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+ 0 - 0 | § What is a dilation?

Did we ever describe what happens during one of Alex's dilations?  He's had 11, but I'm not sure that most people know what they are.  Well, here goes the detailed description:

They take him to the OR, then give him some sleeping gas to put him out.  Then, the anesthesiologists give him an IV and start fluids.  (Which is actually pretty difficult these days.  Alex's veins have all been used more than once for IVs, and they haven't really had time to heal in between, so IV access is difficult at best.  They had to give him a scalp IV yesterday.)  Then, they intubate him (put him on a breathing machine), and start the procedure.  The dilation itself is pretty simple.  The surgeon first tries to pass a camera down his esophagus through the stricture (narrowed part) to see what it looks like.  If that doesn't work, he dilates first, by using increasingly larger diameter tubes to stretch the stricture open.  Eventually, it's stretched to a point where either the surgeon feels he shouldn't go further (so that he can avoid the complications listed later), or until Alex's esophagus is at an appropriate size for his age.  The possible complications of this include infection and bleeding (as always), anesthesia issues, perforation of the esophagus or stomach, and some other less common things.  If they perforate something, Alex would have to have immediate surgery to fix whatever was damaged, and would end up in the hospital for a few days.  They will generally do a chest xray after the procedure to confirm that nothing is leaking.

Yesterday, the surgeon was able to easily get Alex's esophagus up to a size that is pretty appropriate for his age.  He said that he could have stretched it quite a bit further, which indicates that Alex probably could go longer in between the dilations now, or we may even be done.  To figure that out, we're going in for another one in three weeks.  Two weeks after that, Alex will have a swallow study, where they do xrays after Alexs drinks some chalk, to find out how open his esophagus is.   If it's still wide open, he'll put off the next dilation.  So far in his short life, Alex has been under general anesthesia no less than 15 times (4 surgeries, and 11 dilations).  Most adults can't match that.  But Alex is still the happiest little kid...we're amazingly lucky to have him!

+ 0 - 0 | § Great news...to be used with caution.

The news about the dilations was really great and surprising, but as with everything in the medical field, we have to be cautious.  For all we know, this could have been a fluke, and Alex could have to go back many more times.  I want so much to trust in the surgeon's experience, and I really don't think he would have said that without being reasonably certain, but as Dan said...we can't get our hopes up too high.

In other Alex news, he is also mastering the art of playing the drums.  He beats on things with his hands, and will knock toys together to see what sounds they make.  It's really satisfying to see all of the normal baby things that he's been doing lately.  Dan and I feel like we're finally being able to experience the joyful part of parenting.  I wish we could post him on this board to let everyone see how he's been doing lately.

In other non-Alex news, my friend's baby, Nicky (who recently had heart surgery) has been improving steadily since I last posted about him.  They even extubated him today!  Thank you to everyone who added their family to your thoughts and prayers.

+ 0 - 0 | § Trying not to get our hopes up too much

So Alex had another dilation today, which apparently went well. Much to our surprise, the surgeon said that it was a rather easy job, and that after the next dilation, he may not need another one.  Of course we don't want to get our hopes up too much on this, but if it did turn out that way, it would be great! Not having to worry about the dilations would be a great load off, plus it means that Alex wouldn't have to be put under general anesthesia as often, which is always worrysome.