We went to the doctor today

Today we visited with Dr. Dale Swift, the pediatric neurosurgeon who will operate on Caleb. Thought you might find it interesting to learn something of who he is...

Dr. Dale Swift was born in Lorain, Ohio. He attended the College
of Wooster in Wooster, Ohio, where he graduated Phi Beta Kappa in 1980. He
earned his M.D. at Case Western Reserve University School of Medicine in
Cleveland and was invited to join Alpha Omega Alpha, the national honor medical
society.Dr. Swift completed his surgical internship and residency in
neurological surgery at Columbia Presbyterian Hospital in New York City. He
completed a fellowship in pediatric neurosurgery at Children’s Hospital of
Pittsburgh in 1992.Since 1992, he has been an attending neurosurgeon at
Children’s Medical Center Dallas, Medical City Dallas Hospital and Texas
Scottish Rite Hospital for Children. He is currently associate clinical
professor of neurosurgery at The University of Texas Southwestern Medical
School. Dr. Swift is certified by the American Board of Neurological Surgery and
the American Board of Pediatric Neurological Surgery.Dr. Swift’s research
interests include the pathophysiology of Chiari malformations, neuroendoscopy in
children and arachnoid cysts. He participates frequently in international
pediatric neurosurgical training, most recently in Bangalore, India, under the
auspices of the International Society of Pediatric Neurosurgery.Dr. Swift and
his wife, Denice, have two children.

Dr. Swift consults all over the world and in a couple of weeks is meeting with some French doctor friends who, with him, have been developing some new techniques. Normally a shunt would be placed strategically in the brain to drain the excess fluid, but he is working on a technique that would open the required area without the use of a shunt and it would provide better flow control, reduced potential for infection and other problems caused by a foreign body in the brain. He is going to give them a call in the next few days to discuss Caleb's case.

At any rate, in about 3 weeks, we will go into Children's Medical Center Dallas for his surgery. He will go in one evening, surgery the next day, come home the following day for a week of recovery.

Consultation Day

On October 12, 2003, Egyptian conjoined twins were separated in Dallas (http://faculty.washington.edu/chudler/ntwin.html) The same neurosurgeon will be caring for Caleb.

Thursday morning, we go to Children's Medical Center (http://www.childrens.com/Patients_Families/HospitalServices.cfm?servicesID=52) to consult with a team of doctors who have studied Caleb's tests from last week. We expect to make a decision as to which procedure to pursue.

Caleb's disorder is known as the Dandy Walker Syndrome (http://healthlink.mcw.edu/article/921724673.html). There are several approaches to take. Check back here Thursday night and I should have an update.

Thanks for praying

Caleb - Wednesday

Time to go home!

We met with the doctor this afternoon and reviewed the condition and some of the possiblities. Seems that the consensus is moving towards some kind of shunt. However, we meet with the neurosurgeon next week to finalize plans.

Meanwhile, Caleb was dismissed from the hospital today, will expect to return to school tomorrow and meet the next round of doctors next week.

Today he was in good spirits and looking a whole lot more like himself!

Stay tuned... more to come.

Mack

Tuesday Night

Caleb was in pretty good spirits tonight. He's learning how to operate all the machinery he's hooked up to. He likes to move his fingers, twist his muscles and do whatever to make the numbers on his monitor change.

He also got his Game Boy(s) tonight so everything is fine now. He's curious about the tests and procedures he's going through.

Thanks to so many who are praying for him. We appreciate it so very much.

Meanwhile, this may be the "break" Rachel has been needing. Stuck in a hospital with nowhere to go. Now she'll have to get some down time - maybe some rest to help with her own healing.

Keep checking back here as I will post when I have new news.

Caleb Update

A lot of new experiences for Caleb today. If you are interested, here's the web site of the hospital where he is being treated: http://www.mcchildrenshospital.com/

Rachel is there and is very satisfied with the doctors who are caring for him. So far, three ophthamologists, a neurologist and a neurosurgeon, and numerous supporting medical professionals.

Last night while going through ER, Rachel and Caleb had opportunity to really begin to discuss what was going on. We had intentionally not told him ahead of time so he wouldn't sit around and worry for days before going in. Now that it was happening, he was very relieved to know that there are explanations for the headaches and other physical symptoms he has noticed.

Today he endured three ophthamological exams; a 3-hour MRI of head and spine (now he has a headache). Doctors have stated that up to now he has compensated for the loss of brain capacity, but he's reached the limit of that option. He has excelled academically, musically and enjoys sports - a pretty successful, well-rounded adolescence.

His ailment has a name as well: meet Dandy-Walker

What is Dandy-Walker Syndrome?Dandy-Walker Syndrome is a congenital brain malformation involving the cerebellum (an area at the back of the brain that controls movement) and the fluid filled spaces around it.

The key features of this syndrome are an enlargement of the fourth ventricle (a small channel that allows fluid to flow freely between the upper and lower areas of the brain and spinal cord), a partial or complete absence of the cerebellar vermis (the area between the two cerebellar hemispheres), and cyst formation near the internal base of the skull. An increase in the size of the fluid spaces surrounding the brain as well as an increase in pressure may also be present.

The syndrome can appear dramatically or develop unnoticed. Symptoms, which often occur in early infancy, include slow motor development and progressive enlargement of the skull. In older children, symptoms of increased intracranial pressure such as irritability, vomiting, and convulsions, and signs of cerebellar dysfunction such as unsteadiness, lack of muscle coordination, or jerky movements of the eyes may occur.

Other symptoms include increased head circumference, bulging at the back of the skull, problems with the nerves that control the eyes, face and neck, and abnormal breathing patterns. Dandy-Walker Syndrome is frequently associated with disorders of other areas of the central nervous system including absence of the corpus callosum (the connecting area between the two cerebral hemispheres, and malformations of the heart, face, limbs, fingers and toes.

National institute of Neurological Disorders and Stroke

For you who are interested there a numerous web sites devoted to Dandy Walker. He does not exhibit many of the "typical" symptoms, but certainly some are evident - especially as you begin to assess them. He looks normal, is a handsome, intelligent, outgoing, fun-loving kid.

Right now (4:00 pm, 9/19/2006) we are waiting for the neurosurgeon to review all the MRIs, CTs and other tests with the pediatric neurologist to decide which of the following standard actions to pursue:

• Insert a shunt for drainage
• Drain the cyst - but without a permanent shunt
• Medication to treat the symptoms - headaches, etc.

We do not know right now when he will be dismissed from the hospital.

We covet and thank you for your prayers.

Truly, God is gracious
Mack

New Development

Tonight, Rachel left home with Caleb to go to the Emergency Room at Medical City Children's Hospital in Dallas.

Caleb has a cyst on the base of his brain. He has had headaches for years and we have probably now discovered the source. However, in the past week, he has gotten noticeably weaker, more lethargic, inactive, not hungry, tired, nauseous, and this evening EXTREMELY weak.

He has an appointment with a pediatric neurologist for mid-October, but I guess it will now be late September...

Oh, by the way... I've been cleared to return to work at DFW Airport starting at 4:00 am tomorrow (Tuesday).

Rachel is not doing well. She is taking a month off from the hospital to try to heal. Her leg hurts more, her ribs/chest hurts, and now her wrist hurts from using the crutch. She has a choice, walk on the broken leg - and it hurts and doesn't heal well - OR, use a crutch to protect her leg and hurt her wrist. She needs to sit down and rest!