Friday, August 13, 2021

One Year Anniversary and One Heck of a Ride

 July 28 marked one year since Lily's final connection surgery for her esophagus. Happy 1 year anniversary Lil! Wow. This July also marked a time when Lily was home longer than she was in the hospital. 9 months if you count the stent placement in February. It's amazing how much progress she has made this past year. When she came home at 8 months old, she could barely hold her head up. Now she is almost walking! There are certainly a lot of things to celebrate and give thanks for, but I can't help also feeling defeated sometimes. Lily eats very little by mouth right now. For a while, she was eating puree 2 to 3 times a day and wasn't throwing up or spitting up very often. Now, she throws up at least once a day and has very little interest in eating. She won't eat if it's something I have to feed her, like the purees. She will eat a few nibbles of something she can feed herself. 

Some days it feels like we are making zero progress (with eating). Some days feel like this is a horribly long journey that has no end in sight. Sometimes it almost feels like the NICU days were easier. I know that seems crazy, but the goal and the one thing we longed for most was the day we got to bring her home. So up until that day, we had something we were working towards and getting closer and closer to. Now that she's home, it's not like everything is magically fixed. I can't help but feel sorry for myself because our lives are not what they would be if we had 3 healthy children. I know that sounds horrible, but I just want to try to explain some of what I'm struggling with and working through. Lily's feeding tube dependence and frequent throwing up really limits what we can do. We occasionally get a babysitter, but I worry about what could happen with Lily if I'm not home. I often worry that Rose is missing out on normal childhood fun because I can't take her a lot of places. I know that is nonsense. I'm thankful that she is young because all it takes is going outside to play with bubbles, and she is the happiest girl in the world. I realize that I am putting a lot on myself. I am trying to be a perfect mom, creating a perfect childhood for my kids. I know if a friend or even a stranger were telling me this about themselves, it would be easy to say, "That's crazy! You can't be perfect! You're doing an amazing job! Your life is hard, but your kids are happy!" Lol. It's never easy to see that though when it's you. 

So it's a DAILY struggle to deny self-pity and to embrace what the day brings. I have been relying so much on my own will and determination and that has gotten me nowhere. When I try my hardest, I end up angry, yelling, screaming, basically becoming someone I do not want to be. God has been reminding me over and over the past several months that I need to just give it all to Him and rely on Him. He's been showing me how much I NEED Him. I need His grace daily. Like every second of the day actually. It can be hard though to know how to do that. Like, what does it look like to surrender it to God? Oswald Chambers wrote, "To be certain of God means that we are uncertain in all our ways, not knowing what tomorrow may bring. This is generally expressed with a sigh of sadness, but it should be an expression of breathless expectation. We are uncertain of the next step, but we are certain of God." When I stop striving and just embrace I realize how absolutely wonderful my life is. Our lives may not look like the life we would have without a medically complex kiddo, but that's ok. It's still a great life. Sorry I'm going on and on, but it really does help me to write about it. That's why I'm also including another post after this called, One Heck of a Ride. I wrote this next one over the course of a few months, January 2021 to March. I didn't know if I wanted to post if for a long time, but decided why not.


One Heck of a Ride

This isn't an update really, but my attempt to process some of the things that have happened this past year. I won't be offended if you don't care to read it. It does help me to write about it though, so if you do read this feel free to comment or reflect. Sometimes it's eye opening to see someone else's perspective of what you're going through/went through.

Speaking of eye opening, as a healthcare worker it has been crazy to be on the receiving end of healthcare so much. It's a really weird feeling. It's like you know what goes on behind the scenes and you're part of this play or act,  but suddenly playing a very different role- a role in which you feel very powerless. Mostly, it has been inspiring or motivating for me to be a better nurse. I'm happy to say that's because most of the care we received was so stellar. There were some bad things too, but for the most part our care team was incredible. There are some nurses, doctors, and other caregivers I will never forget because of how they cared. It's not just about the skill, although that is important too. It's about how you speak to a grieving parent, or deliver some bad news, or how you stop to listen and let someone think. I'll never forget Lily's cardiologist in Grand Rapids. Her name is Heather. She is the one who viewed the fetal echocardiograms and diagnosed Lily with the VSD and possible aortic arch concerns before she was even born. I remember I could tell something was wrong as she viewed the images. With Cora's images, she just kept saying "beautiful" as the ultrasound tech went through the pictures she got. When they got to Lily's pictures, she just said "ok" and asked for more pictures. She kept her voice calm and quiet the whole time. When it was time to tell me what she saw, she sat down next to me and calmly and slowly explained what was wrong with Lily's heart. She drew pictures. She sat in silence as I bawled my eyes out. She encouraged me to email her with questions as they came up because she knew that I would think of questions later as I digested the news. I did message her, and she responded the same day.

Lily's cardiac surgeon was another life saver. Literally. It just blows my mind when I think about human hands operating on such a tiny vital organ like a premature baby's heart. Like, how do you do that for the first time? His name is Marcus. He had this calm demeanor everytime we talked to him. It probably helped too that he had a British accent, ha! He was confident, but definitely not cocky. He had numbers and research to back up his reasoning for doing or not doing something. That was reassuring. He also was very personal. He never felt rushed. There's no worse feeling than feeling like someone doesn't have time for you when it's so important to you (and your baby). 

I know I've talked about Lily's primary nurses before, but I just have to say a few things about them as well. The first few days and weeks in the NICU were so chaotic. Having consistent nurses that knew Lily was such a reassurance to me. I should mention Cora too since she spent 3 weeks there. Cora had Beth and she took great care of Joe and I as well as Cora. I feel so blessed that Lily had Betsy and Emily a lot early on. It was the best decision to ask them to be primary nurses for Lily. A NICU doctor told me much later on that we had a very good team of primary nurses.

A lot of people tell us that we handled (are handling) everything so well. They say things like, "You are so strong" and "Your faith is amazing" and things like that. I always felt a little weird receiving those compliments and didn't know how to respond. I did feel pretty calm and in control most of the time, but I also felt like I wasn't processing anything and that surely it would all catch up with me at some point and I would completely fall apart. I was in survival mode. We did what we had to because what else was there to do? There were a few times when the gravity of the situation would sink in, and I would send up desperate hail mary's. Right before her first heart surgery I remember just praying, "Please.." During her several hours long second heart surgery I had to fight back the panic. During her failed extubation in Boston I thought I might fall apart as I watched the attending ICU doctor step in and start bagging Lily while the team prepared to reintubate. I remember I watched silently, helplessly as tears and snot were pooling under my mask.

Those were some dark moments, but most of the time I felt like I was just taking everything in and putting it somewhere to deal with later (emotionally at least). On good days, I knew that our calmness and resilience was not of our own strength, but from God. I've witnessed in others and also experienced myself that He gives us the grace that we need for our unique situations. I'm often reminded of a Beth Moore lesson I heard several years ago about the Israelites going out to gather manna each day in the dessert. Just enough for their daily needs. And every new day they would go gather fresh manna for that day. God provides us individually with what we need. Sometimes I felt very distant from God when I realized that I had spent very little time pursuing Him either in the Word or in prayer. Most of my time with Him was spent listening to worship music on my way to and from the NICU each day (about 25min each way). There were a few songs that really sustained me. I Choose to Worship by Rend Collective, The Secret Place by Phil Wickham, and I Breathe You In, God by Bryan and Katie Torwalt. There's something very powerful about saying, I choose to worship you, God, even when I don't feel like it or when I have doubts. Even when I don't understand, I will choose you, God.

It's also really strange to look back at the beginning and see how much changed in the world. The girls were born Jan 20, 2020. Almost 2 months before the lock down and before covid was even on our radar. Our parents, some of our siblings, sister in laws, and Rose were all able to visit Lily in the NICU. No one was wearing a mask. The nurses had so much fun playing with Rose and letting her play with the Big Sibs toys in the NICU. Then one day in March I got a call from the hospital informing me that no one would be allowed to visit Lily except for me and Joe, and only one at a time. Not even Rose and Cora. Thankfully, the next day they changed the policy so that twins were allowed. I was able to bring Cora at least. Our experience with covid was different than so many others' because we did not/could not quarantine at home. I still went to the hospital most days and thankfully, Joe was still working at the airport. I couldn't help but feel some resentment when people would complain about being at home and being bored. I would have done anything to be stuck at home with my family (all together and healthy). In some ways, what was happening within our family, with Lily, was so monumental that even the world coming to a halt didn't seem to register or worry me. It did affect us of course (the limiting of visitors and not seeing friends and family), but in some ways our lives would have looked the same covid or no covid. Work, kids and NICU. 

I'm overwhelmed when I think back on all the love and support we received from our families, friends, coworkers and even strangers. We received a tremendous amount of financial support, sometimes anonymously. We received many home cooked meals and treats, which I appreciated a lot. Cooking at the end of the day was always the last thing I wanted to do. There were a couple women from our church who came to watch Rose and sometimes Cora while I went to the NICU or ran errands. Friends sent encouraging letters and texts, and I have no idea the colossal amount of prayer we received. All I know is that it meant the world to me. At a time when it was difficult for me to pray, I welcomed all the intercession on our behalf that we could get. Thank you dearly, to all who supported us in any way, big or small. 

Our journey is far from over. As I write this last part, Lily and I are still at Boston Children's following her stent placement for a stricture (not now, this was in March). I'm hopeful that the biggest hurdles are past us and that the road will be smoother for her going forward. We appreciate your continued prayers.



Sunday, June 13, 2021

Things are Good

 I can't believe it's been 2 months already since our last update! Lily and I went to Boston this past Thursday/Friday for another EGD. Her esophagus was at 10mm, and the doctor said it looked really good so he didn't even dilate this time. Yay! Her esophagitis, or irritation from reflux, is much improved as well. She still has a small hiatal hernia, but it's not something we have to worry about right now. If it gets bigger or we feel it's contributing to severe reflux in the future, she may need a procedure to fix it (Nissen). We are going to have a virtual visit in 3 months to see how she's doing and go from there. So no current plans to go back to Boston.

Lily is doing great with her glasses and the eye doctor said that they are helping with her focusing issues. She's been doing well with physical therapy as well. She's starting to cruise a little bit. Now we're working on supported walking and climbing stairs. Her oral intake is about the same, but her feeding therapist did give her the ok to start trying dissolvable foods, like rice puffs or crackers. So far she hasn't wanted to eat them very much, but it's progress! She's still not drinking hardly anything, so we are trying a few different things to get her to drink from a cup or with a straw. She still gets all her necessary nutrition through her feeding tube. We've had some ups and downs with her reflux. Her local GI doctor wanted to switch her to a toddler formula, so we got that all set up with the supply company and insurance. Unfortunately, she did NOT tolerate it. I think it was way too thick and she could not digest it fast enough because she would throw up a few times a day. So we switched her back to her infant formula while waiting for a different toddler formula to get processed with insurance/supply company (MAJOR pain in the butt). It arrived a few days ago and so far so good. We are kind of easing into it this time. 

Rose turned 3 in May! Oh my goodness, where does the time go? She got a surprise visit from Uncle Jordan and Aunt Margeaux right after her birthday. We had a blast visiting with them and going to Acadia National Park. Rose got her first bike which she is loving. We are also spending a lot of time in our kiddie pool, on the play structure and at the neighborhood park. She is becoming more social and confident around other kids. She has so much fun at Sunday school and we even sing the songs at home during the week. 

Cora is doing well. The twins are almost 17 months. Cora is sooooo close to walking. She loves to climb on everything and play with her sisters. They both say about 5 words. 

Joe is very busy at work. He stays late every day and even worked a 24 hour shift last weekend :( Hopefully it will slow down later this summer when his first big project is done. I was able to meet a lot of our neighbors at a neighborhood get together last weekend. That was really nice and now I recognize faces when we're out walking or at the park :)

I hope you're all having a great spring and start to summer. 


Cora the climber

Rose loves to help in the garden



Pool!!

We love the summer weather

Cora at the park

New bike!




Sunday, April 18, 2021

EGD Number...?

 Lily had another EGD with dilation this past Thursday. She and I went to Boston again while a couple sitters helped us out with the other girls at home. Her esophagus was back to 10mm in diameter, and the doctor dilated to 15mm again. He said that was good still. He's cautiously optimistic, so we are heading back in 2 months for another EGD and if that looks good, we can start talking about 6 months between checks and then maybe a year. I can't wait for that day! 

Thankfully the drive there and back went very well. Her procedure was at 7:30am this time, and we were home by 3pm. It was great! 

A couple weeks ago, Lily had an eye appointment. She had one about 6 months ago in Grand Rapids and everything looked good then, but the optomitrist suggested she have another follow up in 6 months. So we dutifully went and scheduled an appointment here in Bangor. This time, the doctor said her eyes were overfocusing on close up objects, and he did see her eyes wander a little. So now Lily is joining the glasses club! Hopefully the glasses will correct it and she will outgrow them eventually. 

We've had some beautiful spring days, and Joe put the girls' play structure up last weekend. Rose was over the moon! We've been plugging away at house projects too. We go our guest room ready and cleaned up the attic. Joe cleaned gutters and Rose and I raked up leaves and cleaned up the yard. 

We found a couple more babysitters and we're hoping to get out a little this summer and explore more of Maine.

We also went to in person church for the first time today as a whole family! Rose LOVED Sunday school and can't wait to go back :)

The new glasses :)




"Mom, take my picture and send it to Grandma!"

So Big!!


I love Rose's smile in this picture!

3 girls and their dad, off to the park


Helping Mom clean up the yard


Friday, March 26, 2021

Follow up EGD

 Lily and I went back to Boston just for an overnight stay Wendesday/Thursday this week. The Boston team wanted to see how her esophagus looked after having the stent out for a couple weeks. 

Our babysitter came over Wednesday at noon to watch Rose and Cora until Joe got home from work, and then Lily and I packed up the van and hit the road. Thankfully, she did great on the 3 1/2 hour drive. The weather was good and so was traffic. She got her standard Covid test Wednesday evening, and we got the call for her procedure time.. not until 2:30PM!! Normally she goes at 7:30am. So we hung out at our hotel Thursday morning and finally headed over to the hospital around noon. 

When the doctor came out to talk to me afterwards, it was all good news. Hooray! Her esophagus was at 10mm. Just for reference, it was at 1mm with her stricture last month. He injected some steroids in the tissue that was still healing a little from the incisions  he made a couple weeks ago. The steroids are suppose to help further scarring. Then he dilated her esophagus up to 15mm. That's the widest it's ever been. He recommended coming back in 3 to 4 weeks for another follow up. If things still look good then, we can push check ups even further apart. We drove home afterwards, and made it home just after 9:30PM. 

We are so grateful for good news and a good trip. Now we need to get to work on oral intake.

Rose was rather clingy today (understandably), but otherwise is doing great. We're enjoying time in our play room and playing outside now that it's warming up a bit. Cora is cruising and very close to walking. She loves giving us hugs and saying hi. Joe and I think both Cora and Lily's first word is Hi :)

Joe is very busy at work. His project is going full steam ahead for the next couple months. 

Hangin at the hotel

The cutest patient ever

Fun at the park with a new friend







Troublemakers


Tuesday, March 16, 2021

Finally Home

We made it home on Sunday! Lily did great after the stent removal, but later Friday afternoon, her feeding tube started leaking around her skin. They didn't want to send us home until we fixed the problem. We tried a few different things and then on Saturday morning, put her normal G tube back in (she had a GJ in since the stent was placed) and thankfully that fixed the problem. They kept us Saturday night to make sure there was no more leaking. On Sunday, we packed up, got our discharge instructions, and took an uber to the bus station. We took a bus all the way to Bangor. Joe and the girls picked us up when we arrived at 6:30pm. It was a happy reunion! Thank you for your prayers, and please continue to pray as we try to get back into some routines. It's very tricky keeping Lily hooked up to her feeding tube/bag/accessories now that she's so mobile. Part of the problem is that she's back to more of a continuous feed schedule. Because she didn't have feeds going into her stomach (G tube) for 3 weeks, we have to go slow as we start to feed her that way again. The J tube was in so that her feeds could avoid her stomach and go straight to the jejunum. 

We have an appointment with OT in a couple weeks, and I can't wait to get going with them again. Hopefully we can advance her oral intake and start decreasing the amount she needs through the feeding tube.





Friday, March 12, 2021

Stent Removal

 Lily had her stent removed today! Just as planned (for once), Dr. Manfredi removed her 2nd stent after one week of having it in. He also injected some steroids around the scar tissue to help prevent further scarring. He said he was very pleased with how everything looked though. Yay! He also said he would expect her esophagus to narrow a little again, but nothing like the stricture we had a month ago. So we will come back in 2 weeks for a follow up EGD with possible dilation and go from there. I'm very hopeful that this is the last BIG thing, and that we can start moving forward with her oral intake and decreasing her feeding tube volume. Despite being here for almost a month, Lily hasn't moved backwards at all in any of her skills. I'm so glad she tolerated the stent well because she was able to play and learn and communicate just like normal. She even progressed in some things. She is crawling on her hands and knees now instead of just army crawling, she's playing peek a boo and mimicking a lot, and she even did the sign for more a couple times.

As long as she does ok today and tonight, the plan is to discharge home tomorrow (Saturday). We are so ready!

Thank you all for your loving support and prayers! It's been a crazy 3 weeks.


Rooftop garden of the hospital. You can just see the tall Prudential tower

Such a happy girl through all of this

More music therapy fun. Rose even joined in on a video call :)


It was 67 degrees on Thursday!


Saturday, March 6, 2021

Stent #2

 Yesterday (Friday) Lily went back to the OR. Dr. Manfredi removed the 10mm stent and made a few more very small cuts in the scar tissue. Then he dilated her esophagus to 13mm. Then he placed a 14mm stent- a little bigger than the 12 we had talked about. He said her esophagus tissue looked good. There wasn't any damage from the first stent. So, all good news! He wants to leave this stent in for just one week. Lily and I will stay here for one more week, and hopefully go home next weekend!

She was pretty sleepy yesterday, but overall is her normal happy self. She's such a trooper!




Music therapy :)


Tuesday, March 2, 2021

A Success Story

Last summer, I befriended another couple who was here in Boston for their daughter. She was also born with long gap EA and had the foker surgery. Here's a neat article she shared with me about their story. Lily had the same surgeon.

https://answers.childrenshospital.org/arya-foker-process/

Today the word is Friday for Lily's next EGD.

Monday, March 1, 2021

Waiting Game

 Just a quick update to say I still don't know when Lily's next procedure will be. She's tolerating the stent well overall. She usually is gaggy on and off in the morning, often spitting up some. But by the afternoon, she is over that and back to her normal happy self. Even in the mornings she's usually happy (other than the handful of times she gags.) It's very common for the stent to make kids gag. But she doesn't seem to be in pain. Dr. Manfredi has gone back and forth on the plan. We thought up until about half hour ago (4:30pm Monday afternoon) that the plan was to place the larger stent tomorrow, Tuesday. But a resident just stopped by to say Dr. Manfredi wants to wait a few more days since she is doing so well. I'll have to ask some questions tomorrow, because it seems to me it would be better to get the larger stent in and have more time with that. But I'm not a doctor. There's been talk of her possibly going home with the stent and coming back to get it removed, but that is also up in the air. Just going to take it one day at a time I guess. 

So for now, we play with toys in her room and go for walks in the stroller around the unit. I read and drink coffee when she naps.. and that's our day. (Can you tell I'm getting a little bored?)

I'm starting to get pretty homesick, and I know Rosie is really missing me too. Thankfully, Aunt Margeaux just flew in for a week or two. 

Thanks for the continued support!







Wednesday, February 24, 2021

Successful Stent Placement

Good news! Dr. Manfredi was able to place the stent without any issues yesterday! He said her esophagus was down to 1 or 2mm in diameter. He made some incisions in the scar tissue, dialted her esophagus up to 10mm, and then placed a 10mm stent (all endoscopically). He said that most likely, she will go back to the OR next week to have a 12mm stent placed. He didn't want to push her esophagus too far yesterday. He also changed her G tube to a GJ tube, so she is currently getting slow, continuous feeds to the jejunum. The nurses are giving her tylenol and ibuprofen regularly to stay on top of pain, and also zofran to help prevent nausea. It seems to be working well because she is her normal happy self this morning. She also slept good last night. 

They did a chest xray right after the procedure to verify the stent placement, and then they will check subsequent chest xrays every couple days to make sure it's staying in the right spot. A Physician's Assistant, PA, came to check on her while she was still in the PACU, and he told me that he was really encouraged by what they saw during the scope. He said it was amazing to see the difference in her esophagus from before the incisions to after, even before they dilated. Just the incisions made a big difference. So I am very hopeful that the combination of incisions and stents will get her esophagus to where it needs to be. 

Thank you so much for all your prayers yesterday and continued prayers for the next few weeks. 

Joe is holding down the fort at home. He's been working while our babysitter watches the other two during the day. Today, his mom, Wendy and youngest brother are flying in to stay a few nights. I'm so grateful for their help, and I'm so glad for Rose. She's been missing me and I know this will really cheer her up. 

Love you all!

Before her procedure

Recovering in PACU

Snuggles back in her room