Wednesday, December 3, 2008

Long Day, Good News

I took Monday off work to take the kids places they'd rather not be. I got up at early o'clock in the morning to take my ten-month-old son to an MRI appointment at 6:30 a.m. All things considered, he behaved remarkably well. He even smiled and cooed at the nurse while she was prodding him during the pre-scan evaluation. He only started crying when it was time to hold him down to get the IV put in, and that didn't last long. The hardest part was the administration of the sedative and his insertion into the machine. I held him as they gave the sedative. It acted surprisingly quickly, and it was only about 30 seconds before I had to support his head to keep it from flopping back like a newborn's. He fought to stay awake, but within a couple of minutes he'd gone limp.

Then I had to stand on a mat in the control room, just outside the scan room, and watch through the doorway while the nurses took him from me and placed him on the scanning bed. The noise of the machine was enough to make him wake up and cry a bit, so they had to give him an additional short-duration sedative to keep him asleep. They attached monitors that would ensure that he was not having an adverse reaction to the sedatives (pulse, blood pressure and oxygenation), and an oxygen line, since the sedatives cause his breathing to be more shallow. When they returned, I had to leave and wait in the sedation recovery room while they curtained off the control room and performed the scan.

As irrational as it is, a parent can't help but imagine the worst while waiting during a procedure or test, no matter how minor. The scan itself really only took about half an hour tops, but the minutes seemed interminable as I sat in a chair next to an empty hospital cradle. I soon gave in to temptation and began pacing the room. Finally, the nurses pulled back the curtain and brought him out. With them came the radiologist, who told me that he still needed to do a thorough reading of the scans, but from what he had seen they looked normal. The nurse laid him in the cradle and again attached monitors to him, along with a saline drip to keep him hydrated, since he was required to be fasting for the scan and had not had anything to eat or drink since he went to sleep the previous night.

Thus began the 90-minute wait for the sedative to wear off enough to wake him. This was almost as nerve-wracking as the scan, thanks to the list of things we'd have to watch for over the next 24 hours that the nurse gave me. If we can't wake him, call 911. Make sure you don't allow his head to droop during the ride home, since it can impede his airway. Don't let him curl into a ball while sleeping or otherwise position himself in any way that could constrict his chest or airway. Watch him carefully while awake, since he may have trouble holding up his head or maintaining balance while crawling or sitting. Keep him on clear liquids for several hours, since the sedative can make him sick to his stomach. If he throws up, try to prevent him from aspirating any vomit, as that can cause pneumonia.

I kept checking his breathing over the 90 minutes, even though I knew perfectly well that a monitor would start screaming bloody murder if he stopped breathing. It seemed unnatural that he was so still. He somehow looked smaller, sleeping with a pre-warmed blanket over him, almost as if he were a newborn again. Perhaps I was unconsciously recalling the last time he was in a hospital cradle, just ten short months ago.

At last it was time to wake him. Fortunately, he woke up readily and immediately started protesting that his tummy was empty! He greedily chugged down 14 ounces of juice and gave a vigorous burp, to the amusement of the nurses. After that he seemed pretty happy and fairly normal, except for his head being a bit wobbly. He was discharged and I drove us home while he napped.

That afternoon, I took my daughter to the school district headquarters to be evaluated, in order to determine whether she is eligible for special education services. For most of the two-and-a-half hours that we were there, she was inconsolable. Something about the place just set her off and she screamed like someone was killing her. My time there was mostly spent answering long questionnaires about her behavior with my right hand while holding her in my left arm and rapidly going deaf in my left ear.

Eventually it was determined, to nobody's surprise, that yes, she does indeed have autism and yes, she is qualified to receive special education services. A good thing, since I was not really wanting to get into a big battle with the school district should they have taken it into their heads that she didn't need the services. As soon as I took her hand and told her that we were “going bye-bye” she immediately cheered up, smiled and waved at the people she'd been screaming at the whole time, and literally skipped out of the building.

Final note: Yesterday, we received word that the final reading of my son's MRI scans showed no abnormalities. This leads the pediatrician to believe that the most likely cause of his strange manner of crawling is simply preference for the right over the left, and that with time it should straighten out. Good news, but it does mean that we now have to wait and see if that pathetic-looking crawl of his really does work itself out.

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