Thursday, January 22, 2009

I'm so frightened

Not for myself, for my 6 month old daughter Anwen. Forgive me this break in 'Fish Fortnight' to bring you a very personal post. I don't know why major events happen every time I try to run a theme on Dracovenator.I will throw in a bit of science so that I can keep my uber-nerd status. Plus knowing about a problem always helps me come to terms with it.
When Anwen was born she had a tiny lump in front of her fontanelle (where the frontal and two parietal bones of the infant skull fail to meet). I paid it no mind as it was virtually invisible amongst the lumpy irregualrities of a new-born's head. However it didn't straighten itself out, instead it got bigger. By this time it was obvious that it was a soft tissue structure of some sort. We showed it to the doctor who thought it was a benign cyst of some sort and that it posed no real problem because it appeared to be in front of the fontanelle. We went about getting an appointment for a general surgeon to remove it. The surgeon was a little leery of operating so close to a babies fontanelle and ordered MRI images of the lump. And what a sensible move that was. The MRI images show a tumor (probably a benign dermoid cyst)that rests largely IN the fontanelle. And therin lies the big problem.
But first a little about dermoid cysts and why they are classically located on the midline of a person.
It all comes down to early development of the embryo. Anwen, like all chordates, has a dorsal nerve chord formed by a process called neurulation. In neurulation a stripe of cells from the outer layer (the ectoderm), that runs down the back of the embryo, thickens, curls over and eventually pinches off to form a tube. This tub is what becomes the brain and spinal chord. You can see the process nicely in this diagram (of an amphibian - but the process is more or less the same in humans) which I nicked from Pharyngula. Incidentally Pharyngula has a much more detailed post about neurulation if you want to know more.



What happened in Anwen's case is that a few cells thay were supposed to stay in the ectodermal layer above the neural tube and go on to form the skin (the white tissue in the diagram above) became trapped under the ectodermis when the neural tube closed over. Thus stuck out of place but already set on the path to skin-hood they grow into a little sac of skin-like cells that we call a dermoid cyst. Normally these present no problem at all and can be removed with the minimum of fuss. However in Anwen's case the position is a real bummer. The cyst is not surrounded by fatty tissue as they often are and as a result the lower surface is in contact with the structure underneath. This just happens to be the sagittal sinus. This sinus is a space bounded by the dural membranes that runs between the hemispheres of the brain and collects the venous blood and returns it back to the heart. Several veins that drain the brain enter into the sinus in the vicinity of Anwen's cyst (or at least if I understand the surgeon correctly). These veins are not robust structures like the ones you find in your limbs, they are delicate membranous structures that are easily torn. Such a tear can have catastrophic even fatal consequences.
So there you have it. Anwen has a tumor on her head that if left will grow larger, impede skull development and probably eventually constrict venous bloodflow from the brain. To remove it is a tricky operation with the risk of tearing a dural vein which may lead to her death. We have the services of a skilled neurosurgeon of high repute but we are still understandably frightened. Its not an easy decision for a parent to expose their child to risk, even if small and for her greater benefit in the long run. Nonetheless the operation must go ahead and will probably happen next week. I'll let you know how it goes.



Anwen and her pesky little bump

25 comments:

MJC Rocks said...

I don't get really personal on my blog either, but please know that you and your child are in my prayers, for whatever that is worth. Good luck, and blessings upon you.

ReBecca Foster said...

Wow. You have every reason to be frightened! I will keep you and your family in my thoughts. Your daughter looks like a very happy cute baby! Just think of it this way, in a few years you can do two things - watch "the Last Unicorn" with her (a little girl cartoon staple!) and then show her pictures and tell her that she too was a Unicorn ;) She will be thrilled and the envy of every other little girl :)

My dad has a bump on his skull and he always told us when we were kids that it was his alien antenna trying to come out (and I still turned out half-way normal!)

Good luck!

Christopher Taylor said...

Good luck, and best wishes.

Traumador said...

i too wish good luck and courage.

the nice thing about having science with which to quote and keep you ubber nerdom, is it also comes in handy for fixing these sorts of problems!

Andrea Cau said...

Good luck, Adam, and best wishes.

Callan Bentley said...

Your family is in my thoughts. Good luck.

Adam Yates said...

Thankyou all for your kind words of support. The operation is scheduled for Thursday next week.

Adam Pritchard said...

May all go well, Adam.

Sean Craven said...

My best wishes to Anwen and your family during this time.

Jeffrey W. Martz, PhD said...

I'm sorry you and your family are going through this. I hope everything comes out all right.

Bill Parker said...

My son had problems with the closing of his fontanelles and I remember the fear I felt (and his) when he went into the CT scanner. Fortunately everything was OK.

Not to belittle anyone who does not have children (so please do not retort), but it would be really difficult to understand what Adam and his wife are going through right now. It must have been very difficult (yet hopefully somewhat theropuetic) to even type that post up. Thank you for sharing and know that my thoughts (and those of your readers) are definitely with you and your family through this extremely tough time.

Zach said...

Good luck, brother. I'm sure it'll all turn out all right! I kind of like ReBecca's unicorn idea. ;-)

Raptor Lewis said...

You and your family in my thoguhts and prayers, sir. I'm sorry about your daughter and I believe you have every reason to be frightened. Anwen is cute and I don't want anything bad happening to her despite the fact, you and I just met.

BTW, I think I like this blog of yours.

Mike Taylor said...

Adam, thanks for posting this. You have my deep sympathy; I'll be praying for you and Anwen.

... but I couldn't help laughing at the sentence that begins "Anwen, like all chordates ..." :-)

Anonymous said...

My prayers for you and your daughter.She is a beauty.

Crazyharp81602 said...

Your daughter is beautiful, Adam. My best wishes and prayers goes out to you, your wife, and especially your daughter. Hope she survives the operation.

Anonymous said...

God bless you and your family I hope everything turns out alright.

Andy said...

Thoughts and prayers for your family. . .

Mickey said...

Wow. I'm so sorry to hear that. I send my best wishes for her safety.

Dinorider d'Andoandor said...

my best wishes for your family

have a successful next week, then

what a cute little baby you have!

archosaurmusings said...

Sorry to hear of your troubles old boy, and I'm sure everything will be fine.

Augray said...

My best wishes for your daughter (and you and your wife), and I fervently hope for the best possible outcome.

Anonymous said...

thanks everyone for your well wishes, adam will keep u updated
celeste yates

kiss said...

WoW shares many wow gold of its features with previously launched games. Essentially, you battle with wow gold cheap monsters and traverse the countryside, by yourself or as a buy cheap wow gold team, find challenging tasks, and go on to higher aoc gold levels as you gain skill and experience. In the course of your journey, you will be gaining new powers that are increased as your skill rating goes up. All the same, in terms of its features and quality, that is a ture stroy for this.WoW is far ahead of all other games of the genre the cheap warhammer gold game undoubtedly is in a league of its own and cheapest wow gold playing it is another experience altogether.

game4power.comEven though WoW is a Cheap Wow Gold rather complicated game, the controls and interface are done in warhammer gold such a way that you don't feel the complexity. A good feature of the game is that it Cheapest Wow Gold does not put off people with lengthy manuals. The instructions cannot be simpler and the pop up tips can help you start playing the game World Of Warcraft Gold immediately. If on the other hand, you need a detailed manual, the instructions are there for you to access. Buy wow gold in this site,good for you, BUY WOW GOLD.

wow gold said...

Weekends to peopleig2tmean that they can have a two-day wowgold4europe good rest. For example, people gameusdcan go out to enjoy themselves or get meinwowgoldtogether with relatives and friends to talk with each storeingameother or watch interesting video tapes with the speebiewhole family.
Everyone spends agamegoldweekends in his ownmmoflyway. Within two days,some people can relax themselves by listening to music, reading novels,or watchingogeworld films. Others perhaps are more active by playing basketball,wimming ormmorpgvipdancing. Different people have different gamesavorrelaxations.
I often spend weekends withoggsalemy family or my friends. Sometimes my parents take me on a visit to their old friends. Sometimesgamersell I go to the library to study or borrow some books tommovirtexgain much knowledge. I also go to see various exhibition to broadenrpg tradermy vision. An excursion to seashore or mountain resorts is my favorite way of spending weekends. Weekends are always enjoyable for me.
igxe swagvaultoforu wowgold-usaignmax wowgoldlivebrogame thsaleGoldRockUbrogameswagvaultgoldsoonoforuigxethsale