Tuesday, July 24, 2012

Anal botox? Hmm... that's something that I have never heard of...

Mama came with koko to the NICU since gong gong said he will join us, so, after that, he can bring koko home.  Thank goodness everything came back normal, so, we don't have to wear the gowns today. 

As soon as I walked in, the attending doctor asked me, are you Ms Wan?  I said yes and she started telling me about your condition.  Said that we have changed the vent settings and it seems that your CO2 is in the 50s range.  Apparently, the pulmonologist, Dr Sanchez came to see you and said that if you are in this rate for 48 hours, they will accept you at Our Children's house but of course, that's pending GI's input. 

In addition to that, Dr Magason inserted a tube in your anal, apparently that tube is to help decompress some of the air from the intestine.  I think they are still not thinking that your case is like Landon's whereby there are chunks with cells and chunks without?  Anyway, yes.... the doctor was telling me about the anal botox, right away I was thinking about face botox and the doctor said yes, it's like a botox for face, basically for face, you tigthen up the skin on the face, therefore the anal is basically to tigthen up the intestine since they think that there are some loose intestine?  Hmm... interesting. She said they are not 100% sure for now but said that Dr Magason thinks that you are a candidate for this.

Ok, so, I did some googling and found this:

Procedure:

This procedure involves the injection of Botox into the internal sphincter muscle which will relax the area, promote blood flow to the area and reduce pain associated with an anal fissure. The procedure takes only a few minutes and involves having a rectal exam and injection of Botox into the internal sphincter muscle in one spot. There is no special preparation needed prior to this procedure so you can eat and drink as usual the day of the procedure and you do not need to do any bowel preparation. You will be awake for this procedure and will not be given any sedative or pain/numbing medication so you will be able to drive home after this. We do use topical or gel numbing in the area to make the injection less uncomfortable for you. The Botox may sting a little as it is injected but this sensation lasts for only a few minutes. The injection does not cause any cutting or damage to the muscle so you are not at risk for having any fecal incontinence/seepage. The Botox takes effect in approximately 72 hours, sometimes longer, and last for approximately 2 - 3 months.
Activity: There are no special restrictions after this procedure and it is best to continue with the same regimen you were on prior to this procedure and you will not need to take any time off of work.
Potential Side Effects:  
It is normal for your symptoms to slowly improve since the Botox injection isn’t effective immediately. BOTOX INJECTION ALONE IS NOT EFFECTIVE FOR ALL FISSURE PATIENTS. For those patients with anal fissures, it is normal to have pain/bleeding which should improve over the next 2 to 4 weeks.
 Ok.... that's not good if it only last for 2-3 months, if that's the case, for the rest of your life, do you need this all the time?

Here is what you had :(  I am very sure it's very uncomfortable... poor baby.




Anyway, you were a little more awake today, I guess it's because at that time, your CO2 were lower?  So mama took pictures with you.


 Mama was messing with you.... mama made your hair like yee ko, what you think?


Hmm... maybe not.... LOL

Mama was able to take some really cute pictures of you... finally you were a little awake to do some of this for mama.

Dada said you looked like you were thinking of plans to expand your stay in NICU.


Ok... thinking too hard till you were tired?


Ok.... maybe I'll think in my sleep


Koko left with gong gong while mama is sitting here.  You drank 65 cc for mama by bottle and you started to show like you were tired and slept.  Now... T com readings are about 60s to 70s now :(  Not good again.... sigh.  You just don't want mama to go I guess? 




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