The verdict

I'll go through the day in another blog - but the important thing now is what the consultant said:

The MRI scan shows all is normal:

"There is thoracic scoliosis concave the the right. No obvious vertebral anomaly seen. Normal appearance of the spinal core. No evidence of cord tethering. The cord terminates at L1/2 level. No evidence of a syrinx. Normal appearance of the craniocervical junction. No evidence of cord compression or disc prolapse is seen." 

There is no need for any further MRIs.

The consultant thinks that the curvature will resolve - possibly by the time J is 18 months old.

The consultant compared the x-rays from today (he had 2 - one on his back and one lying on his side) with the one from May 5th and thought there had been a drop from 33* to 30* since May. He said the chest one from Feb couldn’t be used to compare (it doesn’t show things well enough).

[NB the spinal nurse explained afterwards that there is a margin of error in the calculations for angles, so whereas Mr Marks said 38* and Mr Thompson said 33* for the May one, that isn't important. The important thing is the same person's comparison between May and now.]

If it does resolve now, there will be no consequences in later life.

So what happens next? We will carry on with the soft casts, changing them every two weeks and then J will have more x-rays in 2 months' time and another appointment with one of the consultants. He expects to see more improvement by then.

We discussed other things including Mehta casting but I will do a separate post later. He is not an advocate of Mehta casting - let's leave it at that for now.  

It is, I think, cautious good news. It was all couched in terms of "I would put money on [this being a curve that will get better on its own]" and "I think..." - but he's very experienced and he believes it will be one of the 85% of infantile scoliosis cases which resolve.

It could have been progressive. There could have been all sorts of things on the MRI. But instead it looks as though J might be lucky and have one of the "good" types of scoliosis which correct themselves (with a bit of help from the cast too).

I don't feel exactly happy - we're not there yet - but there is cause for relief about what it isn't and what it looks like it might be. Fingers crossed for good improvement by the end of September.....

update:
Just to say - I can't remember what he said about braces except that they're not as effective as casting for this stage (harder to get traction). Mr Marks seemed to think a brace would be necessary after the casts to maintain the spine until J is 4 years old. That was the best case scenario he gave. I will need to ask about that in a couple of months.

MRI scan

A change of venue today - rather than the Royal Orthopaedic Hospital in Birmingham, we were at the Birmingham Children's Hospital for J's MRI scan. Basically all went well and we were very well looked after by all the staff, but J was deeply affected by the sedation and would not wake up, so we were there till the day unit closed at 6pm!

We had been asked to be on the ward for 11.20am for a scan at 1.20pm. J was not to have eaten for 3 hours before we arrived and we were told the sedation would be more effective if he was tired. We'd also been advised to allow plenty of time for traffic and problems parking, and that was very true. So we arrived about an hour early with a very hungry and tired baby!

Fortunately they had a great play area where we spent a happy half hour on the toys wearing J out even more :-)

 J enjoyed the fish on the ward too.

 Once on the ward, there was paperwork to deal with, but mainly it was a question of simply waiting (ie entertaining J). In some ways that's great - I love spending time with my little man - but when he's overtired and hungry, it takes rather a lot of energy!

I administered the sedatives myself using a syringe - the same as with nurofen. J loves nurofen, so was very willing to sit like a baby bird with mouth open and be fed - or rather he was for the first one, but the second didn't taste very nice and he was not impressed.

Then it was like watching someone getting steadily more and more drunk until he couldn't stand up any more and keeled over asleep. The monitor shown below was for oxygen levels in his blood and heartbeat. We couldn't attach it with him awake (he has v sensitive feet and was having none of it!), but no problem when he was knocked out.

At about 1.30 we took J down to Radiology in his wheely cot. The MRI scanner room is painted like a tropical island (as I sat for 30 minutes for the scan I had time to wonder who the artists for these things might be as all the hospitals seem to have walls covered in sea motifs. Do you think there are dedicated hospital wall artists who specialise in such things...?!).

The scanner is huge - see below - and extremely noisy. J had cotton wool and big pads over his ears. I had ear protectors. J lay motionless until right at the very end when he started kicking about, but thankfully they'd already finished. His vital stats were monitored throughout. The images were clear and we will be getting the results next Thursday (I hope!).

Usually children take an hour, maybe a couple of hours to wake up. J just slept on and on!

At one point, J was on his side and we noticed that his arm had gone a dark shade of purple! The cast was cutting off his circulation. It's true that he sleeps on his front usually, and to be in such a deep sleep probably meant he was like a dead weight with the cast pushed into his arm. Poor thing. The circulation did return, but it took a while.

Not one to miss an opportunity, I borrowed a pair of scissors and gave J a full manicure and pedicure. Fantastic to be able to get them all done without lots of kicking and screaming (he's not keen on nail cutting).  My tip for anyone else: think of what you'd like to use the time under sedation for and take what you need (nail clippers, nail file etc). I also washed his face and cleaned his nose!

Each nurse tried a different technique to rouse J - ranging from tickling his eyes and ears with the corner of a tissue, to tickling his tummy and wiping his face and neck with a cold, damp cloth. Nothing worked. After he'd been asleep for 4 hours (!) and we'd tried all sorts, one nurse said to just leave him for half an hour and then try. So we did - and afterwards she did her utmost to annoy him - tickling, lifting limbs...  and he finally awoke protesting!

Children who've had sedation are not allowed to be discharged until they've eaten and the little boy in the bed opposite was kept in all day because he hadn't eaten - but that wasn't a problem for J. We had read the Hungry Caterpillar just this morning and it was like a re-enactment: he ate his way through lots of ham, a mountain of cheese, one yoghurt, a rich tea biscuit, several grapes... and when we finally got home he polished off a heap of potatoes, mince and peas, 3 more yoghurts, a couple of jam sandwiches, a gallon of milk (ok that last one is an exaggeration, but it was a lot)... mainly with his eyes shut!

He was so dopey all the way to the car, and slept much of the journey (photo below of him shows he's still not-quite-there!).

So now it's just wait and see - what will the results reveal? I'm already going through different scenarios in my head in preparation for what might be shown and the questions/treatment we need to discuss with the consultant.

Here's hoping for a quiet night tonight (following on from the sedative) and a happy baby tomorrow (it can make them irritable for 24 hours).