Caroline had her follow up appointment at Duke today and all went well. Dr. Prose is pleased with her progress and thinks that the hemangioma has decreased in size some, but most certainly has not grown. So, we are meeting the goal of giving her the steriod. For now, we are going to continue giving it to her at the same dose and return to Duke in two weeks. At that time we may begin decreasing the dose slightly. The goal is for her to take as much of the steriod as necessary, but no more than necessary to keep the hemangioma stable. Because of the potential side effects of long term steriod use, we only want her to be on them for as long as is necessary - it's a balancing act. Caroline's two month check up went well. She now weighs 9 pounds, 4 ounces and is 21 and 1/4 inches long. On the growth chart she's only in the 10th percentile for height and weight! Seems she is going to be a petite little peanut! She's very proportionate though, and is growing well so no worries! The poor girl had to get three shots. She handled them pretty well I must say. Today she has been quite fussy though and just acts like she does not feel well. Hopefully she'll be all better tomorrow. Here's some pictures of Caroline showing off her "boo-boos." Check out the tazmanian and daffy duck band-aides!

Meds are going down easier!

Caroline is doing much better with taking all the medicine. Thanks for the prayers! The concentrated dose is working much better. Even though it tastes just as awful, I can get the syringe further back in her mouth, and give it to her with a bottle and she does not mind as much. I'm also starting to see some changes to the hemangioma. It is definetely shrinking some, and the redness has dulled a bit in color. Caroline has a follow up appointment with Duke dermatology on Friday, so I'm anxious to see what Dr. Prose has to say. The day before, Caroline has her two month check up with her pediatrician. Lots of shots- yikes! Mommy is the one who will need the prayers that day!

Medicine whoas.....

Getting the prednisone (steriod) in Caroline is proving not as easy as it would seem. The medicine apparently tastes horrible, despite the grape flavoring to try to mask it, and Caroline does not appreciate having it forced into her mouth. She chokes, coughs, gags and spits the entire time. We are trying every different trick to try to get it in her, but so far sometimes it seems more is on the burp cloth than in her stomach. I did call a local compounding pharmacy who suggested that they can mix the medicine to make it more concentrated, so that she has to take less volume per dose. The docs at Duke said this would be fine, so it's been called in and it's worth a try. It would decrease the amount from 3 cc's to 1 cc, which is pretty significant. It won't be ready until tomorrow afternoon. In the morning, I'm going to try mixing the 3 cc's of medicine with 3 cc's of apple juice and give it to her in a bottle nipple. We'll see.... I'm running out of ideas! The bottom line: 2 month old babies should not have to take this kind of medicine! This really stinks! Any moms out there who have other suggestions, I'm open to anything!

Update on appointments at Duke and UNC

It was a very long and tiring day for all three of us, but we do have some answers, options, and a treatment plan for Caroline. It seems the unanimous recommendation from both institutions and all three doctors we saw is to begin Caroline on steriod treatment. This involves giving her a daily oral medication. The expectation is that the steriod will work to stop the growth of the hemangioma nearly immediately (within a few days), and encourage it to shrink faster. All agreed that due to the location of her birthmark and the rate at which it is growing, "doing nothing" is not an option. Steriod use does have some potential side effects, some of which include weight gain, stomach upsets, the potential for slowed growth, and some suppression of the immune system. Because of this we will also be giving Caroline a prescription antacid to protect her stomach, and she will be taking an antibiotic three days a week as a preventative measure. We will also have to be careful about not exposing her much to very large crowds or to anyone who has a cold or other infection. How long Caroline will have to take the steriods depends on the response of the birthmark, but most likely she will require this treatment for several months. The plastic surgeon at UNC also discussed the possibility of laser treatments in conjunction with the steriods. This would decrease the redness of the skin as well as encourage the hemangioma to shrink and resolve faster. She would need 2-5 treatments total and would have to have anesthesia for the treatments. This is something Zack and I are considering as well but plan to give it more thought, prayer and research before making a decision. The earliest she would begin laser treatments would be late October or early November. All in all Zack and I were encouraged by what we were told. With treatment, it is expected that when all is said and done, Caroline should have a completely normal appearance. This was certainly reassuring. We were also very impressed and felt very comfortable with the doctors we saw, the dermatologist at Duke (Dr. Prose) in particular. We also really liked the plastic surgeon at UNC, but will probably have a consultation with the plastic surgeon at Duke to discuss his thoughts on laser treatment, as it would make things much easier to have all our specialists at one place. Caroline was such a trooper all day and didn't seem to mind all the traveling, poking and prodding. She even charmed some people on the elevator at Duke with her sweet smile. We are so blessed with such a precious baby. Please continue to pray for Caroline that the side effects of the steriods are minimal and that they do their job and begin to stop and shrink the hemangioma. Please also pray for Zack and I as we continue to make decisions about treatment for Caroline and what is best for her, now and in the future.

Caroline is 8 weeks old....WOW!

Today Caroline is 8 weeks old! It is so hard to believe, yet it also seems like she has been with us forever. I've been wanting to update for a while but the days pass so fast... I don't even remember what I did before having a baby! Caroline is doing great. She is growing and changing at such a rapid rate sometimes seemingly overnight! Her most recent weight at the doctor's office yesterday is 8 pounds, 9 1/2 ounces! She's getting to be a very big girl! She is the sweetest baby, and charms Zack and I everyday with her precious smiles. She definitely knows Mommy and daddy and loves to be cuddled and held. She now loves her bath and this seems to be one of her favorite things during the day. She has started to "play" with her toys and is beginning to bat at and even grab some of them, and we are starting to hear the beginnings of some giggles and laughter. Her newest love is her swing (thanks Margie!) which has been a lifesaver because it always seems to end up putting her to sleep (smile). Speaking of sleep, our precious baby is nearly sleeping through the night! She usually sleeps for a 7-8 hour stretch at night waking up at 4am to eat and then going right back to sleep (with a little persuasion sometimes) until about 7am-8am. Such a good baby! As most everyone knows or can see in her pictures, Caroline has a rather large birthmark under her right eye on her cheekbone. It's called a hemangioma, and we have known about it since she was about one week old. We first thought it was rather benign and would disappear on it's own, but it seems it has become a little more complex than we first thought. Caroline's type of birthmark tends to grow rapidly until 6 months to 1 year of age, creating a mass underneath the skin before tapering off and then slowly going away by early childhood. Hers is unfortunately growing very quickly, and we are seeing a difference every week, sometimes every few days. It is beginning to effect her field of vision slightly (by 15%) and is starting to effect the right side of her nose. Because we don't know how quickly or how large it will grow, and the possible impact on her right eye, we have decided to seek treatment for it now. We have appointments tomorrow at Duke medical center with a pediatric dermatologist and at UNC hospital with a pediatric plastic surgeon to discuss what our options are. Laser surgery is one possibility. Please pray for the doctors that we will be seeing as well as Zack and I as we may be faced with some decisions about what is best for Caroline as far as treatment. We certainly want to do whatever is necessary to protect her development, both physical and emotional / psycho-social as both of these will play into treatment decisions that we make. Zack and I are definitely struggling with the fact that our little girl has to be faced with all of this, BUT we are also trying to keep things in perspective and be thankful that she is healthy and happy. We are keenly aware that we could be dealing with much, much, worse and are so thankful that is not the case. We will certainly update again once we have more information about what our next steps will be. In the meantime here are some new pictures to enjoy: Check out my wild hair! This is called my "worried look" Silly Girl All dressed up for church With mommy at my GiGi's house. My paci doesn't match my dress but what a fashion statement! My Aunt Tracy loves me!