Sunday, November 30, 2008

Mac n Cheese

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Video taken 11/13/08

Tuesday, November 25, 2008

Get up Daddy!

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Video taken 11/22/08

Singalong

Zachary was trying to grab the ball that was bouncing across the screen - just like the cats!

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Video taken 11/20/08

Friday, November 21, 2008

House for Sale

So we've put our house on the market. The reasoning is that Curtis is scheduled to finish his degree this summer and he's unlikely to find a job here, so we'll be moving this year. We don't want to get stuck having to sell the house, so we'd rather sell it now, at our leisure. Although we haven't gotten any interest yet, I've been looking at apartments and houses for rent, and I'm curious what some of you think we should do. I've created a poll and I'd appreciate your vote. If you have more to say, please leave a comment on this post.

Here are a couple links to the house, if you're curious :)
Zillow
The Daily Classifieds

Neurologist

The first thing everyone wants to know is how did Zachary's EEG turn out? Normal. Perfectly, absolutely, beautifully, normal. We got a copy of the report, and the doctor said we can get a CD of his whole EEG, so I'll be looking into that.

The next item of interest is what did the doctor say? He says that it wasn't a seizure. When Zachary shook, he trembled all over, whereas a seizure will produce more jerky motions. I tried asking if postictal symptoms often follow a breath holding spell, and he had me describe Zachary's behavior after the event over and over, but he never really answered my question. He kept talking about an experiment that was performed by a group of German students where they induced themselves to lose consciousness (faint) and it was shown that losing consciousness can cause a person to twitch and shake. Something about syncope. I was a little irritated at the doctor because he was rather dismissive in his behavior. Curtis says he was trying to be reassuring. I also told him about the possible connection between the hemangioma on Zachary's chest, lipomas (which my dad has) and seizures. He looked Zachary all over (looking for other discolorations) and determined that Zachary absolutely does not have whatever that condition is. Then Dr. Reyes examined Zachary, checked his reflexes, checked his muscle tone, looked in his eyes, and asked about my pregnancy and Zachary's development. Everything was normal. When he went to check Zachary's reflexes, he tapped his right knee with the rubber thingy and Zachary's leg kicked (like it's supposed to). When Dr. Reyes tapped the other knee, his leg didn't kick. My first reaction was, "How weird! Zachary doesn't have a reflex in his left knee!" But then the doctor tapped the right knee again and the leg didn't kick and we all laughed that Zachary was purposely holding his legs still. Silly boy! Throughout the whole exam Zachary sat very cooperatively on Curtis' lap and watched everything the doctor did. He didn't even try to grab the instruments. Most of the things the doctor did Zachary thought were funny, he was smiling almost the whole time. The doctor kept commenting how social he is, how happy he is, etc.

After the exam, the doctor reaffirmed what he had said before: it wasn't a seizure. He explained that a child that is perfectly normal in every other aspect has no reason to have a seizure. Children with seizures usually have symptoms in other areas (their development, primarily). Then he brought in the doctor we thought we were going to see, Dr. Garza. I had to go through the whole explanation again (some parts of it more than once), and Dr. Garza agreed with Dr. Reyes that it was a breath holding spell, not a seizure. He told us the story of the German students too. I still felt like they were dismissing Zachary's behavior after the event. I tried explaning it better, and Curtis tried to help, but the doctors never explained whether Zachary had really experienced postictal symptoms or not and whether postictal symptoms can follow a breath holding spell. I asked if seizures can be caused by a combination of factors and I explained that Zachary's blood sugar and sodium had been low. I can't actually remember how the doctor answered, but it wasn't very satisfactory. Something about how all seizures are caused by a combination of factors, and then the same thing that the ER doctor has said about how the glucose and sodium levels weren't low enough. I get so frustrated! These people don't listen and they don't try to understand what was going on. At the time of the event, we don't know what Zachary's glucose and sodium levels were. It is entirely possible that, in combination, they were low enough to cause a seizure. When the ambulance personnel tested Zachary's blood sugar on the way to the hospital, he said it was low, but not outside the range of normal. This makes sense, as Curtis explained, because the body is able to bring glucose levels up in an emergency. Finally, when Zachary's blood was taken at the hospital, he had eaten some cheerios, thus skewing the results. But all the doctors look at is the results, and they say, "Nope, levels aren't low enough, that couldn't have caused it."

So I looked up "breath holding spell" on the internet. The following paragraphs are taken from different webpages.

Breath-holding spells are brief periods when young children stop breathing for up to 1 minute. These spells often cause a child to pass out (lose consciousness). Breath-holding spells usually occur when a young child is angry, frustrated, in pain, or afraid.

Breath-holding spells are categorized as either cyanotic or pallid.

  • Cyanotic breath-holding spells, the most common type, usually occur in response to anger or frustration. A child's skin typically turns red or blue-purple.
  • Pallid breath-holding spells produce a pale appearance to a child's skin. These spells usually occur in response to fear, pain, or injury, especially after an unexpected blow to the head.
The pallid form typically follows a painful experience, such as falling and banging the head or being suddenly startled. The brain sends out a signal (via the vagus nerve) that severely slows the heart rate, producing loss of consciousness. Thus, in this form, the loss of consciousness and stoppage of breathing (which are both temporary) result from a nerve response to being startled that leads to slowing of the heart.

The child stops breathing, rapidly loses consciousness, and becomes pale and limp. A seizure may occur. The heart typically beats very slowly during an attack. After the attack, the heart speeds up again, breathing restarts, and consciousness returns without any treatment. Because this type is rare, if the attacks occur often, further diagnostic evaluation and treatment may be needed.

http://www.drgreene.com/21_557.html
http://www.webmd.com/parenting/tc/breath-holding-spells-topic-overview
http://www.merck.com/mmhe/sec23/ch269/ch269g.html
Also, Wikipedia: http://en.wikipedia.org/wiki/Breath-holding_spells - this article lists four, rather than two types, and considers one followed by seizure activity to be a "Complicated" one.

So, Zachary didn't turn blue or purple, and his experience followed a painful event (bumping his mouth on the deck). Also, his blood pressure was really, really low in the ambulance. So, if he experienced a breath holding spell, I think it would be the pallid form. And, oh look! A seizure may occur. Wait, but I thought the doctor said it wasn't a seizure. He made it sound like if a child experiences a breath holding spell, it's not a seizure. Now I'm thoroughly confused. Was it, or was it not a seizure? Is Zachary now at a higher risk for experiencing another seizure? Or are breath-holding-spell-induced seizures not that same as other seizures? A neurologist should be able to answer these questions! I think part of the problem is that most of the seizure patients that neurologists see are suffering from epilepsy, or some other seizure condition. So when a patient comes in with no seizure condition, they're hesitant to say it was a seizure. There's no wiggle room. I realize as I'm writing this that it may sound like I want it to have been a seizure. This is not at all the case! I want to know what happened, what made Zachary shake, what caused it, and how to prevent it. Or at least know how to predict it. Ugh. Anyway.

The good news is that Zachary is perfectly normal, all the way to his brain waves (of course, we already knew that :) ). Whether he experienced a seizure is in doubt, but whatever it was is not due to a condition, and he's extremely unlikely to have an experience like that again. Thanks for reading my "book", and please feel free to leave comments - I'd love to know what you think! (And that goes for all my posts, by the way.)

Monday, November 17, 2008

EEG

Zachary's EEG went really well last Friday. He stayed up two hours later than usual and just played with his books while we watched Jane Austen's Persuasion. Then he and I got up two hours earlier than usual. He was a little grumpy at being woken up, but no fussies. The hardest part was keeping him awake until it was time to go to the appointment - he kept trying to fall asleep on the floor!

While getting set up for the EEG, Zachary just laid on the bed and watched cartoons while the technician attached 23 nodes to his little head. She went on and on at how well behaved he was. There were two steps to attaching the nodes: the gal scrubbed the spot first and then used electrical paste to attach the node, then she covered the node with a bit of gauze. Zachary did not have to get his head shaved. After all the nodes were attached, she wrapped his head with more gauze to hold everything in place.

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During the test, I had to hold Zachary's eyes closed for 10 seconds a couple times, but he never fussed - he thought it was funny! Then we did a strobe test where a strobe light flashes at several different frequencies (to see if the flashing light induces a seizure). Not only did the flashing light not bother Zachary, he thought it was a camera and kept smiling at it!

For the last part of the test the technician turned the lights down and left the room, hoping Zachary would sleep. This is why we had had to keep him up late and get him up early. But everything was too interesting - he was wide awake. The gal said that often happens. They still got good measurements though.

What was really neat, though, was to watch the computer screen. It showed four bands of brain waves and then a little screen of Zachary (there was a video camera trained on him.) So while watching the screen we could see what he was doing and what his brain waves were doing at the same time. For the most part they were evenly spaced, but when he laughed, some of them became denser and then when he tried to roll over, the brain waves were all over the place!!

We'll see the doctor (a pediatric neurologist) on Thursday to interpret the measurements for us.

Removing the nodes didn't take nearly as long, of course, as putting them on, but getting the paste out of his hair took forever! There was a sink in the room and the technician attached a spray nozzle to the faucet. It took at least twenty minutes of scrubbing his hair with shampoo and using lots of water to get all the stuff out. Fortunately I had Curtis' help holding him still!

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Monday, November 10, 2008

Mario Kart Wii

We're a MarioKart family - even Zachary plays :)

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(Video taken 11/6/08)

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(Video taken 11/8/08)

Slippers

Zachary continues exploring his shoe fetish.

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(Video taken 11/6/08)

Wallet

Curtis was keeping an eye on Zachary. When I came downstairs, this is what I found:

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(Video taken 11/5/08)

Morning 'Toons

Zachary got ahold of the DVD remote this morning - one of his favorite toys. Within five minutes he had turned the player on to DVD mode (it also has tuner and audio input modes), his VeggieTales DVD started playing, and he pulled himself onto the couch, all ready to watch!! I turned the TV on for him and then had to take a picture. Too cute!!

We try to put the remotes away, ever since he reprogrammed the DVD player to only show black and white. It took us a while to get it back! We've tried giving him a remote that doesn't work, but he knows better. He only likes the ones that do something, and he knows the DVD remote is better than the TV remote.