Tag: infant surgery

When there is no “getting better”

When there is no “getting better”

by Jaime S. G. ♥ 1 Comment

When there is no “getting better”, your definition of “better” changes.

Recently I read another blog titled “When Your Medically Complex Child Is Never Really ‘Out of the Woods'”, by Brandis Goodman. It sparked a few good conversations with family and really got me thinking about how I can express how the term “better” has changed for me.

Normally when people ask me if Lyra is “better” they are thinking in terms of normal illness. You know, like you get “better” from a cold. In that sense, Lyra will never get better. We can’t add the generic code that is missing, or take away the extra code that she has. We can’t change how her brain formed. We can try to help her other internal systems function more normally, but she will never be fully free from complications. She will never be “better.”

However, Lyra will have better hours, days, weeks, months, and (hopefully) years. When you care for a medically complex child, that really is all you can focus on. When I mentally check in on how she is doing, my thoughts sound like this:

“She has a better night, but a rough morning.” “Today was better than yesterday.” “Her morning was better.” “The last three days have been better.”

Now, does this mean that you shouldn’t ask me if Lyra is “better”?  Absolutely not!  Never be afraid to ask me about my child. Just recognize that we may be using different definitions of “better.” “Better” for Lyra doesn’t mean that she won’t stumble a few times, or end up in the hospital again, or need another surgery. “Better” doesn’t mean that she is “fixed” or cured. Better is all relative for her and changed day by day, hour by hour.

And really, there is no cure for cute.

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Never Underestimate a Qualitative Analyst

Never Underestimate a Qualitative Analyst

by Jaime S. G. ♥ 0 Leave a Comment

Before I get going, let me just state that Lyra is finally home and doing great.  Not to toot my own horn, but it had everything to do with my strategy to feed her and persistence to get GI involved in the hospital. This is directly relevant to my title.

By trade, I am a Qualitative Analyst. Don’t get it confused with a Quantitative Analyst, those are the number crunchers. I deal with words, not just numbers. Now, data analysis is important and often plays a role in qualitative analysis. The difference is, I work with things that can’t be quantified. I take information from various sources and tell a cohesive story. I answer the questions, “So what?”, “Why is this relevant to me?”. I also use that information to propose solutions to complex problems. Many people (including my sister) have been baffled about how to apply this skill set in and out of the work place. So, let me put it in context of caring for Lyra.

Lyra has many people who are on her team. Her care (outside of family) involves an occupational therapist, dietician, gastroenterologist, cardiologist, surgeon, pediatrician, geneticist, and we will be adding physical therapist in the near future.  All of these people orbit Lyra and have opinions and insights to her care. However, they do not all communicate directly and the only common denominators are Lyra and myself. I am at EVERY appointment. Part of my job as her mom is to take the information that each of these caregivers, along with my own observations, and present it in a way that makes sense to everyone. My job is to tell the story that is “Lyra” that goes beyond test results and numbers on a paper.

According to test results, Lyra should not have been throwing up while getting NJ feeds. Also, according to test results, she should have been able to handle the volume/hr of formula the surgeons were prescribing. However, Lyra WAS puking and Lyra was NOT tolerating the volume/hr of formula she was being fed. Looking at the problem a few things came to mind:

  1. I know Lyra has trouble adjusting to rapid changes in volume. I have been puked on enough times to have solid evidence of this
  2. Her dietician had mentioned that, with cases like hers, you often can only increase feedings by 1 mL at a time
  3. Genetics has told us that most rules probably won’t apply to her since we have no idea how she will be physically/mentally impacted by her genetic abnormalities
  4. GI had previously told me that we will likely have to go by trial and error with her. If something doesn’t work, we just have to try something new

Using this information (mostly 1&2), I was able to come up with a solution for feeding her and present to the surgical team in a rational way. Was I sure that it would succeed, hell no. In fact, I anticipated it would fail. However, it has been about 6 days, Lyra is HOME, she is tolerating the total volume she needs every day, and she has only thrown up 3 times since we started using my method. What we had been doing wasn’t working, and we needed to try something new. Even the “wait and see” method had been tried and failed. With my professional skill set I was able to take the information from multiple sources, put it in context, and solve a problem. I didn’t spread sheets, or complicated equations. I took words from many sources, told a story that was relevant to audience, and proposed an information based solution. Because of my qualitative analytical skills, my daughter is home.

So what is a Qualitative Analyst? It is someone who using words, not just numbers, to tell a story and come up with solutions. In today’s world of big data, never underestimate the power of a Qualitative Analyst.

A light at the end of the tunnel

A light at the end of the tunnel

by Jaime S. G. ♥ 0 Leave a Comment

We finally feel like we can see a light at the end of the tunnel. This has, by far, been our toughest hospital stay emotionally. The surgery went great and Lyra healed really well. The surgeons did what they do very well. The problems came when we started to try to put formula back into her system. At first Lyra was fed through a NJ tube (tube that went through the nose, past her stomach, and past where they performed surgery). By the time we got up to “full feeds”, Lyra was throwing up stomach acid and bile every 5-30 minutes and becoming very dehydrated. The only way to stop it was to stop the NJ feeds. It was awful and didn’t make and sense. There wasn’t anything actually going into her stomach. Mid week we felt like we would never be able to bring her home. The only thing that kept Mark and I sane was our nurses who backed us up and argued with the surgeons about needing to change our approach and get GI involved. At the end of the week they did another test and discovered that everything was moving through her system just fine (meaning no need for additional surgery).

So, I proposed a new approach and surgery let me run with it.

We stopped using the NJ tube all together and moved on to using her G-tube. My thought was, if she was producing so much bile, we should give it a job. The worse that could happen is that she would throw up…. she was already doing plenty of that….Also, I remembered a dietician saying that with babies like her you can only increase feeds 1mL at a time. Before we increased the feeds my 5mls and we saw how well that worked. So, we started at 10mL/hour and increased by 1mL every 2 hours. Sounds crazy, I know. BUT IT WORKED. By 2 am last night we got up to the goal rate of 36 mL/hr (just over an ounce).

We also finally got surgery to call in GI to consult (it took 3-4 days of me pestering them). GI thought we did well and gave us a game plan for getting back to bulous feeds. They also gave us the total number of mL’s she needs per day, so we know if she is getting enough calories. When GI followed up with us this morning, they basically said that we were capable enough to do things from home with the information we have. Plus, it isn’t like we don’t have support. We have a nurse that stops by the house as frequently as once a week, plus an occupational therapist to help with feeding, my dietician is always available via email, and my GI doctor has an office 15 min. away from our home. Oh, and we have done this whole feeding tube thing for the last 3 months.

So now we just need to convince surgery to discharge us. They did an AMAZING job with her surgery (she has healed beautifully and they fixed the problem with her duodenum) We are hoping we get to go home tomorrow, but it might not be until Wednesday. The good news is, Mark and I see a light at the end of the tunnel. Our little one is quite the fighter.

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Yes, I know this is for breast cancer support, but she is a little fighter

AND

it’s nice to support breast cancer research at the same time

Nine Days and Counting

Nine Days and Counting

by Jaime S. G. ♥ 1 Comment

I am sure some people wonder how I can go home every other night to sleep (Mark and I trade off), but the reality is we have to. This is a distance race, not a sprint. We have been in here for nine days now and progress is slow. Mark and I need to have nights where we sleep through the night because sleeping at the hospital is brutal. If she isn’t waking us up, nurses coming in to do vitals are. They try their best to be quiet, but we sleep so lightly. The “beds” are far from comfortable and we are always worried about her puking. She pukes a lot. Those nights at home are key for our health.

However, those nights are hard in their own way. Right now we are living in a 450 sq. ft. house. Our main room contains a small couch, the glider we rock Lyra to sleep in, her changing table, her crib, and her swing. Some of her cloths are in our bedroom and her shampoo is in the shower. The thing missing is her, and there is no way to escape it. Most of the time I deal with it okay, but this morning was tough. I just want my baby home. I know she needs to be in the hospital. I know it is the best place for her. And I KNOW we made the right decision for her to have surgery. But frankly, the whole situation just sucks.

I miss laying down and playing on her play mat with her. I miss rocking her to sleep at night. I miss seeing her little face light up with awe whenever we would go outside (she is hooked up to too much for me to take her out here). I miss watching my family play with her. I miss swimming with her, or even just watching her wiggle and squirm in the bath tub. I miss putting her in her jumper and watching her talk to the lion. I miss carrying her around in her moby wrap.

I miss getting her dressed.

Right now she has so many things hooked to her that it is almost impossible to dress her. We have tried a few times and modified a few items of clothing, but she just ends up puking on them within minutes. I can’t even count the number of towels, burp cloths, and blankets we went through yesterday.

This morning was just tough. I just want my baby to come home. She is getting better, but it is painfully slow. Not only does her digestive system have to re-learn how to work, but it has to learn how to work correctly (something it has never done before). Her intestines have figured it out; now we are just waiting for her stomach to get with the program. It’s a long slow process and we are looking at at least another week here. Other days will be easier. At least today she has mostly sleep and have only puked 2-3 times. It is a better day for her, Mama will find tomorrow easier.

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Lyra and her new apple hat. Thanks Dawn for making her such a cute hat!

“Yay, a Fart!”…. Something I Never Thought I’d Say

“Yay, a Fart!”…. Something I Never Thought I’d Say

by Jaime S. G. ♥ 0 Leave a Comment

Okay, I never thought I would be so excited about a fart. Well…. three farts to be exact. Why am I excited? Because it means that Lyra’s pipes are starting to move again! This means taking one of the tubes out of her nose and being able to ween her off of IV fluids. One happy Mamma!

To catch some of you up, in my last post I mentioned that Lyra needed another surgery. Well, about two days later she stopped being able to keep anything but pedialyte down. While we were able to keep her hydrated, she wasn’t getting any nutrition. On Sunday the decision was made to admit her to the hospital and for her to have surgery ASAP. They tried to fit her in Sunday night, but she ended up not having the surgery until Monday afternoon. Due to some other tests they had to run, she was under anesthesia for over six hours. It was gruelling for Mark and I, but luckily my parents were there to keep us distracted (we will have to have a Hearts rematch later). Lyra did  great during the surgery and has been recovering really well.

Out of surgery she had three tubes. One goes down her left nostril, past her stomach, and past her duodenum We will be using it to feed her now that her intestines are waking up and are moving again (she just started getting 3 mL/hr in that tube). The second one, down her right nostril, was draining fluid from her stomach to reduce pressure on the areas where they performed surgery (they were able to take that tube out this morning). The third tube is her G-tube, which is currently just being used as an additional drain. Once we know she can tolerate her food and things are really working, we will start to feed her through this tube.

Since surgery she has only had to have four or five doses of morphine. Other than that, she has only been on tylenol and ibuprofen for pain (not bad for having your intestines mucked around with). She has had moments of smiling and playing. Her current favorite thing to look at is a giant dragonfly balloon that Grandma brought in yesterday. She has also been sleeping soundly when she sleeps. As I mentioned at the beginning, there are signs that everything is starting to move again! She farted a whole three times! Now we are waiting for her to actually poop…. I have never anticipated someone else pooping so eagerly in my life.

Anyways, the point is, she is recovering well.  She will likely be in the hospital for at least two weeks, but it’s for the best. She is well taken care of here and Mark and she has lots of eager visitors. Thank you everyone who has reached out to offer support.

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Lyra right after surgery

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Lyra yesterday (I couldn’t resist putting a bow on her)

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Lyra today… Good Morning Mommy

(The brace is just so she won’t pull her tube out. She has been trying)

P.S. I do have more photos like the series from her last surgery, I just have to use a different computer because mine is having issues with downloading photographs from my good camera.

Prepping for Surgery and a Note From a Friend

Prepping for Surgery and a Note From a Friend

by Jaime S. G. ♥ 1 Comment

For those of you who don’t know, we are back in the hospital already waiting to have surgery. Lyra stopped tolerating her formula, and she couldn’t live on pedialyte. Upon admittance yesterday we were told they were going to have her go in for surgery ASAP. There was the potential for it to happen last night, but now it looks like it will happen this morning.

A friend of mine sent me the narrative below (in bold) the other day, and I wanted to write about it. She did not write it, but it really struck me. I was thinking about it quite a bit last night, but fell asleep before I could write about it:

Some Mothers Get Babies With Something More
-Lori Borgman

My friend is expecting her first child. People keep asking what she wants. She smiles demurely, shakes her head and gives the answer mothers have given throughout the ages of time. She says it doesn’t matter whether it’s a boy or a girl. She just wants it to have ten fingers and ten toes. Of course, that’s what she says. That’s what mothers have always said. Mothers lie.

Truth be told, every mother wants a whole lot more. Every mother wants a perfectly healthy baby with a round head, rosebud lips, button nose, beautiful eyes and satin skin.

Every mother wants a baby so gorgeous that people will pity the Gerber baby for being flat-out ugly.

Every mother wants a baby that will roll over, sit up and take those first steps right on schedule (according to the baby development chart on page 57, column two).

Every mother wants a baby that can see, hear, run, jump and fire neurons by the billions. She wants a kid that can smack the ball out of the park and do toe points that are the envy of the entire ballet class.

Call it greed if you want, but we mothers want what we want. Some mothers get babies with something more.

Some mothers get babies with conditions they can’t pronounce, a spine that didn’t fuse, a missing chromosome or a palette that didn’t close.

Most of those mothers can remember the time, the place, the shoes they were wearing and the color of the walls in the small, suffocating room where the doctor uttered the words that took their breath away. It felt like recess in the fourth grade when you didn’t see the kick ball coming and it knocked the wind clean out of you.

Some mothers leave the hospital with a healthy bundle, then, months, even years later, take him in for a routine visit, or schedule her for a well check, and crash head first into a brick wall as they bear the brunt of devastating news. It can’t be possible! That doesn’t run in our family. Can this really be happening in our lifetime?

I am a woman who watches the Olympics for the sheer thrill of seeing finely sculpted bodies. It’s not a lust thing; it’s a wondrous thing. The athletes appear as specimens without flaw – rippling muscles with nary an ounce of flab or fat, virtual powerhouses of strength with lungs and limbs working in perfect harmony. Then the athlete walks over to a tote bag, rustles through the contents and pulls out an inhaler.
As I’ve told my own kids, be it on the way to physical therapy after a third knee surgery, or on a trip home from an echo cardiogram, there’s no such thing as a perfect body.

Everybody will bear something at some time or another. Maybe the affliction will be apparent to curious eyes, or maybe it will be unseen, quietly treated with trips to the doctor, medication or surgery. The health problems our children have experienced have been minimal and manageable, so I watch with keen interest and great admiration the mothers of children with serious disabilities, and wonder how they do it.

Frankly, sometimes you mothers scare me. How you lift that child in and out of a wheelchair 20 times a day. How you monitor tests, track medications, regulate diet and serve as the gatekeeper to a hundred specialists hammering in your ear. I wonder how you endure the clichés and the platitudes, well-intentioned souls explaining how God is at work when you’ve occasionally questioned if God is on strike.

I even wonder how you endure schmaltzy pieces like this one — saluting you, painting you as hero and saint, when you know you’re ordinary. You snap, you bark, you bite. You didn’t volunteer for this. You didn’t jump up and down in the motherhood line yelling, “Choose me, God! Choose me! I’ve got what it takes.” You’re a woman who doesn’t have time to step back and put things in perspective, so, please, let me do it for you.

From where I sit, you’re way ahead of the pack. You’ve developed the strength of a draft horse while holding onto the delicacy of a daffodil. You have a heart that melts like chocolate in a glove box in July, carefully counter-balanced against the stubbornness of an Ozark mule.

You can be warm and tender one minute, and when circumstances require intense and aggressive the next. You are the mother, advocate and protector of a child with a disability.

You’re a neighbor, a friend, a stranger I pass at the mall. You’re the woman I sit next to at church, my cousin and my sister-in-law.

You’re a woman who wanted ten fingers and ten toes, and got something more. You’re a wonder.

The part that got to me last night was, “You didn’t volunteer for this. You didn’t jump up and down in the motherhood line yelling, ‘Choose me, God! Choose me! I’ve got what it takes.'” While there is much in motherhood that no one signs up for, there are moments when I think, “I really didn’t sign up for this.” Those moments, for me, have nothing to do with anger. They don’t happen when she pukes on me for 8th time that day, or when she is screaming at night and won’t sleep (although those moments I have other thoughts…. a particular book comes to mind). No, I think that when I am getting news that something else is wrong with her, when I am holding her down and she screams while the perform another test, or when I sign more consent forms for surgery.

I am sure I will think it when I hand her to the nurse and watch them walk into the operating room. I will think it every minute for the 3+ hours the surgery will take. I will think about it when I see her right afterwards. And I will likely think it every day we are in the hospital this time (it could be weeks).

While I may not have signed up for it, I can’t change it. I am not a hero. I am not any more than any other mom. I do what my child needs, and what is best for her. Sometimes, she just needs a little more.

Awake and Fussy and NO BREATHING TUBE!

Awake and Fussy and NO BREATHING TUBE!

by Jaime S. G. ♥ 1 Comment

Today feels like progress. I came in this morning to find Lyra with just oxygen and her NG tube in. NO MORE BREATHING TUBE!!!! She is breathing on her own, totally alert and a little fussy. Fussy is good in this case. She is sucking on her binky because she is hungry! They also started to reduce the amount of fluid going through her IV and adding breastmilk to her NG tube. I am one happy Mamma. It looks like we are going to get to leave the PICU today and move to the regular floor. Now we just have to make a game plan for her eating. Once we have that, we will have a general idea of when we might go home.

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Some Days Are Harder Than Others

Some Days Are Harder Than Others

by Jaime S. G. ♥ 2 Comments

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Some days are truly harder than others. Yesterday I held Lyra for a good portion of the day. She was cuddly and sleepy and it was nice to have that time with her while we waited for surgery. This morning is tough though. Lyra is on the same size bed I slept on in the hospital, but she is only 7 pounds. Her tiny little body is almost hard to spot since the sheets are white and she is wrapped up in white blankets with white tape covering most of her exposed face. I can’t pick her up and I am not even sure how much I can touch her.

Surgery yesterday went well. They were able to trim the extra tissue and open her airway up. However, she did need help with her breathing during and after the procedure. This morning she is still on a ventilator. That is the reason there are so many monitors hooked up to her and why I can’t hold her. During surgery they also identified an additional abnormality that may be impacting her breathing. Today she is likely having an MRI to try to determine what is causing the problem. For now, I will just sit in the rocking chair watch the monitors.