Tuesday, March 31, 2009

Avoiding Surgery

We've been spending a fair amount of time at Arkansas Children's Hospital since we moved here. With almost monthly visits, we've become familiar with the ENT clinic, the Ophthalmology clinic, and the Cardiology clinic. Bella's favorite part of the hospital is watching the waterfalls (both inside and out).


Bella climbing up for a better view of the waterfall

We always stop by the indoor waterfall near the main entrance, and Gabi reminds me to be careful to step on the stepping stones, as the floor tiles make a mural of a rocky river. Bella then points out the pretend ducks "flying" overhead. Fortunately, I can redirect the kids' attention towards the cool multi-story mobile by the elevators so we can move past the hospital entrance.

Gabi thinks the hospital is a place to go eat lunch, see Daddy in the middle of the work day, get fun stickers, and play. Oh, and there's that boring part where she has to "just sit" while we the doctors check out Annabelle. And for the last two visits, Daddy's been busy and couldn't get out of work to join us for Annabelle's appointments.


Bella reflecting on the reflecting pool


Look! Water!


Ah! So relaxing.

While Bella is enamored by water, Gabi is intrigued by the cave with skeletons on the walls, stalactites hanging from the ceiling, and especially stalagmites on the floor. Gabi thinks the stalagmites look like piles of worms, but she has learned the name stalagmite now. Oh, and she also knows the word cardiology. Her echo ("picture of her heart") is still on the refrigerator.


Gabi atop a stalagmite


Fun climbing adventures in the cave


Bella running straight through the cave

Last week, Bella had an ENT appointment. Her doctor says that she does not qualify for surgery based on ENT criteria at this point (yay!) but he would like to take a better look at her throat if she goes into the OR (for her eye surgery). When he scoped her (put a camera down her throat) before, he couldn't even see the larynx (vocal chords) due to the tightness of her aryepiglottic folds. But, really, all her symptoms are controlled by the Prevacid, so there's no reason to "fix" what isn't causing problems. If she were in the OR anyway, he'd take a look and maybe make some minor incisions, but we'd just see. Oh, and her vocabulary is incredible now, so we have no more worries about needing tubes in her ears!


Bella peeking through the dock rails


Watching Gabi climb the hill


Stop to smell the flowers



This afternoon, we went to Bella's surgery consult with the oculoplastic surgeon. Back in January, her ophthalmologist had told us that she would need to have a procedure to open her nasolacrimal ducts, as her eyes were still too watery even though I thought they were improving. A week or two later, her eyes started gooping up excessively and her pediatrician started her on antibiotic eye drops. After a month of Vigamox, I asked for a less expensive medicine, and we switched to gentamicin. Bella's eyes gradually stopped collecting goop and were just watery as usual.

Two weeks ago, about the time we returned from our trip to Stephanie's wedding, Annabelle's eyes cleared up completely. Hooray! Yesterday the girls both woke up with a cold (Gabi's was severe enough that I kept her home from school), and Bella's eyes started tearing again. But I assured the eye doctor that her eyes were clear for the last two weeks, so he's going to let us watch her and go back for another consult in a month or so.


Gabi wanted to touch the water


It's a bit too far to reach, though

Dr. Westfall was encouraged by the story of Bella's eyes being clear for two weeks. If a membrane was blocking the tear drainage, then it would be obstructed all the time. If her eyes are only watery when she is sick, that suggests that her nasolacrimal ducts are just too narrow. When she gets a cold, the ducts swell and constrict to prevent the tears from draining, just like nasal inflammation can clog your sinuses. As she grows, they will eventually get bigger such that the narrow ducts won't be a problem, so the doctors won't need to do any intervention. He did want me to stop using the eye drops because long-term antibiotics can cause problems. So we'll see how she does without the drops, wait for her to recover from this cold, and keep an eye on her eyes. But at this point, we do not anticipate surgery!

1 comment:

TheCeiba said...

Yay! I'm glad no surgery will be required!