The Monster in him

I cried so hard my eyes were swollen. After a big cry and a few calls (to my mom and my sis) to get it out of my system I was feeling so much better.

This morning I took Zac to see Dr Lee. Dr Lee gave him a thorough check and had a good look at the swelling. He said Zac is a very healthy boy with a very good weight. As for the swelling he didn't really comment much, he probably was puzzled too like all the other doctors. He did however say that since it didn't seem to bother him and it is not painful, we should just leave it and monitor it for a while. He adds that he has seen a lot of cases like these where some will go away after a while, some gets bigger and some becomes permanent. He did however add that Zac could probably have been born with it and it grew overtime without us realising. He said a child surgeon would probably be able to tell us the diagnostic and options better and suggest that we see a Dr Goon who is in a clinic next to his.

Since we were already there I wanted to meet with Dr Goon if he is available. Thankfuly he is. After waiting for a few mins, we went in to meet with the surgeon. Our hearts pounding. Dr Goon inspected the swelling and the ultrasound and the first thing he said was 'there is water inside here' referring to the swelling. Then he went on to explain about the complications of the area and what are our alternatives. He used a lot of medical terms and chinese words and we tried to understand as much as we can. The discussion went on for about 15 mins. So whatever I am writing here is based on layman terms, ie terms that I can understand and they are not exactly the terms/words he used.

Dr Goon said what's inside are fluid but whether it is blood or some clearer liquid (he said something about 'lymph' something which I could not remember) is something we cannot determine. He said the swelling is located right at the lymph nodes which is just next to the ear and he is also unable to determine if it is in the lymph nodes itself or if it is next to it or if they are actually connected/touching. I asked him if we could do some other scans to determine what it is exactly and he said even a CT Scan will not be able to give him an answer as they are really close.

The lymph nodes is where the main vein is controlling the facial movement and it is very dangerous to operate anywhere near there as the chances of it being affected during surgery is usually very high. If the main vein gets affected, he will end up with facial deformities, unable to control his eyes/nose/mouth are some of the effects. He went on and listed out for us the possibilities:

Worst case scenario

He said some will continue growing until it begin to affect the child. Some child's face will tilt to one side to accomodate the growth or the lumps will begin causing issues to the nodes and veins. In cases like these we will need to discuss again and determine the suitable course of action. Surgery might be an option but not without the risks. Even with a surgery, we might also need to consider whether to extract the whole thing or have it partially removed. 'Septated' in the earlier report by the radiologist means that it is a clutter, not just one :-(

Middle case scenario

Dr Goon went on and said that some might just grow to a certain size and then stopped growing. In cases like these we might decide to just leave the lump as it is as it is not life threatening but it means he will have to live the rest of his life with an ugly lump on one side of his cheek. For cases like these we can also consider (if the child is older) to extract the fluid out using a syringe and get it tested to confirm what it is. The test results might also help us to decide what's next ie whether to leave it alone or figure out if it's safe to be surgically removed.

Happily ever after scenario

There are also chances that the lump will decide to go away on its own just like how it magically appeared over a period of time. How long no one knows. It might take days, months or even years.

So what's next?

We will need to continue to monitor the swelling for any growth. Dr Goon did say that it is common for the swelling to subside for a day or 2 and then return bigger for a few days etc. So we should not be alarmed if there are sudden changes in a few days. We should monitor it closely over a longer period and if it constantly gets bigger over a few days, then we need to bring him back for a check up.

We also need to monitor for fever or redness in the swollen area. As the lumps are made of fluid, Dr Goon said he might get infections. When that happens he will need to take antibiotics to control the infection.

We will need to return for a follow up in 6 months.

It really broke my heart to think and imagine what he 'might' need to go through in the near future. Although things are still uncertain for now, like most mothers, I will not stop worrying and blamimg myself for whatever will happen to my child. If given a choice, I would like to take his place and go through whatever he is going through. If given a choice, I would take the lumps and put it in my cheeks. If given a choice, I would ask God to please spare him and let him grow up healthy and normal.

Unfortunately the choice is not in my hands. All I can do now is hope and pray that the lumps will go away on its own very very soon. In the meantime, I will never stop kissing and hugging and loving him and of course his sister too!

The monetary damage today is RM205.