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This video is from way back in November – right after our first real snowstorm I took Patrick outside in his new snowsuit to experience snow. At first, he just tipped over a lot. This video is when I finally got him to be willing to touch it.
This post is a follow-up on last week’s rant. It turns out that Patrick’s low-grade fevers were caused by RSV, a highly dangerous respiratory bug. He probably picked it up while he was trying to taste every piece of furniture in his hospital room the week before.
He was discharged to home before noon.. less than 24 hours after he was admitted. They sent us home with orders to visit the outpatient respiratory clinic as often as needed and boy have we been glad to have that resource! I think we caught this bug the first day… The symptoms didn’t really hit till Friday. Friday morning when he woke up he was working hard to breathe and my best efforts with steam and a bulb syringe wouldn’t budge things so I took him in. The respiratory therapist described the secretions as “glue”. He said that is was possible that Patrick was needing extra fluids, since I couldn’t give him drinks to keep him hydrated. So I stopped and asked for a prescription for some extra fluids.
The next night, he hardly slept! Finally at 3 a.m. I put the fluids on and he finally started to be able to clear his airway and went to sleep. When we took him in again his oxygen saturations weren’t in the dangerous zone, but they had dropped significantly.
That was the worst of it, though.. Patrick is actually doing much better these last couple of days. I think we finally have him rehydrated and he’s breathing much more easily now. We haven’t had to take him in for help in a couple of days now. I think that other than the long contagoius period and resulting quarantine, he’s on his way back to normal.
As for our car – well, it turned out to need $4000 in repairs. This is NOT what we wanted to hear in January, the month where we pay all of our out-of-pocket medical for the year.. We ended up approving the repairs, but have also decided that it’s time to sell that car and drive something more affordable to repair. And maybe once that car’s sold and our tax return comes back and things are a bit more stable, we can revisit the idea of having a practical car for me to drive in Seattle while leaving Brian with a practical car to drive here.
None of this excitement has done much to hinder Patrick, though. Despite being sick and grumpy and working to breathe, he is still growing up more and more every day. A week ago, I took a load of laundry downstairs. When I came upstairs I discovered Patrick halfway across the kitchen floor. He had dragged his IV pumps in their backpack by the tubing a good 4 feet trying to follow me downstairs. The next day we invented a safer way for him to get around.
Now when Patrick’s playing on the floor he wears a safety harness connected to a little cart that his backpack sits in. This way, he can get around the house without as high of a risk of ripping his central line out. He’s enjoying exploring how far he can go, and getting faster all the time! The funniest thing is how much he loves being under furniture. I’m amazed at all the places I find him. (And have to subsequently save him from.. because he gets his tubes and harness tied all around the furniture legs).
He also spent most of his last hospitalization improving his standing skills and he now dares stand himself up to some furniture and can walk around a big holding on… especially in his crib.
Patrick had a couple of doctor’s appointments this week and this month the doctors were all smiles! After such a hard summer, everyone is happy to see him doing so well.
Patrick has actually been gaining weight.. He’s at 85% of the recommended weight for his height right now, and for the first time rising ahead of the curve. Today, with his clothes on, Patrick weighed 18 pounds.
In even better news, his liver tests looked good! His bilirubin (the measure of bile in his bloodstream) was in the normal range and his liver enzymes, although they show that his liver is still inflammed and unhappy, have been trending downward. His liver even “felt” normal on exam.
All of his other tests were normal! This is SPECTACULAR, as it is so hard to keep him stable for any length of time.
Today, I took him to be evaluated by the rehabiliational medicine department at Primary Children’s. The goal was to see if any physical or occupational therapy can help him to make up some of the developmental delays that came from this long illness this summer and from his delicate health in general. (We’ll be starting physical and speech therapy soon, in addition to his developmental theraphy).
At the end of the appointment, one of the hospital’s residents came in to visit. She took care of Patrick while she was on the GI service 3 months ago.. when he was still so sick and fragile. Now she was doing a rotation in PT. And she was THRILLED to see him! She held him and played with him and just couldn’t stop talking about how much he’d improved since she’d last seen him. She just kept saying, “he looks like a healthy baby!”
In the end, Patrick left with gifts of a new ball and blanket and a big hug and kiss on the head.
We are so proud of our little man and how well he’s doing, especially after all he’s had to fight through. (Just hearing his history today, the doctor said she came in expecting to find a vegetable, and instead found a happy, playful little boy). We’re praying to be able to keep posting glowing reports like this one.
We were able to bring Patrick home again yesterday afternoon. My apologizies that it comes as such a surprise. Patrick’s surgeon was out until last Thursday, and we didn’t see him till Friday. The other surgeons led us to believe that we’d need to stay in the hospital until Patrick no longer needed his stomach drained to compensate for his too narrow large intestine.
When Dr. Rollins, the surgeon, came in on Friday he said he’d like to get us out of the hospital as soon as possible. However, weekend discharges are difficult and don’t often happen.
Dr. Rollins called Patrick’s GI, Dr. Jackson, in to give his recommendations and, well, Dr. Jackson always wants us home whenever possible. Despite all these recent infections, Patrick has a pretty good track record of staying healthy at home. So Dr. Jackson always prefers that he be here, especially with RSV and flu season upon us.
And so, much to everyone’s surprise, including ours, we brought Patrick home yesterday.
He is on erethromycin (don’t know that’s spelled right), which causes the stomach to contract… the idea is that it will help improve motility through the intestines. And he has a g-tube extension attached to the button in his stomach. This gives his stomach a sort of release valve for when his stomach contents build up too much. We put it to drain periodically throughout the day, though the goal is to keep that at a minimum.
So – my care of Patrick has changed, but is still very time intensive. And as he gets better and has more diapers to change and is allowed to eat, I expect to get even busier.
He’s doing great! It’s amazing to me to see him willing to play on his stomach now that the ostomy is gone. He’s also become quite good at sitting. It will be different to experience this new level of activity here at home.
Patrick discovered a couple of weeks ago that his activity center is a jumper. Since then, he has jumped at every possible opportunity.
We always stall as long as possible between Patrick’s haircuts, just cuz we love his little mophead. However, Patrick had hair in his eyes in front and his hair was past his collar in back… all except the very back of his head where he’s rubbed all the hair off while scooting around.
This is the best before picture he’d allow. His eyes are closed because he didn’t like the mist from the water bottle.
Most of the haircut was patient waiting, with a few wiggles.
Of course, he did start to get sleepy by the end.
But in the end, still turned out quite handsome.
Thanks to Wes of The Hair Place for a great haircut. And for keeping Daddy looking nice, too.
We’ve been a very busy little family lately. Patrick is 5 months old now. And in the time since I last posted, we’ve had a lot of firsts. So, here are some highlights.
First giggles
Patrick learned to laugh a while ago, but we didn’t get out and out chuckles until we discovered that the kid who used to scream his head off whenever he got undressed is ticklish and loves to have his clothes off. Dressing and especially weighing are now favorite games… but it’s best when daddy just picks him up without clothes on and tickles his back.
Today we learned that you can also get belly laughs if you squish his cheeks.
First fever
Well, it all started with a cold, that turned into croup. After a week and a half trying to fight it off, Patrick got his first fever. Fortunately, it didn’t go much higher than 100.4 (38 degrees Celsius) and so we were able to have blood cultures drawn at home and his fever was gone in a day. No infection, thankfully. Just a day at home with Mom holding Patrick and taking his temperature every half an hour to make sure it hadn’t hit the danger mark yet.
First necktie
My brother Steven got married at the end of March. Although we were crazy busy working on his wedding cake and pictures, I just couldn’t help taking the opportunity to make Patrick and Brian matching neckties. We bought a tie with a matching handkerchief. Patrick thought his tie was a great toy to hold and chew on.
Oh, and a disclaimer on this picture. Patrick hates bright lights of any kind and we had studio lights on. Someday we’ll get a family picture with him not crying.
First rollover
I set Patrick down and turned my back on him for just a minute. When I turned back, he was on his tummy looking up at me as if to say “Whoa, Mom! What do I do now?” So far no signs of him having any idea how he did this or how to do it again. But we’re having much more play time on the floor to encourage him.
First haircut
After weeks of trying, we finally got time to take Patrick to my Grandpa’s house for his first haircut. In my defense (for those of you who thought I should never cut it), his hair was in his eyes and under his chin. Patrick was ok with the whole haircut idea till we hit the ticklish spot behind his ears. Finally, though, he fell asleep and we were able to finish. It’s a nice short cut.. but we hope that means it can grow for a while again before it needs another cut.
First ER visit
Last Saturday night, I noticed some bleeding under the dressing for Patrick’s central line. The line had shifted and, on closer inspection, we found that it had been pulled. It didn’t pull out, but was far enough to worry us. So – we got to make our first trip to the ER.
We were probably quite the sight there because, unlike the other families, we weren’t panicked. Central line issues are just part of life with Patrick. We’ve been planning and practicing for this trip for a while.
We arrived at 10:30 p.m. and had a bit of a wait in the waiting room because we were definitely not the most urgent case there. They took some x-rays to see the position of the line and about 1 a.m. the surgeon who placed Patrick’s line came into the room. He had been called in for an emergency appendectomy, and stopped in to see Patrick while he was there. He looked at it and said that the line was in a good position and he didn’t think it needed to be replaced on an emergency basis. Instead, we were to put antibacterial ointment on it twice a day to prevent infection, which meant lots of dressing changes, and then get a second opinion on Monday.
We were amazed, but happy, and after teaching an E.R. nurse proper technique for dressing change (yes, us teaching her), we were sent home. We got home at 3:30 a.m., connected Patrick’s feeding tube, and slept in till 11:30 a.m.
First outpatient surgery
So that brings us to Monday. About a month and a half ago we started the battle of the granulation tissue. Patrick had a patch of it next to his stoma that just kept growing back, no matter what we did. We learned to use silver nitrate to treat it, but it just kept coming back. So – we decided that maybe it was doing no harm and we’d leave it as it was.
No sooner had we made that decision than I discovered that his g-tube was surrounded by granulation tissue. A visit with the nurse practitioner in the GI clinic taught me better technique for nitrate treatments and after 10 miserable days of treatments, his G-tube site was clear of it. However, the spot by his stoma was starting to make it hard to keep a bag on and his skin was getting sorer by the day. I tried my newly practiced skills, but the tissue just kept coming back
So, we called and scheduled an appointment to have it electrocauterized. This is a minor procedure, but it’s painful and so they put babies to under so they don’t have to suffer through it. The surgeon we saw in the E.R. told us to as for follow-up at our appointment on Monday. It was still looking sore and red and swollen and the surgeon didn’t like the look of it, so he decided it was best to change the central line.
This means that they took it out of one vein and put it into another one, coming out in a different place on his chest. Again, this is something we’d been warned about, so it wasn’t a complete shock. However, we were a bit nervous and, after an already long weekend, quite tired.
The surgery went well. Patrick woke up and was able to come off the ventilator in no time at all. He was, as always, a favorite with the nurses in post-op. Brian got to reconnect his TPN in post-op, which was kind of funny to do. Our nurse was fascinated with the different equipment. We got some curious looks as Brian drew up vitamins with syringes and injected them into the IV bags.
It’s a curious thing to be the old pro parents in the hospital. I often refer to myself as a “hospital mom”. We know the routine. We’re patient with the nurses, doctors, and other staff and, although we are concerned for Patrick, we are not scared or intimidated by our surroundings as we once used to be. It’s kind of odd to feel perfectly at home in a hospital… But makes all of this more bearable.
Patrick was sore and tired for a day and still whimpers if we move his not-quite-healed shoulder the wrong way… But overall he’s back to himself. As for Howie and myself, well, we’re slowly but surely catching up on our sleep and getting back to a normal routine. And preparing for the adventures ahead.
First steps to transplant
And that brings us to the last of the firsts for this entry. We have made the first steps towards transplant evaluation for Patrick. We have appointments for April 27th and 28th at Seattle Children’s Hospital to meet with the surgeon, gastrointerologist and just about anyone else who might have anything at all to do with Patrick’s transplant. Theevalution process is big, long, and very detailed. They want to make sure that Patrick needs and will benefit from a transplant, that he’s healthy enough to have one, and that his home life lends itself to as successful of a recovery as possible. This trip is the first step in that process, and we are excited to go and learn and start building relationships there.
Patrick still has a long way to grow. He’s almost halfway to the 10 kilo weight goal. (He weighs 10 lbs 11 oz.), and so we know this visit won’t end with him on a list. But it’s a start and a step in the right direction.
And so, those are the firsts we have to report for the time being. We’re looking forward to continuing to see him learn and grow. He is so good at using his hands now! And has just started to discover that he has feet. His spirit grows by leaps and bounds every day. Most of all, he amazes us with his incredible patience and optimism.
Patrick is 3 months old now and is starting to look and act much more like a little boy than just a baby. Oh sure he still wakes us up at night. And I can still tuck him under my arm and carry him around like he weighs nothing (of course, he’s still very small). But he’s growing (8 lbs 13 oz) reaching that fun stage my family calls “interactive baby”.
First of all, he’s started to give out smiles all the more willingly. I can bet on the fact that I’ll get a big grin whenever he wakes up and realizes I’m holding him. This past week, he’s also started to react more when I play with him. He’ll laugh and talk when I sing him songs or talk to him, and I can get him outright chuckling if I pretend to eat his cheek or tummy. He also is starting to take an interest in peek-a-boo. Of course, this is all the more incentive for me to sit and do nothing for hours besides just trying to get smiles from Patrick.
He’s taken a new interest in his toys. He loves to sit in the bumbo seat that Howie’s co-workers gave him. He’s actually learning to hold things so his gym, rattle, rings, etc. are suddenly much more interesting.
Course, he’s also learned to hold onto his central line… which is a bit more of a problem. Don’t need him grabbing that and giving it a yank. Thankfully, my mother in law modified a bunch of onesies to a design I came up with that send the line out the side instead of being right in Patrick’s reach and those are helping.He’s sleeping through more of the night and spending more of his days awake. Part of this may be that he’s finally feeling better. (His anemia is resolving himself and we are starting to get a hold on keeping him hydrated again). But I think part is just that he’s growing up.
Daddy went on his first business trip since Patrick came home this week. Thanks to all the friends and family who were there to watch over us, we made it through just fine. And now that Howie’s home, Patrick is just eating up the daddy time.
Perhaps the best news is that it was all pretty good news when we went to see Patrick’s gastroenterologist this week. If you don’t know, the past couple of weeks have been a bit scary as we almost had to take Patrick to the ER a couple of times. First, we suspected he might be developing a fever. Second, out of nowhere his stool output went through the roof and he walked a line with dehydration that we had to watch VERY closely. (Patrick doesn’t have the portion of intestine that reabsorbs fluids, so diarrhea will dehydrate him much faster than other children).
As so often has happened for us, though, the Lord was watching over Patrick. The right doctors were on call at the right times and they were able to teach us how to take care of things at home rather than taking Patrick into the ER. We had blood cultures drawn by his home nurse. He was put on an oral antibiotic to help fight any bacterial overgrowth that might be there. (With so little intestine, Patrick’s body can’t get rid of the “beneficial bacteria” that live there the way the rest of us can and he can get infections in his intestines that could cause diarrhea or worse.) He had his 2 month (yes, I know it was late) checkup with his pediatrician on just the right day so they could do labs to check for other stomach bugs.
And, in the end, the great news is that there is no sign of anything malicious that’s causing the change in output. We monitored him closely and gave IV replacement fluids at home so he wouldn’t get dehydrated. He got pedialyte instead of formula, and then watered down formula for about a week and a half. This week we were finally able to start giving him full strength formula in very small amounts (about a third of what he was getting, before… he’s up to a teaspoon now). And so far, so good. In fact, we’re on the other side of things right now where he’s not losing enough fluids… a sign that we need to increase his feeds. (We want him to need some replacement fluids because that’s where he gets his electrolytes).
So – if our emergency watch level were on the same scale as homeland security, we’ve backed down from red (severe) to blue (guarded). I’m getting to spend more time being mommy and less time being nurse.
I’m so grateful that Heavenly Father answers prayers. And I’m grateful for priesthood power in our home. Brian is an elder in our church and was able to give Patrick a blessing of healing this week. And really, the fact that Patrick is still home with us, and feeling happy and healthy, is nothing short of miraculous.
Speaking of miraculous, (as this blog post reaches an eternity in length), just a reminder that Patrick will be sealed to us in the Jordan River LDS Temple on February 13th and we’ll be having an open house to welcome him into the family that same day. Any of you who are in the area and would like to celebrate with us are invited. For those who are out of town, we’ll try to be quick in posting pictures, thoughts, and memories so you can share in the day with us.
Patrick Hoopes 