Treatment #2: January 13th, 2011

Today was Enler's second treatment on his port wine treatment journey. Graham, I and Grandma Kling took the day off to be with Enler. I woke up at 3 am to breastfeed Enler - his last feed before the morning treatment. Then we were up at 4:30 getting ready to leave by 5:30 for a 6 am check in at Phoenix Children's Hospital (PCH). Grandma met us there.

Because we had been through this before the whole process went very smoothly and quickly. Unlike the first treatment, this time Enler was not the first on the schedule. We also did not have an eye exam this time (he will go for an outpatient check up later this month). We were back in the pre-op area by 7:30 am and Enler was in the treatment room by 8 am. We met with the dermatologist and anesthesiologist prior to going back to the treatment room. Both were wonderful. Enler started a nap while we were in the waiting room and slept until right before going back for his treatment. He was very pleasant throughout the whole pre-op period.

We found it easier leaving him with the doctors and other staff this time. We had been through the process and knew we could trust it and the providers. Once we left him we went and grabbed breakfast. Almost as soon as we got back to the waiting area, the dermatologist headed out to tell us the procedure was over and it had gone well. They increased the magnitude of the laser this time, 8.5 joules the first treatment and 9 joules this time. They will continue to increase it each treatment. Additionally, they have started using Continuous Positive Airway Pressure (CPAP) during the procedure. The thought is by using this during the procedure the vasculature is brought closer to the superficial skin and therefore responds better to the laser. Our dermatologist learned about this recently during a conference by the laser creator in Portland.

Our dermatologist, who we adore, told us Enler's port wine stain is deep so it will take more treatments. The exact amount he cannot predict. Most likely he will need between 6 - 8 treatments, maybe more. The dermatologists plan is to keep going until the mark is completely resolved. If we feel comfortable with the progress prior to that, then we can stop earlier. We are on board for going for complete resolution. Graham had been concerned that Enler's birthmark could become thick and deformed. Our dermatologist told us that some do transform but usually you see signs by Enler's age. He sees none of that so suspects we won't have to worry about that. He also told us that in his practice the chances of needing re -treatment later in life for recurrence does not happen very often, approximately 10 - 20% of the time. The literature shows about a 50% recurrence rate, but his results have been better than these reported values. This was all good information.

After confirming with Graham the best Irish bars in the valley, and dropping off prescriptions, the dermatologist was off and we were being taken back to the post-op area. When Graham and I got back Enler was in tears. The nurses were trying to feed him a sippy cup, but he hasn't mastered the sippy cup yet. I had grabbed a bottle prior to going back so instantly picked him up, cradled him and started feeding him. This quieted him down for awhile. Once he started crying again the nurse suggested I wind him, as lots of times the babies get air in the bellies that causes them discomfort. After a huge belch, Enler was back to finishing his bottle. Graham went and got Grandma and she came back to give Enler cuddles and love with me. We hung out with him until the IV was out, he was changed and ready to go. We were all home by about 11 am.

We had thought Enler would sleep most of the day like he did after the first treatment and we were prepared for massive cuddles. But because Enler did not need intubation this time, he did not receive as much sedation. Therefore we had a pretty normal day at home with him (with just a little more cuddles than usual). He ate, napped and played like normal. He is starting to crawl faster and can pull him self up to a standing position like a pro. He had a visit by his Uncle Alex before bed and was all smiles and giggles up until bed.

It was a good day and we feel so lucky to have such excellent doctors, nurses and facilities to take our baby to for his treatments. We also feel so lucky to have such a supportive family. It was easier today then the first treatment and we imagine it will only continue to be easier. We will document his bruise resolution progress and post that next! Thanks for following along.