Surgery and Then Some

Overall Sam’s surgeries went well. The second surgery was a bit more invasive than we expected, but with a few restrictions, he was back at school the next day.

Recovery has gone well for the most part. We had to keep an eye on some bleeding, but thankfully that subsided.

About a week ago he started more secretions and then retched (threw up) the entire night. After making a call to surgery, we were advised to have Sam be seen either by his pediatrician or take him to the ED (Emergency Department). In order to avoid the ED, I was on the horn at exactly 7:30 that morning as soon as the clinic opened. Sam’s pediatrician wasn’t there, but we were able to see another pediatrician who also sees complex kids. So glad we were able to avoid the ED.

A small recap that morning…

Get the report from the night nurse on Sam’s night after we finally got him to sleep again around 3:00am. Check the discharge paperwork to see the section on, “When to Call the Doctor”. Call the doctor. Bummer…the doctor said to get him into his pediatrician or if were not able, go to the ED. Give the report to the day nurse coming on. Oh yeah, a new nurse is training today. Great day for that. Oh well, it will be good experience for her. Try to keep a smile on my face as introduce myself to the new nurse and hopefully make her feel welcomed. Wake Will and Abby up for school. Make lunches. Eventually tell Will he’ll have to wear dirty socks to school after he, to no avail searched for clean ones. Take Will and Abby to school. Take a shower. Throw in a load of laundry. Run to the store to get Pedialyte since Sam couldn’t tolerate his formula overnight. Throw the load of laundry in the dryer. Double check we have all five bags. Buckle Sam in his carseat. Whew! All that in only a few hours! Only twelve minutes later than when we wanted to leave! We did it! Nice work ladies!

Seeing someone who doesn’t know Sam was a bit interesting. After some discussion and me giving the pediatrician a very small dose of Sam’s medical history, he checked out Sam’s surgery area. I knew as soon as he started fumbling over his words, he was concerned. He danced around his words until I stepped in and helped him finish what he was trying to say, “So, you think we need to get an ultrasound.” He shook his head saying yes. His concern was on the left side. Sometimes I wish there could be something in Sam’s charts that could forewarn medical personnel not to sugar coat things for me. It’s been over the three years now and I know when doctors are giving concerning or difficult news. I wish something said, “She can handle the hard stuff and won’t freak out. Give it to her straight.”

Surgery met us in the ultrasound room. Knowing Sam well and his history from the beginning, she was ear to ear smiles to see how well Sam was doing overall. She also had a good chuckle when the ultrasound tech shared there was a hematoma on the left side which wasn’t too concerning, but there was a small hernia on the ride side. The reason surgery had a chuckle is because she thought it was a classic Sam move to have a little twist in his story.

At the end of the day, the retching was likely related to a cold Sam was brewing, which I also had to explain to the pediatrician after the ultrasound. I reassured him the throwing up wasn’t something we would have brought Sam in for otherwise. We brought Sam because it was so close to surgery and they wanted to be sure the retching wasn’t surgery related. I explained the retching is unfortunately the nature of Sam when he gets a cold.

With an extra boost of nebs, or twelve nebulizer treatments, four times a day, Sam seems to have fought off the cold. Thank goodness!

Just Another Surgery

Tomorrow, Sam will have his forty somethingth surgery. I thought this string of texts between Sam’s teacher and I was kind funny and also shows our perspective on surgery.

Me: Hello! I just wanted to let you know Sam will not be at school this Thursday (10/3) or next Wednesday (10/9). He has a pre-op and then surgery next week. He usually recovers very quickly so hopefully he will be able to be back at school the next day!

Sam’s Teacher: Wow. Ok.

Me: Lol. After sending that…I realized not everyone thinks surgery is no big deal. My world is a bit skewed. 😂

Sam’s Teacher: Perspective is everything.

Me: It sure is. 😊

Me: And attitude. 😃

Sam’s Teacher: Amen.

When Sam was in the hospital a few weeks ago, his GI doc thought it would be a good idea to scope him after he was feeling better. They will look to see if his esophagus is stricturing again. Let’s just say, based off Sam’s symptoms, all of us will be a little surprised if Sam does not need another esophageal dilation.

Once GI is done with their part, Urology will step in and do theirs. This is the 2nd of Sam’s new diagnoses I was talking about that would need surgery. The doctors assumption was correct, Sam would be having surgery in the near future. We did what Urology said, and asked to have them scheduled as well. Quickly, the surgery with both docs was scheduled, which meant we would need a pre-op exam before then. How many times does one have to have surgery in order to get a free pass on pre-op’s?! Just kidding. Thankfully, Sam’s pediatrician almost always finds time for him in her busy schedule and we got the pre-op done.

Even though surgery doesn’t seem like a big deal to us, it doesn’t mean we don’t get nervous. The easy part comes from knowing how to prepare and what to expect before and during. We know how many hours before to stop Sam’s formula and when to start and stop the Pedialyte, exactly where to park, where to go, where the bathrooms are, what the doctors, nurses, surgeons, and anesthesiologists will do and ask, and where to get something to eat. Although a little nervous, we will leave the outcome to Him.

Don’t forget to say an extra prayer for Sam tonight and tomorrow!

Sam Strong!

Faith Over Fear!

Image result for it doesn't get easier you just get stronger

Admitted.

In the two and a half years Sam has been home from the hospital, we have made many trips to the emergency department (ED). In those two and a half years, we’ve always been able to go home, which according to everyone here is just shy of a miracle given Sam’s history. Although we love the people here, we do everything we can to stay out of here.

Unfortunately, there isn’t a clinic or urgent care for Sam. When things go south, it’s either maintain at home or go to the hospital. And unless Sam’s feeding tube comes out or one of his docs wants him to be evaluated, we do our best to maintain at home.

Poor buddy isn’t feeling so great.

Based off Sam’s symptoms, Sam’s GI (gastroenterologist) doc instructed us to take him in yesterday. I was a little shocked when the ED doc thought it would be best to keep him. I, of course, did not plan for getting admitted. No extra clothes or toothbrush for me. I feel like I have to keep apologizing for my stinkiness. 😂

I thought once Sam got some IV fluids in him, he would perk up and we’d be heading home. Not so much. He’s still the same little lethargic boy we brought here yesterday. He’s not worse, but not better either.

Even after fluids, he’s still not feeling so hot.

They are checking all the boxes and are trying to figure out what’s going on. It could be tracheitis, which doesn’t show up for twenty-four to seventy-two hours. He might need another dilation. It could be just a cold. Although, like I’ve said in the past, it’s never “just a cold” for Sam. There are plenty of places he could have caught something. The two biggies are starting school and being in the ED last week cause his feeding tube came out. School = germs and the ED = even scarier germs. They are also monitoring his blood pressure as it has been elevated. With his history of hypertension, there is concern, but they could also be up because he’s sick. Again, there are so many things it could be. There are usually no easy answers with Sam. He a complicated kid.

Let’s pray whatever it is, it will run it’s course and/or get fixed without complications. As of now, he needs to tolerate feeds before we go home.

As always, staying Sam Strong.

Cincinnati?!?!?!

Bam! Pow! Zap! That’s how the appointment felt. I know things could be so much worse, but it felt like a sucker punch right in the gut. I have no idea what a sucker punch to the gut feels like, but at that moment, I think I did. She could not have given the news in a more kind, respectful way, but it wasn’t what I was expecting. It was evident by her demeanor from the time she walked into the room she was was uncomfortable. It wasn’t long before it was clear why she was uncomfortable. She was the one picked to share the not so great news. She asked what my goals were for Sam. In every other word, I told her I wanted to get rid of the trach. It feels a bit foggy after that. All I know is she said they were all scratching at the edge of their boxes. They (Sam’s care team) have some things they could try, but they are very risky, and wouldn’t want something to happen to Sam and then regret they hadn’t referred him to Cincinnati. Collectively, all of Sam’s doctors have decided because of his continued complexity, they are not what’s best for him. They referred him to Cincinnati Children’s Hospital’s Areodigestive & Esophageal Center.

Although it felt like a shock, it shouldn’t have been. It’s a subject that’s been danced around since Sam was two and a half months old. And since March, it’s been really danced around. I think we were just in denial. We have so much faith and trust in his doctors here.

Here is a post I started writing before summer started, but didn’t finish…

Sophisticated can be defined as complex or intricate, as a system, process, piece of machinery,  or the like. Quite fitting for Sam. It’s not the first time, doctors have no clue or haven’t heard of some of Sam’s diagnoses. It is the first time though his doctors are not quite sure what to do.

After discussing with gastroenterologists and surgeons nationally, Sam’s docs have come up with a plan. And thankfully, after some discussions, it doesn’t involve going to a hospital out of state. Let’s just say Sam is a rare case. In all reality he has been since the the beginning. He continues to be quite medically complex, but despite his complexities, for the most part, he’s thriving!

Sam had his 23nd and 24th, if I’ve counted correctly, esophageal dilations in the last couple of months. Once again, he made general anesthesia look easy and recovered very quickly both times. It was a little easier to hand him over to surgery the past two times as he got something to help him feel relaxed and sleepy before they poked and prodded at him. Like I said before, as Sam gets older things get harder for him and, in turn, us. He’s starting to remember what happens to him when we go certain parts of the hospital.

Here’s a short story on him getting smarter…

Because Sam doesn’t eat or drink anything by mouth, there’s a bit of a rush to get a new feeding tube in if it comes out unexpectedly. He’s a very busy boy and despite our efforts to to rig ways to keep the tube in, inevitably it gets pulled out once in a while. It doesn’t help he eats fourteen of the twenty-four hours in a day. Backstory…he goes to radiology to get his feeding tube changed every two to three months. He’s had this type of feeding tube for almost two years and it’s always gone fairly smooth when we get it changed. As soon as we walked into the radiology room, Sam instantly became agitated. One thing we’ve all learned about Sam is unless something is really wrong, he doesn’t get upset. It wasn’t long before we figured out what the problem was. He knew exactly what was about to happen to him. I can’t imagine a six inch tube pushed into your stomach and then through your small intestines feels real hot. Poor buddy. Every procedure gets a little tougher as he gets older, but overall, he’s a trooper.

We will be taking a little trip to Mayo where Sam will have a special test (esophageal manometry) done to determine how well his esophagus works. Pediatric esophageal manometries are not done very many places and it’s a relatively new test done at Mayo for a pediatric patient who doesn’t eat or drink by mouth. We are just happy to be able to stay in Minnesota. Depending on the motility of Sam’s esophagus, will determine which surgery will be best for Sam. Either way, something needs to be done as they cannot continue to stretch his esophagus every month. This creates retching and retching means the trach can’t come out. In short, in order for Sam to get rid of his trach, which we all thought would be long gone by now, all of his tummy stuff needs to be fixed first. As Sam’s doctors would say, Sam is complex. He’s never been an easy fix, but they continue to search for answers and we couldn’t ask for a better, more dedicated team.

Sam will have another dilation in July. Continue to keep him and the rest of us in your prayers.

Again, although Sam is a full-time job and then some, he’s doing very well. He’s making some sounds and knows about 15-20 signs. His newest sign is “outside”. Before, he would grab my hand, pull me to the gate, and want me to hold him. I’d pick him up and then he would wiggle his little body to motion me more towards the gate while also getting mad. Or he would just keep pushing me into the gate. We’ve been working on the sign for outside. The other day, he did his thing where he pulls me to the gate, but this time, signed “outside”! We were pretty excited! I wasn’t going to take him outside, but who could resist that?!

To make a VERY long story short, since March, Sam has had four more esophageal dilations, which I think makes twenty-five. As always, he recovered beautifully from all of them. He also took a trip to the Mayo Clinic. He did not end up having the esophageal manometry done there. Although Mayo is an amazing place, it’s not the best place for Sam. He’s a rare case and his doctors want to him to see the best of the best, which for him, is Cincinnati Children’s.

Since the news about a month ago now, I’ve been able to change my thinking from, we HAVE to go to Cincinnati to we GET to go to Cincinnati. Let me tell you, A LOT of negative thoughts were running through my head when I was hashing it out to the big man upstairs. How in the world are we going to get him there?! We’ve never been overnight with him unless it’s the hospital. What if we have to be there for a long time? I don’t want to split my family up again. How is this going to work financially?! Had I of known, I would have saved the money we used to build a deck and used it for Cincinnati instead. What if we go all the way there and they can’t fix him? 

These are all legitimate concerns I still have and there are many more, but since I’ve changed my thinking from we HAVE to go, to we GET to go, and let go and let God, I’m much more at peace with it. My plans are not His and although that can be hard sometimes, my life is a lot less stressful when I can truly accept that. I will always bank on that, although Sam is complicated, he is here.

We have started the process with Cincinnati, but don’t have any details. Again, we will wait, which according to Dr. Seuss is the most useless place. Yes, I agree, waiting is useless so that’s why I choose not to dwell on it. I choose not to wait, but to enjoy the moments I am in right now, like…

…Sam’s doctors okaying him to start school next week.

…being home and able to send my kids off to their first day of school.

…getting rained on the entire kayaking trip we took for the first time.

…going to the great MN get together.

…taking Sam swimming. Shhhhh, don’t tell his docs.

…having a lemonade stand to raise money for Ronald McDonald House Charities.Lemonade Stand

…going strawberry picking.

…being a part of my sister-in-law’s beautiful wedding.

That is what life is all about.

 

 

 

Here We Go Again

Sam will go to surgery again tomorrow (Monday). His GI surgeon and a GI doctor will stretch his esophagus again for the twenti somethingth time. His ENT will look to see if the sutures stayed intact on the bottom part of his Laryngeal Cleft, or the hole in his airway. His ENT has decided only to look and see if the surgery he did last month worked or not. Both Sam’s ENT and GI surgeons are going into this, hoping to formulate a plan based on their findings.

There are SO MANY things I could worry about with Sam. Of course, I travel down that path sometimes, but it gets me nowhere except stressed and fearful. There is SO little we can control. I know we are doing everything in our control, the rest is out of our hands. We choose to let go, and let God. When that truly happens, I can tell you from experience, the stress and fear factor quickly go away.

Pray the surgery done last month on Sam’s airway was successful. Pray for Sam’s surgeons, anesthesiologist, and anyone else caring for him. Pray Sam will recover quickly, his docs will be able to formulate a good plan, and we will get some answers. Pray for the rest of us too. I joke, Sam recovers faster than I do when he has surgery. As you can imagine, surgery days are pretty mentally and emotionally exhausting. As always, thank you for keeping us and our Superman Sam in your prayers.

When Bad News Almost Feels Like Good News

When bad news means fixable answers to questions you’ve been pondering, about your child’s health, sadly, it almost feels like good news.

I have to start by saying, we didn’t even get asked for Sam’s name when checked in at the surgery desk. I don’t think that was the first time. Many of the staff in surgery are on a first name basis with Sam. It is the most lousy and endearing feeling all in one.

Today was not so great, but it could be much worse. Sam’s ENT told us, “Most kids go one, two, and maybe three, but Sam goes one, two, three, four, five, six, seven, eight, nine, ten…”

In order for me not to write a book, I can tell you…

…Sam’s last surgery did not work. They did part of the surgery, but the rest will not get done until all the GI (tummy) stuff gets figured out.

…his esophagus needed to be dilated, AGAIN.

…they couldn’t check to see if his nissen surgery came unwrapped, which would be for the fourth time, because they weren’t able to pass the scope through. They will likely do other testing to check on this.

…we will wait to see what the biopsies tell us.

…Sam will likely get a more complicated feeding tube placed when they dilate his esophagus, AGAIN in four to six weeks.

Although there was quite a bit of heavy news, everything is fixable and that is the good news. The other good news is we were able to find answers to the elcalated retching and aspiration episodes. What’s another surgery when you’ve had more than thirty and you’re not even three years old yet?! I’m close to forty and I haven’t even had one people!

Even more good news, Sam recovered amazingly, once again. He makes anesthesia look easy. He makes surgery look easy. He makes hard stuff look easy, period. Maybe he really is Superman. He’s our Superman, that’s for sure.

“Dear brothers and sisters, when troubles of any kind come your way, consider it an opportunity for great joy.” James 1:2