Friday, October 5, 2012

Day 5: How is Spina Bifida Treated At Birth?

Welcome to 31 Days of Spina Bifida Awareness: Day Five!SB awareness

While Spina bifida has lifelong medical challenges and potential surgeries in the beginning you don’t think about that.  All you worry about is what will happen when the baby is born.  Will there be surgery?  Will my baby stay in the NICU?  When will we be able to come home?

A child with Meningomyelocele usually is operated on within two to three days of birth. This prevents infections and helps save the spinal cord and nerves from infection and further damage.  A NICU stay is assured and the length varies.  Mason stayed 10 days, coming home on his due date.

A child with Meningocele (a sac of fluid without nerves or cord inside) is generally treated with surgery, and more often than not, the child is not paralyzed.  Most children with this condition grow up fine, but they should be checked by a doctor because they could have other serious problems, too.  Again, with surgery you’ll spend time in the NICU. 

Spina Bifida Occulta (no opening on the back at all) usually does not need to be treated at birth.


A Piece of Our Story

Mason was in the operating room having his back closed within 7 hours of birth.  {A week later he had a shunt placed, which I will talk about in another post.}  It took a pediatric neurosurgeon and a plastic surgeon both because the opening was large and did not have a lot of extra skin to work with.  Mason then had to lie on his belly for several days as the healing process began.  His scar ended up being horizontal, with dog ears of extra skin at the ends.  These were left in place to allow him a bit more room for the quick stretching and growth of the first year.  000_0001See how angry it looked?  The little triangles of skin on each end are hard to see with the swelling, but will become apparent in the next photo.100_8203Here is his back at three weeks old.  There are still parts of the scab along the scar, especially there at the middle.  You can see the deep red that resembles a birthmark all along the scar line.  The stitches had not all dissolved yet.  The skin stood up in a ridge. 100_8428 Here he is at two months old.  Already things are less red, more pink. 100_9406In this picture you see the skin on the left is flattening down while the other dog ear of skin is not.  This is at five and a half months old.  We discovered that he is ticklish along his scar and that a few centimeters below he begins to lose his sense of touch. 100_0803Eight and a half months old, this picture was taken just this week.  You can see that the extra triangle of skin on the left has flattened out pretty well, while the right is still mostly raised. 

One surgery down, but with Spina Bifida it is almost certain that this is only the beginning.  Shunts, shunt failures, tethered spinal cords, and surgeries for bladder or bowels may all be in the future.  More on those later in this series!

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