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Thursday, April 24, 2014

A trip to the pediatrician

When I spoke to neurology about the MRI results, they told me they were sending the report to the pediatrician and to follow-up with her as the next steps would be handled by Izzy's PCP.  So yesterday we set off to see the doctor :p  The nurse gave her stickers while we were waiting so first she hid under the exam table with them:

When she came out of hiding, she wanted to show off her stickers
And then she decorated the diaper bag :p




So, there were a few things on the MRI report.  First, it appears there's some abnormalities with her pineal which I'm told regulates the production of melatonin.  This might explain why she's a poor sleeper :p  But its "normal" enough that there are no recommended treatment plans at this time.

Then there's the Rathke's cleft cyst.  Recommendation is to run an endocrine panel (which her doc already had an order written up and we went for that lab draw after the appointment) and to also, at some point, get an MRI with and without contrast of the pituitary gland. 

There is also some concern about the myelination in her brain and they are asking we do another MRI in one year to check her growth and development and make sure the myelin sheaths are where they are supposed to be.

Now, Iz is not showing any outward signs of a problem with the pituitary gland but we have a pretty good track record of "just in case" checks turning up a problem so we are going to go ahead her endocrine function.  If any of the numbers are off, she will be referred to an endocrinologist and we will set up the MRI of her pituitary gland.  If her numbers are fine, we will wait on the pituitary gland MRI until it can be combined with the one in a year for the myelin.  Unless some problem develops, of course. 

So now we just wait to see what her labwork says!

Wednesday, April 23, 2014

Would you like to see my GIANT EYES?

So it was time (past due a little, actually--the offices we go to switched owners and our call to remind us to schedule got lost in the shuffle :p  Reading that the Rathke's cleft cyst sometimes can effect vision reminded to call and set up an appointment) for Iz to visit her ophthalmologist. 

Normally, Iz does great with these appointments and is incredibly compliant and follows directions and tries her best to do whatever the techs and doc ask her to do.  But, as you know, her anxiety, particularly in medical situations, has been through the roof so this particular appointment was challenging ;-)  Her doctor is so great though, and is very patient and Iz really does like her so she relaxed enough for a good exam. 

However, it was one of those visits where she needed her eyes dilated.  She remembered those drops from a year ago and oh, boy, was she MAD.  We got them in, though, and retreated to the dim waiting room to wait for the drops to properly dilate her pupils.  She gave me her sad panda face while we waited:

And then demanded I take a picture of her eye to send to her daddy.  She told me her eyes felt too pointy and she couldn't look at the books they had in the waiting room.
While we were in the waiting room, she got restless because everything she tried to do from looking at books to playing a game on my phone looked funny to her and she didn't like it.  So I was leaning her back down my legs so her head hung down and I tickled her.  She would sit back up and tell me again, so I'd lean her back and tickle her again.  The four year old sitting across from us asked his mom if Izzy was a vampire because her top teeth to the side are pointy LOL  It was adorable.  I promised him she wasn't a vampire and he settled back down.

Soon it was time to go back to the exam room.  She explored a little:
And played peekaboo:
And then finally was ready for her exam.  (Not really, she ended up needing me to come sit in the chair and then she sat in my lap and I helped her hold her head still :p  If I tried to let her do it on her own, she grabbed my hands and put them up to her head.  Silly girl).

So the prognosis is astigmatism is still there, near sightedness has gotten worse but she is just under the cutoff for her age group to get glasses.   So no glasses yet (which made her made--she really wants some and kept howling in the checkout line "I want glasses!  I want glasses!") but I think its almost guaranteed next year.  The rate at which her eyes have gotten worse did slow down, though, so we are going a year instead of six months until her next check up.