eyes and face. The nurse told us she did great with the gas but as soon as they took her off she popped up awake which never happens and then she took out her own IV (sooo Olivia - she won't even wear a band-aid) and that he was going to have to do some paper work before talking to us and apologized (guess thats why it didn't take long). The entire time she refused to eat or drink and kept coughing like she was choking, she would sleep with a paci and then get mad and throw it. FINALLY she took some juice and let us dress her after we got our discharge instructions we went to the lobby where she finally ate some gold fish but was still fussy. We made it to the car and got her strapped in but as soon as we got in our seats she started choking on her gold fish (her mouth was too dry to swallow them) and she puked them back up on my hand as I unbuckled her. Once buckled back in she calmed down and we took mom back to work where Liv screamed bloody murder over her leaving. Then we went to Todd's office - by the time we got there she was doing MUCH better. We then went CVS and picked up her Keppra and then went DQ and got her lunch and I got a Strawberry Shake that she LOVED and drank most of (see below). The doctor should have the results in 24-48 hours but we may not know anything until Monday when we meet Dr. Cruz, based on the results we may need to do a repeat EEG. I will update on Monday :)