Thursday, December 22, 2011

Update 47


 
It has been several months since my last update and I have a few things to report, but as is usual for Thaddeus, there are more questions than answers.

First the good news. He seems to be growing well. At his last checkup he was 75 percentile for weight, 50th percentile for height, and 95th percentile for head circumference. He is happy most of the time as long as he is fed and someone is within his line of sight. He loves to jump around and stand for a long time. He doesn't have the balance yet, but he sure has the leg muscles.


Dede took him into the developmental clinic a while back. The tested him to see if his development is on track or not. Unfortunately, he had a cold at the time, so they think some of his data may be off due to his cold. The tests showed that his hearing was not up to par. That may have been due to fluid in his ears from the cold. Of course it is also possible that it is due to the way the test was conducted. They put Thaddeus in a quiet room and then played soft nosies to see if he would respond. Personally I think this test is a bit suspect due to the fact that it assumes the child will care enough to respond to a quiet noise. This may be true for many kids, but I am not sure it holds true for a boy with 4 brothers and a sister, 3 of whom combine to play musical instruments.
He also tested behind on his gross motor skills. His fine motor skills were right on. So in other words, he can reach for a small toy and pick it up, but if he starts to fall, he generally just lets himself fall. He also show no interest in crawling or walking. If he really wants to get somewhere badly enough, he rolls there. He also did not seem to respond to his name more than any other noise. (Maybe that is due to being called Quintin so much . . . .)


He was scheduled to have a circumcision and echo cardiogram done a few weeks ago. Unfortunately no one told us that we had to stop his daily aspirin dose before this. In fact the nurse that called Dede to discuss things pre surgery, didn't even realize Thaddeus was on aspirin until Dede mentioned it to her. As a result they had to cancel the circumcision. This means the echo is canceled as well. Since they have to sedate him for both procedures, they want to do both on the same day and not sedate him twice. Since they canceled it (back on the 7th) we have not been able to get anyone to schedule a new date. The issue comes in that we are trying to coordinate several different people and their schedules. We need the surgeon, the cardiologist, and he anesthesiologist. They all have different schedulers and we can't seem to get any of them to talk to each other. Lately it feels like we can't get them to even call us back. So, we don't have any idea when that will be rescheduled. Dede is also getting the run around from the developmental clinic, so we don't know when, if ever, we will take him back in for follow up tests now that his cold is gone.

SO the long and the short of it is that as far as we can see, he looks great! If you think he looks good in the picture, you should see him bouncing around in live action. He has a smile for everyone and laughs at most anything. He even cheered for himself a few days ago when after much effort he managed to get a toy that had seemed just out of reach. However, as far as the heart's workings and his developmental progress, we still really don't know.   
 

Update 46

GO BADGERS!

TWO TEETH!

Hey everyone! Thaddeus is doing quite well. He is still gaining weight right on track. He is rolling over some, and loves to jump around (go Badgers!) in his jumper. He even has two teeth in! He is having some issues with the digestive tract, but nothing he can't work out with some effort. He has started to get his immunizations and is set for another check up in November. That's about all for now!
In closing  I'd like to apologize to Thaddeus's godmother, who attends the University of Minnesota, for sending out a picture of her godson in Badger apparel, but since I am not really sorry, I can't! GO BADGERS!

Update 45

Greetings everyone! It has been a while since I have written but I wanted to let you know that no news is good news! Thaddeus had a check up with the cardiologist last week and one with the birth to three program today. Both are very impressed with how well he is doing. To be honest, they are also impressed with how cute he is! The cardiologist said he doesn't need to see us again until November. The oxygen is gone, the pulse ox (machine that measures the oxygen in his blood) is gone, the scale is gone, the diuretic is gone, the antibiotic is gone, the feeding him on his side is gone, the not lifting him under the arms is gone. In fact other than a scar the only things left from the surgery are 1/2 of a baby aspirin each day and three doses of a blood pressure medicine each day.  One of the major blessings that we have that both groups were happy to see is Thaddeus' size. He weighs in at just about the 50th percentile. To put that in perspective, the other five children who don't have cardiac disease all came in about the 50th percentile as babies. So despite the fact that many of these babies have trouble eating, Thaddeus is completely average weight. We even started him on cereal this weekend.

The birth to three folks thought he was making excellent progress. They were happy to be able to come and see a child who was doing so well. One lady even wanted to come back and visit him just because he was such a good cuddlier. They did find a small degree of developmental delay in the areas of rolling over and sitting up on his own, but that is completely expected and normal considering what he has been through. They didn't think it was any cause for concern. We will be making periodic trips to Milwaukee to have Thaddeus evaluated in the developmental clinic at Children's. They will keep an eye on his developmental progress and make sure he stays on track. They try to schedule those appointments on the same day as the cardiologist. It makes for a long day, but it saves us a trip.

So for now we just keep close watch on him and let him do his thing. Somewhere withing the next four years we will take him back in for the third surgery, but for now he is doing remarkably well! God is good!

Hanging out in Jeremiah's Chair.

Swinging in the yard.

At the pool.

He loves that thumb almost as much as me!

He loves to jump.

I just think this picture is funny.

Update 44

 I was just letting everyone know that Thaddeus is doing well. He did great at camping and seems to have suffered no ill effects from the infection. Dede is heading down to Milwaukee today to get the official word, but he looks great.

Update 43

Thaddeus and I headed down to Milwaukee today so that he could get his incision checked out. They managed to squeeze us in today after we called yesterday, but I had to wait 20 minuets for the Surgical PA to come and take a look at Thaddeus. When he saw the bump on Thaddeus and realized that it was fluid filled, he left and went to find our cardiologist. So Thaddeus and I waited some more. I had forgotten my book, but fortunately for me, Thaddeus wanted to play and was all smiles. When the cardiologist saw Thaddeus, he decided that he should talk to the surgical PA and see what he wanted to do. However, the surgical PA was waiting to talk to the surgeon who did Thaddeus' operations. So, Thaddeus and I waited some more. He grabbed at the frog toy I dangled for him and I smiled at him smiling at me. Eventually, the surgical PA came back. He had talked to the surgeon and the cardiologist. They all agreed that the bump needed to be drained of the fluid, but otherwise we should just continue with the antibiotic the pediatrician gave us, keep and eye on it and check back in in a week to ten days. They are not overly concerned since his numbers were not elevated much and he otherwise seems healthy and happy. So, the surgical PA went to go get supplies while Thaddeus and I waited some more. He ate some and burped some. During all of this waiting, Thaddeus was smiley and couldn't have been happier. The second the PA started to sterilize the bump, Thaddeus let him have it. The boy isn't even 5 months old, but he knew something was coming. We gave him some sugar water on his nook to get the endorphins going and the PA cut into the bump and let the blood drain out. It did not seem to be filled with puss so that is good. Thaddeus registered his displeasure over the whole thing, but he kept breathing for the most part. (He tends to hold his breath when he gets really mad. He turns colors that are not at all reassuring.) After some gauze and tape we were good to go. Fortunately, Thaddeus fell asleep and stayed asleep the entire ride home. He has been a bit grumpy since we have gotten home, but that is understandable. So all in all, the doctors are not overly worried and the infection seems quite minor. We are supposed to keep an eye on him, like they needed to tell us that, right? Not exactly the birthday I had planned for my wife, but she said she would take Thaddeus being OK as her special event today.

Good night and God bless.  

Update 42

We are headed for an unexpected trip to Milwaukee tomorrow. Earlier this week we noticed a bump on Thaddeus' incision spot. It is in the same spot his infection was before. I placed a call to Children's and they told us to keep an eye on it since Thaddeus didn't have a fever, didn't seem extra irritable, and the spot didn't have that red around it that an infection gets. Well, since it didn't get better, we took him into the Pediatrician in Fond du Lac today. She didn't like the look of it and wanted the surgery team to look at it. She also had some blood drawn to check his white blood cell count and his CRP level. (Same stuff they checked last time.) Since his CRP was high, she gave him more anti-biotics. However his white count was not elevated at all, so either we caught it early or he is fighting it well or both. I will take him down to Milwaukee so Tim the surgical PA can take a look at him. (Same guy who looked at him and drained the spot last time.) They will decided what they want to do with it. Last time they drained the fluid and tested it to see what kind of infection it is. Right now the anti-biotic is a 10 day one and is oral, so there is no reason we couldn't keep him out of the hospital, unless they want to put him back on the super duper burn your veins out anti-biotic. We shall see. We are not sure what this means for our camping next week, but since we won't be much farther away from Children's then we are here, I don't think it will necessitate canceling the trip.  

Update 41

We are home.

We just got home a little while ago.  Thaddeus is still on his blood pressure med, aspirin, and they have temporarily put him on a diuretic to try and clear out his lungs. He is not on oxygen all the time, but we still have it and are to use it as needed.  Thanks for all of the prayers. I am going to go enjoy being home after 16 days away!  

Update 40

Well it looks like there is no CT scan in our immediate future. Thaddeus' numbers from Friday to Saturday were pretty static, but his numbers from Saturday to Sunday took a very positive turn. He also has not had a fever for several days. In addition he has been in a pretty good mood for the past several days. The plan for now is to keep an eye on him. They will give him the rest of his antibiotics up through today. The last dose is this evening. After the last dose is given, they will keep an eye on him. If he is still infected he should spike a fever in 12-24 hours. If that is the case, then we are looking at a few weeks of antibiotics and possibly a surgical exploration. If he doesn't spike a fever, we are  . . . wait for it . . .looking at going home. So, good news today, but nothing definite. 
Well it looks like there is no CT scan in our immediate future. Thaddeus' numbers from Friday to Saturday were pretty static, but his numbers from Saturday to Sunday took a very positive turn. He also has not had a fever for several days. In addition he has been in a pretty good mood for the past several days. The plan for now is to keep an eye on him. They will give him the rest of his antibiotics up through today. The last dose is this evening. After the last dose is given, they will keep an eye on him. If he is still infected he should spike a fever in 12-24 hours. If that is the case, then we are looking at a few weeks of antibiotics and possibly a surgical exploration. If he doesn't spike a fever, we are  . . . wait for it . . .looking at going home. So, good news today, but nothing definite. 

Update 39

Well, here we sit and not much has changed. Unfortunately, this time we want more to change. It seems as if he may, or may not be getting this fever under control, but his white blood cell count is still high as are his other numbers that indicate a problem. They are starting to look for the possibility of another infection, or possibly the infection fooled them and is deeper than they thought. They will retest his numbers tomorrow and if they aren't better, they are planning on giving him a CT scan to look for signs of infection. We were also supposed to have an ear, nose, and throat attending check for an ear infection. We got one of his "underlings" as I like to call them, but she couldn't tell for sure. She didn't think there was an ear infection,but was going to talk to the attending. We didn't hear anything back, so maybe tomorrow. Anyhow, it seems that tomorrow will be a big step towards seeing if we will be able to go home on Monday or not.
As for the new room, we are settled in and doing fine. It isn't as nice as the room we had in CICU but it could be much worse.
As for me, I am really getting emotionally drained and am so sick of the cords and tubes and wires oh my! Cords, tubes and wires oh my!
In this area, they don't come in to check on Thaddeus quite as often, but between meds, and vitals, it can be hard for him to get a good long stretch of sleep. They also don't tend to come running as quickly if he cries or if an alarm goes off. I am even getting to the point where the alarms barley phase me.
A nurse commented that I had been here too long. As I thought about that some thoughts came to mind.

Signs you've been at Children's Hospital too long.

8. You can find your way around this gigantic place without help.
7. Youv'e had discussions about books with the cleaning staff.
6. The volunteers recognize you.
5. The security guards don't even bother to ask what patient you are with anymore.
4. The doctors don't bother to explain medical jargon anymore.
3. You no longer have qualms interrupting and correcting the doctors on rounds.
2. The doctors ask you as many questions about the patient as you ask them.
1. Alarm bells ringing wildly no longer get your attention.

Update 38

Not too much new here. My cell phone minutes are lower, I am on the 4th of the 4 books I brought, (good thing my Dad just got me another one) and Thaddeus is still the cutest baby in the joint. The only real difference is that we have been moved out of CICU. We are now in the East tower on the 8th floor. This is acute care instead of intensive care. Basically, Thaddeus isn't sick enough to take up a bed in ICU but he isn't done with his course of antibiotics so he can't come home yet either. I don't know if he figured out something because he has been clingier and looks worried more today than yesterday. Of course since he was smiling most of yesterday, it wouldn't be hard to look more out of sorts. Other than that, his numbers are the same, he is still on a small amount of oxygen (praying we can be off of that when he goes home), he is still on antibiotics, I still don't know what infection he has, and he still has a bit of a fever. Oh yea, he is still eating like a champ. So enjoy the picture and that's all I've got!

Update 37

I have been waiting to write until I have more information. However, I know how antsy some of you get without regular updates, so I am writing to you know with what we think we might possibly know as long as nothing changes, maybe.

1. The doctor believes that Thaddeus does in fact have a staff infection.
2. He is working on the assumption that it is a surface level only infection. The lab doesn't have the exact infection figured out yet, but since Thaddeus is acting mostly like his old self, all of his numbers with the exception of a light fever are good, and the surgery team found nothing besides the fluid, it is highly unlikely that he has a nasty deep reaching infection.
3. As a result, Thaddeus will most likely be on antibiotics only until Monday when he might be able to go home.
4. Since he is doing so well otherwise, he may get moved to the 8th floor and out of CICU. However since he is still a cardiac baby, they may keep him in CICU regardless.
5. I found out more about PIC lines yesterday. I had mentioned that they basically are just using a larger artery. Well what I learned yesterday is how that happens. When they go to put it in, they take him to radiology. There they use ultrasound and x-ray in order to find the arteries they want to use. They used his thigh, but they aren't just putting it in at the surface level. They snake it through until it is located right near his heart. So by the time the medicine, antibiotics in this case, enter his body, they are right near the heart.
6. Since they put that in, he has to be on an anti-clotting medicine called Heparin. (I always think of the great Katharine Hepburn). However that is normally administered through the same system currently delivering the antibiotics so they can't do that. They are giving him a different version (Audrey Hepburn?) that has to be injected.
7. They put him on ?7. They put him back on oxygen to put the PIC line in. They started lowering the amount last night, but he is still on some. They will keep lowering his amount and keep an eye on his numbers.
8. Fever is still hanging around but it is lower than it had been.
9. He had some visitors today and he sat while I held him for about 25 min. He smiled frequently and hammed it up for the camera.
10. If you ever find yourself in the hospital, you are the primary person. Ask, ask, ask and do what you can to understand. Speak up if you feel the need. The longer I am here the bolder I am getting and they tolerate it very well. They'd rather have that than too little involved.
11. I've said it before and I'll say it again. GO HUG A NURSE!

Tuesday, December 20, 2011

Update 36

I am happy to report that Thaddeus just took 90 ml of formula from a bottle just now. This is a good sign that he is recovering well. The catheter has been removed and we are working on weaning him off of everything else that we can. There is still much work for Thaddeus to do, but so far he is certainly doing his part. He had a nice quiet night and is resting nicely now.    
 
36 B:

Well I didn't get to read my book or sleep, but I did get Fred Astaire Ginger Rodgers, and those dirty diapers I was looking for.

36C:
Thaddeus has had kind of a rough day. He has been out of sorts and rather uncomfortable today. The surgery, as I have mentioned, causes him to have extra blood pressure in his head now. This will give him something like a head ache for some time. (When I ask how long it will take him to adjust to this new pressure I get told anywhere from a week to months and months.) In addition he has had some painful gas issues. He has been consolable and is still eating, but he is certainly not himself. Now, in addition, his last temperature reading was over 101 degrees. This could mean a fever from an infection, but it could also just mean he is warm from working himself up over his other pain issues. They are trying to draw blood now to check his white blood cell count, but getting a needle in a 4 month old's vein is harder than it sounds, and it sounds pretty hard.  (He called in reinforcements and they got it now.)
Thank you for all of the prayers, but if I may, I'll ask for a few more.
36D:

It's an infection.
White blood cell count is very elevated indicating an infection. They will probably put him on anti-biotics and I would assume keep him around for observation longer than we had thought.

36E:
Hey everybody,

Thaddeus is still feeling out of sorts today. I have been told that the higher white count is an indicator that there MAY be an infection; it doesn't guarantee it. So, obviously we would prefer he doesn't have one. Either way, he is still running a fever and definitely not as active as he was before. How much of that is surgery related vs fever related no one knows. We had a physical therapist visit and do some work with Thaddeus. He was not using a full range of motion, preferred not to move or be moved much, and frankly he looked worried. She worked on getting him to relax some of his muscles and move around some and that seemed to really help him feel a bit better. He is still eating, not as ravenously as he had been before, but apparently it is normal for babies to burn less calories after this surgery than they did before, since the surgery is designed to help them not to have to work so hard just to get blood around. He is also losing weight, but that also is not surprising since he had gone up 12 ounces in 6 days. We are assuming that a lot of that was fluid weight and he is getting back to normal. The hard part for us right now is trying to get a grasp on what kind of issues and uncomfortableness are normal with the surgery and what issues might be unusual and more of a concern. However, since "medicine is not an exact science" and "every baby is different" no one can really say.So, we will sit back and wait for the Lord to take care of it.  
 
36F: Earlier today, I noticed that Thaddeus had a bump on his incision mark and some discoloration on the tape over it. A surgical person came and took a look at it. He said that it seemed to be filled with fluid. He also thought it felt like there was some separation of the sternum underneath the spot. As a result, tomorrow they are going to sedate him once again and cut into his incision. They will drain the fluid and test it for infection. They will also look inside to see how it looks. This could simply be a case of the sternum not being closed yet so fluid is collecting at that spot. This would mean they drain it and no big deal. It could also mean that there is a very serious infection there. The fluid may only be at the surface, or it may be collecting underneath and forcing its way through the sternum. This would mean that they would dig deeper and clean things out. If it is the infection they fear it might be, it is a very nasty one. It would involve a potential of four to six weeks of anti-biotics. Since the anti biotics they use will collapse a vein if it is put in a peripheral IV they will put a PIC line back in. (Instead of just using a little one on the back of the hand they have to put another line into a major artery.) This would also extend his stay. It is possible that he would get sent home on anti-biotics, it is also possible that he would be kept here the entire time. So in summary, we know he has a little bump on his incision that probably contains fluid. Other than that we don't really know much of anything yet.

Update 35

I am happy to report that Thaddeus just took 90 ml of formula from a bottle just now. This is a good sign that he is recovering well. The catheter has been removed and we are working on weaning him off of everything else that we can. There is still much work for Thaddeus to do, but so far he is certainly doing his part. He had a nice quiet night and is resting nicely now.    

Update 34

At the moment Thaddeus is doing better than the Brewers. About an hour ago the doctors decided to turn off the sedative completely. This allowed Thaddeus to wake up enough for them to take the breathing tube out. He is still on a pretty high level of oxygen but it is just though the regular nose tubes that he has had for three months anyhow, not a breathing machine. After they got the tube out they put him back on the sedative. I was able to keep him relatively calm until with the help of the sedative he fell asleep. There is no guarantee that he won't need the breathing tube back in, but as of right now things sounded good when they listened to his breathing. The real test will come over night as we monitor his numbers. We will see if his system can handle the workload without the breathing machine. If that goes well, they will work on getting him back to his regular meds. They have decided to give him another round of steroids to see if they can't get the inflammation in his airway down even further. His CVP numbers have been high since he got back from surgery. These are the numbers that measure the pressure in the vessels in the part of his system that they just redirected. One of the nurses is hypothesizing that the numbers may not be totally accurate because of some 'extraneous' tubing that was added into the sensing system. She has removed this piece and we will see if the numbers change. They also have him on a diuretic to help keep fluids draining. That can help the heart and lungs not to have to work so hard. Long time readers will remember that pee is a big deal here.

We are told that we won't have to do the day by day monitoring of all his stats but he may or may not be on oxygen for a while. I am not sure what the medication regime will be like, but I am fairly sure that he will at least be on aspirin, and maybe one other. We will find out about that when it is closer to time to go home.

Update 33

Greetings all. We had some very exciting weather here last night, but in the room not too much was going on. As you know the plan was to have Thaddeus just take it easy for a day and give him a chance to settle in to his new body, and let his vocal chord swelling go down so that we can get the breathing tube out hopefully today. The only problem with that is that it apparently was not Thaddeus' plan. Let me just pause here to say everything is fine and no real problems occurred. I know, that is not how we build suspense, but suspense is not what we are here for is it? Anyhow, Thaddeus is a wiggler. He likes to move around. He likes to pull on and out any tubes or lines attached to him. This is why they felt the need to sedate him. The thing is, the sedation didn't really do the job that well. He was still moving and shaking so much that they went to a more potent sedative called fentanol. That helped to mellow him out. Well it mellowed him out enough to so that I took a nap and the nurse stepped into the hallway. That is when Thaddeus made his move. He made a grab for his breathing tube and sure looked like he was going to try and get it out all by himself. The nurse saw him and stopped him in time. As a result of that little stunt, Thaddeus now has "restraints" on. They let him move his arms around, but just not enough to get his arms up to his face. They also increased his sedative to the maximum level they can without completely knocking him out and stopping any independent breathing. Despite this, he continues to wiggle around to the point where they left the restraints on. Personally I love it. I love seeing how strong he is and seeing that despite sedation, his regular personality is still coming though. I apologize to all the nurses out there, because Thaddeus is keeping them hoping, but it makes me feel better to see him as feisty even through the sedatives.

So today they were able to take out all of the chest tubes and the heart line. After they pulled out the chest tubes his lungs looked much better on x-rays than they had before they pulled out the tubes. They are weaning him totally off of his blood pressure medication. They are also working on taking him off of the fentanol (the sedative the works better but impairs breathing) so that the breathing tube can come out and give him the best chance to breath on his own. They are going to put him back on the other sedative to try and help keep him calm when they take out the tube so that he doesn't injure himself with too much movement when they are taking it out. They are also dialing down the breathing machine to make him do more and more on his own even though the tube is in. Since there may be some swelling yet, they also have heliox on standby. This sounds very interesting to me. What they do is to mix oxygen and helium together. This lightens the oxygen and makes it less dense. This will allow it to move around in the body more easily than plain oxygen, yet it still contains enough oxygen to do the job. So, if he is having some troubles when the tube first comes out, this will make it easier for him to get the air passed that vocal chord. His diuretic is on a very low dose as well.

So while the breathing tube going back in is a set back, it is not directly related to the heart and the surgery. That seems to look good yet. The pressure in the new blood pathway is still not quite where they want it to be, but it is not an alarming level either. The body is still adjusting so while they are watching the numbers closely for any problems, the more important thing will be how his numbers are in a few days.

On a different note, we were given tickets to the Brewers' game tonight so at least some of us will (it depends on how Thaddeus is doing at that point) get to go.

I'll try to let you know later if they get the breathing tube out or not.
 
33 B:

Well, the joke is on me this time. They have weaned Thaddeus off of the heavy sedative and have him on a low dose of the other sedative so that he will wake up and we can take the breathing tube out.  After some initial wiggling, he is now sleeping peacefully and not moving at all. Now that we want him to wake up and look around and wiggle, he is sleeping peacefully like we wanted him to yesterday. I have heard that my grandfather responded in the opposite fashion when he was sedated, so I don't know if there is something in the family or if this is just payback for the nurses for me laughing last night.
So I have sent my dad to the Brewers' game in my place and I will stay here to see how things pan out. Of course now I just heard that Aaron Rodgers is throwing out the first pitch. Maybe I should have gone . . . . . .

Update 32

Well, so much for boring. When we got back to the hospital, we got an unpleasant surprise. We are off of boring and back on the roller coaster. Thaddeus has been intibated. In other words they had to insert a breathing tube. This is not the oxygen that he had before, this is a full blown breathing tube. This only happens in 10% to 20% of the cases. As far as we know this is not indicative of a problem with the surgery, it indicates that his body is having a harder time adjusting to the change in pressures than we had hopped. His blood pressure is also higher than they would like while his other stats are lower than they would like. The medicine they are using to lower the blood pressure is not doing so yet and keeping him sedated is not helping either. They seem confident that it is simply a matter of time before his body adjusts. In the meantime they are "tweak" things to try and make it as easy as possible for him. They gave him some morphine and are keeping him on a sedative for the night. We will check back in tomorrow when he should be allowed to start waking up, at least some. We don't know when he will be off the sedatives totally or when he will be able to eat from his bottle again or breathe without the tube, but they are optimistic that he should recover sooner rather than latter. On the plus side his bleeding is very much under control and you long time readers will be interested to know that his pee production is good.

On that note, good night all. 
32 B:

Little Change

Long time readers will recognize the phase 'slow but steady'. So far not a lot of change this morning, but there is some positive news. His blood pressure is back into the acceptable range. The next step they are looking at is to remove the heart line. When they do heart surgery they put in and leave in a line directly to the heart. This gives them access in  a worst case situation. They are planning on taking that out in the next few hours. It wasn't doing anything, but their willingness to take it out indicates that they are not very worried about his heart suddenly stopping. This doesn't mean he is out of the woods, but it does mean they don't think they need the deforesting machines to get him out of the woods, a chainsaw, axe and a hand saw will do.

32 C:
OK, we have a little more information. First of all, they expected Thaddeus to have high blood pressure right after surgery, in fact they would have been worried if he had not. Thanks to medication, his numbers are where they want them to be, and as he gets used to everything, they should be able to wean him off of the medication. As far as the breathing tube goes, they think they know why he needed it. It turns out that his left vocal chord (the one that had trouble after the last surgery) was severely swollen from having a breathing tube inserted and pulled out on Monday, and then having one inserted and pulled out again on Tuesday. It was so swollen that it was blocking the airway, so they had to put it back in again. He is now on steroids to help reduce the swelling, and he is sedated because lets face it, who wants to have a breathing tube in and be wide awake for it? So the plan right now is to simply let him rest for about 24 hours and let the steroids do their thing. Now when I say sedated, I don't mean totally out of it. He is still managing to wiggle around and suck on his nook like he can't wait for his next bottle, but he is not totally awake and crying either, so that is good. They are also able to control how much the breathing tube does or does not do, even to the point where he can control when it pumps. So when the swelling is down, they will dial down the breathing tube as well. If he deals with that well, they will take it back out again and see how he does. Then it will be a matter of just letting him take his time adjusting to having new internal plumbing. 

Update 31

The last we heard we were still on for surgery today. They are looking to take him about 1:00. So we have started the hard part. He isn't allowed to eat, and he really wants to. It is hard to listen to him cry and not help him. They have decided to sedate him early to keep him quiet. Now we just wait until they take him away. They don't anticipate him coming back until 7 or 8 tonight. This is all assuming that the first surgery of the day is done on time of course, so we will have to wait and see.

More later. 
31 B:

They just took him away to prep him for surgery. 



31 C:
Surgery is underway. They are though the sternum and Thaddeus is on 'bypass'. This means that he is being kept alive by a heart and lung machine. The machine circulates his blood and keeps him breathing so that they can do the repair on his heart. They tell us that the biggest risk factor is actually not the surgery itself, but going onto and off of bypass. So far he seems to be responding well to everything they are doing.
 
31 D:
Boring. Did you ever notice how we underrate boring? It always seems to have a negative connotation and yet sometimes we are counting on, praying for, boring. Thaddeus's surgery, was to a certain degree, boring. For that I praise the Lord. It all went the way it was supposed to. The surgeon saw everything he thought he would see and did everything he thought he would see. The internal echo showed what they thought it would show. In fact, everything seemed to go exactly the way they thought it would. How boring, and how wonderful. Thank you God for boring.

They are finishing up with him and he should be heading back to the room within a half an hour. We will get to see him on his way to the room, but then we need to give them some time to let them get him all set up in the room. We will go catch some supper and freshen up meanwhile, and then come and check up on him later tonight. He will still be a bit under the effects of the sedation and the spinal block that they did for pain (yes I asked and it is similar to an epidural that some women get for delivery.) As such, he will be mellow and probably not eating. So, we will head back to the Ronald McDonald house to catch a few hours of sleep and come back tomorrow. That should be when he will need us the most as he will want to eat and will be very uncomfortable. Since they are re-routing his blood flow and changing the pressure some of his blood vessels, especially the ones in the brain, will be under, he will have what they describe as a headache. This will be on top of the rest of the aches and pains. They have already warned us that he may be inconsolable for a few days. This would be a big change from our happy smiling boy.

We thought he would be off of oxygen after this surgery, and he should be. What we didn't know is that it may happen right away after or several months after the surgery. We are really looking forward to not having to keep putting that up his nose. He LOVES to pull that thing out at any chance. In fact, last night he not only pulled a sensor off of his head, he also kicked a IV line right out of his leg. You Dad's can imagine how proud I was, and yes I know you moms are horrified. Don't worry, he didn't really need it.

That's all for today. Thanks for the prayers and remember to not give boring such a bad rap.

Update 30

WE'RE AT IT AGAIN

Hey everybody. We are back in Milwaukee at Children's Hospital for the next step. Before I get into all of that, perhaps now is a good time for a bit of a review. In short, Thaddeus was born with the right side of his heart not working correctly. So, while the left side of the heart was still going strong, the right amount of blood was not going to the right parts of the body. So shortly after birth he had a surgery. This surgery was to take both the artery and the vein that exit the heart (one normally goes to the lungs and one goes to the body) and tied them together to send all the blood to the body. Obviously there still needed to be blood going to the lungs. They put in a shunt (think a drinking straw) from the heart to the lungs. This is a temporary fix as he will soon outgrow the shunt. Why do it then? They used to go right to the main surgery, but over time they found out that they got poor long term results when they made things too easy on the heart and lungs right away. They need to make the baby work a bit to help things grow and develop properly. The problem this creates is that is allows the oxygenated (red) blood to mix with the de-oxygenated (blue) blood. His oxygen saturation level (what percent of the blood that could carry oxygen is carrying blood) has been in the upper seventies to low eighties. A normal person will be 99% give or take 1%. As he gets bigger and more active his body needs more oxygen and 80% isn't going to cut it anymore. So right now Thaddeus is in surgery for a catherization. What this means is that they are sending a small camera though his leg vein into his heart and surrounding areas to check things out. They are checking on the results of the first surgery and also getting information for the surgery tomorrow. This allows the surgeon to plan better what he will need to do. The general plan is that he will need to take out the shunt that he put in last time, and close the opening he made. However, since blood obviously still needs to get to the lungs, they are going to disconnect the vein that runs into the top of the right side of his heart. They are going to seal up that hole and then re-connect that vein to another spot that leads to the lungs. Normally the blood would flow into his heart and be pumped towards the lungs, but since his right side isn't working there is no point in going to the heart. This will help to keep the blue blood and the red blood separate and should raise his blood oxygen level. In another few years we will be back at it again as they do the same thing on the bottom of the heart. This will eventually raise his blood oxygen levels to around 95%. The down side of this of course is that the left side of his heart is doing the work of both sides. This will mean that it will probably wear out faster so with today's technology he will need a heart transplant somewhere around the age of 25. However, who knows what technology will be discovered by then? We aren't spending much time thinking about that.

The medical personnel here are very pleased with his weight and size. He is much larger (15 lbs) than the average cardiac baby. In fact, at Dede's last visit, they told her he is the healthiest looking cardiac baby they have ever seen. When we brought him in today at 6:30  they did note that his color looks a little too blue, (meaning his body isn't getting quite enough oxygen) so it is time for the surgery.

We just had an update. So far everything is going well. The preliminary results of the echo are good, and they have the cath in place. We won't know much for a few more hours. So far the worst part has been not being able to feed the poor guy.

That's it for now.

P.S. For my students and their families: I took book one of the series you got me along and have started reading it. Thanks!
Update 30 B:

Everything looks good and we are on schedule for surgery tomorrow afternoon. However, as you may remember from last time, schedules tend to change A LOT around here. He was sedated and as he came out of it, he was not allowed to eat or move much. The thing is, those happen to be two of his favorite things to do! We just got to feed him and he is feeling better, at least until they have to stop feeding him again tomorrow in preparation for surgery. Otherwise things are going as expected.

Update 29

Surgery is Scheduled

Well everyone, we have a surgery date. Thaddeus is doing very well but we are approaching that four month time frame that the doctors look for. At our request, since it won't matter to Thaddeus, they are scheduling surgery for right after school is out. So, Lord willing, we will go in to the clinic at 6:30 AM on June 6th. They will do some tests on Thaddeus to make sure he is up for the surgery. Assuming everything will come out fine, they have scheduled surgery for June 7th. The recovery time is usually about a week to ten days. We are going to try and get back into the Ronald McDonald House again, and maybe dive up the kids between various relatives and us, otherwise one of us will go home and one will hang out.  After this surgery, he may be still on oxygen but hopefully only for about a month or so. He will still be on a blood thinner, probably for life, but he should be off the other medications. He is currently over 13 pounds and is gaining an average of an ounce a day.

We did have some folks form the Fond du Lac county Birth to Three program come out and evaluate Thaddeus to see if there is any developmental delay. They felt that he had about a 17% delay. This is actually a good thing in my mind from the stand point that this is a small enough delay to not be overly concerning, but a large enough one that they will come out and evaluate him again after his next surgery.  We went and had some family pictures taken back on my birthday. Enjoy!    
 

All Six

 

Quintin with Thaddeus


 

Update 28

10 lbs 6 oz 22 inches

 

Just hanging out.

First time in the bouncy seat.

I know I am long overdue for an update. I haven't really had much time for sleep lately much less an update so please forgive me.


Thaddeus had an checkup yesterday and he came in at 10lbs 6oz. This is good growth. We were getting concerned about a week and a half ago. He had lost weight three out of four days. When we took him in to Milwaukee they told us that his weight over a five day and seven day period was still a net gain so there was nothing to be too concerned about as long as he didn't continue to lose. He was exceeding his minimum amount of formula but not reaching his goal. Well, since then he has exceeded his feeding goal almost every day. (I am getting convinced he listens to and understands what the doctors and nurses are saying.) We were also concerned about his blood oxygen levels being a bit lower than we really want. However, we were more concerned that the reading changes depending on what foot you take it on. The folks down at Children's didn't have an answer for that. They weren't worried about it, but it still concerns us that they don't know why the numbers are so different on different feet. It is interesting because they are trying to get us not to fixate so much on the numbers, but they really want us to keep track of every possible number. It is hard to monitor all of that and then try to ignore it. We have been told that the second surgery usually takes place when the child is four months old. That would put us in June. However, we have also been told that the second surgery usually takes place in the ten pound range. That would put us at now. So clearly he is going to throw off the average one way or another. This just reminds us what a blessing it is that he went full term and was not preemie like many cardiac babies. As for Thaddeus specifically, he is not showing the signs of needing the next surgery yet. He is still eating well, exceedingly well actually, he seems very active and content during awake times, his O2 levels are sometimes a little low, but then we just check him on the other foot and he is fine, and his color is still very good. So for right now we are just working on getting him bigger and stronger, and he will let us know when it is time to get that shunt out!

On a different note Quintin is now 2! He has really started to catch on to the idea of sentences and is coming up with something every day it seems. Two days ago he asked me "Please have food.". Yesterday during the day he said "Daddy at school." Of course he also thought Thaddeus was at school. After I called that night to let Dede know I was on the way home, he looked at her and said "Daddy in car." So that is pretty cool.

I better wrap it up, that pile of work doesn't seem to be going anywhere . . .

Update 27

FAQ and Update

Greetings all. Thaddeus had a checkup at Children's this past Tuesday. He goes to Children's' once every two weeks and sees the doctor up here on the off weeks. He weighed in at 9lbs 2oz. He has averaged a gain of 1 1/3 oz per day since he has come home. The goal we were given was 2/3 of an oz per day. He was measured at 21.5 inches which is an increase of 1.5 inches. He is doing well and the other kids are doing very well with him. I was most concerned about Quintin suffering from some jealousy, but fortunately, he seems to like getting attention from Dede, Charlie, or me almost equally, so much of the time there is someone around to make him feel loved. Charlie has been a great help to us holding and feeding Thaddeus. So much so that we have to keep an eye on her to make sure she is doing her other work! I have had a number of questions pop up recently so I thought I'd do a FAQ.


Thaddeus is on four different medications that he takes from one to three times a day. These will keep up until the next surgery. We also weigh him daily, check his oxygen level in his blood and keep track of every ml he drinks. This also will continue until the next surgery.

He is on a low dose of oxygen. It is not life sustaining in and of itself, it just makes it easier for him to breathe, thereby easing the work load on the heart. He can go without it if needed, which is somewhat often considering how many times he has pulled the tube out of his nose on his own! The oxygen should be around until after the next surgery as well. We have a large compressor in our bedroom for him most of the time, but we do have a large profitable tank for the first floor and smaller portable tanks for when he goes out. He even got to come to communion on Sunday. Dede held him and I got to hold the oxygen tank!

In addition to us driving to the doctor each week, a nurse comes to see us from one to two times a week. Children's' also calls us once a week to check in.

The next surgery is not scheduled and will not be until Thaddeus lets the doctors know it is time. While we are happy with how well Thaddeus is doing right now, the reality of the situation is that we are waiting for him to start to go down hill. The shunt is meant to be a short term solution. When he outgrows it, his numbers will begin to fall across the board and then it will be time to go back in and take the shunt out. The doctors will then disconnect and artery from his heart and reconnect it elsewhere. This will stay that way until he needs a heart transplant. So right now we rejoice in every oz or gram gained, but he can't really come into what will be normal for him until he gets the second surgery and that won't happen until he is no longer doing so well. So we will take it while we can, but we know it won't last and in a certain sense look forward to it ending so the longer term healing can begin. The third surgery will take place in a few years when they will disconnect the other artery to the right side of his heart and reconnect that one elsewhere as well.

Waiting To Come Home 

Home for the First Time 

Ready to Travel 

Hanging Out With Dad This Morning 

Update 26


THINGS ARE GOING WELL

Well, Thaddeus has been out of the hospital for five days now and things are going very well. We have not had a problem adjusting to giving him his meds. Having him attached to oxygen tubes everywhere he goes has been a bit of a challenge. However, a very challenging part so far has been the simple lack of sleep. He is supposed to eat every three hours. Generally he likes to go about two and a half. He tends to eat less each time and eat more often than our other children did. So, you can do the math. He likes to eat about every two and a half hours and it takes about a half an hour to feed him, that leaves about two hours in between to sleep. Dede has been doing more of the actual feeding at night while I tend to take care of getting bottles ready, doing the meds and such. That way I get more running around, but I get to go back to sleep sooner. I am still exhausted all day long. You can imagine how Dede feels! However, it doesn't bother us as much as you might think, because of the simple fact that OUR BABY IS HOME!

The doctors want him gaining about 25 grams per day. So far he has been averaging close to 50 grams per day. They also want him eating a minimum of close to 400 cc's of formula. He has been averaging close to 500. He is wiggling around quite a bit. He even lifted his head and turned it to the other side while he was lying on me yesterday. I know that doesn't sound like much, but for a baby who had open heart surgery a few weeks back, that is a very good developmental sign. We even hooked up the portable oxygen and took him on a trip. So far everyone involved could not be more pleased with his progress. The only disappointed ones are his brothers who can't wait until he is old enough to play with. Charlie is having a great time holding and feeding him and has been a fantastic help to us.
Our visiting nurse has been here twice already. She seems very nice. I for one was comforted knowing that she served as an ER nurse for about a decade before doing this. We have also seen the pediatrician in FDL and that went well. Next week Dede will take Thaddeus back down to Milwaukee for another check up. We are also trying to set up an appointment with the lady from the birth to three program. Thaddeus is at risk to develop learning disabilities, or at least developmental delays. The birth to three program is designed to watch for signs of a problem and if any are seen, to start early intervention. (The previous lesson in my graduate class on learning disabilities was on the importance of early intervention.The Lord works in mysterious and some times not so mysterious ways.)
So all in all we totally underestimated how much time and effort it takes to deal with all of the medical calls and appointments, but it is made easier knowing what great progress Thaddeus has been making.
The worst part of the entire thing though, isn't the almost daily reports to medical personal, or the total lack of sleep, or the dirty diapers, (times two remember, although Quintin did pee in a child potty chair for the first time today) it is dealing with the insurance companies. Granted I'd rather deal with the mixed up bills and the multiple half hour phone calls rather than have no insurance, but it is no picnic. The worst part is that about when we get it all straightened out, the new budget plan will change everything again. Sigh. Well, somehow the time has gotten away from me again and I best sign off before I fall asleep on the keyboard.

Night all.

26 B:

JINX!

Is it just me or do things change right ever I send an update? Apparently I spoke too soon. Thaddeus had a light eating day yesterday and lost around 60 grams. After going up around 50 grams a day for the first few days, he slowed down, and now is actually at a loss for the past three days average. Say a prayer that he pigs out today and gains some grams because I really don't want to have to re-admit him. In fact how about a prayer that I lose some weight and he gains some. That would be even better!

By the way, as a side note, for those of you who are getting these updates by way of forwards, if you look at the bottom there is a button for update your profile. Clicking on this will allow you to add yourself to the subscription list if you so desire. We can use all the prayers we can get.

I did break down and pay the big bucks for the video monitor. We found out that you can even hook it up to the TV and watch and listen on the TV. The kids like watching Thaddeus TV and it has been a great comfort to us, especially since he is so quiet and the oxygen compressor is so loud, it helps to be able to see him as well as hear.  
 
26 C:

His weight is up!

He gained enough weight yesterday to make up for Friday's loss and still come out 16 grams ahead. Thanks for the prayers!

Update 25

 
 
 
 

Update 24

COMING HOME?

 Anyone who read update 23, 23b, 23c, and 23d knows that things can change very quickly when it comes to Thaddeus.Things have been stable for a couple of days now, so I will what has been going on since we last chatted.

Due to the concern over Thaddeus' mediocre eating, the doctors had contemplated replacing the feeding tube, feeling that they had removed it to soon. Thaddeus must have heard this discussion and took it as a challenge. The very next feeding he ate quite a bit, so they held off on the feeding tube. The next several feedings were all at least at the minimum and were creeping nearer and nearer the goal. As I may have mentioned, several days ago, one nurse felt that Thaddeus was sucking on his low flow nipple so hard that he was pinching it off. This made him work harder and tired him out sooner. Those nurses then changed Thaddeus to a regular flow nipple. This increased his feeding totals quite a bit. However when the woman in charge of feeding found out, she immediately changed it back to the low flow nipple. This was because Thaddeus has a damaged nerve that doesn't allow his left vocal chord to close on command. So, he can't have a regular flow nipple because it may allow food to go into his lungs instead of his stomach. As such, he was put on a low flow nipple again for a few days. Then one night a nurse noticed how hard he was working to eat so she switched to the regular flow nipple and he ate better. I asked her to please check with the woman in feeding since that had not been allowed before. When the woman in charge of the feedings found out she fed him herself again. She noticed that Thaddeus seemed to be sucking so hard that he was pinching the nipple closed. (No, I didn't just copy the same part over by accident.) So, since she still believes that a regular flow would be bad for Thaddeus, she had Dede buy a specialty nipple. More of a medium flow I guess. Since that time he has been feeding very well. His goal is 60 cc's every three hours. He had many feedings at 70 a few 80's and even a 90. Occasionally he has a 30, but that seems to be a snack and he then makes up for it on the next feeding. The biggest thing they are looking for is weight gain. We had been celebrating 2 gram increases. The last three days he increased 50 grams, 50 grams and 10 grams. His goal is to average around 25 a day. So they did a heart failure test last night and when the results came back today, he had passed. So, the plan is we get to take him home tomorrow!

That said, let me explain what home means in this case. He is still on oxygen and may well be until surgery number 2. We have a large machine in our house that takes the air in the house and removes most everything but the oxygen. It is about the height of Quintin and weighs about as much as Jeremiah. It comes with a very long hose, but we do we have three stories counting the basement. We are sure how Dede is supposed to carry Thaddeus and this machine down the steps at the same time. We do also have some small oxygen tanks for when she needs to leave the house with him, but those do cost extra and we don't know if there is a limit on how many we can get. As I mentioned once before, we will have to weigh him each day, check his blood oxygen levels each day, administer medicines three times a day and keep track of each ounce he eats. We will also see the Doctor here in Fond du Lac every other week. On the opposite weeks we will need to take him to Children's in Milwaukee. Always on a Tuesday. It seems that if your life isn't in danger they can only see you on Tuesdays. Anyhow, we will also have a nurse come to our house once to twice a week to check up on us, and Children's will call us each week to check in as well. This will continue until his second surgery. No one knows when the second surgery will be since it is really up to Thaddeus. The average is at 4 months old which would put us at mid June which of course would work fine for me. However, they have had it as early as two weeks after the first surgery. (It already has been three for Thaddeus.)

If you are having the same question we had, you are wondering why if he needs all the monitoring he is going home, or if he is well enough to go home, why all the monitoring? When they used to just sent the babies home and check in once every two weeks or so, they found out that they lost about 20% of the babies before the next surgery. Since Children's started the Inter-stage Monitoring Program (he is inter-stage since he had the first surgery and is waiting for the second) they have lost 0. The program is designed to catch anything, anything at all, early. Since any little thing can be a big deal, they want to deal with it before it does. If he gets a fever it may increase the vascular pulmonary resistance. Add to that he won't want to eat so he gets dehydrated. That may mean his shunt clogs and blood stops going to the lungs. OR, his numbers go down, we call in, they admit him, he gets an IV and is fine and goes home in a few days. In fact we were told that 60% to 80% of all inter-stage babies get readmitted to the hospital before their second surgery. We also have to be a lot more germ phobic than we are used to. So we will be collecting small bottles of antibacterial gell and spending much of out time asking people not to touch Thaddeus even though he is really cute. (Speaking of which, I hope to have some more pictures by next time.)

So, this isn't simply a matter of taking him home and waiting for the next surgery. It is a lot more involved than that, but WE GET TO TAKE HIM HOME!!!!!!!!!!!!!!!!!!!!!!!!!!! Well,Lord willing.

 

Update 23

A Backward Step

Thaddeus is still doing well overall, but he has taken a backward step. His eating has slowed down significantly, to the point where earlier today they put an IV back in to give him fluids to make sure he doesn't get dehydrated. He has a very small shunt that allows blood to go to his lungs. If he gets too dehydrated it makes it more likely that his shunt could get clogged. This obviously would be a huge deal. This also delays our hope of getting home. He is also still on a low oxygen flow, but the doctors are less concerned with that. They feel that this is something he will grow out of eventually, and they have no problem sending us home with oxygen if it comes to that. The guess is that due to his damaged vocal chord nerve, he is getting a small amount of fluid in the lungs. This fluid is causing his breathing to be less efficient. Over time, as the right vocal chord starts to compensate, and the lungs grow into greater capacity, they think he will be fine without the oxygen flow.

While we are disappointed to see Thaddeus move backwards, we are trying to keep in mind that he is doing extremely well and has moved very fast to get to this point. His cry is getting louder, he is feisty and moves around well. He doesn't favor his chest near the incision. (Apparently some babies after surgery don't want to bring their arms back in front of their chest. He has no problem with that.) His sucking on the bottle is very good, we just can't get the volume in him. He also has been extremely good natured so far. He will lie awake and just look around for some time. We have been told that many of the babies who have this surgery done, don't even get to go home at all until after the second surgery several months later. This is especially true when they have this condition on the other side of the heart. So we keep reminding ourselves that even with this delay he is way ahead of even the more optimistic predictions we were given. We still do not know when he will come home, but since we have passed our 24 hour test and our infant CPR test, and Thaddeus has passed his car seat test, as far as we know we are only waiting on his eating to stabilize. This could of course still take weeks or something else could come up, but as of right now we are feeling optimistic about him coming home sooner rather than later. This is of course assuming we can get him away from his girlfriends, I mean nurses. Until then, we will keep doing the back and forth thing until God, in his infinte wisdom, decides Thaddeus is ready to come home.



P.S. After typing this Sunday night, I did find out that he somehow managed to gain some weight and was up on his weight Monday morrning. Let's see if he can keep that up! 
 
23 B: P.P.S.I have just been informed that the doctors have decided to reinsert Thaddeus's feeding tube. Apparently they don't think he is ready to be on his own after all.

23 C: So what I am being told now is that the doctors have decided they pushed Thaddeus too much too quickly. They want to step back and let him recoup and then move him forward at a more gradual pace. He tried his best but trying to keep up with the pace that was set for him was just too exhasting. Dede is glad they are letting him take it at his speed. I can't help but feel disapointed, but I suppose it is a dad thing to want to see your kid fight it out and prove how tough he is. 

However, I did sign two waivers that stated that I acknowleged that medicine is not an exact science. I guess this is what they mean.
 
23 D: The child is only a month old and I already can't keep up with him. Once the decision was made to put the feeding tube back in, Thaddeus had several very good feeds and a few decent ones, all of which were above the minimum and quite near goal. As such, they have decied to hold off on the feeding tube and see how he does with it all. He should be sedated and heading down to have an echo done on his heart as I type. We will see how his heart and especially the shunt, are doing.