Thursday, September 24, 2015

HOME!

Maybe there's a confluence of beautiful things happening with the Pope coming to town? Or maybe there's something magical about 72 days?

It'll be a busy evening getting settled and unpacked and caught up with the home medication schedule (a hefty set of stuff)...

...but James is home!

We scooted out just as barriers and police officers were starting to fill the streets, and had an easy commute headed away from the Pope visit. James did great - climbed the courtyard steps on his own and walked around his room pulling out favorite toys. He has been a little powerhouse, constantly in motion, rediscovering his favorite places and things and getting into snacks that he can't have for a long time still. His room was all ready for him after this long 10 weeks and 2 days away!

More to come but for now, we are kicking back with our kiddos and enjoying being home together, at last :)




Monday, September 21, 2015

Tube Freeeeee!

The good news:
The second tube came out yesterday!

............

The not-so-good news:
It was taken out mainly because it was starting to come loose anyways (they only last so long). Docs still weren't quite sure he was ready, and today has shown that he probably wasn't. His Xray shows that the fluid effusions are starting to collect inside again.

The effusions are still relatively minor, so he's on increased diuretics in hopes they will dry him out and he can pee it all off, and we can stop the leaking again without needing a new chest tube inserted.

No promises.

But, walking around with an unencumbered and tube-free James for the first time in 10 weeks was a pretty awesome time! We did some artwork, and played some music in the playroom, and took his wagon outside. He saw a black car and made a beeline for the car door... alas, not our car, and not his time to go home.






Saturday, September 19, 2015

ready set go!

And one tube is out!

(stop sign)
Right tube is staying in another day.

Hopefully tomorrow we'll speed up again and chest tube #2 will come out.

I wonder what James will be thinking when he finally tries to walk again with no tubes dragging behind him?

Thursday, September 17, 2015

For the First Time in Forever

We brought James to the hospital on Tuesday, July 14th.

It was less than a week before we knew we'd be here longer than expected, and just under two weeks before we knew we'd be here indefinitely. It was just under a month before the idea of going home for recovery was completely obliterated from our thoughts, and just over a month before hospital folks were able to be comfortable treating James like a whole person and child instead of an urgent care case (it is the ICU, after all). Finally, it was just over two months, what seemed like the first time in forever, before doctors uttered our favorite four-letter word: home.

Tuesday, September 15th, after noticing James' pleural output (for reasons still unclear) had dwindled to almost nothing, the ICU team finally uttered a mention of sending James home.

Today, Thursday, September 17th, a plan is in place to bring James home within a week.

As always, no promises, but to have a plan to bring James home at all is amazing. Especially since as of last weekend - all the way up to a mere 5 days ago! - the plan was another surgery, a heart surgery which was to have been fairly massive and risky and entail permanent repercussions and would have required transfer to another hospital because even NYP/Cornell didn't feel up to the task...!

Then all of a sudden, James' body decided it was ready to heal. His fluid output has remained low for about 4 days, indicating his chylothorax is drying up, so tomorrow the team has plans to remove one of his two chest tubes. If his output stays low for another day and his chest x-ray looks clear, they'll take the other tube out Saturday. If things still remain clear Sunday, he'll come home Monday or Tuesday.

That's a lot of ifs to send this boy home, but mommy, doctors, nurses, and I are all confident James will be home soon.

Keep your fingers crossed, and send your prayers, happy thoughts, and homeward bound wishes.




Sunday, September 13, 2015

Kiddos growing up

We've been in the ICU for 2 months, and that's a serious amount of time in the life of a little one!

Elise has grown from 6 months old to 8 months old. She started solid food and formula. She learned to crawl, sit up, stand, and cruise. She began babbling and dancing and playing peek-a-boo. She fits in the toddler stroller now, loves music, and loves the swings. She hates being confined so we have to coax her to stay in the baby rocker and playpen long enough to let us do chores. She picks up snacks with her fingers to feed herself, and will be walking within days... she's almost there. She's grown in height and even more around the middle, and she's got the cutest chunky legs.

James has also grown, in his own ways. His feet are gigantic; he just started wearing new shoes this summer and he'll need new ones again this fall. His t-shirts are still tight, even though his swelling has pretty much gone down by now: he's simply bigger. Two months is plenty of time for him to continue growing into his preschooler body, with IV nutrition pushing him along.

I hope he's home before he grows out of his entire wardrobe...!




Tuesday, September 8, 2015

Favorite Sayings

My dad, rest his merry soul, is an unknown legend in the modern world. In the 20th Century, a fan of classics, he re-appropriated and resolved centuries-old debates, he reminded us of the importance of selective geography, and he even invented Latin words and phrases. And he did all of these things through simple, everyday sayings and re-minted coined phrases.

He would often spout these nonsensical Latinate sayings and other quotidien quotes in response to the outlandish and childishly (and naturally) silly requests and behavior from his eight children and loving wife (and occasionally members of the general populous).

Though he would never tell us what these words meant, and I never learned latin (or greek) well enough to figure them out at the time, it was clear he expected we would learn from his eternal wisdom and expertise, glean something of the nature of the universe that had yet to be revealed, or maybe just take a moment to reflect on how our demands and actions must seem to the rest of the world.

Today, as James continues to recover from another of his myriad procedures, docs line him up for another, and family and friends continue to shower us with support and happy thoughts, I am reminded of three of my dad's favorite sayings:

1. Honesty is the best policy. Clearly, adults need to remember this saying more than children, though we hope our kids learn this adage early so they are less likely to become the kind of adults that need to remember the importance of true honesty. Kids are more prone to trivial lies, the kind that make us smile and laugh and say "awww, that's so cute," but adults can take that same trivial lie and turn it into something much more complicated.

In the last few weeks, all of our doctors told us cute little white lies about some not-so-common things: chylothorax is common; octreotide and/or TPN and a low fat diet commonly have a positive, sometimes curative, impact; thoracic duct ligation is a common step when TPN doesn't work. The trivial part: yes, these things are common. The complicated part, that none of our doctors wanted to say, but all were yelling implicitly: James and his progress so far is not common. That our doctors wouldn't come out and say this caused much confusion, because they were all trying to say things that sounded better, instead of simply telling the honest truth: James is the first patient anyone at NYP has seen after a Fontan to go this long with chylothorax.

Is honesty actually the best policy? Which would you prefer if it was you or your child?


2. Going to Buffalo for pencils. I can see how someone not from upstate NY might not get this, except that everyone knows the unfortunate Buffalo Bills, and I bet no one would want to go to Buffalo, a grey, steel-belt town on the Canadian border, just to get something you can pick up at any five and dime (aka, corner store). To keep this one simple, going to Buffalo for pencils is the opposite of keeping it simple. It is the accidental (or accidentally intentional) process of making something simple insanely complicated.

James has, by all medical reckoning, an insanely simple, albeit amazingly annoying, medical condition. Chylothorax pleural effusions are not complicated: high pressure causes a vessel to pop, and it leaks. The trick is, of course, how to stop an oil (aka, fat) leak. But even that isn't that complicated, it's just very difficult to stop (think Deepwater Horizon oil spill).

Our medical team does amazing things, and is capable of doing even more amazing things than I hope we ever get to see. I am extremely happy and grateful for what they have been able to do to keep James smiling still to this day, as well as their willingness to include mommy, James, Elise, and me in their decisions and decision-making process.

But for some reason, many of us involved in this epoch of James' life have decided that going to Buffalo for pencils is just the right plan.

Maybe the extra time for reflection and meditation while on the extended journey for something simple is just the right thing. Maybe not.

You decide.


3. Fortis stomis screatus scrat. This one's my favorite, but also the most strange of the bunch. Dad would say this supafast, “fortistomiscreatuscrat,” and for years and years I had absolutely no idea what it meant. Then I learned some Latin: 

Fortis (adj.): strength
Stomis (n.): voice/music/flute (also, Greek: stomach)
Screatus (n.): to clear the throat; throat-clearer
Scrat (?.): This one doesn’t have a Latin equivalent, though there are many words this could come from or be a part of, and it seems to be of Greek origin used in Latin. For example, -(-)crat(-), a common suffix to many words, usually in the form of “cratus” or “crate” or “cratis.”

The ones that seems to fit best with the other terms are:
Consecratus (v.): to consecrate, to curse, to vow.
Sacratus (adj.): hallowed, holy, sacred   (also, Greek as a suffix: to govern, to rule, authority, power, etc.)

So, in other words, for all things holy and true and honorable, clear the throat, use your voice, and say whatchoo gotta say loud and clear and with force, cuz otherwise no one will listen.


That was a lot to read, wasn't it? This might be one of my longer posts in a while, if not ever on this blog. I do have a purpose here, I promise.

I'm going to be honest, because I was told this is the best policy...

To all of you reading and following, we appreciate your care and concern, and we thank you deeply for all of the support you've been providing. For those of you who have been able to take time out of your days and lives to come visit with us, having someone with James all the time, to keep him company and help keep his spirits up, is crucial, so we thank you immensely.

However, when it comes to making medical decisions and determining his future care, while we appreciate the input from family, friends, and doctors, we can and will handle it on our own. We have been anticipating this, in as far as what is happening can be anticipated, for almost 4 years. We've done our homework, we continue to ask questions and do research where new situations arise, and we are constantly evaluating old information, even as it becomes less meaningful and helpful. 

It is kind to offer an idea or contact, but please stop there: we will follow up as we feel appropriate and necessary. Please do not try to make decisions for us, insert yourselves into our decisions, or ask to become a part of the medical and logistical decision-making process. And please do not ask about things beyond what we have shared.

James, and all of our family, needs your presence, your love, your caring, your support. Anything beyond that is... going to Buffalo for pencils.

Fortistomiscreatuscrat.

Monday, September 7, 2015

James having fun

Our boy has had some cranky days lately, but he's starting to show his smiles again. He has one particular iPad app that he LOVES and that makes him laugh. Several times this week, he's been playing this app while his doctors have gathered around him for morning rounds (which he normally hates) and he has astonished them all by breaking out in giggles.

The playroom in the pediatric ward has a fancy kitchen with lots of accessories, and our little guy has been enjoying cooking and grocery shopping. He will eat anything... as long as it's plastic and only pretend...

The duct ligation hasn't made much impact, so here we are with another week's update devoid of medical news. James is on track to be the longest Fontan-chylothorax patient they've had here (depending on who you ask).

His preschool started last week, but he obviously didn't attend. Instead, he should be starting the pediatric 6th floor preschool here in the hospital. Tomorrow is the first day :)


Tuesday, September 1, 2015

another OR trip checked off

It's been a bit of a whirlwind lately so we have some catch up to do on the blog. But for now, just the highlights: James had a thoracic duct ligation (surgery) this morning. It was performed by his heart surgeon, but this is not heart surgery, and was much lower risk than his past surgeries. They went in through his right side, so he has a new scar to add to the mix... our swashbuckling superhero.

He is back in his room now, on morphine, and doing fine. It'll take a few days at least, if not longer, to see if this is helping reduce his fluid flow or not. His chest tubes are still in, and the hope is that in the next couple of weeks he can heal on his own - the duct ligation ideally acting as a shortcut to help the fluid stop a little faster.

No walking or trips to the playroom until this new scar heals a bit :( but a few days should see him back on his feet!