Patrick – Page 8 – Patrick Hoopes

Sealing and blessing

As of 4:10 p.m. on February 13th, Patrick is officially a member of our eternal family!

We started out the weekend’s events with a little bit of humbling. Howie took the day off to help get the house ready and I was going nuts trying to take care of every little detail from ironing temple clothes to prepping food for the open house. But, a flat tire on the freeway ay 10:30 the night before we went to the temple was a good pull back into reality. Changing the tire was easy, but it revealed other bigger problems and we made it home on a prayer and half a rotor on the front passenger side. Boy did my priorities realign quickly, especially as I watched our car be taken away on a tow truck, just trusting that we’d get through the weekend all right anyway.

Howie’s family helped get the church set up for us to go the temple, and then his mom made it here just on time to watch Patrick while we got dressed to go. She drove us to the temple and we tried took a few pictures. Although it was sunny, the wind was bitter cold and Patrick was NOT happy so we didn’t stay too long.
My mom and dad met us at the temple. Mom was there to take care of Patrick in the nursery. (Including dressing him and reconnecting his IV’s). We left him there in capable hands and then went off to get dressed in white.

We met the sealer (this is the official title for the man who performs a sealing ceremony in the temple). Turns out he had been the community doctor in the town where my family grew up, so he knew my grandparents and dad, and some of my mom’s family, too.

They kept trying to start early… But my grandpa and some of my friends hadn’t made it there yet.. So we just made everyone wait. Our friend Tifanie was so excited that she couldn’t contain herself and ran over and gave me a hug… making everyone cry.

Finally everyone all of the guests had arrived and they went and got the man of the hour. My mom brought him in, dressed in a white tuxedo and wrapped in a white afghan she made just for the occasion. Brian and I knelt across the altar from each other, holding hands, and Brian’s mom brought Patrick and laid his little hand on ours. At first, he was a bit fussy, but we turned him around so his right hand would be on ours, and he caught my eye, and he settled down immediately. We watched each other’s eyes the whole time.

A sealing for a child is quite short… just a few lines said by the sealer that bind the child to his or her parents (in the eternal record) and then promise special blessings. Patrick seemed to soak up the entire experience, and then, completely content, went right to sleep as soon as it was over and I had him in my arms.

We celebrated and welcomed him into the family that evening with an open house at the church. I went smoothly (thanks in part to awesome family who helped with the food prep, set up, and clean up). There were enough people there that I couldn’t quite make it to talk to them all. Finally we wrapped up, cleaned up, and got home COMPLETELY exhausted! And with way, way, WAY too many leftovers. I think next open house I’m going with punch and cookies.

Saturday we got to recoup a bit as we visited with family, which was nice because we knew Sunday would be another big day. Patrick got to know his cousins and aunts and uncles a bit better.

Sunday morning Patrick could barely sleep. After his morning feeding, I sat in his room holding him and he just kept waking up and grinning at me. I swear he knew what was going on that day.

Because he had us up early, we were able to take our time getting ready. He spent a little time cuddled with his Daddy in the bed, and then we got him dressed and ready for church. Our ward has classes first, followed by sacrament meeting, so I went off to Primary with the children and Patrick went with Brian to his classes.

We snuck out a bit early to change Patrick into his white tux… and luck of all luck… found that his ostomy bag had started to leak. Luckily, by now Howie and I are a pretty smooth team and we were able to pull of a pretty amazing quick change in one of the classrooms and still make it to the chapel on time.

When the time came, Brian took Patrick to the front of the chapel. Brian is an Elder in our church, and his brothers, some of my brothers, our fathers, and my grandfather are also priesthood holders, and therefore could help with the ordinance. They surrounded Patrick, each with one hand holding him, and then Brian performed the blessing.

In a baby blessing, the child is given a name and then given personalized blessings. Among other things I remember from the blessing, Patrick was reminded of the love that brought him into our family – both our love and the love of his birthfamily. He blessed him with strength to face the difficult medical journey ahead. He reminded him that he was a child of miracles.

When they came back to sit beside me, Patrick was just glowing. His daddy held him and I could see the love that they had for each other. I also knew, as I looked at Patrick, that he understood all that had gone over the weekend and was happy about it. I really believe that, although he was adopted, the Lord promised He would waste no time in making sure that Patrick received these two very important ordinances.

Since then, well, I can’t quite get enough of my son. I don’t know what the future hold, though I’m sure there are rough times ahead. But I do know that I was blessed with a very special gift and a very important calling in this life when I was given the opportunity to be Patrick’s mom. And I will never forget the day he was sealed a part of our family forever.

3 months old

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.

Button, button, he’s got a button

We finally were able to trade in that long, awkward g-tube that Patrick liked to get caught in his toes. On the 13th, Patrick’s GI replaced it with a mic-key button. This is small port with a tiny tube that goes directly into his stomach. We can snap a tube into the button to use for feeding or any other needed access to his stomach. But, when it’s not in use, he has only the much smaller button to worry about.

Tummy time, wearing pants, and zerbets are all now much easier.

You may be asking, well do you use his button? What’s it there for? Well, the goal of an “enteral feeding tube” is to put food or medicine directly into Patrick’s stomach without him needing to take it orally. Now, anyone who knows Patrick knows that he loves to eat. However, we’re hoping someday to be able to use this tube to feed him overnight so he can sleep through the night. There’s a pump that will pump formula from an iv-style bag into his stomach at a nice slow rate.

We tried doing just that over the past couple of weeks. However, we’ve learned that Patrick so far doesn’t sleep soundly enough for it to be worth the extra effort. Because food is going directly into his stomach, we were giving him smaller oral feedings during the night… but Patrick didn’t think that was enough and was quite vocal all morning most mornings letting us know he wanted more.

So – right now we’re not using button. However, we’re hoping someday to use it and finally let Patrick sleep a whole night long.

Inch by inch

Patrick is now 22 inches long and weighs a whopping 7 lbs 11.8 oz. Now, I understand this is small to some, but this means that he is just about out of his newborn size clothes… So right now, it’s HUGE to us! I can’t believe how well he’s growing. The doctors are pleased too.

The story of this week has been trying to get settled into a non-holiday routine. We had our last wonderful daddy-home days this week as the holidays came to a close. We went to bed early on New Year’s Eve because Patrick was willing, but still celebrated a bit when it was time for his midnight feeding. New Year’s day, Howie took some pictures of Patrick (just to see if the backdrop worked). We also watched a few bowl games and went to the mall just to have a warm place to go for a walk to help a bit with the cabin fever we’ve been experiencing.

While there, we bought Patrick his first church clothes. They’re overalls, of course, because that’s the best option of pants to protect his central line. And they’re also huge on him right now, since we bought 0-3. But I’m such a proud mama with a son wearing real clothes instead of just jammies all the time.

Medical milestones this week… They readjusted Patrick’s TPN (iv nutrition) to a 22 hour schedule instead of 24. This gave him 2 hours a day disconnected, which sounds pretty fun, but he’s decided is his preferred time for sleeping, so I don’t think he knows much difference. This week we go to 20 hours… we’ll see how that goes.

We’ve had to start doing a lot of replacement fluids this week. He doesn’t have the right portion of intestine to reabsorb stomach juices so he’s at a really high risk for dehydration. We keep track of all the fluids he loses and then calculate what he needs to have given back. Previously, we hadn’t been replacing much… But this week things got really high. That means one of two things. 1) He might be sick and just manifesting it differently. Fortunately, though, no fevers so far. 2) He might have just hit his limit for oral feedings. We’d been increasing things, and this might just be all that he can handle.

In other news, his labs this week are starting to show the beginnings of liver trouble… which we expected to see at one point or another.. so some adjustments may need to be made to the formula of his TPN. He’s also starting to be a bit anemic again. (Too much labwork required for a kid who’s not old enough to make his own blood cells). I guess it’s time for us to start praying that his body kicks in soon and his blood counts look better. Transfusions put the success of a transplant at risk, so if we can avoid another one, it would be ideal.

Mom and dad are doing fine… Just ever busy and ever sleepy. Fortunately his Christmas sleeper still works wonders and he isn’t up nearly as much at night.

Patrick’s First Christmas

Although this picture may not reveal it, Patrick had a very nice first Christmas. It almost came and went, we’ve been so busy. It was a definite feat to get Christmas letters out (sorry to those of you who are still waiting), goodies made (again, sorry if you haven’t gotten yours yet), the tree up (only took a week of intermittent effort) and presents bought and wrapped.

But the most important elements of Christmas were still there. Brian and I had our traditional Christmas Eve dinner and Patrick played in his bouncy seat nearby and enjoyed his feast of 14 mL’s of formula. We opened our Christmas Eve pajamas (another family tradition), and Patrick loved his so much that he slept his best night yet in his. We decided it was probably the last year we could get away with sneakily opening our other presents on Christmas Eve (this is a remnant of being the kidless ones who travel around to family on Christmas Day)… so we opened all our presents before going to bed. All in all, considering everything that’s happened in the past month, it was still a very nice Christmas. I can’t wait to find he time to dig into the books that Howie bought me.

Patrick’s had presents rolling in all week, so we only wrapped him one for Christmas… a gloworm that he loved so much when we found it in the store that we had to buy it. But he was definitely spoiled by friends and family… and we were able to finally just about finish getting his nursery furniture, appliances (yes, he has his own fridge), and decorations together.

We spent the afternoon and evening… and actually all weekend… visiting with family. Everyone loves holding Patrick so much that I have a hard time keeping track of it so that it’s fair for everyone. It was fun to be able to share him with grandparents, aunts, uncles, and cousins.

We’re hoping for one more miracle this Christmas and will post details about it as soon as we know if our wish comes true.

Home Sweet Home

This post is a bit late in coming but it’s about time that I posted the news that we were able to bring Patrick home with us on December 9th.

Things moved a bit quicker than we’d expected they would. With Patrick’s broviac line in place and his infection cleared, there were no medical reasons left to keep him in the hospital. They made the decision on a Friday afternoon to release him early the next week. We hurriedly trained that weekend to be able to take care of him and the hospital staff worked to make arrangements for home health care.

We got home around 5 p.m. on December 9th. It was so strange to be able to pick Patrick up and walk away from the bed, let alone to carry him around our home.

We’ve been home for almost 2 weeks now. Patrick’s sleeping pretty well at night,thankfully, and we’re starting to get a routine. Of course, after so much time away and with Christmas fast approaching, we’ve been swamped so we’re stretched a bit thin and aren’t getting as much napping time as we’d like… But it is so good to be home.

Patrick seems to be enjoying the quieter atmosphere. He definitely likes his new toys and all the friends and family who’ve been visiting. He’s doing very well and growing at a very good rate. Today’s weight was 6 lbs 14 oz.

Broviac Line

I wrote earlier that Patrick was going to have a broviac line placed after his infection had cleared. However, since he has tiny, tiny veins it’s really hard to get a peripheral IV into him and equally hard to keep him there.

Because he doesn’t have enough of his bowel to be able to absorb nutrition or medicine that he takes orally, Patrick depends on an IV to give him the nutrition that he needs. Also, as he’s recovering from this most recent infection, he needs IV antibiotics.

When I arrived at the hospital this morning, they told me that they’d be placing his Broviac line today instead of waiting a week. He’s been stuck just so many times trying to place an IV that they were running out of places to look – and he was running out of patience for it. He went to surgery this morning to have the line placed. It goes in through a vein by his neck and is “tunneled” under his skin. A catheter, or IV tube, comes out of his chest. This is a more durable IV line that should last him several months. In fact, one requirement to take him home was to have this more durable line put in.

Patrick went into surgery a little before noon today and was in recovery by 12:15 p.m. So far he’s been sleeping quite peacefully. We expect a quick and easy recovery. As soon as he’s awake, he should be able to go back to his normal routine.

If you’d like to know anything more about the line, this link will take you to the info sheet that Primary Children’s Hospital gave to me.

Getting settled at Primary Children’s

Arriving at a hospital on Thanksgiving morning is not the best of plans. Although we’ve been well taken care of, it took a few days before the regular hospital staff was all here and we could really start to get settled. But they’ve taken good care of him so far and we’re feeling a bit less like a family of fish out of water.

The hospital immediately started working on perfecting Patrick’s nutrition and have made regular adjustments to his TPN (iv feeding) and formula. He’s now eating 13 cc’s (maybe 3 teaspoons) of Elecare, which is a predigested formula. And, since Patrick loves eating, he still just gulps it down.

On Saturday he gave us a bit of a scare when his temperature shot up to approximately 101.9 degrees. It turns out that he’d gotten an infection in his PICC line. He’s been on antibiotics for a couple of days and today they pulled the PICC and switched his TPN to a periferal IV. (That means that it is in his hand rather than going in through a central line to his heart). He’ll have that until the infection can clear and then they’ll put in a Broviac line, which is a central line in his chest that’s a bit more sturdy so he can go home with it.

He also go quite anemic, especially when they had to start taking blood samples to check his infection so he had a transfusion this morning. His color us much better and he’s much more active and alert.

We have been getting lots of training on home care for him and are pretty good now at changing his ostomy bag… though I’ll admit that if one more person comes and shows me the same pictures of possible complications for a stoma, I might just lose my mind.

We have a care conference scheduled tomorrow morning. This means that the doctors and nurses and social workers and discharge planners will all sit down with us and we’ll talk about a plan for Patrick’s long term care. Our two main priorities are getting him listed for transplants and making plans for him to be able to go home with us until he’s big enough and an organ becomes available. After that meeting, we might be able to answer the question of when he’s coming home. I know a lot of our friends and family are dying to meet him and we appreciate your patience with us as we’ve been trying to get him settled and healthy here.

Sorry for a post with no pictures. Patrick’s due to be fed and I don’t have the time to get them off the camera. If I get a chance later this afternoon I’ll send out a post of just pictures.

Coming Home

Well, it took a few days longer that we’d hoped… But on a grand scale we actually made incredibly good time at getting back home to Utah. The ICPC came through late on Monday… unfortunately too late to do anything about it. So – Tuesday morning arrangements began to be made for the air ambulance. We were scheduled to leave Michigan at 2 p.m. Wednesday. Since space on the plane was limited, and there were things to do at home, Howie flew home Tuesday as soon as we’d made arrangements. I stayed behind to tie up the last loose ends and to take care of Patrick.

Of course, the best laid plans… Weather and mechanical things put the air ambulance enough behind that they had to take an FAA required break… So instead of leaving at 2 p.m., they finally made it to the hospital at midnight. I did my best to sleep before then… but Patrick wasn’t too keen on that idea so I was pretty tired even before I left.

The trip home was a very unique experience. 3 flight nurses and 2 EMT’s showed up around midnight and talked to the nurses at Beaumont to make sure they understood Patrick’s needs. Then, we wrapped him up in the snowsuit I’d bought for him at the last minute and strapped him into the carseat, which had been secured to a stretcher.

We made our way out through the ER of the hospital and were loaded into an ambulance. When transporting an infant, their biggest goal is to keep them warm… So the ambulance was a bit like a sauna. It took 45 minutes to get to the airport in Pontiac.

They put me on the plane first to get settled while they got things warm and ready for Patrick. Then they brought the rest of everything along. (Everything means Patrick in his carseat and a tiny little vital signs monitor and a tiny size pump for his TPN). Plus the flight nurses. We rode home in a leer jet so the space was quite cramped, but pretty comfortable. There were two nurses, a respiratory nurse (to make sure Patrick didn’t get hypoxic), and two pilots.

We flew at 70,000 feet because there is less turbulance at that altitude, so the climb took forever. But Patrick, who’d been asleep since we’d put him in his snowsuit, barely stirred. Once we reached altitude, I got to trade seats so I was closest to Patrick. But he was determined not to wake up. I had to work really hard to get him awake enough for his feeding, and then he fell asleep again right away.

Since he was determined to sleep, I went back to the comfier seat myself and tried to get some sleep in. I think I slept for about an hour and a half, and then woke up on time to start recognizing the silhouettes of mountains. One of the most stunning sights from the flight was the moon setting over the rockies, seen through the front windows of the jet.

We landed at the Salt Lake Airport about 4:30 and it took about 40 minutes to get loaded into the new ambulance and up to the airport. We found the NICU at just about 5:30. The hospital staff knew we were coming, but had expected us several hours before. And, for some reason, the ambulance crew didn’t think to call ahead and came in through a back entrance they weren’t expected to use… so we caught them a bit off guard.

They did an exceptional job through getting us in. I guess that, although the hospital had been in communication with the GI accepting Patrick, that information didn’t get passed along to many people. So, fortunately, the staff at Beaumont had done a great job educating us and we were able to help provide the basic information they needed to get started with his care.

They did pull me out to do some admissions and orientation stuff. And right about then the stress of the past day and the flight hit me. I was so glad for a stash of food and water in my bag because for a few moments there I was sure I was going to pass out. Fortunately, Howie finally got to us (he’d missed us because we came in an unexpected door) just as I hit the non-functional state and was able to take care of the most crucial things there.

Then, with Patrick mostly settled, we went home to get some much needed rest. I would have liked to spend a few hours with him, but I’d about hit my limit. So we got home at 7 a.m. Boy was it nice to see my own car and my own house!

We slept a few hours then got up, put the 200 some odd pictures we took in Michigan into a photo album (Howie had all those digitals printed), and then went to Thanksgiving dinner. It was early afternoon before we made it back to the hospital but Patrick was doing pretty well when we got there. He wasn’t sleeping, he was just laying there looking at his new surroundings. (He’s in a much busier room and I’m sure was confused).

That night, he got to meet my dad, his grandpa, for the first time.

Now we’re just trying to get things settled. We brought stacks and stacks of pages from his chart in Michigan with us. But- as we’d been warned they would- for most information they are relying on us to help explain. Again, we are so grateful for those doctors and nurses who took time to make sure that we really understood everything from Patrick’s care to his treatment, tests, and diagnosis.

This is a bit of a big adjustment for us. Different hospitals do things in different ways. Of course, the hospital wants to do their own assessment, so we’re repeating some things. He has to earn his way back off of pulse-ox and back into a crib. But they’re also being pretty proactive in his care. They’ve tried continuous feeding… but it sent his output levels through the roof. So now we’re trying progestamil by mouth… and he seems to be doing fine with it. We’re hoping to be transferred into the infant unit instead of the NICU pretty soon… but that all has to wait till the end of the assessment period, so it may still take some time. Some of the fun changes in this hospital are that we are dressing Patrick ourselves and he gets a bath 3 nights a week. I got to give him a bath last night, and boy oh boy did he love the baby lotion massage afterwards.

We expect things to pick up once we make it through the weekend. Yesterday, as people came back from the holiday, we started to meet some of the important people who’ll be involved with Patrick’s care. Monday we expect to see the most progress as things are finally back to work as usual.

The last legal hurdle

Our adoption process is a bit like a triathlon. The first leg is the home study and finding process. Most of you have heard about that. You answer a bunch of questions, clean every nook and cranny of your house (even the ones a caseworker would never look at), and then wait and publicize and wait some more.

The second leg for us has had a lot of hurdles. Some of the milestones have been a pre-placement agreement, enrolling Patrick in our insurance, a court date to establish custody, pre-authorizing a medical transport, and today we crossed the last hurdle… the Interstate Compact, or ICPC.

An ICPC is a formal agreement between two states about how an interstate adoption will be handled. It has to be finished before the child can leave the state. And we’ve been sitting here anxiously all weekend waiting for it to come through. And finally today at 4:15 EST we got the authorization we were waiting for to take Patrick back to Utah!

So now the only thing left for us to be able to go home is arranging the air ambulance for him. We expect that to be worked out tomorrow morning. If we’re lucky, we’ll make it home before Thanksgiving. (Knock on wood). Then the last leg is 6 months’ supervision and then the adoption will be final.

We are so excited to be able to bring Patrick home and let him meet the family and friends who have been praying so earnestly for him.

In the meantime, I’ve thrown a couple of other pictures of him in just because that’s what a bragging mom should do.

Patrick’s doing really well this week. His surgery on Monday seems to have been a success. A couple of days ago his jejunostomy started to work. They started feeding him again yesterday and today advanced him to formula. (Patrick doesn’t get much nutrition from food, but eating stimulates his other organs to work and may help preserve his liver and increase his chances of making it to a successful transplant.)

He’s also making great strides in winning us over. He’s pretty good at convincing me that I should hold him for hours for no reason beyond just that he wants it. I’m a sucker for the little smile he gives me when he recognizes my voice or my face. Howie’s not faring much better in resisting his charms.