Wow, I can't believe I haven't sent an update since November '08...I've created this blog as a means to do just that! After Emily had the heart catheterization to embolize 6 collateral blood vessels, she's had a few procedures and appointments to further explore the gum and knee joint bleeding, the knee AVMs, and the possibility of the genetic disorder HHT (Hereditary Hemorrhagic Telangiectasia).
**AVMs (Arteriovenous Malformations) are when capillaries are bypassed and the arteries are connected directly to the veins; there are a lot of these abnormal connections so an AVM looks like a tangled up mass of vessels. HHT is a genetic condition in which one can develop AVMs in the nose, lung, brain, liver, etc.
I’ll try to summarize what she’s been up to since November:
Cardiology: 4 trips all good. heart function is good, everything is the same including O2 sats. She remains on oxygen.
Orthopedic: scoliosis hasn't progressed any further but a bone density test shows that her levels are very low so she is now taking a vitamin D3 supplement.
Cincinnati Children's Hospital:
-Vascular clinic: 12/08 brain MRI/MRA negative for AVMs but showed some old activity probably from when she had surgeries and loss of oxygen as a baby. 2/09 ultrasound of the abdomen looking for AVMs in the liver came back negative.
-Genetics: genetic testing for HHT and PTEN came back negative.
Neurologist: confirmed that brain MRI shows old activity but wants to re-do one in the summer to confirm. She was having some episodes of tingling on the left side of her face; he believes that was due to a neck muscle spasm from her scoliosis pressing on the occipital bone and facial nerve. The tingling has has since subsided.
Ophthalmologist: negative for AVMs
Dentist: cleaning done with no gum bleeding.
Praise God - lots of negatives! However, Emily’s knee started acting up again on 5/9/09. This happened before exactly 1 year ago....if you remember, they found that she has suprapatellar AVMs in both knees (looks like a tangled up mass of vessels right above her knee cap) Thankfully, it is only causing a problem in the one knee. These blood vessels tend to be fragile and in this case have leaked blood into the joint space causing a lot of swelling and severe pain. We made a trip to the vascular clinic at Cincinnati Children’s Hospital. Emily had an MRI and then an ultrasound the next day. We also met with an Interventional Radiologist. They then informed us of the ways to treat AVMs:
- surgically removing it (this would also require tendon reconstruction) and given Emily’s heart history, they would like to avoid this.
- insert a catheter through the femoral artery in her groin. Since she will need future heart catheterizations, and that access, so they would like to avoid this too.
- sclerotherapy - under anesthesia they directly inject a small amount of alcohol to the nidus (the center of the AVM) to eliminate the vessels.
Sclerotherapy will probably be the best option but they want to consult colleagues first. As they put it, Emily is a special and unusual case! They want her knee to heal and the swelling to resolve before they do anything. They sent her home with pain meds, but she ended up with a horrible weekend and wasn’t even making it the 4 hours until her next dose! Back to Cincinnati we went….this time to see an orthopedic there who confirmed that the fluid is coagulated and cannot be aspirated and it is just going to take time to resolve – they think that the blood vessels may still be oozing, reiterating the need to take care of the AVM asap. She’ll probably need to have some physical therapy as she cannot straighten her knee and bleeding into the joints can cause cartilage damage. The hematologist there has also done additional blood work to triple check clotting issues with her blood.
She has been much more comfortable the last few days and even made it to church! (thanks to the crutches from a friend) We are praying that she remains comfortable and heals quickly. Thank you so much for your love and continued prayers!
6 comments:
Holy Holy Holy, Praise to the King of Kings, you are my everything and I will adore you. (From the Revelation song by Phillips, Craig and Dean)
Wow, what a great blogspot!! A beautiful place to tell a story of a beautiful family, their challenges and their courage as they walk through this. Your faith is a true testimony to a wondrous God who cares personally for each and every one of us.
Thank you for this story which gives us so much information and hope.
God Bless,
Rachel
We praise the Lord for you, Emily! You are a great blessing and an awesome testimony of the power and greatness of our Lord Jesus!! We know it has been so difficult to go through this struggle, and we pray that the Lord will touch you and heal your body. We will lift you up to our Lord in prayer often and look forward to more updates on the blog. Your mom is awesome for doing this!!
Emily, Jim Donley from church (Becky's dad) has traumatic right heart hyperplasia do to being crushed in an auto accident when young. He is beginning to experience some right failure after 44 years and many surgeries. God has been very good to us and we continue to pray for you. All things from God are for a reason. Mary
Emily is just the sweetest girl! and I am continually amazed about your calmness and trust in the Lord...its just an honor to know you all!
Thanks for sharing all of this...it helps us (and reminds us to pray).
Love,
Leanne
Wow, so amazing! Emily you are such a great person and a great influence to many others. Just remember God has everything in control. I know you will have frustrating days but we are all by your side as with God is as well. Love ya Janel
Wow - what a true blessing you are Emily. Your courage and strength in all that you have been through is a true testimony to so many. You are beautiful!! I pray that the Lord grants you healing and provides you peace!!
-Christy Millen
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