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.