Tuesday, February 13, 2018

Feb 13, Toddler MRI Experience

The long awaited MRI day!  I think everything went as well as could possibly be expected.

Phoebe fussed a little bit around 5, but put herself back to sleep without me checking on her.  Of course, I did not go back to sleep because of the anticipation of the day!

The MRI had to be done on an empty stomach.  She could have water or clear fluids like pedialyte or clear apple juice before 6:30 am, but absolutely nothing after that.  They also said she could have her ibuprofen.  

However, at 6:30, Phoebe was still asleep.  I was really torn between wanting to go in and wake her up, and giving her medicine and letting her have a drink..... or just letting her sleep as long as possible.  If I woke her up, she would have a loooong time to wait until her appointment.  However, if I didn't wake her up, she could just as easily wake herself up at 6:40 and start demanding things like "Muh!" (milk) and "EAT!" (one of her favorite words).  Anyway, letting her sleep was clearly the wiser choice, so I crossed my fingers and just let her rest.  Cordelia got herself up around 7, but Phoebe cooperated and slept until 7:30, which is as late as I could have hoped.  We changed her and got her dressed.  She did ask to eat, and I told her we would eat "soon," not wanting to say no to her outright, because that would have just been unnecessary.

We dropped Cordelia off with her Meme and Papa at 8 and by 8:20 we were at the W.C. UCSF Children's Hospital, where I had never been before and hope I do not have to visit often.  But it was very beautiful and colorful, and the walls were covered in huge, familiar Eric Carle animal murals. 

We got checked in and briefly filled out some paper work, before being brought to an exam room.  It turned out the nurse helping us was the lady I had spoken to on the phone, when getting ready for the appointment.  It also turned out that the person she'd mentioned was her favorite anesthesiologist (though she'd said they were all excellent, and she couldn't guarantee for sure who we would see) was the person who would be doing Phoebe's anesthesia.   So that felt really good right from the start.

Phoebe was very calm the whole time.  She was a little nervous about being put on the exam table and having her clothes taken off and being weighed.  


Phoebe was given a hospital gown with sleeping tigers on it.  
Everyone was saying she was just so cute and sweet and commenting about her precious curls.


They did a routine exam: temperature forehead scan, blood pressure ("hugging your arm"), and an oxygen sensor on her toe with a little red light.  Phoebe did not like it being taped to her toe but they put socks on over it so she couldn't take it off until they were done.  Phoebe also did not like her medical ankle bracelet.  She repeatedly pointed to it and said "OFF."

But after that, she was quietly watchful, and even relaxed enough to play with some toys.  She played with a dinosaur that played music and a big activity play station that sang songs and had different instruments.  She liked that quite a bit.  

The nurse gave us an outline of everything that would happen throughout the morning. Then, all of those things happened: 

The first person to come in was someone whose job is to engage with the child on their level and talk to them about what was going to happen.  Sorry, I don't remember her exact title, but she was very peppy and sweet.  And, surprisingly, she had gone to Mills College, where Jason works! (He was wearing his Mills sweatshirt.)  So it was nice to have a connection right away.   She showed Phoebe a teddy bear, who was wearing a hospital gown, like her.  She then introduced the breathing mask Phoebe would wear to be put to sleep.  She put the mask on the bear, then on Mama and Dada, and then on Phoebe.  It was surprisingly soft and flexible, not hard plastic.  We let her play with it for a while. We even got to pick a "pleasant" smell to mix with the gas for when it was given to her: apples, oranges, cotton candy, mint.  We picked apples.  

Next she showed us a picture of the exam room, with the computer and devices and the big bed.  I told Phoebe that is her bed and she was going to take a nap there.  Then they showed us a picture of the recovery room, and I told her that is where she would wake up.

  
Here is Phoebe with her visual guide of what will happen.


She then gave us some more toys, including a doctor's kit.  Phoebe liked taking things out of the bag and wearing the stethoscopes.  She also liked the toy blood pressure pump. 

Then we had to wait for a while until the anesthesiologist could come in and consult with us.  She arrived at last and was mainly asking if we had any history of family health conditions or allergies.  She said if Phoebe had any difficulties breathing or was snoring while she was asleep, she would put a little tube in her mouth and down her throat to keep her air ways open.  She warned it was normal for them to fall asleep with their eyes open or rolled back or to even jerk a bit, so not to worry if that happened, it wasn't a seizure.

Finally, we were brought down the hall to the induction room where they would put her to sleep.  I pointed to the bed and told her that was where she was going to take a nap.  She was pretty tired at that point.  They brought her some new toys to distract her, like a light up cupcake wand and some squishy balls, but honestly that was a tiny bit overstimulating. They gave her those but then also almost immediately had her lie down, so she wasn't going to have a lot of time to adjust to the scene.  But, it is what is, maybe a slightly older child would appreciate it more.  Anyway, I helped her lie down and they put the mask on her.  She cried of course, but the mask was able to fit over her pacifier, so she had to breathe through her nose.  That probably made it go even faster.  I liked that the nurse said to her,  "It's ok to cry."  Bonus points from teacher-me for the feelings validation in the moment.

 To me, she fell asleep very, very, very quickly.  Her eyes were a tiny bit rolled back, and she looked just so little.  My baby.

They had said when they tell you to give her a kiss, that was your cue to leave.  But nobody said that and it was obviously time to go, so I asked for it myself.  Jason gave her one too.  They said to make it quick, so that you weren't bending over the gas mask too much.  I guess it could still knock you for a loop if you caught a whiff!

After that we got to wait around.  There was no room with a window to watch, like you often see on TV.  They had a separate waiting room or said we could go outside and just come back in like 40 mins.  The whole thing took longer than I was expecting.  I mean, an MRI of the knee-- that can't be that big right?!  But it was like an hour and 15 mins.  

I wanted to go outside and be in the fresh air.  We had a little snack and held hands a lot.  Jason wanted to go in sooner, to be around as soon as they called us, but I didn't really want to be cooped up and worrying with other worrying parents whose children were also there for sad circumstances. But eventually we did go in and, yup it was jut very quiet..... everyone minding their own business, not looking to engage with each other.  Being able to be lost in your smart phone is a welcome distraction to pass the time easily!

At last, they called us in!  We went into a recovery ward where there were lots and lots of bed, partitioned by curtains.  Phoebe was towards the end.  She was still sound asleep. So sweet, so little, I almost couldn't believe she was my little baby lying there.  She took a while to come out of it.  When she woke up, she said "Mama!" and I got to pick her up.  Next, she notice a light switch on the wall near us and said "OFF!" because she loves to flip the switches.


I didn't know it, but Jason snuck a picture of me giving her a kiss, waiting for her to wake up. This picture is so sweet, but also breaks my heart.   Poor little thing.


The nurse helped us take off her monitors and eventually she was ready to have her IV off from her foot.  (They'd put it in after she was asleep).  I asked if she'd needed a tube in her mouth and it turned out she hadn't.  (Yay!)   I offered her some water (they'd suggested I bring a familiar sippy cup!) but she wasn't very interested.  They also gave her a grape otter pop, but she wasn't interested in that either.  

They said she was ready to go home and just relax! They said to let her eat whatever she wanted, but just to be aware that throwing up was a common side effect, so we should just be prepared to see it again.  They also gave us the big warnings list, like if she starts having a fever or trouble breathing etc.  They mentioned something about her cheeks could get red or flushed later, but that was also normal....

And we got to take her home!  She was ready to go!  My brave, brave girl!  It is pretty sad when your 18 month old is having a more complicated medical procedure than anything you've had to have in your whole life!  But she rocked it!! Go Phoebe!


Thank you W.C. UCSF Children's Hospital!!!!!  
We had a really positive experience and are so grateful!!

We went home and had lunch.  Phoebe wanted to eat all the dehydrated strawberries out of her Special K cereal.  Apparently I need to buy just dehydrated strawberries, she could not stop eating them!  I gave her her motrin.... she still wasn't ready to walk.  We watched some Sesame Street and then she took a nap.  It was a pretty short nap, just barely an hour, but she was super hyper when she woke up and wanted to hold the phone while I called Jason (who was out picking up C) and my mom to check in.  

She did some walking around eventually and was pretty playful all afternoon.  She also wanted to eat a lot, and even ate chicken and carrots at dinner.  Phoebe really liked the flowers from Uncle Jonathan.  She pointed to the inside of the daisies and said "Ball!" about their round centers.  


I showed her how to sniff the roses, which she did adorably. Sniff! Sniff! Sniff!

In the evening, her cheeks were maybe having some flush to them, which I remember them saying something about.  Maybe even a tiny, tiny bit of puffiness?? Anyway, she's been so completely fine, I'm not stressed about it, but I did take a picture in case it looks more swollen or different later.    

Tomorrow I will be going back and forth a lot between school and Meme's and the rheumatologist, but hopefully, we will start to move forward on this thing!  









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