Friday, October 15, 2010

More Fear, More Relief (I think)

I swear, I really don't want to be traipsing off to doctors constantly. I don't want to be a hypochondriac. So about a month ago when Matt mentioned that the back of Toby's head seemed awfully lump, I laughed and said, "This is Toby, do you know how many times he's hit his head? Of course it's lumpy."

Then on Wednesday evening I gave Toby a long-overdue haircut. I couldn't believe all the bumps I found under that mop of hair--seven! And it was hard to get the hair clippers over and around them. Ranging from 1-2 cms in diameter they appeared over both ears, three more on the lower back left of his head, and two more on the lower back right. At least a couple of the bumps were too prominent to pass off without a worry, especially since I was sure they weren't there (or at least not that prominent) at his last haircut three months ago. I took Toby in to see our friend, Dr. A. the next morning. She greeted each of my children by name in the hallway as she was going in to see another patient. We're old friends by now.

Dr. A smiled broadly at the kids when she entered our room, but her smile quickly faded when she took a look at Toby's head. She quickly checked all the lymph nodes in Toby's body--none swollen. Of course she had trouble pinning him down for this examination. She ended up following him as he climbed onto the arm of a chair and into the windowsill. She examined him right there, standing in the windowsill of an open window, looking out into the parking lot. She said it was the first time she'd done an exam in a windowsill. "Well, the bumps are sure prominent!" she remarked, but observed that they didn't seem to be painful or tender, and that he didn't seem to act ill at all.

"I'm going to order a plain x-ray," she said. When I asked her what she was looking for she drew a breath and said, "Well, we're praying that it shows soft tissue...that Toby's head is just bumpy because he's Toby, and he's active, and maybe he's hit his head a lot." "What else could the x-ray show?" I pressed. I know this annoys doctors, but I needed more information at that point. She listed some options: bone cysts, other cysts, fibrous growths. She never used the word tumor, but when I asked if "something" growing inside the skull could cause it to push out like that she replied matter-of-factly, "It could." She encouraged me to take Toby to the hospital for the x-ray that afternoon so we could have the results before the weekend.

I worried, of course, all the way home. I told Matt, we looked at the Internet (bad, bad, bad!), I called my parents, but I resisted the temptation to sound the alarm. After lunch I left the girls with Matt and drove Toby to the hospital. I told the technicians to be prepared for the fight of their life trying to pin Toby to a table and x-ray his skull. It was his normal nap-time and he was visibly sleepy, so I pointed to the table and told him he was going to go "nigh-night" there. I called the foam cushions around his head his pillow and the lead apron over his body a blanket, and he willingly laid down! To my amazement he nervously looked at the lady squeezing his head with the two foam cushions and the other lady dangling a foam penguin in front of him, then he looked back to me in my lead apron and squeezed his blankie tighter, but he didn't fight. They were able to get good pictures quickly, and then we just had to wait.

There's nothing like waiting around when your pediatrician has just shown worry about the bumps on your toddler's head. Fortunately, there was no shortage of things to keep me busy. I did revert back to Internet research last night after the kids were in bed. I knew I was only signing myself up for more worry, but I'm like a moth to a flame. After an hour or so of looking at articles on cysts, fibrous growths, tumors, and other scary things I decided to give up and go to bed.

I waited anxiously for the phone to ring this morning and tried to keep myself busy with laundry, dishes, meal-planning, and shuttling Emma to and from preschool. Just before noon I called the doctor's office, but they hadn't received the radiologist's report yet. Finally, at 2:00pm I decided to take Hannah and Emma for a field trip to see that piano that plays all by itself at the hospital. Matt was home to stay with Toby while he napped. The girls enjoyed the piano, and I just happened to stop by the imaging department and pick up a copy of the report myself, you know, since we were already there.

I thanked the receptionist and nonchalantly slipped the paper under my arm as I led the girls back to the hallway, but as soon as I was alone in the hall I looked down at the report. "The skull has a normal appearance. No abnormal mass is identified."  Phheeewww! I felt like skipping out of the hospital with my girls.

But the question remains: why is his head so lumpy? I look at pictures I had taken of his head back in March after his first haircut and I don't see any lumps...maybe a little bit, but nothing like what's there now. And I'm sure they weren't there at his last haircut about 3 months ago either. What could cause lumps to grow on my child's head that wouldn't show anything on an x-ray? Dr. A had acted like if the x-ray didn't show anything then we would just say, "OK, that's Toby, no problem." But I still want to ask her if there's anything else bad that it could be that just wouldn't show on an x-ray but might on an MRI or CAT scan. She never called me today, and now it's the weekend. I guess I'll have to harass her on Monday.

So if any of you have any insight, let me know. I'm pretty much relieved, but not completely until I hear the doctor tell me that I should be. It may be a long weekend.


  1. When did he have his last ear infection? He had tubes put in but has he has any infections since then?? Lymph nodes drain the ears, sinuses, scalp...with his head bumps...he may have some swelling of the lymph nodes as they are draining the "swelling" from the bumping of his head.

    Has he had any immunizations recently...last three months? Flu shot? Those are things that I would think of they would activate his immune system.

    I hope that you get your questions answered on Monday. I know that it is hard to not worry...but no sense in borrowing trouble from tomorrow...worry (anxiety) is allowed in your situation but try to save it for when you have objective data...until then...try to set it aside.

    "Cast all your anxieties on him for he cares for you..."

    Take care....

  2. His right ear tube fell out already in August and he did have another ear infection in his right ear from Sept 18-26 with drainage from his ear, that wouldn't clear up with antibiotic ear drops. He had a course of Zithromax that cleared it up. He had one Hep A shot on Sept 17.

    I think Dr. A suspected the lymph nodes too that's why she checked all of his lymph nodes first. She said that one small bump at the base of his skull behind the left ear felt like a lymph node but this was tiny (5mm?) and not one that I had raised concern over. The large bumps are solid, fixed, and not in the right spots for lymph nodes.

    The other thing that doesn't fit is that Matt and I felt these bumps over a month ago, (but didn't see them as his hair was covering them) and we dismissed them. I know they haven't sprung up since the shot or ear infection. It seems to me that they've been there for awhile but are slowly getting bigger.

    I'm feeling less worried as time goes on. Plenty to keep me busy again today.

  3. I'm a chronic internet researcher, too. It's always especially annoying to know you have to somehow remain calm through the weekend until you can pester the docs. :)