Second Opinion
I know. I know. It's been an entire week since I last updated. We've been busy. We took the boys to their first Drum Corp show, left a day early for a vacation in the Dells, swam, swam, and swam some more. Everything was awesome. We had to take Liam home two days early from vacation to make a neurologist appointment in the city. Since we felt just a tad guilty about leaving vacation, we decided to make a day of the trip. We took the train, a taxi, visited the zoo, and got some popcorn for the train ride home.
At the zoo
The neurologist thought Liam looked great. He tested the strength on this right and left side and said there was still a slight weakness on the right - something Liam's OT and PT have reported. He also said that there's no treatment or drug that is given to children while they are in the acute stage of a stroke - so nothing different could have been done in the ER or at Loyola upon our arrival. He agreed with the plan of treatment that was given to us (therapy and a baby aspirin a day). He took the medical reports we brought with and studied them in his office for about 40 minutes while we waited.
Waiting at Lurie's Outpatient Center in Lincoln Park
After looking over the report he did suggest one more test that would give us a definite answer to be sure there are no blockages in the neck. A type of angiogram - it would require an overnight stay in the hospital, sedation, inserting a dye into his blood stream, and checking the arteries in his neck. These were checked with the MRI and MRA he had done at Loyola, but this test is just more accurate and would show smaller blockages that might not appear on the other tests.
If this test comes back normal than this neurologist would consider this stroke to have no known cause. I will say here that the main doctor at Loyola that oversaw the case feels that serious consideration needs to be given to the chicken pox vaccine causing this stroke - if no other causes are found. Our own pediatrician also agrees with this. There have been reported cases of this happening in other children. I will definitely be talking more of this in the future. But for now our goal is to focus on ruling out any cause that would require a specific treatment and for continuing with our therapy.
It this test did show a small blockage then Liam would be monitored as he grows with MRIs and would continue the aspirin regime.
I'm not sure if our original neurologist will be suggesting this very same test at our follow-up appointment. It needs to be done after the acute stage of the stroke is over so this may be something he already had on his radar. We will be asking him for his opinion before we make any decisions.
The neurologist from Lurie's (second opinion guy) also suggested a few blood tests that he didn't see on the report. We're seeing the hematologist today so we'll bring those up with her.
The view from the doctor's office.
Labels: angiogram, childhood stroke, ischemic stroke, liam, MRI, neurology
posted by Cathy @ 7:42 AM
4 Comments
4 Comments:
Isn't it crazy how fast you become familiar with medical terminology? Are you a person who benefits from being able to do your own searches and find out information or does that sort of thing spook you? It helped us tremendously - both in learning possible causes/diagnosis/etc. and for figuring out the pertinent questions to ask the doctors. I'm glad he's getting such good care.
Cathy, I was at my neurologist appointment last night and I mentioned Liam's stroke to him...I really trust him and just had questions due to my concern for Liam and the shock of something like this happening to a child of 5. He said the one thing that Liam needs to be checked for is something called moyamoya. When you mentioned the angiogram being suggested, I wanted to post what my neurologist said. You may have already been talked to about this but in case you haven't, here is the link: http://www.ninds.nih.gov/disorders/moyamoya/moyamoya.htm I hope you are able to figure out what caused this for Liam, I know it hasn't been easy. Oh, by the way, my neurologist also said that for Liam to be coming back so well with his physical for op therapy that is a huge plus, the speech and language is usually better within 6 months but he said if the physical and op didn't come back as quickly that it would have been a more difficult problem for Liam as time progressed. I hope you don't mind me asking my doctor, I just really wanted to help Liam and to also understand how this happens to such innocent children.
Looks like this would have been discovered during the MRI and MRA that Liam had done. This link does mention having an angiogram as well. http://www.ask.com/wiki/Moyamoya_disease#Diagnosis
I don't mind you asking your doctor.
The thing with all the tests that were run we were never told WHAT they were looking for... so hearing of a specific disease requires me to look to see how that disease is diagnosed.
I'm pretty confident that all that's been done (minus the angiogram) is all that needs to be done to look for anything.
It is amazing...
I don't mind looking things up and reading about them, but that's really Mike's forte. If a doctor mentions something I usually write it down and read more about it later. Sadly, there's not a lot of information out there on childhood strokes/causes - so we do rely on the doctors and then check into what they are talking about.
I've found that I enjoy looking up therapy methods and talking with his therapists about what they are doing in their sessions and what we can do at home. (I don't accompany Liam - just wait in the waiting room.) Mike and I are a good balance this way - he explains some of the medical stuff I might not understand and I explain the different things we should be trying at home with Liam. I'm hoping to get a therapy post up soon - especially with the stuff I've learned from his speech therapist about aphasia therapy.
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