Thursday, September 20, 2012

River- vision update

We've known for a long time that River has some visual deficits. He has nystagmus (trouble focusing his eyes, they roam a lot). I can count on one hand the times that River has looked at me, met my eye, and I knew he was really seeing me. It has happened twice. In 14 months of life I've only gotten to share that with my son twice. If you asked me to make out a list of area's I wanted to see River improve in and what developmental traits I'd like to see him achieve... looking in my eyes would probably be at the top of the list. I have come to realize we take eye contact and recognization for granted. Oh, I know he knows me. He calms when I hold him if he's upset, he visibly relaxes at my touch or sound... but to have your child look you in the eyes and know he sees you? To see your child light up when you enter a room? You can't put a price on that. You don't know what you've got till it's gone rings a bell here.  


River is about a week old here. This was the day (actually hours before) he had a pulmonary hemmorhage. It was the first time he ever looked me in the eye. His Nana Kathy took this picture with her phone standing over my shoulder and I remember sobbing to her and Matt that River was looking at me and seeing me. It still hurts my heart to look at this picture... even though it remains one of my favorite pictures and memories ever. 


So yesterday we saw an eye specialist at the U A B Center for Low Vision. River's occupational therapist recommended this doctor and I've been both dreading and anticipating it for months. When it comes to children with special needs there are rarely easy appointments. Most hold the potential to either make or break your day (week, month, year) if you let it. You just never know what a DR is going to tell you, what diagnosis is coming next. Even though River has had a  little success in tracking objects during therapy and we've seen improvement in his eyes roaming I was still scared that we might go and be told that River can't see. Would that be the end of the world? No. Would we rally (just as we have with everything else) and move on? Yes. Still, I don't think anyone ever wants to hear their child is blind. 

Let me back up and say that their is nothing wrong with River's eyes... on the inside and outside they are beautiful and without any problems/complications/issues. He has no optic nerve damage. But as it goes in children with brain injury... the problems lies in his brain getting a message to his eyes that he is seeing. River has CVI (cortical visual impairment) and that is a neurological visual disorder. 

The DR we saw was probably the best we've ever seen when it comes to River's DR's. She told us that she would NOT say that River is blind, but he does not have good vision. She thinks his vision may be somewhere around 20/100. That's not something we can tell at this point. He is far sighted (typical of a child with brain injury like his) so she prescribed him glasses. She's unsure if they will help, but she says they definitely will not hurt. So given that she wasn't able to give us a lot of information on what River is/isn't seeing you may be wondering why I would say she is the best we've seen. Here's why: She is the best because she believes River's future is not defined by his present. She is the best because she believes he can get better. She was extremely encouraging and kind during the whole hour and half she spent with us (mostly just talking), but at the end of the appointment she looked at me and she said, "I'm sorry I wasn't able to give you more information, but at the end of the day it doesn't matter what I or any other doctor tell you. I have been doing this for 20 years now and I learned a long time ago not to say what a child will or won't do because I have seen my share of miracles." She then went on to tell us of the story of one of her favorite patients who doctor's said would never see, walk, or walk. He goes to school with her own children and she said the day that he walked for the first time the entire school cheered. Everyone loved him and everyone was invested in his care... they wanted to see him succeed. And he did. Kid's brains are so plastic that just because River has a lot of damage to the area of his brain that controls vision doesn't mean he can't see.... their brains rewire and his can use a totally different area to control vision. When you think about it's really amazing. She said River is on his own schedule... he's not walking yet, but he's working towards it and he can do it. Just like that he can catch up with his vision. I appreciate a doctor who realizes the potential of my son, who realizes there is Someone bigger than all of us, bigger than brain injury... and He can move any mountain. 

So we wait with hope... and I'll keep dreaming of the moment I can share with my son when he looks in my eyes again and really sees his Mommy. 
Wednesday, August 8, 2012

River's Story: the beginning



“I've discovered that sometimes God wants us to live inside of the questions. Sometimes he wants us to linger in the waiting, hoping, praying. In fact, sometimes it's right in the middle of our darkness, in the middle of our crisis, in the middle of our Plan B struggles that God speaks most clearly.”Pete Wilson, Plan B: What Do You Do When God Doesn’t Show Up The Way You Thought He Would?

I bought this book when I was pregnant with River. We’d been through A LOT the 3 years before (high risk pregnancy, being diagnosed with 2 more autoimmune diseases -for a total of 3-, open heart surgery for Matt, Matt losing his job and being without a full time with benefits position for 18 months, financial troubles, etc) so I thought we’d been through our Plan B. I thought we were on the other side of it. I had no clue where we were headed. I’ll be honest: I still haven’t finished the book. River was born and I learned God had a whole other Plan B for me and my family and I’m still trying to wrap my head around that.

(Disclaimer: I didn’t blog about this in real time, I didn’t facebook it, and other than with very close family and friends we didn’t talk about it. That was just our decision and it’s still one I feel was the right thing for us. It wasn’t easy and we didn’t have the full support of family and friends at times… they wanted to share everything, but we never had peace about that. We knew God was calling us to wait on Him, to be still, and to trust in Him for His timing. I knew that people were praying for us even without knowing all the details and I knew –and know- that God moved. He had the details after all. In times of crisis yes, you do want people praying… but what I didn’t want? I didn’t want my son becoming the dinner table gossip. If you weren’t going to be lifting him up in prayer then quite frankly I didn’t want you talking about him or us. I believe there is power of life and death in the tongue (Proverbs 18:21) and while my sweet boy’s life hung in the balance I only wanted edifying, encouraging, LIFE spoken over him.)

When God tells you to be still you do it… and two days after our son was born and Dr’s were telling us he’d had a brain bleed while in the womb God told me to be still. He wasn’t done with River. He’s still not, but He’s made it clear He is ready for me to be the vessel in sharing parts of  this story and to bring glory to His name. River’s story is already written and God knows what that entails, but I do not. I don’t know what the future holds for my sweet boy, but I know who holds it.

Back to the beginning… despite my high risk pregnancy I never for a second was worried about the health of River until the finals weeks of our pregnancy. (At the end I did become concerned as he started failing almost all of our BPP's which would lead to being admitted for observation, but without fail I'd be discharged within 24 hours and we'd start the whole process over again.) Because of my high risk pregnancy I’d had a targeted ultrasound (basically an hour and a half long ultrasound where Dr’s look at the heart, lungs, brain, stomach, everything for potential problems) at 20 weeks which showed a perfectly healthy baby. We were thankful, but not surprised. We’d already had one healthy, beautiful baby with no issues.  I don’t know if I was just naive or if God was protecting my heart by not allowing me to think of any other outcome other than a healthy baby. All I know is I was not prepared… that’s probably a blessing in disguise. After all if I had known there would have been nothing I could do about it. It would have been just months of fretting and blaming myself, months of tears, months of worry, months of stolen peace.

I think I was still in a haze of pain meds and shock over an emergency c-section and having River in the NICU when we were told about the bleed. I don’t remember who told us, I don’t remember much at all about that conversation…other than being scared. That conversation just seemed to be the starting point for millions of more that scared us. The bad news kept piling up and it got harder and harder. It didn’t stop at Day 2 when we learned about the bleed (by way of routine ultrasound). On Day 4 River was struggling to breathe (even though he’d been extubated days before and doing great on room air) and spitting up blood. He was re-intubated for bad blood gases and tests were ran- we were told he’d had a pulmonary hemorrhage. (Days later one of R’s neonatologists hypothesized he hadn’t had a pulmonary hemorrhage, but rather a clot from his brain had broken off and caused the distress and blood in the lungs, but we’ll never know.) He was given blood and plasma and started on antibiotics in case of infection. In the NICU you learn to be thankful for stable. You stop caring about progress and good reports and start praying for stable days where nothing happens… even the good days wear you out because you’re waiting for the other shoe to drop. We had a couple days of stable and felt comfortable enough to sleep at home instead of the hospital. Our first night home (Day 7) the phone rang at 1 AM. River’s sats were dropping even though he was still on the vent, his blood sugar had shot way up (a sign of stress in infants), his hematocrit and platelets had dropped. He was transfused platelets. They switched him to a different vent, an oscillator. Imagine a jack hammer and you’ll understand what an oscillator is. It makes the same noise as it literally shakes your child. It’s heartbreaking. Dr’s weren’t sure what was going on- maybe he’d had another bleed, maybe a clot had broken off, maybe a seizure. When some tests came back and his CO2 was through the roof (it was 180 during the episode during the night) we learned that most his vent had gotten clogged. They weren’t suctioning his vent because of the pulmonary hemorrhage so his C02 went sky high and likely caused his body to go into distress. On Day 9 he was able to be weaned off the oscillator and back onto a regular vent. On Day 10 he was extubated. On Day 11 despite great blood gases and high sat’ing River kept having moments of dropping his sats, holding his breath, gasping, etc. They ran labs which were mostly normal aside from his calcium and sodium being low. They adjusted the meds and he stopped de-sat’ing. On Day 12 we had a stable day. On Day 13 River stopped breathing. Multiple times. I will never forget holding him in a rocking chair as I watched him very simply stop taking breaths and go blue. I will never forget standing behind the nurses as they bagged him. The doctors were baffled. One minute he’d be high sat’ing and the next he wasn’t breathing as we watched his sat’s and heart rate plummet. One of our sweet resident’s came to talk to me. He said they weren’t sure if they should place him back on the vent considering he was high sat’ing most of the time. I asked him to please reintubate and they did. They ran labs and once again calcium and sodium were low.  They adjusted his iv med’s to straighten this out and in less than 24 hours we were back off the vent and stable. It seems his body had a metabolic reaction to his calcium being low. Calcium causes our muscles to contract and when River’s got low his muscles (lungs) stopped contracting. Through all these ups and downs the news of the brain bleed  had slipped to the wayside. We simply had too many other scary things happening from one moment to the next to even think about the bleed. All we’d been told was the damage was done and at discharge we’d be set up with a pediatric neurologist who would follow River. 


My sweet River on a bad day at UAB


On July 30th we left the NICU and went downtown to eat dinner. When we arrived back in the room our nurse (one of our favorites, Amanda) was trying to calling me. She looked heartbroken and my heart sank. I don’t know who started the conversation, but we learned we were being transferred to the local Children’s Hospital for neurosurgery observation. Over the last couple of days River had started to exhibit some symptoms of increased pressure in his brain from his brain bleed (clinical term being IVH- intraventricular hemorrhage). His eyes were drooping, he was irritable, and his head circumference had suddenly shot up after weeks of being stable. When these things start happening it usually means the person needs to have surgery to have a shunt placed. UAB doesn’t do pediatric neurosurgery, so we had to go to Children’s to simply be evaluated. I cried and cried. The RNICU at UAB had become our home and more importantly we had hand-picked our care team and I completely trusted them with my son’s life. There were a few of them who I knew had come to love my sweet boy and we loved them right back. We did not want to, but we had no choice- we had to go where River could get the help he needed.


River a couple of weeks into our stay at Children's Hospital


We transferred to Children’s July 31. (I was blessed that one of my wonderful friends works there in the NICU and I was able to have some peace of mind because of her and a few other nurses we came to know and love.) “Wait and see” become our motto at Children’s. Once River was assessed by his neurosurgeon (who we are grateful we have not needed his services, but also love him!) we felt better as he let us know River was not an emergent case and at this point our game plan was to “wait and see”. We established a plan of twice weekly head ultrasounds and twice daily tracking of his head circumference. I spent most of my days texting my close friends and family, “Head circ up. Ultrasound the same. Keep praying.” Or, “Stable head circ, ultrasound same. Keep praying.” While we were grateful River wasn’t requiring surgery we were exhausted not knowing what was coming.

River was now having stable days and even making progress. We’d had no scary episodes since a few days before we left UAB and we fell into a predictable pattern at Children’s- except for feeding which was a nightmare. While at UAB he’d been on and off the vent so much he’d not had a lot of chances at bottle feeding, but when he did River had done great. Once we got to Children’s he wanted nothing to do with his bottles and most of his feeds were given through the NG tube down his nose. He started refluxing and projectile throwing up feeds and meds. We started working with Occupational Therapy. We very slowly worked up to taking an ounce by mouth during day feeds, but he seemed to stall out at an ounce and rarely did more than that. Doctors began encouraging us to think about having a g tube placed. Let me interrupt here by saying we have another child and she was 3 years old at the time… I told my mom one day that I had never questioned any decision I made for Briley. I’d never felt unsure, but with River…from the moment he was born I felt unsure. I had no clue what was best for my son and that was very hard to stomach. We weighed the pro’s and con’s of a g tube. Agreeing to the g tube meant we could come home from the hospital and work on bottle feeding at home. We’d be away from the risk of infection, we’d be together as a family, we’d be HOME (after 8 weeks in the NICU and living in a hotel this was rather appealing). I was struggling with the thought that if we agreed to the g tube did that mean we were giving up on River and not giving him a chance. Some well meaning people made me feel like we were giving up God by agreeing to the g tube. We prayed about it. We talked about it as a couple. Over and over. It was and remains one of the hardest decisions I've ever made. We told the doctors we’d like to give it a week and see what kind of progress River made with bottle feeding. If it was a lot of progress we would continue to work on feeds in the hospital. If not we would set a date for g tube surgery. 10 days later he had made no progress. On August 25th he had surgery to have a g tube placed and for a fundoplication (a procedure where surgeons wrapped part of his stomach around his sphincter to control reflux). We began to learn the in’s and out’s of his g tube and prepared to go home. We experienced some mild set back’s (bleeding around the g tube site, brady’s during bottle feeds), but we finally brought River home on September 8th, 2011 (exactly 8 weeks old).


Heading HOME!!!


Where we’re at now is a whole other post in itself. I would like to say that God moved mightily and we’ve seen no issues stem from the brain bleed River experienced in utero, but that is only half true.  We HAVE seen God move mightily… he spared my son’s life and he is here, on this Earth, with our family and for that I will give Him eternal thanks. Unfortunately though River does have damage from his bleed and that has led to a lot of developmental delay. Like I said… another day, another post.

So there it is… 13 months later (on God’s timeline, not mine) my sweet boy’s story… but just the beginning. I don’t presume to know the plan God has for River, but I know it’s big. When River was in the NICU I would stand over him and pray many, many things, but always that he would one day “stand, walk, talk, and proclaim the works of Jesus” in his life. I believe that with my whole heart and I hope if you’ve made it this far and read this short novel ;) you would be encouraged to only speak encouragement over and about River. We welcome any question’s you might have, but do understand that at the heart of this it is intensely personal and there are some things that we choose to keep confidential because we feel it best for River and best for our family. “Wait and see” still remains the mantra for life with River. He is on his own timeline and he’ll do things when he does them… it’s just our job to believe he WILL do these things and to work with him on these things. 

Thank you for all the love and support our family and friends (that have known all this) have shown us. There were many days when a text from one of my best friend's, a card from my mom, or just a hug and someone to cry with were the only things that got me through the day. I have seen the love you have for my son (and I get it... he's pretty impossible not to love ;) and it means everything to us. Please keep praying for him, for us, for Briley. We love ya'll!
Thursday, May 31, 2012

Reflux update & Life with River



A few weeks ago River had an impedence probe test done to measure his acid reflux. We went inpatient for 30 hours and he puked as per normal during it. His morning feed in fact he puked up 210 mL's of 240! Honestly I was so relieved he was throwing up during the test because it meant FINALLY we would get him some help. Surely this test was going to have a purpose and his doctor would finally be willing to give us some help. So when the doctor's office called us a week later to let me know his results were "within normal range" and his GERD is considered "controlled" by meds. I sat stunned when the nurse told me that and I guess it was an awkward silence for her because she suddenly goes, "SO THAT'S GREAT!" Well... Mama lost it at that point. I said, "Actually it's not great. He throws up all day long and in the morning's he is throwing up anywhere from 5-7 ounces of an 8 ounce feed... so no, it's not GREAT. And if his results are "normal" ya'll need to find out why he is throwing up ALL THE TIME." Silence. The nurse then stammered she'd have to talk to the doctor and give me a call back. I said that'd be great, got off the phone, and proceeded to cry my eyes out. I had put all my hope in this test finally being the answer and the kick the DR needed to take us seriously about the vomiting and weight loss (he'd only gained 2 ounces in over 2 months) and now they weren't going to do anything for us. That was on a Tuesday...by Friday NO ONE had called us back so that morning I called our pediatrician and River's two other specialists at Children's. At this point I thought even if they can't help us (since it wasn't their specialty or what they were seeing River for) there would at least be documentation of all the help I was trying to get and I knew my ped would also call the GI doc on our behalf. Someone from all of those offices called me back within an hour of my leaving a message and offered what little help they could. One of our other nurses even practically demanded I have the GI attending on call paged because she felt it was totally unacceptable the way this WASN'T being handled and the way we were being treated. Finally, Friday afternoon a nurse from our GI office called and said the Dr wanted to start River on a new med. I thought, "Hallelujah!" and then she told me the new med... which was one they had tried to treat his reflux with in the NICU and he cried for 3 days straight when they put him on it (without speaking to us first I might add). I told her we were not comfortable trying that med again because of his reaction the last time. When he came off it in the NICU he was fine within 12 hours so we know it was definitely the med and his nurses also noticed the change in him so it wasn't just us. Not to mention he can't even take the med with another med he is on. She said she didn't know he was on that med and I reminded her it was in his chart and he'd been on it since he was 2 months old. She said, "Well I don't know what to tell you to do. I can talk to the doctor Monday and call you back." I said, "How about you get us an appointment to come in please?" So we made an appointment for the next Thursday. 


Meanwhile I decided I'd HAD IT with all the puking and since it didn't look like anyone was going to be helping us I made the decision to cut the volume of River's feeds back. I went from 8 ounces to 4 ounces in the mornings since he threw up worst then and the rest of the day we went from 8 ounces every 3 hours to 6 ounces every 3 hours. I figured our GI office was going to have a fit and say that wasn't enough to keep him hydrated, BUT if he could hold it down then he'd be getting much more than he was when he was puking up over half his feeds. I didn't noticed a difference over the weekend, but by about day 4 the puking had drastically decreased. We went in for our appointment and lo and behold we'd actually gained weight! Even still because of all the throwing up and lack of weight gain River earned the diagnosis of failure to thrive. (As a side note the doctor made a comment that my cutting his feeds back hadn't helped him gain weight, it was just a coincidence. How nice, right? WHATEVER!) Of course, as I imagined they said he wasn't getting enough volume. I reminded them he was having plenty of wet diapers (anywhere from 5-8 a day) and crying actual tears so I knew he wasn't dehydrated.) They asked us to start a night drip and I reluctantly agreed. (A night drip is basically we'd get a pump and we'd set it up where he'd get a slow rate of milk all night long while he slept.) So we got our settings and we headed out to pick up our new medical equipment for the night drip. I held it together fine until I started doing my training to learn how to do the night drip. I'd been so happy that we'd managed to avoid night drips this long because it allowed us to hold onto a semblance of "normal" for River...but I pushed back that feeling and tried to ignore it. We'd had plans to go out of town for the weekend so we decided to start the night drip when we got back home. 


We started last night. River went to sleep around 9:30 and then I hooked him up to start his night drip at 11. I set it up and hopped in the bed myself not really giving much thought to it. Within a few minutes the pump was alarming and I went back in to check on things. I couldn't figure out why it was alarming for a couple of minutes and I guess that gave my brain time to process things. I finally realized I'd forgotten to unclamp the extension on his g tube and that's why it was alarming. I unclamped, restarted the drip, and by gosh- out of nowhere I just lost it. 


What I've learned from life with River is that's it okay to not be okay all the time. We have friends who have to live on this earth without their precious children. We have NICU buddies who went through EVERYTHING with us, who we sat and cried with, who we pumped for our children together as we discussed their futures like they weren't hanging in the balance.... so I GET IT. I know how blessed I am, how lucky I am to have my son in my arms. I don't understand why he got to live and other's didn't... and I still struggle with guilt that he made it. But knowing that... and being grateful for his life... well in the middle of the night sometimes that knowledge doesn't make it any easier to be dealing with things that you never foresaw for your baby. It doesn't take away the sting of a life that isn't quite what you imagined. Am I grateful he's here? Would I do the hardest day every day of my life if I meant he was in my arms? Yes, I absolutely would... but it's still HARD. So I let myself feel that last night. I curled up in bed with my husband's arms around me and God in my heart. I think He understands and I'm grateful for a God that sometimes allows me to just FEEL what I need to feel. Thank God He holds everything.

Thursday, March 1, 2012

Coming Soon


I'm working on it... and this is just to keep me accountable. If I put this out here then I have to finish it. 
Friday, January 20, 2012

Six Months (a few days late)



River, you are 6 months old (January 14, 2011)! 







You weigh 17.2 pounds. You are 26.5 inches long.                                                                You wear a size 2 diaper. You wear a size 2 shoe. 

You are in mostly 6 months clothes, but some 9 months and some 6-12 months 
(and of course, the occasional 3-6 month... why are clothes sized so differently?)

Eating... well, it depends on the day. You've had colds and congestion for the better part of the winter and it really makes bottle feeding harder. When you can't breathe our of your nose and are gagging on congestion taking a bottle just ain't happenin'! Add that to severe GERD and it's a slow go. Back at Thanksgiving you were taking 2-2.5 ounces regularly (but were extremely fussy... like cry at least half an hour of every hour.) When you got the first cold it just went downhill from there and we eventually stopped offering the bottle for a couple of weeks. We have finally built back up to taking 1-2 ounces with each feed. You do wonderfully if you are well rested and not having stomach pains, but that doesn't happen with every feed. We're working on it. I know one day you will conquer this and this must just be part of the story God is writing for you. I've been giving you very, very small tastes of applesauce on your paci occasionally. I think we're still months off from solids. You're taking 6 ounces every 3 hours, but sleep through the night (so about 5 feedings).

You're sleeping pretty good... usually waking up once a night either around 3 or 5 and sleeping till 7 or 8. Sometimes you sleep straight through till 8. We JUST stopped swaddling to sleep (unless you're really irritable or can't settle down) and you sleep just as great not swaddled. 

You've been so social lately... babbling and gurgling with lots of smiles (save for the last couple of days where you've been really fussy and gassy). You do pitch an ugly fit... raring back, stiffening up, and holding your breath. You are a mess! You had an MRI done about 3 weeks ago and the anesthesiologist made sure to come out and tell me how you held your breath for a solid 30 seconds when they were messing with you. No news to your mommy! I feel like most of these fit's are related to GI pain and hope we can find a doctor that is helpful soon. We hate to see you hurting. 

You've gotten much better at riding in the carseat and easier to take places. I wear you in Aunt Kel's Baby Bjorn a lot... we're going to have to find one that holds a higher weight to buy since Aunt Kel will be needing hers back soon for Baby Boy!

Developmentally... holding head up and rolling over like a pro when you are mad about something. When you're happy you hold your head up for a few seconds on your boppy. You're mostly holding it up when you are being held against someone though. We are proud of you.

We love you, River!

Wednesday, January 4, 2012

2011 in pictures


2011 was a wonderful, blessed, long, hard year for us. We were extremely blessed, but also walked through some really sad times. Life, right? I'm looking forward to seeing what 2012 has in store for us. Here are some of my favorite moments from 2011.

January 
Briley had a big announcement to make last January :)

B's first big snow :)

February and March
I can't believe it, but I actually have ZERO pictures from these months... sad! Big events were celebrating our cousin Reed turning 2 in February and we found out we were getting  a baby brother too!

April
B dyed Easter Eggs for the first time

We did a  lot of playing outside and swinging!

May
One of the only pictures I have while pregnant with River... I am HUGE here, but I still had till August to go to (even though we only made it to July).

June
A very special little girl turned 3!

Partying at Chuck E Cheese with her cousins, Reed & Browning

July
4th of July- the kids played for HOURS on the giant water slide


 And Mommy parked herself at the bottom and didn't move nearly all day. I was MISERABLE and ended up in the MEU that night.


 Hmm? And what else happened in July? Oh yeah, this sweet boy made his (early) arrival and we settled in a for a long NICU stay with many up's and down's. 
Welcome to our world, River!

August
 Our 5th Anniversary... spent in the NICU at Children's

 And we took LOTS of wagon rides at Children's Hospital

September
 Somebody broke out of the NICU to come HOME!

 Only instead of home... we hightailed it to the beach for our first family vacation as a family of four. TEN WONDERFUL DAYS!

October
 Happy Halloween from Briley at Boo at The Zoo!

 Our little football's first Halloween 
(and Mommy's first homemade costume)



 Life at home

November

 The month of November looked a lot like this for us... lots of renovating!



 More :)


 Attempting a family pic... Daddy cropped out and B being crazy!

December
 River

 Santa came!

 Seeing Santa had visited!




 

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