~ Kaitlyn Amber Jones ~
Kaitlyn is one of a twin born at 27 weeks gestation, July 12, 1997, "twin B". Kaitlyn was born by spontaneous vaginal delivery. Birth weight was 1100 grams (2 pounds 6 1/2 ounces). Apgars were 4 at 1 minute and 8 at 5 minutes. At delivery she required positive pressure ventilation for 2 minutes then was intubated and put on a ventilator at that time. UA and UV lines were inserted. Chest X ray was consistent with respiratory distress syndrome. Cultures were done and she was started on antibiotics. She was then transferred from the Grace General Hospital to the Janeway Children's Hostipal both in St. John's..
Kaitlyn's ultrasound showed a grade 3 intraventricular hemorrhage with subsequent post hemorrhagic hydrocephalus. Also noted was a small area of encephalomalacia seen on the left side at the site of the placement of the first shunt. She was originally shunted due to increasing in head size and massive increase in the hydrocephalus. The shunt had to be revised due to a blockage and she was then again shunted. Her head circumference seemed to be growing appropriately although a little slow for awhile after this placement of a shunt. She showed no signs of intracranial pressure at discharge. Her cranial ultrasound done prior to discharge showed that though there was still some ventriculomegaly it has decreased in size since the last ultrasound. Her tone was normal and her reflexes were normal. Compared to her twin brother, she does not seem to be suffering from the same neurological deficit. She was followed by Child Development.
Initially Kaitlyn suffered from respiratory distress syndrome and was ventilated. She received Surfactant. She was noted to PIE on X ray and was placed on a jet ventilator for 4 days after birth. She remained on ventilation for a total of 4 days at which time she was switched back to conventional ventilation. She also received a course of Dexamethasone. She was initially extubated on August 15, 1997. At discharge she was doing very well in room air with no signs of respiratory distress. She was not on diuretics.
Kaitlyn had a PDA ligated and has had no other cardiovascular complications. She has normal intracardiac anatomy. She had mild tricuspid regurg noted on a previous echo. An echo done just prior to discharge again showed a very mild nitral regurg, but otherwise cardiac anatomy was normal. The cardiac function was also normal.
Kaitlyn had a renal vein thrombosis noted on an early ultrasound. This was on the right side only. She was on Heparin for this. The Heparin was stopped a few weeks prior to discharge. A renal ultrasound done a few days prior to discharge showed that there was no recurrence of the thrombus. The right kidney however continued to decrease in size and there is no use of that kidney. Her left kidney however is functioning well and has compensated for the loss of the right kidney.
Kaitlyn was discharged from hospital after admitted with exacerbation of her asthma. She had acute shortness of breath, was wheezy and required ventolin, Atrovent as well oral Pediapred. She went home on Ventolin puffer, Beclovent puffer which she requires 1 puff of each once a day. Recent allergy test done and showed that she was allergic to cats, dogs, dust, smoke. The family home is smoke free, pet free and has hard wood floor throughout. It does have hot air furnace but is not used during summer months. There is an extensive family history of allergies and asthma on mom's side of the family.
Summary of Kaitlyn is a healthy looking child alert and in no distress. Her vitals are stable. She is in no respiratory distress at the present with no cough or wheezing. She has normocephalic, tympanic membranes and pharynx are normal. VP shunt is on left posterior occipital area and is fine. Chest revealed no in drawing, she has good air entry bilaterally. Developing as a normal 2 year old.
Kaitlyn as of October, 1999 has been doing well. No sign's of problem's with her shunt and all that has been fine. Earlier this summer she fell on one of her Fisher Price toy's and needed stitches on the left side of her head. But that has since healed well and no problems there. She now weighes 23 pounds, and still wear's 24 month clothes......but Doctor's say that her weight and height charted on the growth chart is the same as a normal 2 year old child. Overall she is doing well.
Update November, 2000
Kaitlyn as of today weighs 13.3 kg (29.3 lbs), height - 91 cm, and her head circumference is 50 cm, all normal for her age (3 year, 4 mts). Found earlier in the summer, thru a CT scan, that Kaitlyn had a small leak in the tubing in her shunt. She was followed on a regular basis to watch and see if it got any worse. October, her Neurologist (Dr. Maroun) decided that it would be best to have the leak fixed as it was getting worse. October 17, 2000, she was admitted to the Janeway Children's Hospital, and her surgery was booked for the following day (October 18/00) at 8am. Everything went well and she was discharged on Oct 22. Her update checkup with Dr. Maroun for Nov 7, 00 went very good, her incesion is healing well and her hair is growing back.. lol :)) She was discharged from Perinatal Program as a 3 year old girl, growing and progressing well for her age. Quite surprised at the many activities she could do for her age. She will be followed by her Paediatric Dr. M Hall on a regular basis. Updates to follow on her condition later.
Update November13, 2000
Kaitlyn on Nov 9, 00, went to see her family doctor about a "sty" on her eye, to have treated and cured. She was given Erythromycin to take until finished for the sty. As days went on Kaitlyn seemed to be getting sick, throwing up, and not keeping things down. On Sunday morning, Nov 12, she woke up to throwing up all day, never ate a bit to eat or drink and became dehydrated. We took her to emergency right away, where they hooked her up to IV. . They assumed that it was her shunt blocked because of the recent revision and the side effects she was having was much similar to a blocked shunt. Upon many tests, CT scans, blood work and a night in the hospital they found out that she is allergic to the medication they had give her for her eye.. "erythromycin" She was immedically given cream for her eye and taken off the medication and insentially she became well again. She got out of hospital the next day feeling much better.
Kaitlyn's admittions at the hospital