cousins – Patrick Hoopes

Who needs sleep?

There’s a song by the Barenaked Ladies called “Who needs sleep?” Here’s a line from that song: “With all life has to offer, there’s so much to be enjoyed. But the pleasures of insomia are ones I can’t avoid.”

If you’ve been waiting for an update on the concert, I need to apologize. See, Patrick’s been having a hard time sleeping this week. It seems every few nights something goes wrong and wakes him up. First it was diaper rash. (When his prescription strength creams fail him, the result is massive skin breakdown that makes me want to cry just looking at it.) Then, I accidentally turned off his TPN pump and had to monitor glucose and hydration in the middle of the night. And my little happy-go-lucky optimist responds to these discomforts by trying to cheerfully play through them. So instead of being up crying, he’s up jumping and playing until I pinpoint the cause of discomfort and get him settled.

So – my good intentions of writing earlier in the week were thwarted by extreme exhaustion. And then a series of coincidences landed us in the hospital for about 36 hours.. not helping sleep, but helping to remind me not to procrastinate.

Here’s a rundown of the other events of the week.

Wednesday, Patrick had an appointment with his GI, Dr. Jackson. Patrick’s central line was a bit slow to heal this time around and was a bit weepy even 2 weeks after placement. So I asked the doctor to look just to make sure there was no infection there. Since we were looking for infection, he checked his temperature and it was 99.3. So – Patrick and I hung around for an extra couple hours in the hospital. Dr. Jackson came in and we took off his central line dressing so he could examine it up close and take a culture of any fluid that was there. It looked healthy, just healing, so I went ahead and put the dressing back on. Then we went down to the lab and had blood cultures drawn. Those cultures were all negative.

That night, I got that getting sick tickle in my throat and started to run low-grade fevers.. kind of like when you get a flu shot. Never sick, but not quite right. Since the cultures were clean, I said “Ok, he has a virus, too” and didn’t think more of it.

Friday, Brian came home early from work and since we’d all missed a lot of sleep, we all laid down for a nap. I got Patrick up to put on his afternoon TPN around 4. Only when I tried to draw ethanol out of his line, I just got air. Tried again, got air again. Finally, 3 syringes full of air later, I looked and found a hole in Patrick’s central line.

So away to the E.R. we went. They’ve implemented a new policy that sent us to the Rapid Treatment Unit (RTU) for the repair which, by the way, is WAY preferrable to the E.R. Many fewer bugs and much quicker, more attentive care. The RTU is set up to give basic medical care that takes 24 hours or less.

Well, part of any admission is to check a temperature and Patrick’s read about 100. They rechecked it rectally and it came up 99.8, so we could justify not automatically being admitted. I explained the viral symptoms, but they decided to check cultures anyway. Then they repaired the line and sent us on our way.

The next day, Patrick woke up feeling great! No fevers. So since it was memorial day weekend, we packed up and headed out to Tabiona – a small town in Eastern Utah – for a family reunion. He loved the car ride.. playing in the back seat, singing with the radio, napping, and even trying to figure out how to whistle. Had a great day with cousins, aunts and uncles.

That evening, we got home to find two messages on our answering machine. The blood cultures they’d drawn were showing a staph infection.

Now, in case you haven’t noticed this, I’ve spent a lot of time learning from infectious disease over the past year. And one thing they’ve taught me is that 1 in every 20 positive cultures is a “contaminant”.. that is, something that grew in the culture that didn’t come from the blood sample taken. And staph, although it lives on all of our skin and can get into central lines, usually isn’t one you pick up at home. It’s most often contracted in the ICU. Every positive “staph” culture Patrick has ever had has been a contaminant.

So – I called the doctor and made my case that Patrick wasn’t sick and that this was likely a contaminant. We decided to recheck the cultures on Sunday.

Well, Monday morning rolled around. For once, we were planning to be home for Brian’s day off and had a big to-do list.. And at 8 a.m. the phone rang. Sunday’s culture was positive for staph, too. Patrick’s still healthy, but we’d better go in.

So, just to be safe, that’s what we did. We got there at 9:30. Because it was a holiday, things took longer than usual.. but by early afternoon they’d drawn a new set of blood cultures and by 4:00 p.m. had started some antibiotics. Meanwhile, Patrick’s nurses got to run to try to take care of all of his basic daily needs.. a slow process when doctors have to write for them and pharmacy has to fill them before it can happen.

A quick soapbox moment. One of the most frustrating things about going into the hospital is how difficult it is to maintain the same quality of care and quality of life as at home. There are so many more steps, so many more people, and so many more lawsuit-prevention policies that it is exponentially more difficult to accomplish the same things that I do at home in the midst of daily life. In a short 36 hour stay, I think the nurses had to call the pharmacy at least 10 times about administration questions, late medications, and my ever-hated argument about whether or not they’ll let Patrick have his home TPN. (I usually lose this battle and they hang something with sugar, water and electrolytes but none of the good vitamins, minerals, and fats that he’s used to.) They started him out on a super high dose of antibiotics. (I won’t let that happen again. I’ve seen it done 3 times now with the same result and I’ll speak up next time.) And they accidentally ran his TPN at a 5% of it’s prescribed rate for the night. ( Thankfully, this only resulted in a grumpy, sleepless night as Patrick got hungrier and thirstier. They caught it in the morning and there was no other harm done.) I can’t really fault the nurses here. They work their tails off trying to get everything right within Patrick’s first 24 hours. The fact of the matter is that he’s a complex kid who has a lot of special care. For me it’s routine.. but in the hospital, it’s the exception. In fact, there are some things that require special permission every time because it doesn’t match hospital policy. Still, it’s frustrating to me to have to work so much harder to maintain the status quo. I much prefer to just do it myself at home. Ok. Getting off my soapbox now.

Yesterday morning, Dr. Jackson came on service. I ran into him at the nurse’s desk looking up info to find out why Patrick was in the hospital. We talked about the 4 sets of blood cultures that had been drawn. By then, the cultures drawn in the hospital Monday were still negative for infection. Looking back, it was looking more and more likely that we’d had two contaminants in a row. So Dr. Jackson said the words that we love him for saying so often: “I think you can do this at home. Would you like to go home?”

He helped sort out a few more questions and then set the wheels in motion for us to go home. Because they’d started Patrick on an extremely high dose of antibiotic, we had to stay till 4 to have them check his blood one more time to make sure that he’d been able to get it back out of his system. Brian got off work and up to the hospital by 5:30 p.m. and we made it home shortly after that.

Patrick will be on antibiotics for the next 2 days at least and then they’ll check cultures again to make sure that he doesn’t have a real infection. And then hopefully things can go back to our at-home normal again for a while.

Whatever happens, we’re resolved to made better use of this time at home. Procrastination isn’t really an option when you can’t tell where you’ll be hour to hour. I would hate to get the transplant call and leave my house in the condition it’s in right now.

And – I’ll be getting that blog entry about the concert up hopefully before the end of the day tomorrow.

Oh – the best news of all? With us healthy and at home, Patrick slept a blissful 11 hours last night! Which meant mom and dad got some sleep for once, too.

Mother’s Day

Patrick is feeling much, much better now. The infection has been well treated with the medicines he’s getting. He’s stable, happy, and playing. Doesn’t need monitors. Doesn’t need much attention at all, except giving his medications on time. There’s only one thing keeping us here. . .

Because this is the 2nd time in a very short time that Patrick’s had a yeast infection, they wanted to make good and sure that the bug is dead before they put a new line back in. Right now, Patrick has a good “deep line” in his leg. This means that it is in deep enough that they can draw labwork out of it and give better nutrition through it. However, it doesn’t go all the way to his heart, which means that it’s not as likely to get infected – but it’s also not really the safest for taking him home with. He’ll get a new central line on Tuesday and go home as soon as possible afterwards.

So, we spent Mother’s day in the hospital. It was a good day, though very quiet. We got to visit with both Brian’s mother and mine today. Patrick got to get all dressed up and go to church. (Best dressed patient in the hospital today, I’d bet.)

Being here has been a good opportunity for me to reflect on how grateful I am for the many different types of mothers who play a part in our lives. Mothering Patrick is not the kind of job I could do all by myself.

I’m grateful for a mother and mother-in-law who’ve been willing to step up and step in to learn how to provide Patrick’s medical care so that Brian and I can get the occasional night out or so that when I’m exhausted and at my wits end I have somewhere to turn. You may not know what a rare priviledge that is that you have given to us.

We are grateful for our mothers. You prepared us to be Patrick’s parents and you help us each day to do it. I don’t think it’s possible to count the number of prayers, meals, phone calls, visits, crazy projects, and more that you have offered for our little family.

I’m grateful for sisters and a sister-in-law who are also there to help lighten my load when I need it, to fill the fun aunt roles. They are helping to raise some spectacular children, Patrick’s cousins, and him as well.

I’m grateful this week for nurses and CNA’s who have taught me how to do this job, who’ve sat rocking Patrick in the dark so I can catch a few hours’ sleep, who listen when I need to cry or share in small, although sometimes icky, triumphs and who make my day every time we see them because of how much they love my child.

I’m grateful for Patrick’s birthmother. I have no doubt that she loves and is proud of Patrick. I am impressed by her strength. I’m grateful to his birth grandmothers who trusted in their children and loved Patrick. It’s not easy to support a son or daughter considering adoption when you know it means a grandchild will be far away. We are grateful for the love and trust and support they’ve shown in us. We also owe thanks to Patrick’s aunts who helped offer comfort when needed and still are lovingly watching over him. What a blessing it is that he was born into a family who loved him so much.

This mother’s day, thank you to all of you mothers who are there for us. You come in all shapes and sizes.. friends, neighbors, family, and more. I couldn’t do this without you.

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.