Wednesday, June 8, 2011

Changes Ahead....

Grace has been looking duskier and duskier as of late. I've tried to chalk it up to mommy worry, but now friends and family have been commenting on it. It was time to make the dreaded call to cardiology. Grace was seen last week by Dr. Shah. He agreed her color was a bit off, but he was most concerned about her behavior. Grace has always been a calm kiddo- but at 2 1/2 years old, she should be FAR more active and energetic than she is. Grace is the type of kiddo that's content to watch Dora (I don't think she can ever get enough of Dora!!), color, lay in bed with mama, or cuddle on the couch. Don't get me wrong, there are times where she's running with her brother- strangling him, hitting him, hugging him, chasing him; the calm times are greater than her energy spurts. Most recently, Dr. Shah thought we'd be able to get to age 5 without surgery, but my gut has been telling me differently- and I think my gut is right, sadly. Mark my words, people-it's the one time in life I would love NOT to be right! :)

Grace's O2 sats hovered around 94 (her norm is 99), and while crying dropped down to the low 80's. Not a HUGE concern, but with the other issues, it's enough of a concern. Her EKHO looked decent. There is definitely regurgitation- but without an MRI or more invasive procedure, it's impossible to know what percentage of regurgitation there is. The thought is, she's not as active or as pink as usual because the regurgitation may be at a more severe range than expected. I'm not sure that her pressures have stayed down either, but time will tell. Dr. Shah ordered an MRI with anesthesia. He had hoped to get it done within the month, but with the merger of the two hospitals, scheduling may not have been ideal.

Thankfully, we were able to get in pretty quickly. Grace will have her MRI on June 22nd at 10:30 am. We'll check in at 9, with nothing to eat or drink beyond 4 am. If there is something that can be potentially fixed in the Cath lab, they'll potentially take her there. Unfortunately, it doesn't appear to be a Cath fix.

The day of cardiology, we started talking surgery. I wasn't ready for it, but knowing my gut, I've kind of known all along- my gut tells me we'll be doing CT surgery within the next 6 months. After talking with the cardiac team, my family, and my God, we've decided to have surgery out of state. Dr. Shah supported our decision, and recommended that we make our hospital decision now- versus waiting until an emergent situation. He suggested Baylor, Stanford, Boston and CHOP as options, among others. Financially and emotionally, Stanford makes the most sense. We are originally from the Bay Area, and still have many friends and family that reside in that general outlying area. I'll be scared to be away from home- but comforted by the familiarity during the uncertain time.

To complicate my worries, we saw GI yesterday with mixed results. The GI asked if we had seen cardiology, as they're noticing a change in her color. UGH! Seriously?!? I explained that yes, we had, and gave them cardiology's plan. GI is a bit concerned that it may be time for cardiac surgery as well, as for the first time in over a year, Grace lost weight, despite the extra feeding therapy sessions. The thought is, if there is less positive blood flow (regurgitation), her gut would be the last organ to receive blood support- thus making it difficult for her. She hasn't been vomiting much, but it's increased above her normal range. Maybe it's because of this? Maybe not... Either way, we're bumping up her caloric intake primarily through tube feedings to give her a better buffer for weight loss due to either CT surgery, or admission to an inpatient feeding program (more to follow on that). Also, because of her daily aspirin dosage, the concern is that there is damage being done to her gut, that would only get worse during CT surgery. Grace will now be taking Omeperazole to soothe her gut lining. Not sure we'll see the outward benefits of this, but hopefully we'll avoid any internal gut bleeds post-op.

Prior to all this cardiac craziness, we had been admitted into Phoenix Children's outpatient intensive feeding program (we had been on a waitlist since she was 3 months!!). We were super hopeful about this being the answer to Grace's behavioral issues when eating. It was helpful, but not nearly enough. GI recommended looking into a behavioral inpatient program. Unfortunately, there is no such program in the state of Arizona. We discussed both Milwaukee Children's and John Hopkins (Kennedy Krieger). The cost of airfare is bound to kill us, but we'll make it work, even if I have to max-out credit cards. After communication with both programs, Kennedy Krieger seems to be the better option. Prior to the cardiac appointment, we scheduled an eval appointment for July 14th.

Fast-forward to now- WOW! So, there are a few ways this can go... 1. Grace will have her MRI and need surgery right away & we'll be sent to Stanford. 2. Grace will have her MRI and need surgery, but may be able to wait a few months. 3. Grace will have her MRI and not need surgery for a year. The big question for our family is- do we risk paying tons of money in airfare to get the eval @ Baltimore, only to have to postpone treatment for surgery, or worse, she succeeds treatment, then has surgery, and loses her skill. UGH! What to do, what to do?!? At this point we've decided to wait it out. We should have some cardiac answers at the end of this month, and we'll make the rest of the tough decisions at that point.

Gavin is doing AMAZING!!! He's been taking his budesonide slurry (mixed with 4 splendas)- he drinks 1/2 in the morning, and 1/2 in the evening- and it's been working!! His latest biopsy shows partial remission. He is clear in his upper esophagus and middle esophagus, but his lower esophagus still has numbers in the 60's. Our GI thinks that by adding Omeperazole we'll be able to combat any reflux that's occuring, and achieve full remission. He'll have another biopsy in 2-3 months, and we're hoping it will be our last for some time. Praying for remission!!

On a brighter note, he's eating EVERYTHING! Falafel, Pad-Thai, milk, applesauce, etc. You name it, he eats it. He gained an average of 12 grams a day- we were shooting for a goal of 8! That's my little overachieving man! He's still having his sensory melt-downs, but we're coming up with creative methods to combat the screamies. Our swim lessons with him are GOLD- he's a true fish! He's already swimming underwater and able to grab the wall, and climb out- all by himself!!

I feel bad for Gav during this time of chaos with his sister- I don't want him to feel my stress and tension, nor do I want him to feel less important. It's a trying time- and I'm finding myself unable to sleep at night, but needing a nap by 10am. I'm hopeful that I'm just in a funk and that I'll work my way through it.

We'll soon have TONS of family around- Felix's parents are moving here this week, and his sister her husband and daughter will be here next month. His brother and wife will be here this winter. I'm stoked to have the kid's relatives around and to have more family time! My mom has lived here for a while now, also Mimi (my other mother). My dad and family live in Wisconsin, but we'll be able to visit more often now that we have less places across the US to vacation.

I think that's it for now. I'm long winded... and tired, but grateful for my babies and content to start over again tomorrow.

As Grace now says, "I You Mama" for I love you- that is ALL I need to get by! XOXO

post signature