Wednesday, May 24, 2006

Genetics, Ya Gotta Love It!!

That last two weeks have been somewhat hellish for the Kidder family. Two weeks ago, during a routine 4-year-old check up, our pediatrician discovered a supraclavicular lump on the left side of my daughter Madeline's neck. Concerned, he did the normal blood work to see if anything was going on internally. The bloodwork came back clean, so he referred us to an orthopaedic specialist. When we got there, the specialist said "right church, wrong pew." It was his opinion that it was a lymphatic adenopathy and he set up an appointment for an MRI.

Enlarged lymph nodes under your chin are not usually a problem. Enlarged lymph nodes in your abdomen are not usually a problem. These usually reflect some kind of infection but nothing usually serious. Enlarged supraclavicular lymph nodes ALMOST ALWAYS reflect something very serious going on. If the lump is on the right side, it almost always means lymphoma.

The MRI was done last Thursday and we spent the weekend not knowing what was going on. In the meantime, my daughter played happily and was perfectly norrmal. Monday afternoon, we got the news. When they aimed the cameras at the lump, the reflection came back as healthy normal bone, but not where bone ought to be. At the follow-up visit with the orthopaedic surgeon, everybody sat down and had a good laugh.

My daughter has a cervical rib. Ordinarily, you have seven cervical vertebrae, twelve thoracic vertebrae and five lumbar vertebrae. Sometimes someone will have a sixth lumbar vertebra but that is rare. The ribs usually begin with the first thoracic vertebra. In 0.5% of the population, however, a rib grows out of the seventh cervical vertebra. That is what is going on with Madeline. So, long story short, she is fine. It is something we will have to watch to make sure it doesn't interfere with her range of motion or cause nerve damage, but all's well that ends well.

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