The dark horse

There was a little miscommunication between the o.b.’s office, the new neurologist’s office, and me this week. What I understood to be an appointment for an MRI this morning was really just a (lengthy) consultation with the new neurologist, which means I eschewed bobby pins and a decent hairdo for the day, while carrying around a wire-free bra in my purse, all for nothing.

Well, not for nothing. Bad hair and extra undergarments not withstanding, the appointment was informative and useful. And yes, of course my new neurologist has a thick accent, originating somewhere in eastern Europe. Even her staff call her just Dr. M.

While Dr. M read silently The Detailed History of My Brain and I sat fidgeting in a chair trying to understand and then answer her questions every few pages, the minutes ticked by. I certainly got my money’s worth for this appointment. The goal was to determine whether or not it’s safe for me to attempt a standard vaginal delivery in light of what we know about Martha.

The short answer is that Dr. M does not believe Martha stands between me and a successful, safe, standard vaginal delivery. The issue my o.b. was concerned about is the strain of pushing and the blood loss/blood replenishment that accompanies labor. But if Martha doesn’t sound like something to cause me trouble in that regard then yay! right?

Enter the dark horse.
In 2006, the first MRI I had to figure out why I couldn’t hold a pen showed a small syrinx in one of my cervical vertebra. A syrinx is “a rare, fluid-filled neuroglial cavity within the spinal cord (syringomyelia), in the brain stem (syringobulbia), or in the nerves of the elbow.” (Thanks, Wiki.) In other words, my brain juice is leaking down the back of my neck and pooling slowly.

The MRIs I had last year–through which we found Martha–showed the same syrinx. It seemed to be unchanged. This is, of course, a good thing.

However.

My syrinx is almost certainly the result of trauma (me+roller blades+a hill+a chain link fence in 2005). All of my symptoms are consistent with the possible symptoms of such a syrinx, which again, we assume was the result of trauma and stress to the area.

So when one considers that a syrinx is an abnormality within the spinal column and expansion would put pressure on the spinal cord and impact functions controlled by the spinal cord (read: all functions), and when one further considers that this syrinx got there by trauma in the first place, it’s not out of the question to assume that further trauma, say, something along the lines of pushing during delivery of a child, could aggravate this syrinx, increase pressure on the spinal column, and result in central nervous system damage and paralysis.

Dr. M seemed unwilling and unable to conclude anything for sure. I guess that’s why they call it practicing medicine. At the end of the appointment she asked me what I would prefer in terms of delivery. I would prefer not to have a brain hemorrhage and I would also prefer not to become a quadriplegic after delivery. But the chances of either one of those are slim, while the work of recovering from a C-section is a sure thing if I have one. My body has handled pregnancy with no serious issues and hardly any mild ones in fact, so the chances of a smooth delivery are in my favor, I think. Then again, what’s a smooth delivery if I’m paralyzed from the syrinx down?

She did mention that I can change my mind once things begin, but that I need to understand that my threshold for changing my mind needs to be much lower/earlier than other women’s. I said I would discuss with the husband and talk to my o.b. some more. What to do?

The Detailed History of My Brain also included details about the dystonia in my neck and arm and the meds I have tried to get my fine motor control back. Obviously we’ve had no success with these medications and I’m rather uninterested in trying another one, or retrying any of those.

Dr. M: Can please write sentence.
Me: Sure.
<awkwardly writes out sentence>
Dr. M: Put arm out on table. We try this.
<ties two rubber exam gloves together, ties them tightly around my arm below the elbow>
Dr. M: Is better?
Me: Yes, actually. My hand relaxed.
<much less awkwardly writes out another sentence>
Dr. M: This is treatment for tennis elbow.
<we look at the blue latex tourniquet>
Dr. M: Ok, not official treatment. Similar.
Me: Is it supporting a tendon?
Dr. M: Yes. It puts pressure on tendon and does not allow hand to overreact.
<removes temporary support, pokes my arm>
Dr. M: Does theeese hurt? Well, except for where I em bruising?
Me: Yes.
Dr. M: We try real support for tendon. Tennis elbow support band. We will not try medicine again. Nize thing about being pregunent, we try mechanical feex, not chemical.

So that’s what we will try for my fine motor skills. The mom has tennis elbow support bands and will send them this way as soon as she can. If that fails, I know blue latex exam gloves tied together just might do the trick.

And so this episode concludes with no final answer to the delivery question and lots of other angles heretofore unconsidered. The husband and I must conference.

Dr. M did mention that just because Martha won’t cause problems for me during a delivery doesn’t mean I’m free and clear yet. I need to have an MRI very soon after the little oyster arrives, and I need to follow up with Dr. M after that. My next appointment with her is already scheduled for October 29, one month (we hope!) after the oyster comes. Martha “ees not something to neglect,” said Dr. M.

And we won’t neglect Martha. Heaven knows we’re always aware that she’s there.

The husband requested that I blog about something more cheerful soon so next up is a babymoon post. I do recommend a babymoon for couples who are expecting but I most certainly do not recommend one in the third trimester. Oy.

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