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Thursday, September 30, 2010

Tuesday Afternoon.....

Tuesday, afternoon,
I'm just beginning to see, now I'm on my way.
It doesn't matter to me, chasing the clouds away.
Something, calls to me,
The trees are drawing me near, I've got to find out why?
Those gentle voices I hear, explain it all with a sigh.



So we have gotten a lot done in these past 2 weeks at Dell. Thurston has had a ton of specialists look at him and has had a real swallow study done and an ENT look down his throat as well. The good news is that his vocal chords are normal and not damaged(we were a little concerned as Thurston does not have a strong cry and it is rather raspy at times). Everything looks normal but he does have some irritation where the NJ tube goes down his throat. The bad news is it really seems as if Thurston has some very severe reflux. He is often very uncomfortable and coughs a lot as well as gags and chokes. I had noticed this in early August as well as some projectile vomiting right before Thurston took a turn for the worse. The doctors have tried every medication, a 24 hour feeding schedule, and an NJ tube that bypasses his stomach to his intestines to no avail, he is still coughing and gagging a lot and it is still making him sooooooo uncomfortable and so now the doctors think that having a gtube/nissen fundoplication( a feeding tube that goes directly in his tummy, and a fundo is placed around his esophagus to prevent contents of his stomach coming back up which will prevent aspiration) will help him immensely with reflux and with oral aversions caused by reflux as well as making him oodles more comfortable as we can say goodbye to the NJ tube down his throat. I cannot even imagine having something stuck down my throat 24 hours a day and it does not seem there is an end in sight due to his high oxygen needs,(Thurston most likely will be on oxygen for a while even at home probably for the next year of his life, his chronic lung disease is very severe).
The other hope with the gtube/fundoplication is that it will help reduce Thurston's oxygen needs. The thought is that because of his severe reflux, Thurston is probably micro-aspirating into his lungs. This micro-aspiration for more healthy babies(Viola being one of them as she also had severe reflux when she was a baby) usually does not effect their lungs. But with Thurston, his lungs are just so fragile and delicate, that even the slightest amount can not only cause higher oxygen needs, but like in August, cause a major life threatening event(pneumonia). So the doctors are hoping that within a month or two after this surgery, Thurston's oxygen needs should go down enough and hopefully to a lower flow(2 or 1) and maybe even low enough that he can finally finally come home(1 liter or less). Its just a wait and see but I truly do feel Thurston will at the very least be a lot more comfortable and his coughing episodes will be eradicated and he can just be a happier more well adjusted baby.


So for now the idea of a trach is put on hold, and we will just hope that this will help him avoid that. His surgery is scheduled for Tuesday afternoon and we will most likely be staying at the ronald mcdonald house for a couple of days so we can be close to him while he is recovering. The most nerve wracking part of the surgery is that he will have to go back on the vent and it might take him up to a week to get off of the vent as he will be sedated for a while to alleviate the pain from the surgery. So we have to expect his oxygen needs to go up and that will be hard for me to take after he has been doing pretty well so far hanging out on 6 liters at around 60 percent oxygen(this hospitals nasal cannula goes up to 8 liters which is awesome as he does not need to go back on cpap at all, another reason to love Dell!!!!)I just hope that his recovery will not entail complications and we can move forward with his recovery.

Thurston also got his RSV shot the synagis(a very expensive shot (1000 dollars a pop) to protect him during rsv season. He will get 1 shot a month through April. Wow talk about an expensive kid.

My mommy is leaving on Saturday, unfortunately, as it would have been great for her to be here for his surgery, but we have had so much fun with her here and it has been incredible to get so much help for so long, we are now officially spoiled rotten. Life at Dell is good though and our stress levels have been significantly reduced since moving Thurston here and just to be able to bring Viola with me anytime I want and/or need to has made our lives much much much more simple and much much more beautiful to just be a family. I love how Thurston and her interact with one another, its just plain cute!!!!!

So next week will probably be a little tough, but we will get through it like we always have, one step at a time, one evening at a time, one morning at a time, and one Tuesday afternoon at a time.......

Friday, September 24, 2010

"Dell"ightful!!!!!

So its been a few days at Dell Childrens hospital and already, we are thrilled and settling right in at our new NICU residence. The exiting news is that Thurston already, in this very short period of time, has been looked at by almost every specialist that must exist. He has been seen by two pulomonologists, a GI specialist, an ENT specialist, a heart doctor, and of course his Neonatologists as well as ot, pt and a life care specialist. The absolutely wonderful thing is the first day we were there, both the neonatologist and the pulmonologist took one look at Thurston and said....ummmm this kiddo does not look or present like a trach kid, with both of the docs saying, "wow, we were expecting a lot worse". WOW WOW and more WOW. Now by no means did they mean Thurston is not sick but I think both of them thought that we need to investigate Thurstons case a lot further before we even think about giving him a tracheostomy. The neonatologist even said he would rather wait even a couple more months and do some further testing then to trach him just to get him home....music to my ears. All I want is the best for my son whatever that entails and in the end, like I said before if he needs a trach than thats what we will do but so far, no one is in a hurry to perform any operation, and everyone seems to think we have some time to do some investigation before that might even be a possiblity. They both also said that they have never really seen a kid on the nasal cannula that needed a trach and the kids that were candidates for trachs are usually vent dependent, not breathing on their own etc. So that was very reassuring. The pulmonologist said that his excessive oxygen needs might also stem from some mild pulmonary hypertension and they are also investigating reflux as a possible culprit as well. So they are switching around some medications, giving him some lasix, doing some more echos on his heart, putting him on nitric(which treats pulmonary hypertension)and they are nj tube feeding him where the tube bypasses his stomach and goes directly into his intestines, with the intention of trying to reduce his reflux, gagging, and incessant coughing episodes. All of this is hopefully going to help reduce his oxygen needs and at the very least, make my kiddo a little more comfortable. Wow, they are really switching things up quite a bit and doing a lot in such a short amount of time.

The next most beautiful thing to happen is my sweet daughter and sweet son finally got to meet face to face for the first time. It was so sweet. The child life specialist gave Viola a doll first that had all of the tubings and wires that Thurston has to prepare her, allay any fears she might have when she meets him, and see how she would react to all of the medical equipement. I have to say, I almost wish we would have moved to Dell sooner, like a few months ago. They really specialize in so muh more than just medicine and we feel like we are such a huge part of Thurstons life now, they really make you feel like a family and that you are just as important as the patient is, now thats what Im talking about.

Viola was so exited. The first thing she did was to put the pacifier in Thurstons mouth. She stroked his head and he just kept staring at her almost as if he recongnized her or something. Then before you knew it, she gave him the biggest most beautiful hug ever. It was such a beautiful day. By the way, I was able to actually leave my mom with Thurston alone when I went to pick up Viola from school. Wow this place is so freeing.

So for now, we are still just trying to figure everything out. Nothing has been ruled in or ruled out, but at least we are on the path of discovery. Needless to say, we couldnt be more "Dell"ighted with our new residence and just hope that we can soon move forward and finally get our kiddo home where he belongs.

Here are a few recent pictures:



Thurstons new digggggs!!!



Awwwwww Brother and sister touching each other...look at Thurston trying to copy sissy!!


Are you sure she's my sister mom?


Viola giving her brother his paci, already mommys big helper!!!




Our first real family portrait...boy are we ever happy!!!!!

Thursday, September 23, 2010

Bicenntenial days...200 days and counting...

I had previously wrote a very nervous and scared post. As I had stated we needed to make some decisions that involved both transferring him to a different hospital and also considering some surgeries. These are both very scary decisions to make and not easy. I am not a willy nilly person. When our dishwasher broke, it took me almost a month to research, and investigate the kind of dishwasher i wanted, the sales going on, I went into stores to try them out, I just really wanted to get the best value for my money, and be happy with my decision with no regrets. Well obviously when it comes to your child, I don't think any parent is going to enter into decisions, especially ones that could involve the life of your child, very lightly. I mean when you go buy a car you always take a test drive right? I know for some it may have seemed like I was dragging my feet, and maybe for a few, not making the best choice for my child, but I felt I had to investigate thoroughly every option for Thurston, so that I could make give him the best informed decision. My child is not a dishwasher or a car, he is a human being and I just needed to make sure that this was the right move for him. If the doctors had told me it was life or death or told me that it was urgent, obviously I would not have hesitated at all, but I had time to do some research and I am so glad I did.

Last Friday I made an appointment to go to Dell Children's hospital to see what it was like. I felt that that would help alot in allaying any fears I had especially as i had heard that the rooms were private. Now for you and I, if we were in the hospital, a private room is pure heaven, but for my sweet baby, who is so used to an open space or a bay as they call it, where EVERYONE and their mother(literally) walks by and says hi to him, talks to him, where he can hear a million conversations, it was very comforting to me to know that he was never ever alone and that he would get all the attention in the world. He is a social butterfly and LOVES to be around people, so that was very hard for me to swallow.

Secondly, I was not sold on the idea of my son getting a tracheostomy. Not that I wouldn't do it in a heartbeat if I felt that is truly what he needed, but I just had this little tick tock inside of me that was telling me not to rush into it, something just didn't seem right about it. Mostly because my son has never had really any testing or specialists looking at him. He has never even been seen by and Ear Nose and Throat doctor, his airways have never been evaluated, he has never been seen by a GI specialist, or a heart specialist for that matter. He has only been seen I think a couple of times by a pulmonologist but to me I just felt, not all of our options have been investigated, he deserves to have every possible scenario exhausted before he just simply "gets a trach" Now if for some reason all of these things are looked at and the ultimate conclusion is to give him one then so be it. But I don't think anyone would even consider an invasive surgery for even themselves let alone their children, especially one so life altering as a tracheostomy, without first exhausting other possible causes of their condition, and perhaps other treatments available.

So before visiting Dell, I was terrified. Besides the whole private room thing, we would have to adjust to all new nurses and nursing styles, new rules and regulations, new procedures, new policies, I just felt almost as if we were back to square one in a lot of ways. Also the drive is a bit further, and most importantly, I was petrified that all of the doctors automatically assumed my son would need a trach, that they would have a preconceived notion about my son and it would already be in their heads and that they wouldn't actually investigate any further what else could really be going on with my son.


OH BOY WAS I EVER PROVEN WRONG.......

First and foremost the NICU rules and regulations are OUTSTANDING and so much less restrictive than NA. Now I am in no way denigrating any regulations at Thurston's old NICU. Those rules and regulations have to be in place as Premature babies are so extremely fragile, its an extremely sensitive time for the families as there are soooooo many ups and downs and uncertainties etc. And most importantly, they expect most preemies to go home by their due dates, so it is unusual for most families to be there as long as Thurston, as any baby needing more support surgeries etc. will usually transfer out of there. So I fully support and am so grateful for those rules that were in place that protected my son in the time that he was there. Because Dell is a children's hospital, they take into consideration the fact that most of the children there have long term chronic illnesses and there is no way to predict how long the families will have to be there, so their rules and much more relaxed and geared toward making the families lives much easier. Here are just a few things that Chad and I were thrilled about:

First and foremost, FINALLY Viola and Thurston can meet face to face and spend some real quality time together. Because viola is on a delayed vaccine schedule, she was not allowed into our NICU(again I totally understood this and supported that) but now I can bring her in every day so they can finally get to know each other. Plus, if I want to go see Thurston I don't have to have a babysitter....I can just bring Viola with me, wow that takes a ton of stress off of us right there. After hearing this, I was sold!!!! That was almost reason enough to move Thurston.

Second...They do not ever close. Chad used to have to wait until 8 o'clock to go into the NICU to see Thurston which meant he had to stay at work an extra hour which meant that he came home later. Also, there were times that I was only able to go later in the day and would have to leave by 630 cutting short my time to be with him. Now we can go in any time we want, whenever we want, and stay as long as we want, which is very nice indeed.

Third...I can bring in any visitors I want any time. We were limited to only 4 visitors the entire 7 months we were in the NICU. That was hard on us as our family lives far away so when we signed up Chads mom and dad, that took up 2 of the spots and they only went in 2 whole times when he was first born. We signed up my friend Karen who also came to help us for 2 weeks and she only saw him about 2 times and then she went home. Then one spot was left when my mom came to visit and then she went home after 9 days. The director was nice enough and understanding of our situation and allowed for us to sign up Chads brother Brad who was only in town for 5 days. So Thurston literally only had probably 10 total visits from other people beside Chad and I in the almost 7 months that he was in the NICU, while other families who had family in town were able to bring them in daily. So we are excited that Thurston will now be able to meet more of our family and friends. More YEA!!!

Fourth...We get to sign up 4 very special people, who will be able to come see Thurston on their own, without Chad or I having to be there. This also will be incredible as we will have more people to give him lots of love and holding when Chad and I cant be there.

Fifth......They have volunteers who come in and spend time with the kiddos. They also have a child life program that includes development, OT, pt, speech therapies, and incorporates Viola in the mix to help her adjust to her brother and his hospitalization. FANTASTIC!!!!!

Sixth...Just a silly thing really but as a nursing mother, they feed me!!!! Yup I get to order from the cafeteria and they feed me for free...Hey Ill take it!!!!

Seventh.....Ok remember my post about HATING those damn sticky labels and the amount of time it takes to clean the bottles for my milk...WELL they provide all the bottles and do not reuse them so I never have to wash another bottle, or try cleaning the stickies off of them ever again. AND I get my kitchen counter back...It does make me cringe a little about the waste of plastic, as an avid recycler, however they said that breast milk is a bodily fluid so for germ purposes they cannot reuse the containers....Hey Ill take it, It would be nice for the break and free up some extra time for me to do other things yea!!!!

Eight...within the private rooms they actually provide my very own breast pump. I don't have to go scrounging for one ever again and the nurse don't have to either YIPEEEEEEEEE plus it is very sanitary to do it that way, so you don't have to worry about other peoples germs...

Ninth....They want me to use my fresh breast milk, and not my frozen if they can help it, and they are now giving Thurston 100 percent breast milk fortified with neosure so that is fantastic

AND drum roll please...the tenth and obviously most important reason is that Thurston will be evaluated by every specialist known to the pediatric world. They are all there, just popping their heads into the room, and it is great to get a ton of new ideas as to how to fix my poor little sweet boy. All of the doctors at NA told me that Dell was the best place for him for this reason alone, and were huge proponents of him moving there, I was just so nervous. We have built a family at his NICU, I love all of his beautiful nurses, RTs, Pharms, Doctors, Receptionists, custodians etc. and they love my son with all of their hearts and souls and I am indebted to them for life. But after leaving on Friday, it just was a no brainer for me, my fear flew out the window and I knew that this was the place for him. It was very emotional to leave however, and I cried the whole time. It was just to painful to say goodbye to everyone. I will have to pop in later, when things are settled to thank them properly for everything they have done for us.

So on Tuesday of this week, just one day shy of his 200th day of life, his bicentennial day if you will and just a just a few short days after my visit to Dell, we traveled to my sons new residence. It was his first trip ever outside and of course, he slept through the whole trip, how funny. A new post of how his first couple of days went will follow this one but just wanted to update everyone on the move.

Monday, September 20, 2010

Fundraiser for thurston


My dear sweet mamas group is holding a fundraiser for thurston...I like to call it a thurst-a-thon. Anyway here is the site. Wer so grateful and a big thanx to Melanie for putting this together

thurst-a-thon

Thursday, September 16, 2010

Decisions, decisions....

Today was a very stressful day. We have to make some very very tough decisions about our son. I am pretty broken up. I hope no one ever has to make these kinds of decisions for their children. It's just very stressful and painful.

Tuesday, September 14, 2010

Candide, The garden of forking paths and The persistence of memory.......27 weeks and counting....

First not too much to report on Thurston. He is still on nasal cannula and they decided to lower his liters and put him on 100 percent oxygen, much like they were doing in August right before he took a turn for the worse. He had a swallow study done where they found he was NOT refluxing so we need to do some further testing to make any more forward moves. They have talked about trachs and gtubes but we are looking into getting some more testing done before we make any decisions. We still have no idea when he will come home and how. We are kind of in a holding pattern. But for now, he seems to be doing ok and is still the king of the NICU, adored by everyone who meets him.
Its hard to believe, but as of yesterday, Thurston has been in the NICU as long as I was pregnant with him, 27 weeks. WOW. Coincidentally it was this week last year that I became pregnant. I often think about all of those early happy memories, the dreams that I had of my pregnancy, how happy I was when I found out a few weeks later, the thought of my two kids taking baths together, what Violas reaction would have been, the playdates we would have went to etc. Those futuristic dreams are now distant memories. I often think of what our lives would have been like had everything been normal, like I am forever trapped in a Luis Borges novella. Every day is a struggle to remain positive and hopeful but I actually find that recently, I have been moving forward with my life, with our lives. There is something about this entire experience that paralyzes you, you feel as if you cannot move. At first its because literally you are like a deer in headlights, you cant believe any of it is happening, you feel like you are walking around in a Salvador Dali painting full of ants, melting clocks, and vast landscapes that seem to go on forever and nowhere at the same time. Then as you settle into your new world, and routine, you don't really plan because you think, well, he will be home soon, its just a matter of time and then after he comes home, you will settle into a routine and then move forward into the future, into your new life. Then suddenly, you realize, there is no end to this, it could be another 4 to 6 months maybe even longer.

But this last experience with Thurston in August when he had a 50/50 chance of living, I realized that I cannot just sit and wait, I must move forward, I have another child at home, I have a husband, and I have myself to think about as well as my son.

Right before all this happened I decided to open up a vintage shop on etsy, called Dust Bowl Vintage. I have such a passion for the early 20th century, mainly, the Edwardian, Flapper and Depression eras. I also love to sew and wear fashions from those eras so I thought, even with a newborn, I would find some time here and there to dedicate to those endeavors, those passions that I have had nearly my entire life.
I was also in the midst of planning things for my little girl who is growing up so fast. Swimming lessons, dance and/or gymnastics, playdates, preschool were all on the horizon when in February we found out my pregnancy was in jeopardy. My husband was supposed to finish his Masters Thesis as well this past semester in college as well as work on finessing his musical prowess by taking private lessons. All of us had so many goals that stopped completely in their tracks. Life completely halted.

So for about 7 months now everything has been put on a back burner. Our lives became just about survival and hard choices. Everyday our choices revolve around the NICU life, and now instead of "should I sew", "should I work on my thesis", "should Viola take a gymnastics class or a dance class", the choices are now; "do I spend more time with Viola today, or should I go see Thurston"; "do I pump before I go to the NICU or wait until I get there", "should we consider getting him a trach and gtube, or should we wait and just let his lungs heal" etc. Chad has always had to work fairly late, but tried to get home to at least be able to see Viola and read to her before bed. Now he has to make a choice; "Should I see my son after work, or do I go home to see my daughter", not a choice I ever thought myself or my husband would have to make, especially for this long. It is hard, I will not lie. Sometimes I feel like people who are undergoing something like this somehow are held to higher standards, like we have to be more stoic, less whiney, or something, that we are not allowed to ever ever complain or occasionally look at the glass as half empty instead of half full. But every day I see people bitching and complaining about their normal lives and their woes......I think we are entitled to the same privileges.

One of the preemie moms on my preemie message board the other day asked how I remained positive after reading my post "a grain of salt and a pound of hope". I told her that it is BECAUSE I allow myself to feel depressed, scared, sad, whiney,and freak out, etc. How can anyone go through something this life altering and not have a bad day....normal people with normal lives have them all the time, why cant I. The other day, I stopped in a parking lot and just balled my head off for about 15 minutes, completely freaked out and then I felt a ton better. I told her the key that I have found to keeping positive IS by allowing yourself to feel all of the other stuff but just not allowing it to take over. There is a very poignant scene from the tv show "Lost" where Jack tells Kate how he conquers fear:
Lost Scene
This is how I now deal with our situation, I allow myself to feel all of the anguish, depression, and sadness, I allow myself to feel sorry for our situation, and to freak out, but only for a very short time, I don't let it consume me anymore, but I also don't pretend that I am made of steel either. This has allowed me to move forward and to ask for help, and we have received a ton of it lately; just this week I enrolled Viola in both a moms day out AND a dance class. I went thrift shopping for the first time in ages(thanx mommy) and found 10 vintage outfits that look like they walked out of those eras that I adore so much, hell I even fingerwaved my hair today, something I have not done since January. Chad has been working on some side projects for people as well. My moms group is organizing a fundraiser to help us out with the unforeseen costs of having a child in the hospital this long(love you guys!). It seems our lives are slowly but surely moving forward. Most days I am very happy and very grateful and although I envisioned my garden going down a different path, that I will not have that ultimate nirvana that I dreamt of, I realize that I must live in the here and now...as in the great last line in Voltaire's exquisite satire, "Candide", "we must cultivate OUR garden", the only one that truly exists.

Sunday, September 5, 2010

GOING THE EXTRA "S"MILE.............

So its been a while and lots to update. First and foremost, my mommy is back in town....FOR A WHOLE MONTH...wow we really have had a ton of help lately and I just cant believe how lucky we are to have my mom back for so long(thanx Juju and Mimi, Shannon, Lonnie, Patrick, Trish and Winnie for helping with everything else). That's going to help a ton as Thurston is now 3 months old adjusted and needs alot more mommy and daddy time to work on his milestones, or should I say SMILESTONES.......

I know I previously posted he smiled and he did but it wasn't necessarily a social smile, you know the kind where the baby actually KNOWS that he/she is smiling at you, in response to your smile etc. As any preemie parent will tell you, especially in Thurston's case where we were told about all of his high chances of having alot of neurological issues, any and all milestones are huge, bigger than huge, because we are told early on that our children may not achieve them. Well this baby is just yet again, "proving those statistics all wrong". I remember that I told everyone I would shout it, scream it when I saw that first social smile, the one that every parent waits for with bated breath, the one that melts your heart...Here I am SHOUTING FOR JOY WHHHHOOOOOOOOOOOHOOOOOOOOOOOOOO. Well not only did we get one but we were recording it while he did it. How lucky was that. It of course made me tear up, cry even, it was just priceless:

video



He is also doing everything a normal newborn should so far....he is reaching out and trying to touch things, he looks around at different objects with intense interest, he is starting to coo just a little, he kicks his little legs and arms, just like a normal sweet little newborn should, we are just so relieved and delighted. I think everyone is. He is also 9 big ol' butterball pounds which is still under the 5th percentile, but he is acutally in the 13th percentile for his height(22.6, according to the average percentile charts) which is absolutely unheard of for a micropreemie, growth restricted, IUGR baby. Way to go my little man. I am just so proud of my son.

Another incredible joyous tidbit of info, although I was not really surprised to hear this(no pun intended) is that he passed his newborn hearing test...YEA....that is just one more thing we can check off the worry list. Thurston always showed signs that he could hear so it wasn't something I was ever truly concerned about, but it sure is great to have it verified by the professionals.

On the medical front not a whole lot has changed. He is still on the nasal cannula at 5 liters anywhere from 40-80 percent oxygen. They did finally wean him off of the nitric oxide as they do have plans to do a swallow study and an MRI which they need to transport him for and a nitric tank would be quite cumbersome to do that with. He still cannot eat by mouth as they want to do the swallow study first to make sure that he is not aspirating while he eats so he is still being fed through the ng tube. They also have him on a continuous feed as they think it is helping with his reflux and oxygen needs. He is still on too many medications to list, but hopefully they can begin weaning him off of a few here and there, especially the seizure medication once they rule out any neurological issues(see...hows them positive apples for ya).

When I was checking his chart today to see how much he weighed I had to do a double take at the day he was on in the NICU.....181 days and counting.....GULP...After this long you just kind of stop adding it up but that just kind of threw me for a loop. And the truth of the matter is, Thurston could quite possibly still be in the NICU by his first birthday, and yes that is a very daunting thought, but we continue to be grateful for all of his progress and we feel so lucky that he is such a little fighter. He shows me everyday what true strength is, what an unbelievable and tenacious spirit he has, and honestly when I think of how much this little Buster has been through, there are no amount of miles I have or will travel back and forth to the NICU that compare to how many miles he has traversed to be where he is, how much he has endured to be here and to stay with us......this kid truly has gone and continues to go the extra mile!!!!!!!!!