Wednesday, November 2, 2011

Approaching the Corner??



Turns out he’s growing THREE bugs down in his lungs, pseudomonas plus two others.  The third popped up yesterday morning and isn’t covered by the antibiotics he was already on.  Seems that Septra is one of the few that take care of it.  (I’ll have to ask again what it is, didn’t ring a bell with me.)  Anyway, they put Septra on board yesterday afternoon along with his new airway therapies.  And I’m cautiously optimistic that we may have at least found the corner, even if we haven’t turned it yet.  This morning he’s on 75% oxygen, which is less than he’s been on for about a week. 
So, my understanding, in non-medical language, is that he caught a really nasty cold which then ended up being a secondary bacterial infection down in his lungs.  He’s still a long ways from where he needs to be, but at least there’s progress.  Baby steps, but that’s okay.  He’s a baby.
We have about four weeks until Thanksgiving.  I’m going to try to remember to write down something I’m specifically grateful for each day until then.
November 1st, I’m grateful for teachers who are willing to go above and beyond in helping my other children stay on top of their school work, and to help me know when they aren’t.  I’m grateful my husband is helping them stay on top of that same homework while I’m gone (and often even when I’m there!).
November 2nd, I’m grateful for a hospital staff that is so invested in Aaron.  I can’t walk or sit anywhere without someone asking about him and how he’s doing.  Doctors, nurses, respiratory techs, social workers, cleaning people and even the ladies who manage the hospitality cart.  They genuinely care.  And two days ago, a nurse who hasn’t had him for months, finished our conversation by saying, “I will pray for him.”  That meant so much to me.



Tuesday, November 1, 2011

Dragon Mother


Very special thanks to my friend, Heather Theurer, for allowing me to
use her beautiful painting here.  Her website is
http://www.heathertheurer.com
There's really not much change, which, itself is a concern.  But for now, he's happy and playing, just still needing way too much support to be stable.  He's got all sorts of people scratching their heads while he bats away at his toys. 

I am a Dragon Mother.  Earlier this year, a book, Battle Hymn of the Tiger Mother was published.  It is supposed to be all about how to raise children to excel.  I'm not a tiger mother.  Not even with my "normal" kids.  I like to think I try to strike a balance between expecting respect and hard work and fun times being kids.  In reality, I think my kids grow up on what I like to call "benign neglect."  Don't ask me to define it.  I'm not sure I could.

But I am a Dragon mother.  In October, a mom in Santa Fe wrote a piece for the New York Times which hit a cord, a deep cord, within me.  It's not often that an article has me in tears, but this one did.  See, her precious child is also dying.  Dying.  Not a word you usually associate with a child.  But hers is.  And so is mine. Not today, and hopefully not tomorrow, but dying nonetheless.  Neither of us will get to see our babies grow up.

She says it so much better than I can put into words.  But I think she hits the nail on the head in her final sentences.  "Parenting, I’ve come to understand, is about loving my child today. Now. In fact, for any parent, anywhere, that’s all there is."  Love, it's what life is all about.

 

Notes From a Dragon Mom






  Emily Rapp is the author of “Poster Child: A Memoir,” and a professor of creative writing at the Santa Fe University of Art and Design. 
Santa Fe, N.M.
MY son, Ronan, looks at me and raises one eyebrow. His eyes are bright and focused. Ronan means “little seal” in Irish and it suits him.
I want to stop here, before the dreadful hitch: my son is 18 months old and will likely die before his third birthday. Ronan was born with Tay-Sachs, a rare genetic disorder. He is slowly regressing into a vegetative state.  He’ll become paralyzed, experience seizures, lose all of his senses before he dies. There is no treatment and no cure.
How do you parent without a net, without a future, knowing that you will lose your child, bit by torturous bit?
Depressing? Sure. But not without wisdom, not without a profound understanding of the human experience or without hard-won lessons, forged through grief and helplessness and deeply committed love about how to be not just a mother or a father but how to be human.
Parenting advice is, by its nature, future-directed. I know. I read all the parenting magazines. During my pregnancy, I devoured every parenting guide I could find. My husband and I thought about a lot of questions they raised: will breast-feeding enhance his brain function? Will music class improve his cognitive skills? Will the right preschool help him get into the right college? I made lists. I planned and plotted and hoped. Future, future, future.
We never thought about how we might parent a child for whom there is no future.  The prenatal test I took for Tay-Sachs was negative; our genetic counselor didn’t think I needed the test, since I’m not Jewish and Tay-Sachs is thought to be a greater risk among Ashkenazi Jews. Being somewhat obsessive about such matters, I had it done anyway, twice.  Both times the results were negative.
Our parenting plans, our lists, the advice I read before Ronan’s birth make little sense now.  No matter what we do for Ronan — choose organic or non-organic food; cloth diapers or disposable; attachment parenting or sleep training — he will die. All the decisions that once mattered so much, don’t.
All parents want their children to prosper, to matter. We enroll our children in music class or take them to Mommy and Me swim class because we hope they will manifest some fabulous talent that will set them — and therefore us, the proud parents — apart. Traditional parenting naturally presumes a future where the child outlives the parent and ideally becomes successful, perhaps even achieves something spectacular. Amy Chua’s “Battle Hymn of the Tiger Mother” is only the latest handbook for parents hoping to guide their children along this path. It’s animated by the idea that good, careful investments in your children will pay off in the form of happy endings, rich futures.
But I have abandoned the future, and with it any visions of Ronan’s scoring a perfect SAT or sprinting across a stage with a Harvard diploma in his hand. We’re not waiting for Ronan to make us proud. We don’t expect future returns on our investment. We’ve chucked the graphs of developmental milestones and we avoid parenting magazines at the pediatrician’s office. Ronan has given us a terrible freedom from expectations, a magical world where there are no goals, no prizes to win, no outcomes to monitor, discuss, compare.
But the day-to-day is often peaceful, even blissful. This was my day with my son: cuddling, feedings, naps. He can watch television if he wants to; he can have pudding and cheesecake for every meal. We are a very permissive household. We do our best for our kid, feed him fresh food, brush his teeth, make sure he’s clean and warm and well rested and ... healthy? Well, no. The only task here is to love, and we tell him we love him, not caring that he doesn’t understand the words. We encourage him to do what he can, though unlike us he is without ego or ambition.
Ronan won’t prosper or succeed in the way we have come to understand this term in our culture; he will never walk or say “Mama,” and I will never be a tiger mom. The mothers and fathers of terminally ill children are something else entirely. Our goals are simple and terrible: to help our children live with minimal discomfort and maximum dignity. We will not launch our children into a bright and promising future, but see them into early graves. We will prepare to lose them and then, impossibly, to live on after that gutting loss. This requires a new ferocity, a new way of thinking, a new animal. We are dragon parents: fierce and loyal and loving as hell. Our experiences have taught us how to parent for the here and now, for the sake of parenting, for the humanity implicit in the act itself, though this runs counter to traditional wisdom and advice.
NOBODY asks dragon parents for advice; we’re too scary. Our grief is primal and unwieldy and embarrassing. The certainties that most parents face are irrelevant to us, and frankly, kind of silly. Our narratives are grisly, the stakes impossibly high. Conversations about which seizure medication is most effective or how to feed children who have trouble swallowing are tantamount to breathing fire at a dinner party or on the playground. Like Dr. Spock suddenly possessed by Al Gore, we offer inconvenient truths and foretell disaster.
And there’s this: parents who, particularly in this country, are expected to be superhuman, to raise children who outpace all their peers, don’t want to see what we see. The long truth about their children, about themselves: that none of it is forever.
I would walk through a tunnel of fire if it would save my son. I would take my chances on a stripped battlefield with a sling and a rock à la David and Goliath if it would make a difference. But it won’t. I can roar all I want about the unfairness of this ridiculous disease, but the facts remain. What I can do is protect my son from as much pain as possible, and then finally do the hardest thing of all, a thing most parents will thankfully never have to do: I will love him to the end of his life, and then I will let him go.
But today Ronan is alive and his breath smells like sweet rice. I can see my reflection in his greenish-gold eyes. I am a reflection of him and not the other way around, and this is, I believe, as it should be. This is a love story, and like all great love stories, it is a story of loss. Parenting, I’ve come to understand, is about loving my child today. Now. In fact, for any parent, anywhere, that’s all there is.
 http://www.nytimes.com/2011/10/16/opinion/sunday/notes-from-a-dragon-mom.html


Monday, October 31, 2011

Happy Halloween!


He wasn't quite sure what to think
of this.  It was "what is this you're
doing to me?"  And while the costume
was okay, he wasn't sure about
the hood at all.  Silly bug.
Last night was a better night.  He only had two desats and came back easily.  MUCH better than the previous 24 hours where we were constantly rescuing him over and over.  Today’s plan had us decreasing the tidal volume on the ventilator.  They’re wondering with his lungs hyperextended if they’re too tight to exchange the oxygen well.  It doesn’t seem to have made a big difference, but it might have made a small one.  Also, they’ve put him on two different antibiotics to try to kick this pseudomonas.  It’s a particularly sticky bacteria, so we’re using an inhaled drug to break up the DNA in the pseudomonas so it’s easier to suction out.  He gets it twice a day and the RT said it would take probably two days to really see a difference. 
 
We also tried lying him down on his tummy.  That was kind of tricky, and I should have taken a picture, but once we got him there, they were hoping he’d tolerate it for at least 30 minutes.  Not only did he tolerate it, he loved it.  He slept like that for about six hours!  Again, it didn’t seem to do much fto improve his oxygenation, but at least he got some really good sleep.  That has to count for something. 

 So there we are.  He’s looking better, happier, but still struggling.  At least it’s not quite as scary.  But I just don’t understand why he’s needing so much oxygen, and neither do the doctors.

 I love the way they cater to the whole child here (and the parent, too).  It’s Halloween.  The kid’s holiday.  Child Life stopped by to say that if we don’t  have a costume, they have them upstairs.  And they’ll be by later to take pictures.  I went up and got the cutest monkey costume.  I think it’s appropriate.  He was asleep when I got back, so we’ll put it on later.  I needed this.

Sunday, October 30, 2011

Sunday Strength

Church today was wonderful, as always.  I don't think I'll ever get to the point where I take it for granted up here.  At least I hope not.  There  is always something that really touches me.  Today, it was the opening and the closing hymn.  The opening hymn was "I Believe in Christ."  I remembered singing that to Aaron several weeks ago, and his spirit singing it back to me.  He does believe in Christ, and he knows that it is through the miracle of the atonement that one day, he will be healed and whole in the royal courts on high. 

The closing hymn was a sweet song from the Children's Song Book, "He Sent His Son."  Last March, after we knew but before we told others about Aaron's challenges, I was asked to teach it to the primary children.  It's a simple hymn about how God has taught us.  He taught love and tenderness by sending his son as a little baby.  He taught us the pathway we should go by having Christ walk with men on earth.  And He taught sacrifice and death by sending His only begotten son to die for us and then rise and live again.  As I talked to the children about the song, we spoke of how precious and tender a little baby is.  Then we talked about what a wonderful example and teacher someone can be.  Then as we spoke of the third part, I asked if they thought it must have been hard for Heavenly Father to watch his beloved Son die.  It must have, but He did, and Christ allowed it because of Their great love for each of us.  And what do they ask of us?  To have faith, hope, and live like Jesus taught.  Not always easy, but what we must strive for.  And the miracle is that His grace will make up the difference between what we can do and what justice requires. 
  

Last week, another mom who has walked this road with her little one sent me this video.  It's been a rough enough week that I didn't feel I could watch it until today.  I was right that it would be hard, but oh so touching.  A reminder that He always does carry me, not only me, but Aaron, and not only us, but the rest of our family as well.  Because although so worth it, the road is hard and the only way we can make it is through His strength.  Please watch this.  I hope it will give you hope and help in your trials, whatever they may be. 

Sunday Morning in the PICU


Aaron's room in PICU
His pumpkin friend is
over on top of the vent,
peaking over the edge.

Sunday, October 30, 2011
Much going on and I’m still trying to organize the thoughts so they are somewhat coherent. 

First of all, he had a quiet night as far as sleep goes, but when he’d go to sleep, his sats would drop after a little while.  So up with the oxygen and out came the bag and they would bag/suction him in an effort to loosen any plugs and move them out.  It happened at least three different times that I know of (can you tell I didn’t get a whole lot of sleep?).  Then this morning, he decided to go all out with it and went into the 70’s.  Yuck.  In addition to bagging, the RT decided to go after his nose.  Suffice it to say that what came out of there was double-yuck.  And his sats improved.  So I guess, even though he doesn’t use his nose to breathe, really, he doesn’t at all, it must influence it.  So we got him back and within the hour we had weaned back down to 85% oxygen through the vent instead of 100%.  (By the way, what we breath, normal room air, is about 21% oxygen.)  So that’s one thing.

The sign outside our door,
warning any staff that
they need to take precautions so
they don't take any nasties back out.
Next on the list is that his trach aspirate, the test where they pulled cells from the lungs through the trach, is starting to grow out.  And it’s got our good ol’ friend, pseudomonas, a lot of it.  He’s colonized with it, meaning he’ll always have some come back, but this time it’s way more than it should have.  Apparently, they’ve been having a real party down there and have gotten out of control.  So they’re putting him on another antibiotic, an even stronger one, just to make sure they get it until the lab can figure out exactly what this strain is sensitive to.  So we’re not sure it’s pneumonia, although it may be, but it’s at least a tracheitis, or bacterial infection in his trachea.  (I think Word needs to add a medical dictionary.  It doesn’t seem to recognize the words I use way too often now.)

Getting his echo.
Third, we’re going to get an echo.  He’s just not budging on his oxygen, and he’s on so much.  They just want to make sure his pulmonary hypertension is not getting worse, although I’m told that it will be higher just because he’s so sick.

Fourth, but probably not until tomorrow, they’re going to talk to neurosurgery about his MRI ten days ago.  It’s just different enough, and we’re a captive audience, so we’re going to touch base with them.

Jammie pants.  Hoping they make
the transition from casts a bit easier.
His casts came off yesterday, and he’s not so sure about that.  His little legs are very sensitive.  They haven’t been touched, except by casting material, for 12 weeks.  It really bothers him to have them handled.  Right now he has little jammie pants on in an effort to minimize the stimulation, or at least try to provide a buffer there.  I’m also going to contact Shriners tomorrow and see if I can pick up his braces.  We’ll have to go back for final fittings before going home, but at least he can have something to protect all this work until we’re out of here.  Which, unfortunately, doesn’t look like it’s going to be anytime soon.

Church was wonderful.   As was a special video a friend sent me by e-mail a few days ago.  I wasn’t up to seeing it until today.  I’ll write more about those later.  Perhaps after a nap…

Saturday, October 29, 2011

Stable, and No Casts


A new friend.
Aaron has been stable all day, thank goodness.  He's been getting a lot of support from the hospital vent and has not come down on his oxygen, but otherwise it's been a good day.  His x-ray from this morning showed his upper right lobe opening up.  This saved him a trip to the ER to have it sucked out with a bronchoscope. 
Getting ready for cast removal.
We're starting to run out of IV sites.  He keeps sweating them out of his head, which is too bad.  It's my favorite place.  Mostly because it goes in so smoothly.  He's such a hard stick in his hands and feet, that they really have to poke and prod and dig to get one in there.  Besides, if it's in his head, he can still play with his hands.  So the casts came off today.  He's not sure what to think about it.  It's been three months since anything but casting material touched his skin on his legs, and I think he's finding it a bit unnerving.  But I'm sure he'll get used to it.
After his casts came off.  We're going
to have to work on those leg muscles.
When I was home yesterday, I bought him a little friend.  When I showed him the pumpkin this morning, he was a bit concerned.  He looked at it as if he thought he might need to be afraid.  After studying it for a while, I took his hand and rubbed the pumpkin with it.  That's all it took.  He broke out in big smiles!  A new friend!

Anyway, we're enjoying that he's stable.  The only time he dropped down much was when he disconnected the vent and it took a couple minutes to discover it.  (The hospital vent doesn't scream as loud as ours does, and it goes off for a lot more reasons.)  Imagine that, no breath, no oxygen, dropping sat rates.  Who'd have thunk it?  Thank you all for your prayers.  Please keep them coming.  He's not well yet.


Friday, October 28, 2011

Please Pray

Please spare a minute and pray for Aaron. He's been in the hospital since last Sunday fighting a virus. We don't seem to be making any headway on it. I went home this afternoon for a few hours, and while I was gone, the hospital called. He dropped his sats into the 80's and wouldn't come back up even with 10 liters of oxygen bled into the vent. They had to bag him for 30 minutes to bring him back up. This earned him a quick trip back to the PICU.

When we got back tonight, he was back on the hospital vent and looking pretty good. But I think we've lost all the ground we gained a few days ago. Please pray that he can kick this. We need our little bug to get better.