We took Chloë to see Dr. Dominey last week. The consult went well. She looked at, measured, and photographed the spot behind Chloë's ear and said "yup, it's a hemangioma."
First she told us what we were hoping to hear. It shouldn't pose any risk or threat to our baby. Praise God. Besides the fact that skin breakdown is to be expected, and therefore tender, occasional discomfort is really all we have to worry about. Then she told us that infantile hemangiomas often grow for the first year or two, and then they start to fade and shrink. Generally speaking, 50% of them are gone by the time the child is 4, and 90% of them are gone by the 9th birthday. So even if we don't do anything, chances are it will fade and disappear with time.
Then we talked about our treatment options. We had been under the impression that laser treatments might be a good way to reduce the growth, but we learned that laser treatment really only serves to cauterize the growth if there is lots of bleeding. To laser the "healthy" skin would just cause bleeding and scabbing and eventually, scarring. So we threw that idea out of the window.
Dr. Dominey talked about corticosteroid treatment, and told us that it has had a high success rate of slowing the growth of hemangiomas. But, there were the obvious steroidal side affects; stunted growth, slowed metabolism, and redistribution of weight. I really didn't want to subject my baby to a drug that would be so harsh to her tiny little growing body.
Then we heard about oral Propanolol. A beta blocker, it is a drug used to reduce blood pressure, and also has an affect on slowing the heart. I was hoping she would have some good information on this, because it seemed like a good option, but it made me nervous to think about giving my baby something that could affect her heart and blood pressure. It is a fairly new treatment option, but it seems to have good results on reducing the hemangioma. But, Dr. Dominey then told us, she had recently learned of three cases of babies on this drug turning blue, becoming unresponsive, being rushed to the hospital, and miraculously surviving. Um, I think we'll pass.
Finally we talked about Timolol. Again, a beta blocker, but a gel applied topically, and not an oral med that absorbs into the whole body. It has actually been around for years as eye drops to treat glaucoma, but only recently has it been used as a topical treatment for hemangiomas. Although it is still considered to be experimental, it has been very successful in halting and even shrinking the growth. Non-systemic, non-invasive, and inexpensive, Bryan and I decided to go for it. We dab it on twice a day, and already I think the hemangioma looks slightly different. We are praying that this works well to at least slow down the growing. We go back to Spokane in a few weeks for a follow-up appointment.
This is how it has changed and grown.
You can find a post about follow up and how the treatment has worked here.