Wednesday, July 10, 2013

Catch Up

By some of the e-mails I have received, several of you are on the edges of you seat waiting to hear how things have been going the past 4 days. I will rewind to my Saturday morning post and try to catch you up to where we are today.

My last post Saturday morning left off as we were waiting for doctors to make their rounds. Hayden had a better night Friday night than he had during the day, but it was still a struggle. Kelsea and I took turns holding him in the chair while the other tried to sleep on the couch in the room on the 10th floor. This went on through the night until he finally fell asleep in Kelsea's arms around 3 or 4 in the morning on the couch/bed while I made my way down for what was probably my 8th cup of coffee and a Snickers as I prepared to watch the next episode of Friends on one of the TV stations.

After waking up, Hayden did much better. He still didn't want to be laid down in his bed, but he was doing better. Rounds came and they said clinically, on paper, he was good to go home. However, they wanted to observe his feeds again overnight. We told them we were ready to go home; however, if they felt it was absolutely necessary to keep him again, we trusted them. BUT....we were ready to go home!

The attending surgeon made her way in to Hayden's room later that morning and checked him out. She said that he looked good and she felt comfortable sending him home with us. She said they know they can trust us and that we are his best advocates and they know that if there was a problem, we would bring him back right away. She finally gave the green light and signed the orders to kick us out. I went back to the hotel to load the vehicle, and just like that, we were gone, heading home, with absolutely nothing attached. I think my dad said it best when he posted the following on Facebook: "Can you believe it? Hayden will be leaving Children's Hospital in a few minutes....... no IV's, no feeding tube, no vent tube, no OG line , no heart monitor, no PICC line.....and for the first time in his life,  NO Omphalocele!!!!!!!!!!!!!! "

Just a week ago, I was certain he would come home with oxygen and a feeding tube. I had even asked the doctors to put a feeding tube in because I was so worried that he wasn't getting the proper nutrition (he wasn't either...remember the PICC line was only a "Pic" line and he could only get the partial TPN!). How many times does a parent ask the doctors to put a feeding tube in??!!!

We were ok with him coming home with those things, apprehensive, but ok if it meant we got him home. However, once again, God blessed us with having nothing attached to Hayden except his mom and dad's arms!

We left the hospital around 3:45 Saturday afternoon. Hayden had a couple of prescriptions, all except for one that were technically OTC. The one that wasn't OTC was the one he really needed. This was to help wean him off of his narcotics. Most pharmacies closed at 6 in Quincy, and I knew we wouldn't be able to get them filled. I thought about getting it filled at a Walgreen's a few blocks from the hospital, but remembered the one in Quincy was open 24 hours....and I was ready to get out of Dodge!

Hayden fussed some on the way home; not his normal asleep in the car self, but it wasn't horrible. We were home around 6 p.m. and I was back out the door by 6:30 (after playing with Tucker for a few minutes) to drop the prescriptions off at Walgreens. They were going to be ready about 7:30, so I pulled around and played on my phone while I waited for them to be filled. However, I was interrupted by a phone call from Walgreen's stating they did not have his medicine and that all the other stores were already closed and they could try again at 10 tomorrow morning once more local stores opened. I had Kelsea call Dr. Asbury and see if there was anything we could do to keep Hayden from going off the deep end with withdrawal symptoms until tomorrow. He was due for his next dose in 30 minutes and would be ready again for the following one at 8 the next morning. She said it would not be good if he missed two doses.

Walgreens informed me that Jacksonville was the next closest Walgreens that was open 24 hours and they would call to see if they had it. My response was, "Jacksonville is 90 miles away and that doesn't help me get the medicine!" I was running on 2 hours of sleep in the past 36 hours, hadn't showered in the same amount of time, was hungry, and ready to be home. The clerk giving me this "dumb" idea was not going to help me. However, I quickly realized what I had to do. Ugh.... Yep.....you guessed it! After all of the aforementioned "negatives" as well just finishing driving 2.5 hours from St. Louis, I left Walgreen's (after they called the Jacksonville store first!!!), stopped and got a large coffee and a large Mountain Dew, and pointed the truck East on I-72 at 8:00 at night!

I called Kelsea as I was pulling out and told her to hold on to him if she could, I would be home as soon as possible. He, of course, was fussing and inconsolable and I felt so bad for her, and him. The drive wasn't all that bad. It went pretty quickly. I was home by 11 and Hayden got his meds. He was in bed asleep shortly after that and didn't wake up until the next morning.

His crying and agitation has continued on and off for the past three and a half days. Kelsea and I try to remind ourselves that Hayden is experiencing many normal baby stuff, but we are also cautious not to just write it off as "normal." We know that gassiness is something that all babies deal with. We know that teething and wanting to be held is something that all babies deal with. However, since his intestines and other organs are not necessarily in the correct anatomical place in his body, we still need to be aware that he does have the potential for problems that other babies wouldn't have. For example, last night was rough. He would not sleep for more than 15 minutes at a time and from yesterday afternoon until about 1 this morning, he had bouts of crying/screaming, almost non-stop along with arching his back. When he was held, he was good (for the most part). When he was put down in his crib, he would start screaming again. When he would fart, he would be better, for a while.

Again, we know these are all things that most babies deal with, but when it goes on for 4-5 hours at a time, it seems like it is excessive.

Sunday brought a new day. Hayden had turned into an absolute pig! The first day he started eating in the hospital, he set a record for the amount he had eaten in a 24 hour period. Since he was eating so little before his surgery, we would still measure the amounts in milliliters and not ounces. His first day, he ate around 650 ml. He had only eaten over 600 ml probably 4 or 5 times in his life!

Sunday, he blew that out of the water and hit the 700 mark. Monday, he did it again and ate over 800 ml in a 24 hour period! This is absolutely some of the best news we have had! Hayden's Broncho/Tracheomalacia can only be "cured" if he outgrows it. In order to outgrow it, he needs to eat. He wasn't eating well before his surgery, but things have changed. He dropped close to half a pound while he was in the hospital, but in the 3.5 days we have been home, he has gained more than a 1/4 of that back!

Over the past few days he has continued to have his crying/screaming fits, but we are still attributing that to gas and his intestines kind of being all over the place. This may be something he fights for a long time. However, he is back to his normal, happy self. Hayden was happy to be home to all of his toys and his Tucker, Slice, and Killer. He was also as close as close can get to rolling over on his stomach (on his own) in the first 24 hours since we had been home from the hospital. If it wasn't for his arm underneath him getting in the way, he would've done it!

We haven't really mentioned it to a lot of people, but if you recall, Mandy Murphy from Fox 2 in St. Louis did a special report on Kelsea and Hayden's birth back in January. You can view that post here. Well, they wanted to do a follow up on Hayden. They actually had their camera crews back in the operating room as they fixed Hayden's Omphalocele. We were supposed to do another interview with Mandy at the hospital last week, but I asked to push it back several times due to Hayden struggling as he was and Kelsea and I were not emotionally ready to do an interview. As luck would have it, Hayden was sent home before we could meet, so she settled for a phone interview yesterday!

It definitely won't be as big of a piece as she previously did (I'm guessing) but it should be pretty informative. It is set to run on the 10 o'clock newscast tomorrow night (Thursday, July 11). Hard telling where it will fit in, but check it out. If you're not in the St. Louis metro area, you can watch it online here: Fox 2 On Air Streaming.

While we were waiting for Mandy to call us, we got a call from Dr. Warner to check up on Hayden. We were both very impressed that he called to see how Hayden was doing since he had been released. Even though we know God is in control and placed this man in our lives for a reason, we are still very thankful for the work/role that Dr. Warner played. I also can't say enough about all of the doctors, nurses, and staff of the PICU and entire hospital. There were several things that I witnessed that a parent never wants to witness that gave me a different outlook. Seeing your son "code" two times (meaning he had respiratory failure) and watching people save his life and breathe for him, put things in a new perspective. These doctors and nurses and technicians took an interest in Hayden, our son, and he was more than just a patient and a job. I could see it in their eyes that they worked on him as if he was their own son. For this, I will always be in debt and grateful for their help.

Obviously, the previous paragraph shows that I am thankful that the good Lord placed these doctors and this hospital so close to us. There are many, many things that I am thankful for and could go on and on for days. Right now, the biggest thing I am thankful for is to have my family all together again....even if there is not room on the couch for me, and that Hayden has been eating like a pig and even though he lost some weight while in the hospital, he is quickly catching up. 

 

Sunday, July 7, 2013

Home

We made it home last night....some of us later than others. We are very blessed and fortunate to have God in our life as well as our family and friends 

Will try to get a good post later today.

Saturday, July 6, 2013

Waiting

So the story is....well, we don't really know! Hayden had a great day yesterday in terms of feeding. However, he wouldn't sleep and was agitated and inconsolable. Not sure if its gas, pain, narcotic withdrawal, something else, or combination of all of the above.

He had a somewhat better night and is sleeping with Kelsea now. Waiting on rounds to see what the doctors think. I am hoping they say he is just struggling because his intestines struggle while "waking up" and decide to pull the PIC line and NJ tube and send us packing. 

Hope to know shortly.

Thursday, July 4, 2013

Complaints

I want to complain about the following things:
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I really could go on and on, but I'm trying not to. Sometimes it is so frustrating to see your child crying, and you don't know what it is for....especially when he NEVER cries at home. Sometimes I want to yell and scream and tell the world just how mad and frustrated I am, but I know that won't change anything. When I take a step back and look at the whole picture, how could I ever complain? When we walk through the halls of the hospital, how could I ever complain? When I see some kids in the rooms next to us who more than likely won't be going home, how could I ever complain? Even though when I look at the moment, when I look at a tiny snapshot of the bigger picture and I get lost in it, I know I need to take a step back and look at where we have come from Since September 17th. I need to look at how happy the doctors are with Hayden. I need to look at the looks on the doctors' faces when they come in and see Hayden. He is a star! There are things that I wish were different right now, but things are good. Things are very good. Kelsea and I are amazed at the outpouring of support, thoughts, and prayers that people are sending out for us. We are truly blessed and sometimes don't feel like we deserve everything God has given to us.

Hayden had to have a little oxygen overnight as we was agitated, however, it is back off and he is doing well. The goal today is to keep him happy. Keeping him happy I think is going to revolve around two things.
  1. Keeping his bowels moving gas and poo....he doesn't like it when either get stuck!
  2. Getting some milk in his belly. Even though he is being fed, the tube goes through his stomach and into his jejunum so he doesn't get the "full" feeling. Once he wakes up and acts hungry
He probably could have made it out to the "floor" today (10th floor/Surgery Recovery), but his PICU doctors want to monitor him one more night just because he was showing some signs of withdrawal from his medicine. They don't think it was full blown, but they want to make sure. We are ok with that. We would never turn down the extra attention and care he so deserves!

Mom and Dad are on their way back down for a few hours. They said a couple of nights ago, when they got home, Tucker was extremely disappointed. They drove my truck, and when he was looking out the front window and saw it pull in the driveway, he figured it was me. Mom said he ran outside and circled the truck several times, looking inside, but was so despondent when I didn't get out! It broke my heart!

That's ok though because I have a feeling we will be home to see him soon! Until then, it is time to try to give him a bottle. Wish me luck!

Wednesday, July 3, 2013

No towels. Need Sleepy.











Feeding tube was placed yesterday (Tuesday). Fairly good day as well, minus a few periods of irritability. Last night Hayden was cranky from midnight to about 5 this morning. Still doing great with breathing. 100% oxygen at 1.5L and saturation at 100% most of the time. Will continue to wean the flow (1.5L.....don't know what that means besides the amount that is getting pushed through tube/support) and start on amt of O2 (100%) and work on decreasing towards room air, which I believe is 21%. 

Parents made it down for a few hours to exchange laundry and give Kelsea and I a chance for lunch and a nap. The dining out curse continued!!!

It's 7:30 am. I have to make some calls regarding insurances and bills, then it's off to bed for this guy. Goodnight moon!

Tuesday, July 2, 2013

Small Glimpse

Rough 36 hours. Hayden, mom, and I have been up for about 33 of them. He continued to struggle off the vent. Actually he was breathing great and was weaned almost down to 1 liter of O2. However, the pain and his addiction to pain medicine got him. They think he was exhibiting withdrawal symptoms from the sedative he was on while intubated, which caused 30 hours of straight crying, which led to swallowing a lot of air, which led to a distended tummy, which meant he was unsuccessful when we attempted to feed him tonight. 

After another one of "those episodes" around 6:45, Hayden was calmed down, had a replogle tube reinserted into stomach to drain gas and fluid, put back on lower dose of similar analgesic, and slept for almost 3 hours. So happy to see him calm for a few hours. Even though I know this is all part of Gods plan, when you see your son struggling, it is hard not to worry and question things. Thank you all for the prayers, for Hayden AND Kelsea and I. I received an email with a perfect message at the perfect time tonight that greatly helped me out. 

Kelsea and I are splitting shifts tonight and hopefully she will wake up and relieve me at 1:30 so I can get a couple hours of sleep and be back by 6 to get ready for rounds. 

Remember, what we are seeing in front of us at this moment is only a photograph, a tiny image of the grand scheme He has laid out for us. 

Sunday, June 30, 2013

Adrenaline or too Much Epinephrine

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It was my turn to sleep in the bed at the room overnight while Kelsea stayed with Hayden Saturday night. Although he had an increase in mucus on Saturday, things were pretty good when I left for the night. Hayden's vent settings had come way down and as I had mentioned in last night's post, there was a very, VERY specific plan put in place in order to effectively take away the narcotics and replace it with a different analgesic (drug that produces an anesthetic like state) so he wouldn't be in pain, but could still breathe on his own during the Extubation Readiness Test.

I woke up around 5 and read a message Kelsea had sent shortly before that. They had done a trach aspirate  (culture checking for bacteria) due to his increased mucus and it came back showing some bacteria growth. This basically means that there were signs of bacterial growth in Hayden, and possibly even his lungs. Kelsea also said that Hayden's heart rate and blood pressure had dropped significantly at one point because he was too sedated, so they stopped the analgesic to bring him back.. When I showed up, the resident stated that these don't necessarily mean they wouldn't extubate, but they would have to have a serious discussion about everything during rounds. He said we don't want to hurry things and cause problems. I agreed, but I was heartbroken. I went to bed thinking the next morning was going to be great and woke up struggling because I thought God's plan was leading us in a different direction than what I wanted. I know, I should be used to that by now, but I wasn't! I could tell in his voice that the doctors didn't think it was going to be a good idea, so I texted mom and dad the disappointing news and started my morning ritual of standing by Hayden, talking to God, and waiting on rounds.

As the discussion got under way, I don't think I even had my notebook of questions, daily goals, data, and notes with me. I was just kind of there. As they discussed the overnight happenings and looked at the morning x-rays, I was only half paying attention because I knew what was coming. When the resident brought up the culture, the Attending Physician, as they always do on rounds, just like you would see on any medial show, started presenting scenarios and asking questions about different outcomes. He asked a little more in depth questions about the results from the culture and asked a resident what that suggested. His response was, "Correct. Ventilator Associated Pneumonia which the biggest way to prevent that is to yank the tube." When he said this, and acted like he was ripping something out of his mouth, my ears perked up. It was one of those moments (Kelsea could describe them for you) when I was overcome with joy. It was like a ton of bricks being lifted off of my shoulders. I called her in the middle of rounds and told her to get over here. I was kind of a nervous/excited mess and the adrenaline was flowing through me because I was so excited to be able to hear Hayden again. Within 30 minutes, the tube was gone!

When somebody is extubated, they have to make sure that the person can do several things. These include breathing at a normal pace, keeping heart rate at a normal pace, keep there blood oxygenated, and not struggle to breathe. Well, Hayden was struggling with several of these. He had a lot of bubbles/fluid coming from his mouth, elevated heart rate, and was working really hard to breathe. After about 20 minutes, I suggested Kelsea holding him might help to lower his heart rate. Boy, was I wrong! Kelsea was a trooper though and did her best to console Hayden as he struggled, and cried, and twisted in her arms. He was not happy! Part of the problem is that he was given two doses of epinephrine to help open up his airways and help him breather. A side effect of this is increased heart rate.


As time went on, I was afraid we were heading down the path or being intubated again. I didn't know exactly what was going to trigger the decision to do this, but I felt it was close. After about 90 minutes of him struggling, one of Hayden's angels (a doctor in disguise) came to the rescue. The same fellow who I wrote about Wednesday (who made the decision to bring him from the Surgery floor back to the PICU just in time to get him intubated) consoled Hayden for about 35 minutes straight encouraging him to suck on his pacifier which was dipped in "Sweeties" (sugar water basically). He was able to get Hayden to calm down so his heart rate dropped from about 228 (it was above 200 for at least an hour) to around 165. So many times, we have gotten to see the human side of doctors down at Children's. Looking at him trying to console Hayden, you would have thought it was his own son. He wasn't just pulling for him as a patient, but he was pulling for him because he wanted to see him succeed. I know this is there job, which they get paid for, but I can never thank everybody down here enough for what they do. His nurses. Wow. As they always have (especially in the NICU...ahem....shout out....kind of since I'm not naming names!) show their human side and love for their job day in and day out.

At 12:30 pm, after three hours, Hayden had calmed down and was doing well. Even though Kelsea and I really didn't do anything, we were completely worn out and emotionally drained. His tube was out and we finally felt like he was going to be succeed this time. Kelsea sent me down to grab lunch and I called dad and gave them the ok to come down. Hayden's Aunt Kelle was in town and wanted to see Hayden. She hadn't seen him since the first of February, so I was really hoping that things would be good enough for her to come down. While eating, his heart rate slowed even more and mom was able to go get something to eat. She also tried to go take a nap (since whoever stays in the room with Hayden usually doesn't get much sleep), but it didn't work for her! Hayden was worn out, but couldn't sleep. He was very restless and just wanted somebody to hold his pacifier in his mouth for him. He wanted to suck on it, but didn't have the energy to do both.

Mom, dad, and Kelle arrived around four and were able to spend a couple of hours here. Hayden continued to relax and adjust to the oxygen that he is on now. They will continue to try to lower and lower the oxygen he is on, but at this point, I don't care if he have to strap a tank to the roof of Kelsea's car! He is still getting treatments every 2-4 hours from the respiratory therapist for junk in his lungs. He doesn't mind the tube they put on his chest which uses sound waves to break it up, but he DOES NOT like the mask they put over his face for the Albuterol. He is acting like putting a mask near his face and having him inhale 5-6 times is the worst thing that has ever happened. However, I guess I can't blame him because everything since Tuesday has been about his face.

He is sleeping now and I think he is going to sleep good tonight. This afternoon, there were several times it smelled like he dirtied his diaper, but hadn't Still good news though because it means things might slowly be waking up down there. His catheter was removed today as well as two IV's (not by choice.....more from him thrashing around). He has his PIC (we are only using one "C" at the end since it is technically not a Central line) and an IV in his neck. However, his nurse tonight is certain the neck IV has run its course and won't hold up much longer. That means he will have to have another one put in tomorrow in a foot or hand, but I am ok with that. They need the access.

They are going to monitor him in the PICU for at least 24 hours. We told his doctor this afternoon that we are ok if it is 48 or even 72 hours. Right now, we are in no hurry to leave the PICU. However, we will be ready for the next step and goals. Not exactly sure, but these will include trying to wean him off of the oxygen and hoping his intestines "wake up" so that we can see if he will eat/digest food and start getting him to put on some weight.

I think there are at least ten things I wanted to say tonight, but forgot. However, the one thing I know is that God is watching over us. While Hayden was struggling, I know for a fact there were so many people and churches as a whole group, who were in deep discussions with our Father. He heard every single one of them and His path for us was once again laid out before our eyes.