MRI at the RCH

On Friday Michael and I went to Melbourne for the day, so he could have an MRI scan at the Royal Children's Hospital. He was born with a heart defect that was corrected by surgery when he was a week old. He has annual checks in Hobart, and every 3 or 4 years goes back to the RCH for more intensive checks. This is make sure his heart is growing as its should, and to see if the scars and slightly stretched vessels are affecting its function. So far so good! He really is a remarkably healthy, resilient and happy little guy, and I can honestly say that I don't think about his heart from one week to the next.

Our state government pays for our costs to undergo procedures like this interstate, when the local system can't provide the specialist people or equipment. Which is a great system – it was a very welcome surprise, hard on the heels of the unwelcome surprise of Michael's diagnosis when was he only hours old.

I always believe its better to be being bored at the airport than frantic on the road, so we had plenty of time to wait. Then a power outage in Sydney delayed our flight by an hour. The low morning sun shines powerfully into the departure lounge at Hobart Airport, so we got out the bits and pieces we had available and did shadow/reflection experiments to pass the time.

We finally got airborne and I started prepping Michael for the quiz I was planning to give him. There was a strong possibility he would need to have a cannula (IV drip) in his hand, to put a contrast agent into his blood for the MRI. This is when I would start asking him tricky flag questions, such as "Which Brazilian state has the word 'nego' on it's flag?"

The lady dozing beside me on the plane while we talked flags opened her eyes to say to Michael "you are a VERY clever boy aren't you?". I told her a bit about him and he answered some fairly detailed questions. She closed by saying "Hmm, Michael Rees. I'll keep my eye out for you Michael".

My plan had been to have lunch and see the resident meerkats at RCH before our appointment, but as we were now an hour behind, we just sped straight there in a cab. I took along my iPad to document the day; Michael had been prevailed upon to write a report on it all for his class, so I was taking pics as memory-joggers for him primarily. He doesn't like having his picture taken.

I was allowed in to sit with him while he was in the scanner. He was very relaxed about it and, as always, very easy to look after. He is the opposite of a drama queen - just keen to be accommodating and cause minimum fuss.

The scan takes about 40 minutes. Kids can choose a movie from a menu (Michael took Ice Age 2) which they can watch using a mirror set-up in the head-cradle thingy. They have audio from the movie and instructions from the operator coming in through the headset as well. They have to hold their breath in, hold it out, etc as commanded. This is quite tricky to master for younger kids, and that's why Michael has not had an MRI up until now (he's 10).

The scanner makes some pretty terrible noises, but not constantly, just intermittently. I had earmuffs, and I watched he movie without sound and dozed. I couldn't speak to Michael so there really wasn't much I could do, but he didn't need me anyway. As it happened they didn't need to stick anything in him, which was a happy result.

Once it was all done they let me stand in the doorway of the MRI suite and get some pics for Michael's report.

So, that was that. We'll get the results at some stage via his cardiologist.

We went up to pay a brief visit to the meerkats and have something to eat. There has been massive upgrade of the hospital since we were last there, in fact I didn't recognise it at all. It used to be that the McDonalds was the most prominent feature of the ground floor. Now there is a small aquarium (but big enough to have at least one shark in it), the meerkat enclosure a number of cafes and a sort of interactive-video-touch-screen-fun-wall, where kids can play Pong-style games but involving their whole bodies. Great idea.

Then we had to summon another cab to get us across to the Melbourne Museum for the 3.15 tour of the Aztecs exhibition. We were running late but the ticket said that's OK as long as you aren't TOO late. While we waited for our cab, someone called my name - it was our friend Andy, a pediatrician who works part of the week at the RCH. She was dropping off some paperwork in the 5 minute parking zone, kids in the car yelling, and so we had a quick catch-up on family news and general goss.

The Aztecs were great! They certainly know how to turn a chunk of basalt into an upsetting icon of the malevolent undead spirits.

This one below reminds me of 1980s swamp-billy band The Gun Club, for some reason.

These perky dudes are actual sacrificial knives, used by priests to cut out the hearts of the unlucky victims. They have human teeth stuck on and eyes made of obsidian and ... white stuff. The spike on the right was used for non-fatal self-mutilation to supply the gods with a bit of extra blood from time to time.

I wish I could recall all of the long Aztec names of the diferent gods. Suffice to say this guy below is offering you some of his liver...

... and this is a mask made a from a real skull. With a knife in its teeth! And googly eyes. Weird enough for ya?

At closing time we scooted out of there and met Dugald Jellie, author, journalist and football blogger, who walked us over to Lygon St for early dinner at his favourite pizza place. He's a terrific fellow who has the happy knack of talking to kids and actually listening to them – which is surprisingly rare.

Dugald even hailed a cab for us. Next thing we knew we were crowded into the tarmac-level hell-basement that is Tullamarine mega-gate 26/27/28/29/30. Having been in a Peruvian bus station during the Festival of San Isidro I felt right at home. The galling thing is the disparity between Gates 1-24 (TV! Tiki bars! Restaurants! Toilets and drinking water!) and the third world downstairs. Never fails to bring me down.

Due to the Sydney shenanigans, we were on a small plane, packed to the gills, and with more legroom than the Peruvian buses but only just. Bumpy slewing takeoff and landing. Delighted to get to our car and hit the road, actually controlling the mode of conveyance. As we turned into South Hobart we counted down the landmarks before home. "Last traffic lights before home ... last cafe ... last pub  ... last turnoff ... HOME!!"

All good in the cardio department

Yesterday Michael and I went over to Melbourne for his scheduled check-up at the Royal Children's Hospital. Michael was born with a heart defect that was corrected surgically at RCH when he was a week old. On our last visit 3 years ago his cardiologist was very happy with his progress, and asked for him to come back this year, at age six. He had not been looking forward to the trip at all, so I was very pleasantly surprised that he was terrific all day.

Our flight left at about 9am, and we managed to get him a window seat. It's not all that long since he has been on a plane, but it's still a novelty, and he let out a delighted whoop as we took off. Flying north over Tasmania is always pretty spectacular, but even when we were above the clouds he was thrilled by how fluffy they were. Descending into Melbourne we were above some patchy low cloud, and he said he thought it looked like ice floes.

Our appointment at RCH was not until 2pm, and I had planned that we would spend the morning at the nearby zoo, then maybe spend a while at the Melbourne Museum afterwards if we had time. It happened that in the taxi to the zoo, Michael found a brochure for the museum, and started picking out the parts of it he wanted to see most. I got the vibe that he was much more into the museum than the zoo, so I re-directed the cabbie and we hopped out there instead.

Michael just hummed with delight throughout the museum. I let him lead me wherever he wanted to go, and we probably covered about half of it. He is really fascinated by the human body, and in the cab he decided the Mind, Body, Spirit exhibit was the main one he wanted to see. It is upstairs, so first we spent some time among the obligatory dinosaur skeletons, and visited the insects. Upstairs I craftily let us get slightly lost so that I could look at the History of Melbourne exhibit that I have never quite got to previously. This is where they keep Phar Lap, in a glass case. He certainly was a big fella. For decades this stuffed horse has been the Museum's No. 1 attraction.

The Mind, Body, Spirit exhibit was like all Michael's favourite library books brought to life. I made one error of judgement when I suggested he might like to come into the tiny theatrette and listen to the audio presentation on the history of human dissection. Yes, I know what you're thinking, but he is constantly reading books about this stuff and I thought an audio thing would not be scary. Well, once they got up to the trial of Burke and Hare, the 19th century Edinburgh grave robbers and murderers, I probably should have suggested we move on. When the judge with the hammy Scottish brogue said they would be "taken from this place to another place and hung by the neck until dead, whereupon you will be dissected like so many of your victims..." Michael himself said he had enough and could we leave please. Sigh. Bad dad, bad dad.

Although I did learn that William Harvey, who discovered the circulation of blood, actually dissected his father and sister. Bodies for dissection were so hard to come by, that once they had shuffled off the mortal coil, he simply couldn't pass up the opportunity to have a bit of a peep inside.

We got out into the fresh air and hailed a cab. Michael was right beside me, hailing also, like a tiny cosmopolitan. At the hospital everything went very smoothly. Just as he did when he was 3, Michael seemed determined to be as positive and helpful as he possibly could. He had an ultrasound, and ECG and finally an exercise test. During the ultrasound he was watching the TV set up over the bed, showing a Scooby Doo episode about voodoo dolls and vampire/werewolf types, who did a bit of toothy shape-shifting. It was actually pretty scary, and on top of the Burke and Hare stuff I was thinking they were seeing his little heart probably pumping at full tilt.

For the exercise test he had to have wires taped all over his chest, and then run on a treadmill. It's pretty hard for a 6 year old to do, actually. Every few minutes it sped up a little and the angle increased, so he needed to run faster and steeper uphill. They were attempting to get his heart rate up to a particular "red line" to see how he coped. Before he got there he was feeling tired and asked to stop. They asked him to give it another three minutes, and he did, but he didn't reach the red line. It was still a useful test, but his cardiologist is keen to see him to do it again in three years, when he will be more able to understand the need to push himself.

The hospital visit was finished quite a bit earlier than I had thought. After the museum and the treadmill, I thought what we needed to do was sit down for a while, so we caught a tram going past the hospital and just stayed on to the terminus, on the other side of town near the Domain. I told Michael there was a cafe just up the road where we could have ice cream and coffee. It turned out to be a fair bit further than I remembered. He didn't complain though, just asked if we could sit under a tree and read for a while before we kept walking. I had bought Michael a book at the museum gift shop (another human body book) so we sat and read that for a while. After we had carried on and got ourselves some afternoon tea, Michael sighed and said "I just want to go to the airport and fly home now Dad".

Our flight was not until 7pm, so all we could do was get a tram to the city, get a cab to the airport and hunker down and wait. Jetstar's gate for travellers to and from Hobart is pretty unglamorous. You feel like you are at the arse end of the airport, maybe one step up from the shed where they park the baggage buggies. You have to walk across the tarmac to your plane. No-one still does that at a massive international airport, surely? We do it in Hobart, but that's because we have a tiny Toytown airport.

The flight home was no picnic - it was dark, and squeezy, and we were both tired. Michael was a bit teary. I hadn't packed very well - I had pulled out reading matter we were too tired to read, but left packed away money for snacks, water to drink and chewing gum for sore ears. Of course we touched down eventually, and it was great to see Marcus and Elf. On the drive home from the airport Michael was his old self, and regaled everyone with an astounding level of detail about the day.

Paean to the RCH

Its roughly a year since Michael came home from his three weeks at the Royal Childrens Hospital. I havent recorded here why he was there, so I'll do that briefly.

Michael was born with Transposition of the Great Arteries, which means the aorta and pulmonary artery are reversed. The aorta normally takes red (oxygenated) blood from the heart around the body. The pulmonary normally takes blue blood to the lungs to be re-oxygenated. In Michael the red blood circulated from the heart to the lungs continuously, while the blue blood was pumped around the body again and again, progessively reducing in oxygen. A few hours after he was born, a midwife at the Royal Hobart Hospital noticed his bluish skin, and did some tests to determine the cause. About seven hours later he, Elf and I were at the Royal Childrens Hospital in Melbourne.

We can't really express our gratitude in words, to the RHH, the RCH, and the Tasmanian State Government's medical emergency procedures. Also to our mums who teamed up to look after Marcus for two weeks until I could fly home.

The prompt action at RHH saved Michael's life. The State Government pays for evacuation, medical treatment and accommodation of anyone who has a medical condition that can't be treated within Tasmania. We had no idea this existed until we needed it. A man called Terry who works in a tiny office in the bowels of RHH organised Michael's transfer by air ambulance, seats on a commercial flight for Elf and I, and our accommodation. We did not have to worry about any of those details, which was great as our worry brain cells were fully occupied.

Michael had a temporary operation immediately that allowed some mixing of red and blue blood to happen in his heart. This bought some time until the "arterial switch" could be performed. We thought it would be done straight away, but for a variety of reasons we had 5 days of nervous waiting. The operation was a success. It was a difficult day for us - we ran out of ways to occupy ourselves, and ended up walking in circles around Parkville waiting for the mobile phone to ring.

Michael spent several days in ICU after his initial minor op, and another stint after his major op. A year on I think of the other children who were in ICU at the time and hope they have had successful outcomes like Michael.

The RCH is regarded worldwide as one of the best children's hospitals. People who can afford to, send their children there from Japan, Singapore, the Middle East. We were asked to pay just $75 towards the costs of Michael's treatment, our flights and accomodation. The RCH is a marvellous thing to have in our region. People (including Tasmanians) who say that we have poor facilities or that we are remote and unloved, should remember that if the worst happens with your kid, they can be at the RCH in two hours getting world class treatment.