Oct 9, 2008

Gastric Emptying Scan & Results

Ainsley in the Gamma Camera

I wonder how many more tests Ainsley will have with names I can hardly remember. The surgeon who will do Ainsley's Nissen wanted a Nuclear Medicine Gastric Emptying Scan to see if she had normal motility. When he suggested it I wondered to myself why didn't we already have of these.......Well now I know.

10:15 that's the time we were to show up for her appointment. When we eventually get back to the room (they always seem to be behind schedule) they show me what they're going to do. Give her a bolus feeding and strap her on a narrow "bed" on her back for an hour?! I NEVER put her on her back after a feeding. When I've had the misfortune of her having poopy diaper after a feeding I dread lying her on her back for the 2 minutes of the diaper change. It has frequently ended in vomiting up into the face. (In fact this just happened while writing this blog post. That Nissen can't happen soon enough.) So my jaw drops and I explain that she is highly likely to vomit in that position. I knew that they'd be watching her for an hour but had no idea it would involve being laid flat on her back and for so long. They try to reach the surgeon who is, of course, not available. So we're waiting for 40 minutes for an answer and Ainsley has not had any food since the previous night. She's HUNGRY. And the few toys I brought are starting to get old so I'm really worried that they'll never last another hour.

Finally we get clarification. Yes indeed he wants us to do it. No surprise really. So we strap her onto the bed with this enormous blue velcro strap and the technician uses the remote control to move the camera over her body. It's like an MRI where you are in a tube and they adjust the height so that her face is just a few inches from the tube. She hates laying on her back and is hungry and scared so of course she starts to cry. The nurse injects a small quantity of tracer into her g-tube via syringe. It is radioactive and allows the gamma camera to track the tracer as it moves through her digestive system and show the movement of the stomach contents on a monitor. Then she is given a bolus of formula. We opt for a 6oz feeding instead of 8oz to minimize our chances of her vomiting. I hold her hands and she starts to calm down once her tummy is full. Then I get creative with my bag of toys and come up with games to play for the hour.

I happen to have a plastic fly. I make the fly buzz and land on the machine over her head. Just like a real fly it buzzes and lands, buzzes and lands. She's loving it and is happy and smiling. But buzzing is not great when you have a headache. On the other hand neither is a crying child who might vomit up the tracer and ruin the test. Since Ainsley gets increased sections while crying it is important that she remain calm and happy since increased secretions = increased coughing = high probability of vomit. Thankfully the technician is able to find me some ibuprofen to take the edge off of my ever-increasing headache. Who thought up this stupid game? Oh yeah that was me. Amazingly, I am able to keep her attention with the fly for about 20 minutes. Now only 40 to go....Sigh.

Then we play with a mirror. Sing mirror mirror on the wall, who's the cutest baby of them all? Tap the mirror on the machine. Tap it here tap it there. Uuuuughhh. This lasts about 15 minutes only 25 to go.

Peek-a-boo with a towel. Ten more minutes, fifteen to go.

Old McDonald with some other small plastic animals but unfortunately I have a lion, dinosaur and turtle and not a lot of farm animals.

But we do have a DOG. So we sing "How Much is That Doggy in the Window". But I can only remember the first few verses. It gets old although it's kind of fun to make the dog bark and wag it's tail.

Finally the hour is up. The best part? We get to come back after an hour and get 5 minutes of pictures then come back another hour after that for 5 more minutes of pictures! They forgot to tell me that about these two additional hours. So the appointment that I was told would take a 1 1/2 hours lasts until about 3:00. Luckily today the kids started woodworking class after school so I don't have to pick them until 4:30, rather than the normal 3:20, and I will have time to run home to drop off Ainsley and our nurse before leaving to pick up the kids.

We take an hour lunch break, go back for pictures.

Kill another hour giving her a feeding and getting gifts at the gift shop before going back for the final pictures.

By now she's fallen asleep and when I have to pull her out of the stroller to strap her to the bed for the THIRD TIME she loses it and truthfully I don't blame her. Poor baby. Funny when the five minutes was up I picked her up and told her we were all done and pointed to the machine and signed "all done" she immediately calmed down. She really seemed to understood me! That was cool!

So the results are in and (drum roll)...............she has normal motility and reflux. Exactly what I told them. I had put food coloring in her feeding and it came back in a day so I knew she had normal motility. And it's been obvious for some time that when she coughs the pressure causes stomach contents back up in the esophagus. It also showed no tracer in the lungs but again, I've never seen the dye come out in her trach secretions so even that was what I expected. Basically it was a lot of hoopla to confirm what I already knew.

1 comment:

  1. I am glad the test came back as you thought they would.Poor Ainsley she looked so sad in that group of pics, I could tell she didn't like being in that machine and I don't blame her. That is a long time to have to stay still, I don't think I could be still that long, let a lone a little girl like her. She did a great job, though.

    I hope your Niseen goes good, I am waiting to see if its the answer to your prayers, oh I hope it is.