Brainiac – Villan or Superhero?

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In my last post when the ophthalmologist said “We may want to follow up with a brain scan” – that’s what happened. Sol’s Delayed Visual Maturation improved somewhat but didn’t correct to the level we could breathe easy at the 6-month mark. We were recommended to Dr Malinee (Paediatric Neurologist) at Pantai Hospital so that Sol could have the speed of his vision and tracking measured and an MRI on his brain. Sol was 6 months when he went through this.

The first test, as shown in the photos, was to measure Sol’s response time from seeing light, processing light and adjusting. Waves of light would flow past his face and his brainwaves would process this input.

The second test required us to sedate Sol as he would need to be asleep for up to an hour for his brain MRI. The hospital perfectly timed all of this so that once Sol had breast fed and we gave him a shot of the “sleepy stuff”, he promptly fell asleep and entered the chamber wrapped tight in blankets and with his head bound to a pillow. He was a trooper and never woke up during this time. Actually, it must have been some pretty good stuff as it took another hour for him to wake after the MRI. The MRI was to assess if there was any structural issues that might give us insight into Sol’s visual processing.

RESULTS – measurements for Sol’s visual tracking showed a “slower than normal” processing time. Expected. The brain MRI showed his right cerebellum to be 30% smaller in size than his left cerebellum. BOOM – the old cerebellum. Now, if you have aspirations to be a dancer or professional ice skater, you are going to need a full functioning cerebellum as balance and co-ordination are KEY. Actually seeing the size difference in Sol’s cerebellum opens a can of worms – Can the cerebellum return to a normal size? How will this affect Sol as he grows? What kind of activities can we do to help Sol “compensate”?

Once we had the test results, we met with Dr Malinee and a geneticist colleague of hers to rule out the potential of further issues. From our family history and Sol’s tests, it didn’t appear that his DVM and undersized cerebellum was linked to family history or a genetic mutation. The amount of detail and information we discussed had me in a “mind-meld”!

I think one of the key take outs from these tests and the discussions with the doctor, was to understand that Sol would have some challenges ahead that would be related to balance, coordination and meeting physical milestones. I know from my own school experience, if you were the kid that couldn’t catch a ball, then you were the last kid picked for the team. I’m going to dedicate a post to all the things we did for Sol knowing what we knew to give him the best chance to succeed physically, socially and emotionally.

The doctor advised us of the following:

  1. Sol might have some “low muscle tone” which would affect his sitting and walking postures.
  2. Sol might struggle to coordinate crawling or be a late crawler.
  3. Sol would be late to walk and not to expect anything before 18 months, likely 2 years.
  4. Sol would struggle with physical activity and get very tired.
  5. And this – his speech would likely be affected and delayed.

So now that Sol is 5.5 years, how did he go?

Yes – he did have some low muscle tone or better known as hypotonia. One of the things I did notice before Sol had these tests was that even up to 6 months, when I carried him, I had to support the upper part of his back. He wasn’t able to “sit on my hip” as it felt like he would flop backwards. And Sol’s speech was definitely affected and I’ll save that for a future post too.

Let’s talk about the good stuff now. Sol crawled from 8 months and continued to crawl very effectively and with significant speed up until 15 months. He actually graduated to a bear cub crawl so that he could get around faster. When you watch someone (adult or child) try to execute a bear crawl, it takes a lot of coordination. Sol nailed this. And there is some research that indicates crawling for longer is great for brain development – I’ll take that one.

Sol started “cruising” around the furniture from 11 months and took his own unassisted steps from 14 months. By 15 months, he was walking. When you’ve been warned that this might not happen till at least 18 months, this was major celebration for us.

And that Sol would get tired of physical activity? To this day, I occasionally wish this was the case. But Sol’s natural personality type as well as his energy ensures that from sun up to sun down, this kid does not stop moving. And I am grateful for that. As we are a family that values health and physical activity, having another child that is physically active and loves it, is a blessing.

Armed with this knowledge, we were able to continue with some of the activities we had already started and add additional activities that would complement Sol’s growth. But, it also made me hyper-aware that Sol might have a higher incidence of accidents. I would say that I did become that “helicopter mum” as I just never knew if he was going to fall off something or walk into something. I must have excelled in that role as I can confidently say that he didn’t have any bumps that were any worse than normal.

RESOURCES

I don’t have any videos of Sol doing the Bear Cub Crawl but if you want to know what it looks like, click here https://youtu.be/TBmfeECk6-4

Pantai Hospital Kuala Lumpur

“One who takes the road less traveled earns the rewards most missed.”

 

 

Why Won’t he Look at Me?

Is this my best side?
Even early photos show how Sol would “autocorrect” his vision by turning his head to one side. Damn cute though, right?

I thought I might start with the whole “being pregnant” thing but that’s not really where the questions started – these come a bit later. Having the fortune of an older sibling and understanding the “milestones” of an infant, I started to think there was an issue with Sol’s eyes when he seemed pained to make eye contact while breast feeding. For any mum of a neurotypical* child, you’ll know that your newborn will literally stare into your soul while you are feeding them. It’s all part of the bonding and “you’re gonna love me” manipulation of helpless, innocent babies. We fall for it hook, line and sinker and here the next 12 months of sleepless torture ensues. But I digress.

Sol would not/could not make eye contact. And it wasn’t just while I was feeding but when I held him up to my face to interact. His head would turn away and then turn the other way as if he was actually “avoiding” making contact. Strange….or is my baby BLIND???!!! You know those crazy thoughts that go through your head when you’re sleep deprived and obsessed with your little one. The thought that there might be a “problem” and off to the paediatrician you go armed with the internets “worst case scenarios”.

Sol would have been 3.5 months by the time I broached this with his doctor. She conducted a simple “eye tracking” test and confirmed that there might be a vision issue. Anxiety goes from an 8.5/10 to a 10/10. Armed with a recommendation to see the paediatric ophthalmologist (say that 10 times fast), we scheduled Sol’s first formal vision assessment.

The tests were relatively simple – tracking of objects, pupil dilation in light and dark and clapping to check speed of response from hearing to making eye contact. The diagnosis.

Delayed Visual Maturation (click on for medical description). OK, so sometimes, I’m going to add a link so you can look up the medical term for any of the words I’m going to write about to describe our journey and I’ll also give you my interpretation. DVM is the inability to track moving objects or focus on any object (includes faces) that are too close. That was my experience with Sol. The photos above all clearly show that he turns his head to focus on an object, face, or in this case, my iPhone that was constantly shoved into his face taking photos of his “best side”.

How do you correct DVM? Well, it’s dependent on the severity of the case but generally, through play that involves rolling balls past them while they are in tummy time or sitting up. We had some brightly coloured balls that we would roll across the floor and Sol would follow the ball but his head would move like he was a robot – not smooth. He also needed to physically turn his head to follow the ball and not just allow his eyes to track the ball. So, from that, I had a question about “peripheral vision”. Actually, I had a LOT of questions. And the other “ego-driven” questions like – how many other kids have this? Is my baby boy going to be like this forever? How will this affect him? When will he be normal again? So, HELLO Facebook Groups. Lifesavers! I joined a FB page for Delayed Visual Maturation and instantly gained insights, ideas and supportive and encouraging feedback from strangers all over the World.

An interesting discussion with the ophthalmologist indicated that we would be able to test Sol further to rule out “other future development issues”. Don’t you hate it when they say shit like that and you’ve gone from a 10/10 anxiety level to a 12/10? All of this while I’m trying to feed Sol and take on medical terminology in a sleep deprived brain fog. Did he say – “You might want to follow up with a brain scan” or “There might be some other factors you’ll want to rule out” or “DVM is not always an isolated event” or ALL.OF.THAT. WTF?

At this point I’m going to leave the “next steps” till another post and finish on a positive. So my Sol-Man has a diagnosis for DVM – we can work with that. As a physical educator and information nerd with a highly tuned gut instinct, I knew there were things other than “rolling balls” that I could do to help Sol. I have a pretty good grasp on how the brain functions and how the body develops. I could also see from Sol’s developing personality that he had a high energy, social nature and that I would be able to work that in his favour. He was feeding well, sleeping well and loved being taken out to different places. He was never easily afraid and seemed highly curious. ALL GOOD THINGS.

Word of the Day – NEUROTYPICAL. I had to really ponder on the meaning of this. Neuro – the brain and nervous system. Typical – expected behaviour. So in a nutshell, it’s when you meet all the benchmark milestones and respond to them physically, mentally, emotionally and socially according to what is deemed “normal”. As my 13 year old daughter Jazz says “It’s the way they teach us to pass tests so we can get high GPA scores and a better chance of getting into a prestigious expensive colleges so we can get the best jobs, be normal and life is perfect”. All said with lashings of 13-year old sarcasm and irony. Jazz is neurotypical. LOL

OTHER RESOURCES

Baby and Beyond (Paediatrician)

International Specialist Eye Centre