Hemangioma: Laser Surgery 5.12.11

Today was round two for Grace's laser surgery. She is napping peacefully downstairs so I thought I'd take a minute to write about today.

I was afraid that as soon as we'd get into the waiting area that Grace would realize where she was and begin to throw a fit. However instead, she found a little girl that's just 2 months younger than her to play with. They shared books and other toys as we waited. This little girl, Carley, has a port-wine stain on her right cheek and was there for a laser treatment too. Carley's Dad and I discussed the treatments and how unprepared we were for their first surgerys once it was time for them to be put to sleep. Carley was soon called back for her turn and we waited more.

Once we were called back into the pre-op rooms Grace's attitude completely changed. She was constantly crying, saying: "go, bye-bye" or "away" she knew what was about to happen. It took lots of blowing bubbles to get her calmed down. We had discussed at her last treatment, giving her something to help with anxiety but this particular anesthesiologist was different and didnt think we needed to go that route.

After pre-op stuff it was time to head back into the operating room. I was dreading this part because of how terrible it was last time. This time they did let me hold her in my lap while giving her the gas but it still took everyone else in the room to keep her still and keep the mask on her for her to breathe in it. Of course, I lost it again but it didn't take her long to calm down and fall asleep (it felt like forever to me though)!

About 25 minutes later Dr. Bellet came out and told me that things went fine. That Grace was already awake and was mad as a hornet. She did say that she increased the intensity of the laser this time and would like to do another round of laser July 14th. She said we could stop the laser treatments at anytime and see where it would go on its own but she felt that we probably needed one maybe even two more treatments for now.

We then got to go back and see Grace. It took us a while to get her called down. We both knew the only way she was going to calm down was to get her out of there. After some ibuprofen and juice the crying turned to snubs and we were able to get the wires and stickers off, get her dressed and get out of there.

Again, it definitely has dark pink/purple splotches (bruising) all over. This time there were even a few spots that were a brownish color that I'm hoping aren't going to form into scabs. It was really red and irritated looking too right after the surgery but that aspect of it has seemed to go away a little bit. We will continue to keep the area moist with Vaseline until the bruising has resolved, which can take anywhere from 10-14 days and keep her out of the sun.

Scott and I discussed the July 14th surgery and because it is summer and Grace being outside and in the sun a lot that it's not a good time. Dr. Bellet agreed and we're scheduled for another treatment in September.

Thanks again for all of the prayers, messages, etc. today! Things went as smoothly as possible and we've avoided all side effects so far. Now we're praying for no scabbing, no infection, and no blistering.

Hemangioma: Laser Surgery 3.24.11

The day has come, and whew, has it been a stressful one! We had to be at Duke this morning to check in by 8:15 as Grace's laser surgery was scheduled for 10:15. Around 9:15 they called us in the back to a small room for the nurses to prep Grace. Here they checked her temperature and other vital signs and we had to change her into a hospital gown. She still hasn't gotten away from 20 lbs. yet. Today she was 20lbs. 11 oz. when they weighed her. Here's a picture of her pre-surgery, as you can tell she was really apprehensive about her surroundings and what was about to go down.



I wanted to take a picture of her arm before she had the treatment  so we stripped her back down so I could get a "before" shot. This image is hard to see much of the area as the room was so bright but you can tell where the texture of her skin is different.

 Today's laser procedure was much different than previous treatments she'd had. Before we went right into the doctors office and the only spots that were lasered were the ulcerated areas. All of this was done while she was wake and sat in my lap. Now, because of Grace's age she had to have general anesthesia during the treatment. Before she was young enough that I could just hold her and she didn't fight back (much) but now she's just too old and mobile to sit still for it. This treament would help break up some of the vessels, as well as soften some of the scaring that she got from the previous ulcers. This laser treatment is sort of the same as the laser she had on her ulcers, yet different too. Its a lighter laser and instead of just doing the laser in certain spots (like the ulcerated spots) the entire hemangioma will be treated.

From the prep room we then took Grace to the operating room. The hardest part of the day was watching them put Grace to sleep. She was already freaking out about what was going on. She knew she was in a place that she didn't like and that they were probably going to do something that would hurt her. As soon as I laid her on the bed she wasn't having it. It took 4 people to hold her down to put the small gas mask over her face. She was fighting them with all of her might. That's when I completely lost it. It was the worst feeling watching your child fight and then basically lay there with no response, even thought I knew she was just sleeping. Having to walk away from her was just as hard. My Mom was with me and we then went back into the waiting room to meet Big Daddy and the waiting game began. That was around 9:50.

About 10:25, Dad asked us what time we had come back out to the waiting room and just as Mom was telling him the lady was coming out get us to take us to the recovery room. Grace was still sleeping when we got back there but in just a few short minutes she began to wake up. As she was coming to you could tell that she was disoriented and that her arm (from the IV) and her shoulder were bothering her. She kept moving her shoulder like it was irritating and she wanted to pull out her IV. She was mad with the world when she woke up. The doctors say all children wake up different. Some groggy, some mad/mean, some sick. If it was me you could 95% guarantee that I'd be one of the sick ones, so I was hoping that Grace didn't inherit that. She woke up more mad/upset than anything. Once we finally got the IV out & she was able to have some juice things were looking up. We were in the recovery room for all of probably 20 mintues before we were able to get her dressed and begin heading home!

Grace in recovery...

Dr. Bellet was pleased with the way Grace's arm looked after surgery. It definitely has dark pink/purple splotches (bruising) all over. It was really red and irritated looking too right after the surgery but that aspect of it has seemed to go away after a while. Now we have to keep the treated area moist with Vaseline until the bruising has resolved. They say that can take anywhere from 10-14 days. We made it through surgery! Some of the side effects aren't too good, so now we're praying for no scabbing, no infection, and no blistering.




There's one last photo that I took once we got home and Grace had gotten some lunch in her.

Healing/Improvement will contine for 2-3 months following this treatment. Dr. Bellet scheduled us for another round of laser (same type) for May 12th. She says it takes up with 2/3 times to see the result she's looking for.

Thanks everyone for your thoughts, prayers, texts, facebook messages and posts, etc! It's comforting to know we have so many friends and family that love our baby girl (and us) so much! Love to you all!

Two Hemangioma Photos

Below are two photos of Grace's hemangioma that her dermatologist sent over. There are many more but she sent them in a powepoint and I can't figure out how to upload it and it takes forever to download each individial photo. So here are two that she sent; the first one they ever took and then the one they took Tuesday.

#1:

#2:

Isn't the difference amazing? God is good!

Hemangioma Update

HAPPY NEW YEAR! Wow- its almost been two months since I've blogged. I guess one of my new years resolutions (along with traveling and getting organized) should be to blog on my personal blog more (especially since I'm so bad at finding time to scrapbook now)!

I wanted to sit down and write about Grace's hemangioma appointment before I forgot anything, here goes...

Today Scott and I took Grace to Duke Dermatology for a check up regarding her hemangioma. She hasn't been since February 24, 2010. Wow. We have been very pleased with the look of it and glad that it didn't start to grow back once she was off the propranolol. We knew in the back of our minds that laser would probably be needed eventually and around her current age based on our last appointment, so we were anxious to see what the doctor said.

Dr. Bellet was amazed at not only the looks of Grace's hemangioma but also by how much she's grown. Its been 10 1/2 months since we were there last so she's certianly done some growing. We began the appointment by looking at the first photos that Dr. Bellet ever took of Grace's birthmark. I was amazed at how bad it really was. Now its barely even noticable. I signed a medial records release for Dr. Bellet to email me the photographs that she's taken at each appointment. Once I get those I'll post them so you can all see the change. It will amaze you! I wish I had been better about taking photos of it but I'm glad that Duke has record of it and will share it with me!

Even though Dr. Bellet is pleased with Grace's hemangioma she said our next step / option was to begin more laser treatments to treat the hemangioma further. This would break up some of the vessels, as well as soften some of the scaring that she got from the previous ulcers. This laser treatment is sort of the same as the laser she had on her ulcers, yet different too. Its a lighter laser and instead of just doing the laser in certain spots (like the ulcerated spots) the entire hemangioma will be treated. Because of Grace's age she will have to have general anesthesia during the treatment. Before she was young enough that I could just hold her and she didn't fight back (much) but now she's just too old and mobile to sit still for it. The area being treated will be bruised for up to two weeks following the treatment and improvement can be seen for up to two months after treatment. Once she has her first treatment and the doctor sees the difference from the initial laser that will determine how many of these treatments she'll need. If more are needed then they will probably be scheduled within 2 months of each other.

Our other option was to wait a little bit (~6 months or so) and reassess. Dr. Bellet said even then she knew that laser would probably need to be done. Scott and I discussed our options and decided to go ahead and have her first laser treatment as soon as we could. We wanted to have it done now, rather than in the summer when schedules are busy and it was bathing suit weather as she couldn't have any sun exposure to the treated areas for a few weeks. My main concern was Grace having to be put under anesthesia. Dr. Bellet assured me that it was ok and she wouldnt be under long. She said the procedure will take up to 10 minutes and then she'd be in a recovery room for about a hour (to get completely woken up) and then we'd be able to take her home. She said that most children are back to normal that afternoon, jumping & playing! My other concern was what sort of pain would she be in after the procedure and Dr. Bellet said none. That some bruising would occur but that she wouldn't be in pain. She wont have to wear any bandages like before (because there are no open wounds: ulcerations) So, Grace's first treatment has been scheduled for March 24th. We are unsure of the time and probably wont know until the day before, but I will try to keep all informed!

On a better note- we had a great Christmas and are excited about 2011! What are some of your new years resolutions?

Love to all,
Megan

10 Months Old

Grace turned 10 months old on Monday (May 8th)!

1*She's pulling up everywhere. Once she gets up she wont walk along whatever she pulled up on to get to an object yet. Instead she falls and crawls to where the object is an pulls up again.
2*She loves waving bye-bye and still enjoys playing peek-a-boo.
3*Grace still only 3 teeth. But it looks like a few others may start to come in at any time.
4*As of Wednesday she is now completely off propranolol. But we're still crossing our fingers and praying that her hemangioma doesn't begin to grow again.
5*Her wonderful sleep habits have changed. It seems that her internal alarm clock has switched itself from 7am to 5:30am. Her napping isn't as good either. I think it has to do with not being on the propranolol anymore.
6*She says "Dada", "hey", "that", "duck" and a bunch of other sounds that we can't quite figure out yet!
7*She has begun to point at things.
8*Grace is wearing 6-9 month clothes. She can fit into some 9mo. clothes, but it all depends on the brand.
9*She had her first vomiting virus Wednesday night. Talk about pitiful (and a mess). I hurt just as much as she did. So glad she's beginning to feel better!
10*She still loves to read. Grace has a bucket of books and a bucket of toys and she hasn't played with her bucket of toys in a while. She heads straight for the books!

These pictures were taken on Monday. We were at Bulls Bay & I couldn't find paper and didn't have a printer to be able to make her a "10 month old" sign. But they were taken on the actual day!


Happy 10 month birthday baby girl. Guess I better get in gear planning her 1st birthday party. It will be here before we know it! :(

Update

Sorry for the slack-ness of posting in February. Just wanted to give you a few updates on our little one.

Feb 19th: Grace went for her 9 month well appointment at the pediatrician.

Height: 27.25 inches long (45th percentile)

Weight: 16.0 (10th percentile)

She did have to get one shot, but she didn't cry much. Her doctor says she is developing wonderfully.

The weekend after Grace came down with some sort of stomach bug and was sick through Tuesday. Thank goodness she's feeling much better now.

Feb. 24th: We went back to Duke for Grace's dermatologist appointment. Dr. Bellet was pleased with the looks of her hemangioma. We've decided to begin weaning Grace off of her propranolol medication. We are still in a grey window because hemangiomas can stop growing anywhere between 9mo-12mo of age. Dr. Bellet reassured us that if we go ahead and take her off of it and it begins to grow back then we can just put her back on the medication. I'm praying that it doesn't grow back because rapid growth can cause ulcers, which I definitely don't think I could handle again, especially with Grace at the age she is now. The doctor did tell us that more laser is an option later (18-24months) to clear up the spot even more, but we're just going to wait and see how things are then. We don't have another appointment until June!

We hope you all are doing well!
xoxo-

Scott, Meg, & Grace

*Double our Birth Weight*

In between the hussle of my Christmas shopping, last minute photography sessions, photos to edit, Christmas cards to design, and getting the house ready for a realtor to come and look at so we can put it on the market, (and many other things) I've neglected our blog. I have so much to blog about including our wonderful Thanksgiving as well as Grace's Christening.

I am thankful that blogs were invented because I can quickly type what's on the brain and add a few images here and there. I dont have to stress about my handwriting being just so or misspelling something b/c I hate mistakes in my scrapbook, I know, I'm silly. If you saw Grace's scrapbook, you'd be shocked. I swore I would keep it updated, but I'm pretty far behind, which is why I'm thankful that this blog is keeping me on track. So, before I forgot a few things, I decided to take a break from the above tasks to just take a few minutes and *twitter-blog*, as Scott likes to call it.


There's my baby girl! She looks thrilled huh? No, she just feels bad, my poor baby is sick! I took this picture this afternoon when we got back from the pediatrician. Yep, we went in for a sick visit. Grace has been very congested since last Wednesday evening and has ran a slight fever here and there, but nothing major. I can tell she isn't sleeping as good and she has had a hard time eating because she can't breathe well with all of the congestion. This morning she just seemed worse so called first thing and took her in for a doctors visit. (Out in the rain. Pouring. Down. Rain.) The verdict: Grace has lots of congestion (duh!) and the beginnings of an ear infection. So we have some antibiotics to help clear that up and we'll be back at the doctors in 2 weeks for a follow-up. The doctor also prescribed a Vick's Plug-in and lots of TLC! :) The doctor also said we needed to fatten her up some and recommended that I give her cereal in another bottle during the day, not just at night. So we're going to try adding that into our routine tomorrow!

HEMANGIOMA UPDATE: The day before Thanksgiving we went to Duke for a follow-up dermatologist appointment. We hadn't been in two months so our nurse, Roseanne, and Dr. Bellet were excited to see Grace and how much she'd grown and developed! Both were extremely happy to see how well Grace's hemangioma looked! They increased her dosage of propranolol to 1.01ml (from .09ml) because they hadn't changed the dosage since she started the medication back when she was just 8lbs. On this particular day (11.25.09) she weighed 14lbs. 2oz. (just 2oz. shy of doubling her birth weight). Dr. Bellet said that we'll continue Grace on the medication until she's 9mo. to a year of age and then we'll gradually take her off the medication. Once she's off the medication we'll assess if we need to do more laser of the hemangioma as a whole, or what, if anything, will be our next step.

I hope you all are staying dry today, it sure is nasty out!
xoxo- Meg

Before & After

On August 9th, we started Grace on the propranolol, her medication to help her hemangioma. I knew it was getting better but I didn't realize how much better until I looked at the picture that I took today compared to the picture that I took the day we started the medication! So, I thought I would share with you her progress within the past 3 months on this medication.

BEFORE: (August 9, 2009)

In the above image you can also see the first round of ulcers we were battling at the time (closer in toward her neck). I'm very thankful that after that battle and one other battle we have been ulcer free since the end of October.

NOW: (November 18, 2009)

Doesn't that look so much better? My oh my! :) This makes my heart happy. You can see scarring from her 2nd round of ulcers here too. They say even once the hemangioma goes away we will still know that something was there and we will be able to tell just were her scarring from the ulcers were.

Just had to share a before and after shot for you today! God is good! Thank you all for your prayers. Please continue to pray for her as she's still on the propranolol and will be for a few more months!

Hugs to All!

20 weeks

Grace is 20 weeks old. People always said time flies, but I didn't realize how much until I had Grace. She is certainly the apple of my eye and I'm amazed at how much she changes every day!

We went to Duke last Friday for a dermatologist appointment for Grace's hemangioma and we got a *WONDERFUL* report! Grace's ulcers have healed (except one tiny spot)! And the best news is that she didn't have to have laser when we were there! :) We no longer have to apply the topical ointment, but we do have to apply Aquaphor and keep it bandaged to keep the hemangioma moist. We've been battling this round of ulcers since mid August, so its nice to have them healed. Thank you for all of your thoughts and prayers. Still keep them coming as we will continue to keep her on the propranolol for a while. Since hemangiomas will grow up until 9mo. to 1 year of age, we're afraid that if we take her off of it now, the hemangioma will continue to grow and get angry looking again, as well as form more ulcers.

Scott has been out of town a lot lately, so I recorded Grace babbling the other night to send him. Thought I'd share with you all too (just ignore me in the background) ;) Sorry for the crummy image, it was taken with my cell phone!

Hemangioma Update

Last Thursday we went back to Duke for Grace's dermatologist appointment. She weighed in at 11lbs. 9oz. and her blood pressure was fine. We talked with the doctor and she was pleased with the way the oral medication seemed to be reacting to her hemangioma, as we can both tell a difference in the color and feel. It seems to be less red (and angry looking) as well as not as raised. She has now been at the target dosage of propranolol for 5 days.

We continued with laser and she lasered the 4 small ulcers that she has as well as one of the older ulcers, but overall those that she's had for such a long time now are looking much better. She has one in her armpit that had really bothering her and keeping her from using her arm like she use to. I was really concerned with this particular ulcer because it just didn't look/smell right. It was like fighting her to get her to lift her arm and that would just make her mad as fire because that spot was so tender and painful to her. They did a bacterial culture on it to send off, as they think it is infected. She has taken us off of our old topical ointment and put us on a new ointment that will help with infection. As of today, that particular ulcer seems to be much better. There is no odor and Grace is beginning to use the arm a little more now.

I found this post online about another baby with an ulcerated hemangioma. She photographed the ulcers at every stage so you can see what one that is ulcerated looks like. I'm not sure what type of treatment she was on though. Ulcerations in the hemangioma are caused when the birthmark grows rapidly, causing breakdown of the surface of the lesion. That's the main reason for the propranolol is to hopefully keep the hemangioma from growing anymore, stopping the growth of any more ulcers!

So, that's all for now! We go back to the dermatologist in 2 weeks.

Here's a few pictures of my Sleeping Beauty...

Fun in the Sun

Well not really, we were in the car but check out these cool shades our Bulls Bay friend, Heidi, sent us along with a cool hat and some socks!

She actually didn't mind them being on her face either! :) (Sorry for the blurry picture, it was taken with my camera phone.)

Hemangioma update: We are still taking the propranolol. Tomorrow we will increase the dosage for the third time and only have one more increase until she's at her target dose. So far the only side effects I see from the medication is that her feet (& sometimes hands) get cold very easily. So I'm keeping socks on her as much as possible. We go back to Duke on Thursday so I'll have more of an update then. As far as being able to tell a difference in the birthmark after being on the medication, the hemangioma doesn't look as swollen to me overall. We're still battling the ulcers though. She has had many more that are creeping up so I'm interested to see what the doctor says about those Thursday!

On a fun note, Grace has begun to coo a lot in the past few days. It's actually like she's carrying on a conversation with you. Maybe I can video tape her and post it to the blog eventually. It's just so darn cute!

Love to all! XOXO

3 months!

Time sure does fly! Grace is 3 months old today!

Grace doesn't like tummy time too much. We're beginning to wonder if its because of her ulcers or if she just doesn't like it. So in addition to tummy time I'm giving her some time in her Bumbo chair to strengthen some of her neck muscles. She did fairly good in those two pictures but slowly begins to drop her head to a more comfortable position. Maybe by next month she'll be more comfortable. She doesn't get upset in the chair though, so that's a good thing!

I couldn't get her to smile in those first few pictures, unfortunately she isn't too fond of the camera in her face plus she was getting sleepy! But I did manage to get this one...

Hemangioma update: As you can see in the picture above she has a small hemangioma on her belly too. The doctors aren't concerned about this spot. If you look at it just right it looks like its in the shape of a heart. This one appeared when she was about 3 weeks old and has changed a lot since she was 1 month old (I compared a picture of it today), but hasn't grown recently. Scott and I have decided to start the propranolol to treat the one on her shoulder. We will begin tomorrow morning with our fingers crossed. I took a picture of her hemangioma today so we can compare it to other pictures once we've been on the medication to see if any progress is being made. Please say a prayer for Grace, that the side effects wont be too bad, and she will deal with the medication just fine. Oh, and say a prayer for my nerves too! Hugs to all! XOXO

Hemangioma Update

Yesterday we went back to Duke for another dermatologist appointment. Every other time we go the nurse weighs Grace and every time we go they check her blood pressure. Yesterday her weight was 10 lbs. 15 oz. (my baby is growing fast!) It's amazing the tiny little cuff they have hooked to the machine to check her blood pressure. The nurse says its hard to get an accurate blood pressure reading on infants so they check it 2-3 times. Grace does fairly well throughout the process, MUCH unlike her Daddy when he's getting his blood pressure taken. :)

Our days that we go to Duke is very tiring. I'm often given lots of information to digest at each appointment about what to expect, what other treatments may be needed in the future, etc. However I still tend to be encouraged that we have professionals there for support.

Out of the 3 ulcers that Grace has one has healed very nicely. Yay! We're still going to put the topical ointment on it for another few days and then we can stop using it on that particular spot. The other 2 ulcers don't seem to be healing as nicely. We went ahead and had her 3rd laser treatment on those ulcers yesterday. There are 2 new places that are beginning to ulcerate as well. I can deal with the hemangioma itself, but its so hard knowing that she's in pain from the ulcers. Whenever it bleeds I feel her pain. It's so heartbreaking to dress her wounds with her crying.

Due to the new ulcers, and the other 2 that don't seem to be healing, the doctor has now recommended that we give her oral medication in addition to the topical cream she's using. This medication is called propranolol. If we choose to use this medication she would start on a very small dosage 3 times a day and every 2 days the dosage increases until it reaches a target amount. Once they feel that she doesn't have to be on the medication any more she will gradually come off of the medicine.

Propranolol is an alternative to prednisone. Prednisone use carries the side effects of elevated blood sugars, and reduced resistance to infection. Propranolol has side effects that include hypotension and hypoglycemia, but these are short-lived and we wouldn't have to be worried about her catching something out in public since she wouldn't have a reduced resistance to infection. Propranolol is a medication that is a non-selective beta blocker mainly used in the treatment of high blood pressure. It is also the only drug proven effective for the cure of migranes in children. Propranolol has been on the market for around 50 years, but is just recently been used as treatment for hemangiomas.

Here's an article that I found intersting, that you can take a look at if your interested: http://content.nejm.org/cgi/content/full/358/24/2649 The images of change are amazing. It also gives you some background to how this drug began to be used to treat hemangiomas.

Although I really like the doctors & nurses at Duke, we're still skeptical about putting any sort of medication in Grace's system. We have the prescription but I haven't had it filled yet. I'm doing as much research as I can to educate myself as well as saying lots of prayers that we will make the right decision for Grace's treatment. In my research I have stumbled across other parent's blogs who have children with hemangiomas that are being treated with propranolol and their comments about the drug are positive. There are many forums I have read as well. It's wonderful to be able to communicate with other parents who are going through a similar process. I guess that's why I'm trying to add as much as I can about this part of Grace's life to her blog. Not only for our information and for us to remember, but maybe other parents that are debating the use of propranolol or just dealing with a hemangioma in general will stuble across this blog and know that there are others out there that have had to make some of the same decisions.

Please pray for the doctors, as Scott and I as we are faced with these decisions about what is best for Grace & the treatment of her hemangioma. We certainly want to do whatever is necessary to protect her development (physical, emotional, psycho-social). Scott and I struggle with the fact that she even has to be faced with this, but we are thankful that she is healthy and happy. We know that we could be dealing with much worse situations and we're so thankful that is not the case. She has such a precious and sweet little personality that shines through more and more everyday. We are indeed thankful and so very blessed.

Dermatologist

During the first six months of life, 5-10% of hemangiomas ulcerate during their rapid growth phase. Although the hemangioma itself, isn't painful, the ulcerated lesion is and is at risk for bacterial infection. Traditional therapy includes topical antibiotics, and local or systemic steroids.
Grace has been on topical antibiotics for just over 2 weeks now. We went back to Duke yesterday for a check up and while we were there they went ahead with the laser treatment. Laser treatment has been found to accelerate healing and reduce pain within few days, often after a single laser treatment. Laser-treated lesions heal in one to five weeks.

They hit me with the laser on the bottom side of my arm so I could see what it felt like. It felt like a light pop of a rubber band. Then they zapped Grace's 3 ulcers. The process took all of 15 seconds and we were out of there. Grace did squeal, but after a bottle, she was fine. We go back next Thursday to determine if more laser will be needed. They seem to think that the one closest to her neck will need more than a couple of treatments, but it will be determined on a week by week basis.

Just thought I'd give you an update! Hopefully these ulcers will go away soon!

Hemangioma

Some of you may have seen or maybe not, but Grace has a hemangioma on her left shoulder. We took her to a dermatologist back in the beginning of June but I didn't feel as comfortable with what he told us so we took her for a second opinion on Monday.

Just a little background:
Hemangiomas are a type of birthmark that is a self involuting benign tumors of endothelial cells (the cells that line blood vessels). In most cases it appears during the first days or weeks of life and will have resolved at the latest by age 10. Hemangiomas are connected to the circulatory system and filled with blood. The appearance depends on location. If they are on the surface of the skin they look like a ripe strawberry, if they are just under the skin they present as a bluish swelling. Females are three to five times more likely to have hemangiomas than males. Hemangiomas may break down on the surface (ulcerate).

Hemangiomas go through three stages of development and decay:
1. In the proliferation stage, a hemangioma grows very quickly. This stage can last up to twelve months.
2. In the rest stage, there is very little change in a hemangioma's appearance. This usually lasts until the infant is one to two years old.
3. In the involution phase, a hemangioma finally begins to diminish in size. Fifty percent of lesions will have disappeared by age five with the vast majority gone by puberty.

When Grace was first born we thought it was a bruise that happened during delivery. If you look carefully in this picture of her just after birth you can see that the skin is red on her left shoulder...


After talking with the pediatrician while in the hospital it was determined that it was either a hemangioma or a port-wine stain but then later at our first dermatologist appointment he told us it was just a hemangioma. Now, here's a picture of it at just almost two months:

Grace's hemangioma is on the surface and under the skin, therefore she has the ripe strawberry look and the bluish swelling. In the past 2 weeks it had begun to ulcerate which means that the skin is beginning to break down in places. The doctor we saw on Monday seemed to think that Grace's hemangioma should fade for the most part by the age of 5. He took pictures of it to begin the monitoring process and said he will be with us every step of the way to help us monitor it. He gave us medicine to put on the parts that have begun to ulcerate. There are 4 small spots. We go back on July 15th to see him again to determine if the medicine is helping the ulcers. This doctor showed us before & after pictures of another little girl who had this same type of hemangioma on her arm and it was amazing the difference after a few years. Just thought I'd educate those that read the blog about Grace's hemangioma as well as to document it on her blog so that when I print it out into a book there will be something about it in there for her to read one day.

We are so blessed to have a beautiful, healthy baby girl! :)