The Hanway Family

Abby learned to do something new last night. As she was sitting on her changing pad, she leaned forward, hit the button to open her wipes box, took out a wipe, and closed the box. It was so cute, even as she put the wipe in her mouth to chew on it. There's no telling what she'll do next.

This is the link to the YouTube site where we are putting videos of Abby.
http://www.youtube.com/user/hanwayfamily

Today Abby had a CTA scan (CT angiogram). This was done to look for a vascular ring or some other sort of vascular anomoly that would be causing her bronchomalacia. This required general anesthesia again. Luckily, we were able to stay with her this time until she was completely asleep. That was very nice. When she woke up, I fed her, then she took another 6 oz of bottle. I'm guessing that she had close to 12 oz of milk total. This wasn't a good idea, because about half an hour later, it all came back up in the hospital cafeteria. And all over Leonard! They were both covered. We had a change of clothes for Abby, but Leonard's were back at the hotel, so he had to stay in them until after the ENT appointment.

We don't have the final report yet, but the preliminary report shows that all her vascular structures are normal. This means that her bronchomalacia is caused by floppy cartilage and won't require surgery! The doctors feel that she should grow out of this by the time she is two. This is great news. She will still require chest x-rays whenever she gets a cold for as long as her breathing remains raspy and wheezy.

We are hoping that this will be our last visit to Children's until her swallow study in May and the cardiologist in July.

Since her appointment was on a Friday, we decided to spend the weekend in Little Rock and go to the zoo on Saturday. Abby didn't seem too excited about it. She liked the larger animals that were moving and did a lot of people watching. It was free admission weekend, so it was absolutely packed! It took us an hour and a half to get out of the parking lot. Madness! I'm posting pictures on the shutterfly site right now.

As you know, Abby had a microlaryngoscopy and bronchoscopy yesterday to help determine the source of her breathing problems. She did wonderfully with the anesthesia and the procedure. All the nurses loved her. She was understandably cranky afterwards and very hungry. She has pigged out since then.

The doctor determined that she has minor laryngomalacia, which we already knew. The procedure confirmed that she has moderate tracheomalacia, or a floppy trachea. This means that her trachea is collapsing on itself when she exhales because the cartilage that it is made of is weak. She will just have to grow out of this, but it probably won’t be until she’s about two years old.

What was found that we weren’t expecting is fairly severe bronchomalacia. The main bronchus (branch off her trachea) going into her left lung is almost completely collapsed. This means that anything that gets into that left lung (mucous, refluxed milk, etc.) cannot be coughed out. This is why she has been coughing so much. From now on, any time she gets a cold or a cough, she will need a chest x-ray to check for fluid in that lung.

Bronchomalacia has two causes. The first is floppiness of the cartilage, just like in her trachea. If this is the cause of her bronchomalacia, she will also have to just grow out of it. The second cause is an artery pressing on that bronchus. If this is the cause, it will most likely mean surgery. At this point, we are pretty well back to where we started, only with a few more answers. She will have to have a CT scan, but at this point we do not know when it will be. The echocardiogram that she had a few weeks ago did not look for any irregularities in this area and the CT scan should give us a better picture anyway.

We go back in three weeks to visit the ENT again. We are hoping that we will be able to do the CT scan that day rather than having to go back again. Little Rock is a three-hour drive each way. This is the third time we have been there in the last month.

Abby did fine while she was in recovery and on the drive home yesterday. However, as the evening wore on, her breathing began to get noisier and noisier, she began coughing more, and her skin was pale. We headed down to the ER in Texarkana and were immediately sent back to a room. The blood work and chest x-ray came back normal. Her breathing difficulties were most likely due to irritation from the scope. She was given a shot of steroids and was sent home with the instructions to watch her closely. I stayed home from work to watch her today and her color was much better. I plan on going back to work tomorrow, but daycare will have strict instructions to call if anything out of the ordinary happens.

We want to thank everyone for your prayers and will let you know what happens after her next visit. I’m hoping to have some pictures of her looking cute in her hospital outfit and pictures of her surgery uploaded tomorrow, but it may be a few days.

Yesterday was our first trip to Arkansas Children's Hospital in Little Rock. We were lucky enough to get in yesterday after having received a referral the day before. After the trip to the ER on Sunday, everything was looking pretty serious.

Abby had an EKG, chest x-ray, and an echocardiogram. She has an 8mm secundum atrial septal defect. There are 5-6 cases of this per 10,000 live births and it is the most common type of atrial septal defect. The hole is causing a slight enlargement of the right side of her heart because it is having to pump extra blood. Right now, they are just going to monitor her and hope that it closes on its own. If it doesn't close, then surgery will be done when she is 4-5 years old or 35-40 lbs (she was 18lb 4oz at her 6 mo. check-up today, which is 90th percentile). Most likely, she would not need open heart surgery to repair it as there is a new surgery that is minimally invasive.

The good news is that she does not have a right branching aortic arch or a vascular ring around her trachea, which would have meant serious surgery. We still don't know what is causing her respiratory problems, but it may be a flimsy trachea or epiglottis. We go back to Arkansas Children's Hospital on Monday to see an ENT. If we don't get any answers there, the next step will be to see a pediatric pulmonologist.

Abby is not in a good mood today. She had her 6 month check-up, which meant 4 shots. She weighed 18lb 4oz (90th percentile) and was 26 1/8 inches long (75th percentile). She still has tiny head (somewhere between 10th and 25th percent), but it is growing fine.

I'll update you Tuesday once we visit the ENT. Thanks for all the prayers!