Little Micah

Feeding Tube Awareness- Part 3

2012-02-09T20:09:00.005-05:00

The current tubie- (and his "belly button" - www.bellybuttonsandbelts.com)
This is a g-tube (short for gastronomy tube). Specifically, it's a mic-key button. Technically, between the NG and this tube, he had a PEG tube, but that's often a temporary tube right after the tube is placed. The PEG is probably 4-6" long, and is a soft silicone tube that hangs from the body. Adults sometimes have PEG's, but most children have "buttons", because they're less likely to be snagged.
This picture was him sleeping, i couldn't get one of him standing still (a surprise, of course).

He's connected to his overnight feeding from about 8:30-5:30. it runs on a little pump at a rate of about an 1.5 oz/hour. The body normally slows down the gut at night, so it can rest. Little Micah doesn't have that luxury. We run it pretty slow for that reason.

One thing i haven't addressed is the "why" of the tube, other than initially (aspiration). He outgrew his aspiration at about 6 months. But, believe it or not, he lost the innate feeding reflexes, not to mention the desire. At about 6 mo, he was cleared for baby food consistency, which is less likely to be aspirated. At 11 months or so, he was cleared for liquid. The long and the short of it is that he's not that interested. His stomach is so small, and his tube feedings so frequent that he has very little idea of hunger (minus the pre-surgery stuff). He also has issues moving food around in his mouth, probably a problem related to the lymphatic malformation or the surgeries to treat it. On top of that, his mouth doesn't open much. Again, probably the LM, surgery, and the fact he's never had to use it. Here's an example of his dilemma. We'll call it, Micah vs. the Dum Dum.

Hopefully tomorrow will be part 4.. We'll see it i get to it... Might be a little late. Hoping to add a little tubie humor, and a little of tubie ettiquette.

Feeding Tube Awareness- Micah's day

2012-02-08T14:18:00.006-05:00

Micah has a bit of a rigorous tube feeding schedule (although not what it used to be, at all! Phew!) His stomach for whatever reason is unusually small (could be not having any food for days after birth, his nissen fundo surgery, ???) He gets 4 "boluses" (a large quantity over not much time) and he gets continuously fed overnight. His boluses are given to him about 1/3 or 1/4 at a time, at 15 minute intervals (so his first feeding is given at 8:30, 8:45 and 9:00, for example)
His tubie schedule:
8:30-9:30- 4.5 oz food, 1 oz H20,
11:30-12:30- 6 oz food, 1 oz H20
2:30-3:15- 4.5 oz food, 1 oz H20
5:30-6:30- 6 oz food, 1 oz H20
8:00- Meds and 1 oz H20
8:30pm-5:30 am, 13 oz food, 3 oz H20.

Overnight (and sometimes during the day) his food runs on a pump that gives it to him at a steady rate. He has significant reflux issues which are currently controlled by meds, and one of his biggest vomiting triggers is too much at a time. We've made significant gains in the last few months (one happy mom!).

He currently gets about 1200 calories a day, and 8 oz of extra water. i never would have thought a 2 1/2 year old would eat that much normally.

Sadly, he normally gets pediasure. it's pretty much crap in a can, but it has a lot of advantages (safety, consistency of calories, portability, ease of feeding). Sometimes we do a blenderized diet, where we blend whole foods or baby foods and put it through his tube. My own OCDish tendencies muddle that process, trying to find perfect combo's of foods to get him what he needs. For example (Here's one of many pages of my calculations). He needs 30 calories per ounce of food, which is a little outrageous, really. The only food i can compare it to is full fat full sugar pudding. Ew. On top of that, you have to at least be somewhat close on fat and protein as well.

Feeding Tube Awareness Week

2012-02-06T22:48:00.003-05:00

Here's my super tubie's first tube, an NG tube. An NG (nasogastric=nose to tummy) tube is a short term fix to get by... Before his NG tube, he was on TPN (nutrition through an iv) if my memory serves me, the TPN got him through his first surgery. This pic was in late Sept/early Oct when we found out he was aspirating severely. When he was without the breathing tube, he had big oxygen crashes and had to be bagged sometimes. His secretions were going into his lungs. Up til he was 6 months old, he was not allowed to have anything by mouth. The NG tube gave him a chance to get used to having food in his belly. He had it for a very short time, which was good because it was a pain!

Been awhile...

2012-02-02T15:54:00.003-05:00

So, (aw man, Micah is getting up as i start to type this...) So, the short story... We had a video swallow study today. it's a test to see the process of swallowing by doing x-rays while eating or drinking things w/ barium. Gross. Believe it or not, he's not a fan. He's had one done before, when he was much younger (11 months, maybe? won't lie, it all blurs) And guess what, all these months later he's doing the same thing he was then. Not aspirating (food/liquid ending up in his airway, very bad thing). But, his swallowing is very strange. He has the tiniest little swallows... basically milliliters at a time. He has a phenomena where he starts to swallow and can bring it up again.. WHAT? You could see it go part way down, then up. So strange. The speech therapist said he was more control than any adult or child she's seen. The whole room was baffled. Leave it to Micah, the entertainer.
We'll have an mri soon, the date is not set yet. He's also going to the OR the day after the mri to let the oral max surgeon see what's going on and hopefully for the interventional radiologist to do some sclerotherapy if the mri warrants it's possible.
Oh, life isn't dull.

Latest trip...

2012-01-27T21:16:00.002-05:00

We went to visit Dr. E, and he did a scope (up the nose=seriously no fun). He had a terrible, terrible time. Travis held him, and i suctioned nearly constantly. Doc cleaned out his crummy ear, and to our advantage, it wasn't "that bad". LOL, that's as good as we get.

The scope showed he's pooling his secretions (not swallowing very well) and some residual swelling, but really, not a whole lot. He came out w/ plans for a video swallow study, which we were going to do anyway. Now that i write this, i'm wondering if he saw something he didn't want to see... We'd been bringing this up since August. Things have gotten better and worse a handful of times between now and then. We'll save that email for tomorrow. Ugh.

Dr. E hopes there's a macrocyst by his temple, and we'll have an ultrasound done next time we go down. Other than that, it depends on what we can find out about his mouth... So, we went to the nearby UC hospital for a consult w/ a new doc. He can't tell us anything straight away, but at least got an idea of what imaging he needs done (x-rays? mri's? ct? mentioned sedation/anesthesia).

Silly boy

2012-01-22T21:20:00.003-05:00

Channeling a Richard Simmons headband meets Superhero bib-cape fashion... And being super cute while doing it!

2012-01-19T11:42:00.002-05:00

Said crummies landed us in the ER last night around midnight. He was coughing bright red blood out of his trach, and believe it or not, we weren't comfortable with that! LOL... There wasn't anything they could do, so we went home. Better safe than sorry... very sleepy now, though. Props to the Lutheran ER for getting us in and out in an hour! The doc was very helpful. He's doing better this morning, normal "cold" symptoms, no fever, bleeding or 02 crazy sats overnight! We're on 2 antibiotics and hoping we stay out of pneumonia land!
We appreciated your thoughts and prayers last night, and anytime!

The crummies...

2012-01-18T20:39:00.001-05:00

We've been dealing with some more serious than average crummies for the last two days. Bronchitis, sinus infection, fever... no pneumonia as of this afternoon. Hoping he can get rid of this hospital free.

Snow fun?

2012-01-16T14:02:00.002-05:00

We're not so sure about the snow yet....

The cold that never ends...

2012-01-13T11:31:00.002-05:00

Things have been going alright over here. Personally, i'm not real enthusiastic about the snow, but it's what you get (and at least it waited this long!)
Micah has been battling a cold for almost a month now! Everytime he gets a little better, he seems to catch another bug and go downhill. Might need to have a hiatus from his therapy at the hospital so he can stop catching every bug in town! Other than that, the poor guy hasn't been out that much since his surgery. We go to Cincinnati at the end of the month to see ENT and oral/maxillofacial surgery. if i had to guess that means we'll probably return shortly after to get whatever imaging the surgeon might want. Hopefully after that we won't have to go down much until the weather improves!
Despite M's cold, he hasn't slowed down much. Never does, does he?

A more substantial post

2012-01-05T22:11:00.002-05:00

Now that I have a fully functioning keyboard... It's less irritating to post.

Since surgery, Micah has had a cold (don't get me started where it came from, trust me). It'll be 3 weeks tomorrow since his surgery. Airway work+cold is not the finest combo. Makes me want to never take him out again.

Today I got a call from the doctors office that our ENT wants us to see regarding Micah's jaw issues. Unfortunately, it's not at Cincinnati Childrens. :( It's practically next door, at University of Cincinnati Hospital. That hospital is... unique. They are very good at a lot of things, one of which being the prenatal/high risk care I received as part of the fetal care program. They're great with trauma and a whole lot of other things, from what I hear... It's also a very intimidating hospital. It's in a bad neighborhood, and get a lot of the shootings and whatnot. Much more dramatic than what I prefer. But, apparently M's ENT thinks highly enough of this guy to send us there, so there we will go. And to boot, we got in on the same day we'll already be down there to see Dr. E at the end of the month... that's a WIN in my book! Hopefully we can get on the path to knowing what's wrong with the poor kids jaw. (In short, it opens probably 1/3-1/2 of what it should, making lots of things rather difficult, most importantly, the surgery necessary to clean up his airway). IF this doc, Dr. K feels like surgery is necessary and is beyond his scope (which isn't out of the question with his LM involvement), we may have to travel to see a team that has a oral-maxillofacial surgeon on their vascular anomaly team (say that 3 times fast...LOL). Somewhere you know, like Boston (dramatic sigh).

In the meantime, we have 3 more weeks til those two appointments. Looking at scheduling another swallow study because... something ain't right. Still. We had a few days that were looking decent, but now, not so much. Hoping it's a short term thing exacerbated by the cold.

New Toys :)

2012-01-02T10:57:00.005-05:00

putting together our new art easel

Spending dad's money :)

A brief but delightful look back

2011-12-31T17:00:00.006-05:00

Christmas 2009

Christmas 2010

Christmas 2011

Merry Christmas!

2011-12-25T22:08:00.002-05:00

Merry Christmas!

Love, Micah

A sick kid plus not swallowing...

2011-12-21T21:44:00.002-05:00

Our house isn't a pretty site (or smell, for that matter) right now. Micah is sick and not swallowing, so you can imagine how that goes. Apparently whatever they did surgery wise makes his breath STINK as it heals... Oh, good grief he's smelly. REALLY hoping that improves before Christmas. That, or he's channeling his inner Pig-pen from the Peanuts shows.

Love ya kid, but you stink.

A rough 24 hours...

2011-12-18T21:09:00.002-05:00

You know you left the hospital too soon when... (should have been the title). M came down with a cold, it seems. Nothing too crazy, but paired with the respiratory issues that come with upper airway surgery, we had a MESS. About 5 times in the last 24 hours he'd cough or cry, and in about 3 seconds (no kidding), he could barely breathe. Or not breathe at all. It was almost an immediate plug of thick as glue crud in his trach. I think I can go from laying on my mattress on his floor fast asleep to upright in less than a half a second now.

When you have a trach kid, you get used to a degree of trouble breathing. It usually sounds worse than it is (you get some funny looks when you're out and about), but nothing where you have to act immediately. When trach kids get sick, you usually suction dozens of times a day, usually thick goop, but nothing immediate. This was different and a little terrifying (even for me). It's terrifying for the little guy too :( Luckily our super awesome doc was great about emailing us back and gave us some tips that have seemed to help get over the hump of the nasties. No scary episodes for the last 8 hours. And thanks to my LM mama friends, I still have my sanity. It's so nice they speak "Hollandese" (a classic special needs poem.. http://www.our-kids.org/Archives/Holland.html )

So, after seeing every hour of the night last night (and probably the night before that too), I'm sure hoping for better tonight.

It's still complicated.

2011-12-16T22:22:00.003-05:00

So... Micah's doing well and is sleeping soundly in his crib on our favorite hospital wing. We have had 2 nurses we've had before, seen plenty of familiar faces, and even our favorite RT. (That's respiratory therapist). Just hoping to see our favorite PCA tomorrow, but I don't think he usually works weekends. M's on just tylenol for now, and doing great. Morphine works well, but is a rough go with the itching. Hopefully this wonderful-ness continues!

So, the doc had trouble getting his mouth open enough to do the work he needed to. This is not a new problem, although it's not one he's always had. In the process of trying to get his mouth open enough to do anything, 3 teeth popped out. This concerns me on many fronts... Speech, feeding, why his teeth fell out so easy, denistry, maxillofacial surgery.. to name a few. The doc was more than apologetic, and even paid the tooth fairy fees (isn't that hilarious!). I'm just sad my baby lost his first tooth without me, and that we've got years to wait for the new ones. Worse things could have happened, though.

Doc couldn't get in to cut out his tonsils and adenoids, so he used something called coblation. It's a radio frequency that shrinks down tissue. That was the plan for the swelling/LM on the base of his tongue. It's sometimes, but not often used for T&A too. The good news is, less pain, less risk of bleeding. Bad news is it doesn't completely remove the tonsils, but should significantly improve the situation. Apparently his upper airway was just massively swollen. His uvula was multiple sizes too large (and not in the good way, like the Grinch). Doc worked on that as well. Add in the T&A, the LM, the base of tongue and things were very tight. No small wonder swallowing food has been a massive challenge since his last surgery. I'm hoping against hope this will improve his eating.

I think that's the gist of it. Sounds like we gotta find some maxillofacial ppl... Unfortunately, Childrens (a top ranked hospital nationally) doesn't have them. Bummer.

But for now, I'm going to sleep. Because I love sleep. A lot.

It's complicated.

2011-12-16T19:56:00.001-05:00

He's out, and he's doing fine.

Other than that, it's a little complicated. Let me mull it over and not dump a ton of medicalese on you.

The trip down...

2011-12-15T20:46:00.003-05:00

We don't just go to Cincinnati anymore... we find all the fun places to stop between here and there!

This trip, Mounds State Park (free admission today, probably thought it was too cold/wet for anyone to go! They were probably right). Trav and I ended up with very squishy feet. Eww...

We had a nice time though. Micah loved the fish tank in the nature center (and the turtles too.. I'm blaming you, Jess).

We're looking at getting zoo tickets for the morning. You can get them free at guest services. Micah would love to just go stare at the fishies for hours, I think. The zoo is open year round, and has a lot of indoor exhibits, so we'll be okay if the other animals aren't out.

Surgery is 2:20pm, FYI.

More Traveling Awareness Bears

2011-12-15T20:36:00.001-05:00

Micah meets MaKenzie... and Luke and Leia

2011-12-14T22:39:00.003-05:00

Meet MaKenzie and the Traveling Awareness Bears!

MaKenzie is a sweet little girl who lives a few hours away. Her mom and I have been chatting on facebook for many many months. Micah and MaKenzie have the same condition, and it even presents in a very similar way! MaKenzie was a little shy, and Micah was a little crazy, so it made for an interesting afternoon. Not sure what the kids thought of it, but Kelly and I had a great time! I can't wait to hang out with them again, maybe somewhere nicer than McDonalds!

Kelly has initiated the Lymphatic Malformation Awareness Bears, and they're off on their journey. They'll spend time with Micah and MaKenzie, and be off and away! Luke and Leia will visit children that have LM all around the world. Both bears are headed to Cincinnati this week for a visit with their doctors. You can follow their journey at: https://www.facebook.com/#!/pages/Track-Luke-and-Leia-for-Lymphatic-Malformation/123863031052474

Ack... Blogger isn't letting me upload more pics. Better luck on the faster internet at the hospital, maybe?

Really unlike me...

2011-12-13T20:31:00.003-05:00

We leave in less than 48 hours, and I'm maybe 30-40 percent packed. Uh oh. I've got M's medical stuff 90% packed, and that's the important part. I'm not psyched up for this surgery... at all. Usually I can get to the point where I'm ready for it, but I'm still waiting this time. I don't know if it's because of the uncertainty of what they're doing/not doing... I'm really hoping to get caught up on sleep before we leave, Lord willing.
Tomorrow is phone call day... Call his nurse for his bloodwork numbers and call same day surgery for the details on when he has surgery. Gotta make a trip to the Ped, then we'll be ready to go on Thursday.
The sliver of good news is that we're planning on seeing our Cincinnati friends from when the kids were babies. We haven't seen them awhile, so it'll be great!
We got Luke Bearowitz this week, can't wait to post pics! Luke is a stuffed bear that carries Micah's story all around the world to other kids that have the same condition. They are called Traveling Awareness Bears. We had a super great fabulous time meeting with the girl bear and her friend this week! Leia (yeah.. Luke and Leia.. get it?) Bearowitz has the story of a little girl that lives about 2 hours away... and we got to hang out on Monday. Pics to come!

About that time...

2011-12-11T14:17:00.002-05:00

Time to really start worrying in overdrive. You'd think I'd be used to this, I think this is something like surgery number 11?
I usually start packing about a week and a half before (I know, a little irrational). I have my super long list of what I need to pack for him, but always forget something anyway.... (Which reminds me, I need to order his meds tomorrow...) We're chancing it again and not bringing some of his bulkiest equipment. We've done it before, but only when we know it's only going to be a night. This time there's a chance he could be discharged to "local" and we'll be stuck there... Hoping not. Usually I push that if it's a possibility, but we aren't going to be in the Ronald McDonald House, and I'd rather not be stuck in a hotel room with him for any length of time.

I'm really hoping this one goes smoothly. No reason why it shouldn't. In theory, this should be easy. (Haha). We're planning on being down there til Monday, but if we can go home sooner, we'll just forego the loss of paying for the room...

In the meantime, I think I'm going to nap. I'm too stressed out. (It won't happen, but it's a nice thought!)

Micah is doing fine. He isn't sick, knock on wood. We have to take him to a doc Monday and Wednesday which is exactly what you don't want to do this time of year.... But you gotta do what you gotta do.... (Which reminds me, I need a pre-op physical form. Why didn't they send that?)

If you havcn't noticed before, I have a really short attention span. :)

Christmas fun

2011-12-08T20:42:00.003-05:00

He's pretty tickled by our Charlie Brown Christmas tree. Just his size :)

A PG-13 Post, parents.

2011-12-04T19:54:00.003-05:00

Feeding therapy is H-E-you-know-what. Dante must have reserved a special level of you-know-what for this. If you have kids, you remember those days where everything was "no" and was thrown or pushed away everytime? That's about everyday in my house.
I don't think I can find something that makes me want to jump off a cliff more than feeding my own kid. It's AWFUL. EVERYDAY. On the best days lately you'll get 5 bites... Of barbeque sauce. Dinner tonight was PUDDING. CHOCOLATE PUDDING. NOTHING.
Lately he's been spitting out (for lack of a better term) what he's drinking sometimes. My heavens, that's so irritating I could scream. He doesn't mean to, but ughhh.....

Here's what some other trach/g-tube moms said about feeding:
"I am constantly telling my friends that I would rather Harrison be g-tube free than trachless Obviously, if I really had a choice, I would take getting rid of the trach bc of the potential for long term damage, but as far as my patience goes, the g-tube drives me crazy. We have taken such gigantic steps backwards in the eating department, and most times I try practicing with harrison, we both end up in tears. "

"We were there for a loooong time. And it sucks. It sucks worse than the trach, worse than carrying a ventilator around......"

"Do you ever just get sick of it? I feel like we are stuck."

That is all.

The hotel rooms are booked.

2011-12-03T13:06:00.003-05:00

Alright, it's official. Since our hotel of choice isn't open to Children's patients anymore, we had to branch out and try a hotel we've not tried before. Now we beg God to keep Micah healthy since we can't get out of the hotel reservation if we need it...

I need to write "The Parents Guide to Hospital Stays" book. If only the RMH was easier to get into. We're not even going to try, since we're only going to hopefully be there Thursday-Monday. Hopefully. Really hard to say... Stupid hotel policy.

Next surgery...

2011-12-01T21:23:00.003-05:00

T minus 15 days.

Here.
We.
Go.
Again.

Explaining nursing...

2011-11-29T08:55:00.002-05:00

I have a major tendency to need to explain myself, even when it's not necessary.

So, here goes... Nursing. We get 46 hours a week. We choose to use 5-8 hour nights to sleep (and a 5-6 hour day shift). Now to understand why we use it that way, you must know how much I need sleep. I don't do well on little sleep. At all.

When you have a trached child, you get a few choices. Sleep in the same room as the child, rely on a monitor, or have a nurse. I will not rely on a monitor. I can't rely on power to not go out, and not hear his monitor (his monitor has a battery backup). So, when we don't have a nurse, Travis and I sleep on his floor. I live in fear that if it were just one of us, we might not hear his monitor, so we both stay in there. It's really an irrational fear, but if you're kids' life depended on it, you might be irrational too.

This week has reminded me why... even though I sometimes can't stand our nurses, I need it. We had Micah 4 of the last 7 nights. Two nights ago, between 11pm and 6am, I was woke up... maybe 6 times? The feeding pump malfunctioned, and had to be reset. Feeding pump needed refilled (so did his humidity, but in my tired stupor, I forgot) Feeding pump needed shut off. Pulse ox alarmed. Pulse ox malfunctioned. Micah kicked me from his crib. Last night was a little better. I think Travis was up once, and I was up 2 times. Little punk decided to toss and turn from 4:45am on= very little sleep. He sleeps so much better when we're not in there.. probably because he can't hear Travis snoring!

In an ideal night, I get up at about 1:30am and 5:30am. That's if nothing beeps, nothing malfunctions, he doesn't need suctioned, and he stays asleep. (Read: this very rarely happens).

So, yeah. Nursing. Maybe someday Micah will be able to sleep without being attached at the foot, neck and belly. Until then...

Interacting with special needs families 101

2011-11-25T19:11:00.003-05:00

(A large group of people including myself put our suggestion in, and this is what came of it. Hopefully it's helpful and it's meant to be shared, so feel free!)

Top 10 Manners for Interacting With Children of Special Needs and Their Families
By Julie Schenk Leach

I was asked to write this list for the MOPS group I'm a part of. It was included in a packet about manners and etiquette for children in various situations. I'm all about taking the fear out of interactions with my child, so I whole-heartedly agreed!

I didn't want the list to just be based on our personal opinions, though. I checked around on the internet and got a few ideas, but most of my research came as a result of a poll of a special needs group I have joined. I asked them what they would like to tell people to do or not do when dealing with their special needs child and his or her family. Let me tell you, the response was overwhelming! 50+ people responded with multiple suggestions. This is obviously a hot topic for special needs families and one that definitely needs to be addressed.

Therefore, I decided to also post the Top 10 list on here. I hope that it helps you know how to teach your children how to interact with special needs children.

Again, these are not solely my opinions. This is a compilation of suggestions from the families of children with a variety of special needs. We hope that you will take these thoughts into consideration the next time you encounter one of our wonderful children!!

Top 10 Manners for Interacting With Children of Special Needs and Their Families

1. It’s okay to ask questions. Children ask questions. That’s part of the learning process. Shushing your child if he or she asks questions about a special needs child suggests that the special needs child is something to be ashamed of. Instead, openly answer your child in a loving, gentle way that he or she can understand. If possible, try to link the child’s physical or mental disability to something your child already knows. If you aren’t sure about something and are close enough to the special needs family for them to hear your conversation, ask them to explain the machines or disability. Most parents would rather you ask about their child directly than avoid him or her. Plus, special needs parents are used to sharing about their child and will probably do a good job of explaining it in a way that your child can understand.

2. Be Tactful With Your Questions. Asking “What’s wrong with him?” is insulting to families who see their children as wonderful just the way they are. Instead, encourage your child to ask, “Why does she have to be in a wheelchair?” or “What is that machine for?” or "What's her story?" Of course, also help your child know when he or she has asked too many questions and is now just inconveniencing the family!

3. Staring is Embarrassing. When you see a special needs child out in public, turn your child’s staring into a teachable moment. Special needs families are probably used to staring, but that doesn’t mean that they enjoy it! Remember that special needs families are trying to live their lives just like you and don’t want to have to constantly feel “different.” Discuss with your child how he or she would feel if people stared at your family like that. Talk about how staring, even “sneaky staring,” makes people feel different and ashamed. Instead, encourage your child to smile, wave, and say “Hi!”

4. Start up a Conversation. As much as possible, children should speak to special needs children the same way they would speak to their own brother or sister (or maybe a little nicer!) :) While they may need to speak slower or repeat themselves (depending on the disability), it’s important that your child realize that special needs kids like to interact with other kids too! Often, these kids feel very isolated from their peers and they would welcome a friendly face.

5. Avoid Assumptions About Intelligence. Teach your child that a physical disability does not always equal a mental disability. Kids in wheelchairs or with physical deformities can often perform on the same academic level as peers, but are often treated by others as if they have learning disabilities.

6. Hands Off! Don’t touch a special needs child (especially the hands!) without permission from his or her parent. Often, kids with special needs have compromised immune systems that make them more susceptible to illnesses than other kids. Likewise, make sure sick children keep a safe distance from special needs children when possible. In addition, some children with sensory issues may not respond well to being touched by strangers. This could cause an episode that will draw even more unwanted attention to the special needs child. Take the cue from the parent, but err on the side of caution with this one.

7. Encourage Them to Find Common Ground. No two people are alike, but everyone has something in common. Regardless of differences, it's important to encourage children to look for things that they can relate to in others. Do both students adore the classroom hamster? Are both great basketball players? Finding common ground builds character and strengthens interactions between children.

8. Avoid Using the Term “Normal.” What’s normal, anyway?! The standard of “normal” changes depending on who you’re talking to, and I would venture to say that most of us would be out of the range of “normal” in at least one category! Using this term sends the message to kids that special needs kids are weird, or that there is something bad about them. Instead, use words like “typical” or the phrase “typically developing.” One mom says she likes, “radically distinctive!”

9. Be Conscious of Your Facial Expressions. Help your child to be aware of his or her facial expressions toward special needs children. You have no idea how many looks of disgust we have gotten, and that is hurtful to families who love their children unconditionally.

10. Don’t Show Pity. It is sometimes very difficult to see a child with major medical problems, but showing pity or saying, “I’m so sorry” sends a message to your child that this is a bad situation or something for which to apologize. For special needs families, they are just thankful to have their children and are doing their best to give them a fulfilling life. These families have fought through the hard times and are stronger for it, so take a cue from them and celebrate the small victories!

Thanksgiving fun!

2011-11-24T18:50:00.004-05:00

Thanksgiving Thankful Thursday

2011-11-24T09:41:00.003-05:00

This thanksgiving brings plenty to be thankful for.

For health, maybe not your "typical" health, but health.

For Micah, who has been through a lot and still has a wonderful wild, crazy spirit.

For Travis, who puts up with me (not very easy) and loves me no matter what.

For my parents who are willing to rearrange the schedules to accomodate babysitting Micah, since they're our only options (not that they'd ever say they'd mind)

For my in-laws, who I can hardly call in-laws since it's not the most positive term. Most people can't say they love their in laws. :)

For the blessing of raising little Micah, and how he is a joy to so many of you guys. We appreciate all the people that love him, even if you hardly know him. It's overwhelming sometimes to sit back and think about all the people that care so much about him, even if you've never met him or only met him once or twice.

I'm so thankful for our Cincinnati second family. They take wonderful care of us, and we couldn't ask for more. They make this road so much easier than it could be. (We're also thankful we haven't had to see them for awhile! It's a catch 22!)

And sadly, today brings about the 10th anniversary of my grandma not being with us. I can't believe it's been 10 years. I just wish she could have lived long enough to meet Micah.

Happy two years home, buddy.

2011-11-19T21:09:00.004-05:00

It's probably hard to understand, but I'm so emotional on this day every year. I think back and realize how much time has passed between his second birthday and today, and it feels like FOREVER. I really can't believe I ever made it through that. He was in the hospital 80 days. To some of you that's nothing, and I'm sure some of you can't imagine it. I can't imagine doing it again.

He's come so far.

OH I'm so excited, I finally got this up. Lizziey B, this was supposed to be a little birthday present from Micah, but couldn't get this uploaded. All the rest of you can enjoy it too. Who doesn't love Green Eggs and Ham. :)

2011-11-18T08:27:00.002-05:00

He may not look like me, but he certainly acts like me.

He's still asleep (its 8:3o). Which is exactly what I'd be doing if given the choice. :)

I usually wake him up at 8 if he's still sleeping (he normally gets up at 7:15)... but there's no time for a nap today. He has physical therapy at naptime, and by the time he calms down after that it's usually too late for a nap. So, we'll make the bet and let him sleep now.

2011-11-17T09:38:00.002-05:00

After a combined 9 attempts between facebook and blogger, I finally got it up both places! Enjoy my silly son.

Thankful Thursday

2011-11-17T07:44:00.003-05:00

1) For Micah sleeping in. Now, ask daddy if he's thankful for this when Micah won't go to sleep tonight, and he might disagree. We've got a busy (boring busy, not fun busy) day so it won't hurt.

2) For my special needs mom's group. Love them, love the fact that I can say all sorts of complicated stuff and they get it. And for the fact that it's at Starbucks (caramel brulee frap... whoa!, and lets just add the muffins the size of my face at Martins.

3) For my respite care morning. I end up being out of the house for like 4.5 hours. It goes too fast, but it's wonderful.

4) For the WCC Holiday Tea (in advance). It's such a girly thing, but I LOVE it.!

In other news, Micah has his last IFSP plan meeting today. It's what early intervention does to set out goals for the upcoming year. I can't believe it, but soon he'll be transitioning to the school system! (Okay, not soon, but this spring!) I'm hoping he still qualifies for all his therapies, although he may not. It's complicated.

I've been desperately trying to get a video on here, and it's not working. Which is SO sad, because I think it's so funny... But I'm his mother, I'm supposed to think that.

So, all I have is a picture. Maybe the video will cooperate someday.

Whooo are you???

2011-11-13T08:49:00.001-05:00

Not sure why, just had a random "Alice in Wonderland" moment.

I'd love for some of you to comment and tell me who you are! People check in from places I've never heard of, sometimes in different countries.

The easiest way to comment is "Anonymous" or with your website, which I'd love to follow. :) Just make sure if you choose anonymous that you put in your comment who you are!

GO!

Thankful Thursday (+12 hours)

2011-11-11T11:49:00.002-05:00

And, Thursday came and went. Oops. Told ya!

1) For getting to see a million people at WCC on Sunday. I only get over there about once a year, so it's nice to see everyone including some from my moms group last year. And...
2) So thankful for my parents staying an extra hour and for my mom taking micah to the nursery. This was the first time he's really gone to the nursery to play with other kids. While the germ-a-phobe in my just about threw up thinking about it, I was SO glad he was able to have that normal experience (and that I got to sit through church for the first time in a LONG time!) I love my home church, it was just nice to have a change of pace!
3) Micah got his cute little feeding pump that goes in a cute little backpack (although the backpack already broke! Boo!) It's nice to let him have more freedom to roam and not be herding him to get fed every 15 minutes!
4) For podcasts online. I've been listening to various podcasts this week from various churches and Bethel. It's been a blessing since I can't always get to church.
5) For a fun group of youth, and the fact that Travis is cool again (in the eyes of Cora, but not Erica). They are great kids, I hope their parents realize this! We've got some fun things coming down the tunnel. New things! :) Can't wait to roll it out! (By the way, this isn't my job, it's my husbands... hehe!)

Alright, that should be enough for the week. It's been a good week. Micah's got some bug (remember that germ-a-phobe thing.. yep... this is why). So far it's been relatively easy... suction city but no sign of respiratory issues other than that! Hooray!

Super fabulous bloodwork

2011-11-09T23:40:00.002-05:00

Micah rocked his bloodwork. His white blood cell count was decent, his hemoglobin was decent enough, and his IGG was through the roof! 490! :) WHAT?!?!

In english... IT'S GOOD!

It means, barring any significant trouble, we can avoid the city of Cincinnati til December 15th or 16th. That'll be 2 WHOLE MONTHS! :)

The abnormal has become so normal, the old normal seems abnormal. Got that? Eh, me either it's past my bedtime.

I'm trying to upload another silly video, it's just not working. Sorry. Internet doesn't seem to be quick enough. I'll try to edit tomorrow and try again.

On a bummer note, the little man is sick, it appears. That's what happens for being let out of the house for the last ten days. As long as it doesn't turn into anything major, it's no big deal.

Micah's first "real" word!

2011-11-08T17:22:00.005-05:00

It may not qualify for all of you as a first word, but we're going to take it!!! :)

Haha, I forgot to mention he's running around without pants because he'd just got a clean diaper :) (Just ignore that part!)

It never fails.

2011-11-06T20:21:00.002-05:00

It never fails to amaze me to watch how many people visit this blog. Crazy! Well, thanks for reading!

Things have been delightfully uneventful here! :) Can't complain about that!

We had a little dance party tonight to the "Walt Disney" station on Pandora. Nothing like the jungle book song "bare necessities" to get your toe tapping. It's a fun station, I'd recommend it!

Micah has bloodwork on Tuesday, mostly to check his IGG and make sure it's not crazy low again. We figure it'll drop, but hopefully not as quickly as it has. It's been 3 1/2 weeks since he's gotten it, the last two times he's been over 100 points low by this point. We figure one more trip to Cincinnati before his surgery (Dec. 16). I can't tell you how happy that'd make me!

Thankful Thursdays.

2011-11-03T08:53:00.003-04:00

I'm totally stealing this idea. :) Whether or not I'll have forgotten it by next Thursday is another story. Remembering isn't my strong suit.

1) So thankful we haven't had to be in Cincinnati for the last 3 weeks (today!) It's been months since this has happened! We love our team, but they'd rather us stay home too!
2) For Target's dollar bins, which make me happy! 48 Christmas cards for $3. Yes, please! :)
3) For a really "normal" Monday. Travis is off on Monday typically and we went Christmas shopping and out to lunch with Micah. Poor Micah hasn't been out much at all in the last year, really! It felt so normal, it was almost abnormal!

Trick or Treat pt 2

2011-10-31T14:20:00.005-04:00

This doctor makes housecalls... if he were only tall enough to ring the doorbell :)

Doctor Micah, making his evening rounds :)

Last stop, grandma and grandpa's house.

Paging Doctor Micah

2011-10-30T21:45:00.006-04:00

Our handsome little doctor in training :)He's learned from the best :)

This, on the other hand, he probably picked up with mommy watching too much "House". :)

Didn't know what to put as his "Specialty" for his ID tag, thought adorable would be fitting!

I'll get more pics up later, blogger is being a pain!

Getting desperate!

2011-10-27T09:17:00.003-04:00

So, the promised post about Micah's feeding schedule. Most of you can just skip this... (this is what most people call oversharing, I call it desperation)

For the last month or so, Micah can rarely hold down his morning feeding. Just this morning, I gave him 15 mL (1/2 ounce) of blended food/pediasure, and up it came within 5 minutes. Sometimes we can't get past his AM meds without puking.

This is his current feeding schedule.

9pm-5:30 am- 13 oz pediasure, 2 H20, multivitamin
8:00- Morning meds if he has them with 1 oz water
8:30 am- (Attempt) 4 oz pediasure, 1/2 oz water ("bolus" at fastest 15 ml every 15 min)
11:30am- 6 oz pediasure, 1 H20 (bolus 30-45 mL every 15 min)
3:00pm- 4 oz pediasure, 1 H20 (bolus 45 every 15)
6:00pm- 6 oz pediasure, 1 H20 (bolus 45 every 15)

He gets minimal food/drink by mouth, at max an ounce of each a day.

We've tried pediasure, blended food (although that usually gets mixed with 1/3 pediasure to thin out). Sometimes he even pukes with water in the morning. Occasionally he has trouble with other feedings, but about 75% of the time it's the first one. He has a BM a day, usually late morning.

I'm baffled as to why he barely tolerate anything in the morning. As you can see by our feeding schedule, we're packed the the max with feedings just to get them in. I've debated going continuous in the AM, but he doesn't have a pump he can carry and he's WAY too active to sit still for over an hour.

I'm thinking it's not a motility issue since it doesn't take anything to make him puke. I'm wondering if it has to do with his nissen... Maybe something is pooling up on top of it overnight. Sometimes the puking is caused by coughing, sometimes by suctioning, sometimes by nothing at all. Or maybe it's allergies, and he has too much going on 'junk' wise in the morning.

The puking has come and gone his whole life, but not with reason. He just came off 7 weeks straight of Keflex because of the drain. I'm sure that's left his system beat. We're doing probiotics to try to negate some of those problems.

Any ideas?

Yuck.

2011-10-26T13:32:00.004-04:00

So far, the only day our surgeon has open THIS YEAR is December 16th. We took it, but nervously. Mr. Micah, as we all know, is the king of pulling stunts. And of course, with LM you don't know what you're going to find until you get in there. The doc has a few things in mind, but won't know for sure til he gets in. He thinks it'll be a 2-3 day max stay, so we should be okay if it's double that (which we've been known to you). Looks like potentially tonsils and adenoids, coblation (a way to remove LM tissue) on the base of his tongue (the back part) and a scope. There's so much to do, it's a veritable laundry list of things that need done in there. We usually just sign off for all sorts of things, and they'll call out with what they want to do when they know.

Not sure what the plan is between then and now, (7 weeks, 2 days). I assume we'll be down there for IVIG at least once between now and then. In theory we shouldn't be having the catastrophic drops because he's not draining. It would be super to only have to make one trip in the next two months... I can't even imagine! That being said, I'm not getting my hopes up.

Looking ahead... trying not to look too far ahead.

2011-10-25T17:09:00.002-04:00

We've got a time frame for the next round, nothing pinned down yet. Looks like it's a scope, with potential for tonsils and adenoids and what he calls a "tongue base reduction". Probably should figure out what that entails, but I can take a guess. Sounds awful though. Still hashing out whether the t ANd A (micAH LOVES pLAYING WITh the caps lock buttoN, IT LIGHTS UP WHEN IT's on). SORRY, whether the T &A will require a lengthy stay in Cincinnati. I've heard some airway families have to stay in town for a week and a half due to the bleeding risk (and no one would want to touch our kids airway). Obviously, that doesn't seem like the norm, but I have no idea what is normal anymore.

I gotta get a post up soon about Micah's feeding schedule, because I need some of you special needs mama's to HELP!

For a friend :)

2011-10-24T17:24:00.004-04:00

This is for a friend who needs a smile, but I'll let you all see :)

The biggest problem... isn't that big!

2011-10-21T08:27:00.002-04:00

We're at a.... dare I say it???... a slow point with Micah's treatment. We got the go ahead to stop 3 medicines yesterday (that's 7 less doses a day), switch one med from twice a day to once (that's 8 less)... We're seriously only left with 4 doses half the week and 2.....2!!!! the other half of the week. This morning, it took me like 5 minutes to realize he doesn't have morning meds this morning!

The drain is out now, so we dont have that antibiotic irritating his stomach, and let me tell you, 7 weeks of a pretty potent antibiotic... UGH!!! Not to mention the one he's been on for most of the last 6 months... I hear parents so tentative to give abx for an ear infection or something... and I can't help but think that I wish we had that luxury to worry about that.

He's off the immune suppressant, the drain is out, and his iGG is fine (for now). What? My kid has an immune system (well, maybe not quite, but soon?!) Oh wait, it's October. Doesn't matter because he doesn't get a free pass out as long as he has a trach, in my humble opinion. The (sort of) good news is that he gets synagis again this year, it's sort of like a vaccine against RSV. UNFORTUNATELY, it's monthly shots for probably the next 6 months. This mama just about had a breakdown when I heard that he qualified again. It's a torturous shot (he was upset for about 5 seconds about a flu shot, this he'll scream for), and he knows by now what's coming. And we just got past weekly bloodwork/sticks. *bangs head against the wall* Poor kid... poor mama and papa. I'm just sick of it. Sick of bringing my kid in for torturing, knowing all the while we don't have a choice. RSV can be devastating for a trach kid. Most kids you only worry about for the first year, but it's constant with a trach kid. RSV is just a specific type of cold, nothing an adult would ever have a clue about having.

He's got his yearly evaluation for First Steps this morning. It's kind of silly because he qualifies for OT, PT and Speech just because of his medical conditions, so why bother? We don't ask for the 4th type of therapy anyway! They'll probably try to convince me he doesn't need PT... Good luck with that one!

Which leaves us with our two "big" problems, his puking and his swelling. I'm hoping somehow the puking is related to all the morning meds he was on (two abx and advil). Unfortunately I know I'm wrong, LOL. In the morning the kid just can't tolerate food. We used to be able to get about 5 oz in an hour. Now we're at 4 ounces in about an hour and a half, and he's still trying to throw up (and being successful if we don't get it all back out of his stomach in time). It's baffling. We've had to increase his feedings from 3 to 4 already to accomodate the increase in volume he needs to grow.

Okay, I'm being incredibly boring to about 90 percent of you who don't live in this world. Long story short, he's got swelling in his face that leaves his eye swollen shut for the first half the day, but it goes down which says it may not be LM, just tissue swelling... but why?

That's enough of a novel, I'd say.

Don't worry, it's not slowing him down (at all)

2011-10-19T17:50:00.003-04:00

Super fun time with super fun daddy :)

This pretty well sums it up! And... he's off!!!

Wow, Mom, your ear sure is interesting!

Two steps back?

2011-10-18T16:41:00.002-04:00

Rough morning. Lately he's had issues keeping his first feeding of the morning down. It could be any number of issues, although probably nothing alarming. We're tweaking one thing at a time trying to figure out the problem.
Until... this morning I get a text from the nurse (it was my errand morning) that there's milk coming out of his trach.
WHAT!?!?!
A basic anatomy lesson... food goes down (and up) your esophagus, not your trachea. He aspirated everything as a baby, but has been cleared for everything for a long time. No signs of aspiration since he was an infant. Milk coming out of his trach... Dang. Of course I wasn't here to see it, but I have to trust she was right.
The conservative approach would say "do a swallow study, don't give him anything by mouth until we know what's going on" . The opposite would be to say (not that one is better than the other) "given his history of not aspirating in a long time, we'll call it a fluke and go back to what you were doing."
So, I think we're going to try to keep the puking to the minimum by slowing down feedings and watch any by mouth feedings carefully. He's not been doing well with them anyway since surgery. He's holding food in his mouth, which can be a sign of other problems.
Hopefully this random aspiration is a fluke. I'm concerned it was enough to actually cough out of his trach.... Not just a little suctioned out of his trach.
(Didn't I just say I thought things were going to slow down? I REALLY need to stop saying things like that!)

Well, the drain is out... at least?!

2011-10-17T20:56:00.002-04:00

Well, the drain wasn't work, and we haven't been able to drain anything from around the drain, so doc asked if Travis would feel comfortable taking the drain out!
I'm starting to wonder if Travis has a second career coming! Mind you, this drain is supposed to be stitched in. Luckily, as we played with a little, we found out it wasn't stitched in anymore, and out it pulled! It came out really easy. He's only gone something like 3 days without a drain in the last 7 weeks! Once the site closes, the kid can finally take a decent bath and get a haircut!!! (And boy, let me tell you he needs both!)
He's still pretty swollen around his eye. Hoping a good long course of advil will take it down (it doesn't seem to be cystic swelling, really).
Looks like we may not have to be down in Cincy in the next week! It's been 4 days and we haven't even had the conversation about returning, whoa!!!

Not much to update...

2011-10-15T14:26:00.002-04:00

We're thankful Micah's leg has gotten back to normal without any intervention. I couldn't even imagine if it were broken or something... He'd be so ticked!!!
No luck getting Micah's swelling under control. We're trying a regimen of advil to bring down the "inflammation" type swelling. We've tried to drain it around the drain, but still no luck even after the doc working on it Thursday. Sad day. As the day progresses he can see out of his eye somewhat, but not usually until the afternoon. Doc wants to watch and wait for awhile, since we've been intervening so much in the last few weeks. I understand, but it's hard. Maybe, though, that buys us two or three weeks from traveling though, which would be a nice change of pace.
I can't remember if I put this last time, but I've requested some time off until the next round of surgery/procedures. Maybe at least a month when this gets sorted out. It's cold and flu season now, which isn't a great time to be out. Don't want to wait too long though, since the weather will turn south in December, probably.

Oh... What to do... what to do...

I've really had enough.

2011-10-14T09:54:00.002-04:00

It gets really frustrating when you just don't know what to do next. Yesterday the Dr. drained tons of (mostly) blood and lymphatic fluid, we'd been just getting lymphatic fluid at home, so he must have gotten a new pocket we hadn't gotten in to. Still no functioning drain, so he's just as swollen as he was yesterday. I thought I understood his philosophy on all this, but the drain AINT working.

The poor kid hasn't been able to see conistently out of his eye for the last week.

Things are just really stressful around here. We don't know what to do to get this all under control. The poor kid... He's been on antibiotics for 6 weeks now. That can't be good for his belly (or for anything). We're doing probiotics, because I have to feel like I'm doing something good for him.

He didnt seem to tolerate the rapamycin again... Even after being off it for about 28 hours, it was still in his system higher than it should have been. I think the consensus is we're at the end of that road.

We've seriously thought about just taking a week and living in Cincinnati and doing whatever it takes to get this figured out... Problem is I don't think that'd even help, because there's nothing new left to do.

This disease is far uglier than I ever imagined. And if you know Micah you'll find it no surprise he's over in the next room playing. His face is swollen like a balloon, he can't see out of one eye, he's puking just about daily, but he's playing. I wish I had his spirit.

2011-10-13T16:25:00.000-04:00

Oh, hospital, how I've not missed you in the last week and a half. Got in late (no room in the inn), finally got infusion going at 4. Should be done and hopefully out by 7:30 at the latest. Hopefully be home by 11:30. Micah was a little trooper through two sticks... Poor kid is just hard sometimes. Did call child life (Tracy Lamar would be proud) for some back up, since I can't take more than one stick!

Still waiting on seeing Dr. Elluru. That ain't gonna be pretty. At least the tylenol is in his system (and the benadryl won't hurt either) :)

A hole in the head, a bum leg and a spent immune system.

2011-10-11T20:30:00.004-04:00

FW Doc tomorrow to hopefully fix the drain-o. Cincy Thursday to fix the immune system.

Still having leg issues. Might be slightly improved today, hard to say. Ped will yay or nay the x-ray in the AM.

The kid is a mystery!

2011-10-10T13:27:00.002-04:00

Still not sure what's bothering his leg. It's not keeping him from walking, he's just a little unsteady and limping. As long as he has tylenol, he's quite a bit better. Doctor doesn't think it's a fracture, which is good (can you imagine if it was...ugh I'm not sure I could take it!) We avoided an x-ray for today, but may do one if things don't improve.

We had a laundry list of bloodwork to get done, I think 7 different tests in all! That might be a record. We should have the first round back this afternoon, and the rest back later this week. We've been in contact with various docs all weekend/today... The bloodwork will hopefully rule out infection, although it seems highly unlikely at this point. Unless is IGG comes back in the toilet we may not have to go down to Cincinnati this week! We are seeing a new ENT in FW to see if he can fix the drain situation. Also, learned we can do IVIG in FW if need be, although we seem to always need to be in Cincinnati for something. (Plus, I'm not sure if they'll do it at the same fast rate we've become accustomed to, since they don't have proof he tolerates it just fine). I'll take the 8 hours of driving and 3 hour infusion over the 8 hour infusion, LOL!

Is it me, or do things just seem really complicated right now? It's my life and I can't even keep it all straight!

Something strange.

2011-10-08T19:55:00.005-04:00

Update: It's Sunday morning, and no real change. Tried tylenol last night, didn't seem to help. Got a baseline for where he was this morning (worse than yesterday) and am trying tylenol again. There's a fair chance we're going to stop the rapamycin, either just for awhile or maybe entirely. It can cause joint aches, and the hematologist isn't convinced it's doing anything for him. It's hard to say, since he was only on it two weeks, off it ten days, and been on it for about ten days again. Unfortunately, we can't get blood work unless we go to the ER. So, we'll go get it as soon as we get the order in on Monday AM. It can take 2 days to get the rapa level back, although we should be able to get the CBC/IGG back sooner, if they order them.

Micah's got some strange symptoms going on. His right leg seems to be causing him pain and is weak. He's limping/dragging his right foot just a little. The reasons could be endless. Luckily, the hematologist called me today (on a sunny Saturday afternoon) because it could have been an infection, which at this point is a trip to the ER. Looking less like an infection, and more like just about anything else. Hoping to figure it out soon. Could be entirely innocent, but it's been going on for 24 hours now, so who knows.

Coming soon!

2011-10-07T07:23:00.003-04:00

I've been invited to take part in a really fun project, Lymphatic Malformation Awareness Bears! They will be named Luke and Leia (teehee, I didn't pick them, but they're cute!) The bears travel the country, visiting children that have the same condition as the bear. Each bear carries a story of a child with LM, and Luke will carry Micah's story! The bears are outfitted with the medical equipment of the child (trach and g-tube in our case) and carry a passport and journal.

Isn't this a super fun idea? You can read much much more at
https://www.facebook.com/#!/pages/The-Traveling-Awareness-Bears/280749945273598

and if you're not on Facebook
http://www.travelingawarenessbears.org/

They have bears for different conditions, including pediatric stroke, congenital heart defects, chiari malformation, cavernous venous malformations, and esophageal atresia/tracheo-esophageal fistula. Those bears are off on their adventures, and it looks like more are in the works.

It will be a little while til Luke and Leia begin their adventures, but you can request a visit on their website.

This is Pat, the Pediatric Stroke Awareness Bear :)

Post #301... Super exciting!

2011-10-06T23:41:00.001-04:00

I've got something exciting to share... but you'll have to wait to find out!

(And no, I'm not pregnant... this is a Micah medical thing, sort of!)

Abbreviated surgical history

2011-10-06T15:58:00.006-04:00

This is for my medical mama friends (and myself, it's hard to get all the info in one place!), the rest of you guys can feel free to read it if you'd like.

8/31/09
Birth- EXIT to airway, intubated 3.5 tube
9/3/09
Micro laryngoscopy/bronchoscopy (ML&B), Neck dissection (bilateral)
10/2/09
ML&B, G-tube w/ Nissen fundoplication
10/7/09
Tracheostomy, ML&B
12/10/09
ML&B
3/4/10
Ultrasound of head/neck mass, ML&B with lasering of lymphatic malformation in airway, ABR hearing screen, bilateral PE tubes
4/12/10
Sclerotherapy, ML&B with lasering
6/23/10
Sclerotherapy, ML&B
3/3/11
Neck dissection (behind ear)
3/8/11
Sclerotherapyi
3/15/11
Sclerotherapy
8/22/11
Neck dissection (bilateral), right parotidectomy
9/1/11
ML&B
12/16/11
Coblation tonsillectomy/adenoidectomy

What you really came for...

2011-10-02T21:57:00.003-04:00

This was at the Camp Mack Festival on Saturday. We all had a good time, and I know I can say I ate entirely too much delicious food.

The other is him just bopping around the house. I'd moved this chair out of the way, and now it's his little climbing sanctuary.

Avoiding this...

2011-10-02T16:45:00.002-04:00

I've been avoiding the blog mostly lately, because I don't really feel confronting what's going on. The kid isn't swallowing. Okay, maybe he is sometimes, I don't know... But not for the most part. Which means he's not eating or drinking for the most part. He's trying to eat and drink, for the most part it's just staying in his mouth or dripping back out. Speech and occupational therapists want another swallow study. ENT doesn't think he did anything to cause such an impairment. His 2 yr molars are near the surface, which could cause drooling, but something else is going on... The possibilities are nearly endless and I don't know where to start, if we can even convince ENT there's a problem.

We go back down tomorrow. Someone asked how many times we've been down there... I think it'd be interesting how many days we've spent down there in the last 800 or so days... Including the time we were there before he was born, we're at roughly 120. That doesnt even count the clinic visits/follow ups/day hospitals. Maybe someday I can figure out a general number. It's kind of depressing, so maybe I shouldn't.

Not a post to read with your morning bowl of oatmeal.

2011-09-29T11:57:00.004-04:00

Sorry for the lack of updates. Our freshly installed internet decided to stop working, and so far, 6 days later, Century Link has failed to fix it.

We went to Cincinnati Friday, they cut open two slits on his face, drained the fluid (estimated about 6-7 ounces), and put in a drain above his ear. Now, I'm not a fan of drains in general, but this is the worst kind. It looks like they put a straw in his skin, and stitched it in place. It doesn't empty into anything (so all over his hair)... It's so open it could catch flies. (It's covered, don't worry). Talk about infection risk, yuck. (As long as it's covered it should be fine, but still).

The good news is Micah was somewhat of an immune system at the moment. His white blood cells are decent (they're never good), and his IGG should be up still. We've made two trips out, one for pizza with some of our youth and one to do some visiting in Warsaw. Both good times, and he's not even sick yet! He's off the rapamycin due to the strange things it was doing to his body, although I'm sure we'll start it again soon. Boo! So, one infection risk of 4... That's the best we've done since oh... March?

We go back to Cincinnati Monday. I'm pretty tired of these visits, won't even lie. Should be quick and easy, although it's not til 5:30, so it'll be a late drive back.

Micah's doing well though, so no complaints.

2011-09-22T15:57:00.003-04:00

Cincy's Liberty campus, tomorrow afternoon. Maybe I can do it myself, since it's not in the city? I just printed off directions not two weeks ago... didn't use them, probably tossed them. Bummer.

More frustration on the lymphatic font.

2011-09-22T15:28:00.002-04:00

His face keeps swelling and swelling, more than what I thought was possible. All the surgeon wants to do is cut open a slit and let it drain, then have us drain it daily (it's awful, but we've done it before). The hope was the Ped was going to do it, but he won't. I spent 5 hours waiting to hear that today. Now it's 3:30 and we still have NO PLAN. Another day, totally wasted. Now we need to find out if we are going down tomorrow (and if we need to leave tonight). Luckily my dad has offered to take me down (Travis is absolutely bogged down this week), but it would be nice if I could know so he could get off work.

Ugghh...

2011-09-21T17:56:00.003-04:00

(this will probably be a very whiny post).

*update* They're letting us stay put til at least Monday, hooray!*

They pulled the drain and of course, it ballooned up literally overnight. We have to try to open up the drain site ourselves tonight. We did it with the last surgery, but it really stinks. Won't even lie. The drain site has been closed for about 48 hours, so hopefully we can get it open. If we can't, we probably have to go back to Cincinnati Friday to put a drain back in. If we can get it open, we have to go back next week it looks like (to put the drain back in).

As some of our youth kids would say... "epic fail". That's about right.

Had to get repeat bloodwork today. I believed they called the vein in his elbow "old faithful" because it's been poked so much recently.

I repeat... UGGHHH. We did get out of one day of therapy, saving a trip to FW. That's good.

Quick recap.

2011-09-19T18:19:00.003-04:00

First IV stick didn't work, got blood off, but couldn't get it threaded. :( Second worked, but half the bloodwork clotted before it could be sent, and they couldn't draw off the IV. Luckily, the nurse was super nice and said "forget it" to those particular labs.

Since he's had IVIG a few times before they were able to run it at twice the speed of normal, 2 hours instead of 4. That meant we were on the road by 12:30... A very unexpected surprise!

They decided to pull the drain since it's showing no sign of slowing down. They're hoping a compression sleeve (basically) will help slow it down. At this point, it's something to try. If it doesn't work, what we were doing wasn't working either. If nothing else, he should be losing less fluid this way since at worst it'll fill up and stay put.

The rapamycin hasn't done much (although it's only been two weeks). A bit of a scare today... his level of the rapa in his blood was about twice what it should be? Why? No one seems to have ANY idea. Scary stuff. We're taking him off it til Wednesday when we have to repeat bloodwork *whimper* and make sure it's out of his system. It's the same dose it was after his last surgery... Puzzling. His body isn't processing it like he should all of a sudden.

We are headed back in two weeks, barring any major changes (haha).

This week is crazy busy... We could use prayer for that alone. Travis has class T, W, Th... works Friday and half day Saturday. Won't even start listing Micah and I's agenda.

*Deep breath*

And this was the quick recap, right? Here's a pic of the sweetie passed out on benadryl.

Micahs Miracle Medical Story

2011-09-17T20:52:00.015-04:00

Thought I'd put together a post about Micah's first two years, and make it "Micah's Story" and hopefully figure out how to link it to my main page.

On June 9, 2009 we went in for our 24 week ultrasound. After what seemed like forever of looking at it, she called in the doctor. Didn't take a rocket scientist to know something was up. The doctor explained as kindly as he could that he had some sort of mass on his neck, but didn't know what it was. Two days later we went to the high risk doc, who explained it as a cystic hygroma, a mass that had a 50/50 chance of being fatal before birth. An amniocentesis ruled out genetic abnormalities, which meant he had an improved chance of survival barring cardiac failure. If he made it to 30 weeks, we'd be sent to Cincinnati for further evaluation. Obviously, he made it! His 30 week tests came out as well as they could, no cardiac problems, no obvious airway blockages etc. They asked us to "relocate" to Cincinnati in 2 weeks, as these babies typically come early. At 32 weeks when we returned I was hospitalized for pre-term labor, ended up being there 17 days that month. Micah was insistent on holding on which was fantastic!

Micah decided that instead of waiting til his planned C-section a few days later that he'd make his appearance at 8pm on August 31st. They did what was called an exit-to-airway procedure (I was under general anesthesia) to do their best to ensure they could intubate him before he was cut off from my oxygen supply. From what they say, he handled it like champ!

Welcome Micah!!!

5 pounds, 13 oz and 19" long.
What we hadn't talked about much was the impending surgery, and the fact that I wasn't going to get to hold him until after surgery (ended up being 6 days, yikes!) He had surgery on September 3rd. This was Micah after surgery number 1, the first day he could be held.

After another week or so they decided he didn't need his breathing tube anymore, and he was extubated. About a week later he started showing signs of respiratory distress and after a particular test they found he was aspirating on his saliva very severely. Luckily, he'd been tube fed or had IV nutrition until this point.

There wasn't a lot of discussion to be had, he had to be reintubated and eventually trached. He also needed a permanent feeding tube. He had his feeding tube at 5 weeks, and after finding mass in his trachea, he was trached at 6 weeks. After his trach surgery we were so happy to see his little face! We were on the grow and get trach trained plan for a few weeks after that. Not to mention the "insurance won't pay to let us have what we need to go home so they'd rather pay for weeks of the NICU" plan. Irritating beyond belief!

By now, Micah had a firm diagnosis of lymphatic maformation. In very easy terms, his lymphatic system did not form correctly. It happens in about 1 in 6000 live births, but often not this seriously. It is not a genetically inherited condition, completely random. His type primarily consists of macrocysts, very tiny little bubbles filled with lymphatic fluid. This type of LM basically is a disease that is managed, not cured. It recurrs, although hopefully with less severity after each surgery. We believe that his mass at birth inhibited the growth of some of the branches of his right facial nerve.

He got to fly back to Indiana on a medical airplane ride, where he spent three more weeks in the hospital before getting to come home. Spent a whopping 3 months in Cincinnati, he spent 8 weeks in the NICU there and 3 weeks in Indiana.

Welcome home Micah :) It was mid-November when we finally took him home. It was a beautiful crisp fall day.

At about 6 months old he was declared safe to start trying baby foods. By this point though, he wasn't interested despite the hard work of the therapists. At about 11 months he was cleared for liquids but agian, same problem. He has multiple difficulties in his mouth/tongue/jaw area that make it difficult to do oral feedings.

Micah at 5 months

We didn't have to go to the hospital much for the next year. He had a few procedures to remove the mass from his airway and a few other odds and ends (scopes, P.E. tubes, etc). Considering his prematurity and time lost in the hospital, Micah was hitting most of his developmental milestones very nicely. (Of course, not speech or feeding, but we'll focus on the good.

He had a really big birthday party and we went on vacation that fall. By now, as you can see, the mass had be returning pretty rapidly and decided that a spring surgery would be in order. As you've probably noticed about Micah, he's a happy, pretty well adjusted little kid. He has about as much personality as you could handle, and he brings people a lot of joy.

The March 2011 surgery was a doozy. They werent able to accomplish as much as they'd hoped because of major blood loss. It helped though, especially with his ear and probably his hearing. Unfortunately the surgery results didn't hold up as well as we'd hoped. He still made a really handsome little man dressed up for Easter (here's the before/after)

His surgery recovery wasn't very easy. He spent 3 days in the PICU (the Peds ICU) and about 7 more days in the hospital after that. He lost a lot of fluids from his drain, and it lasted a total of 10 weeks. He needed replacement IGG (immunoglobulin G) and eventually a crazy medicine to stop the drainage. For whatever reason, a medicine they use to prevent transplant rejections often works to stop lymphatic drainage (don't ask, I don't know!) Problem is, it's an immune suppressant. He was on the medicine a total of about 4 months before the next surgery, just this August. The August surgery was much longer, but overall less dramatic than the March surgery. (THANK GOODNESS!) He spent 8 days in the hospital, and is still draining (about 3 1/2 weeks later). The results from this surgery are much more obvious. I don't have a super recent picture on my computer, I apologize. It has been quite the ride, I won't lie. I wouldn't change it for a thing. I remember reading all the scary words that come up with the term cystic hygroma.. the fetal hydrops, the poor outcomes. It's not easy, but this kid was put on this earth by God for a reason. Never one day have I doubted that. He's our Miraculous Micah. :)

The IVIG monster...

2011-09-16T08:51:00.002-04:00

The IVIG monster strikes again! Usually it only strikes every 6-8 weeks around surgery times, this time it was 2 1/2 weeks! As of Tuesday his count was 368 (most ppl should be above 400, they allow Micah 350). So inevitably, it'll be down well below 350 by Monday. So we'll head to Cincy or part way Sunday night to avoid getting up at 4am for our 8:30am appt. The good news is since it's an AM appt, we should be back at a decent hour that evening. Usually it's 8:30appt, by the time they get going it'll be at least 10. 5 hour infusion, hopefully out the door by mid-late afternoon, home by 8 or 9.

I really hate staying overnight places though. I'm so freaked out about bedbugs. We've got our "favorite" hotels both inside and outside of the city that haven't given us bedbugs yet... Speaking of which, I should probably book one of those.

Oh, the joys of medical parenting.

I am working on a fun post, though. I promise. And if you don't have anything to do on Oct 1st, come join us at the Camp Mack Festival. They have pontoon rides, hay rides, kids activities and delicious food (and I'm sure so much more!) If you want more info, let me know. (or go to www.campmack.org)

Last minute change.

2011-09-15T18:53:00.002-04:00

Last minute change of plans. No Cincy trip tomorrow, he needs IVIG which means we need to go to the day hospital and can't get in tomorrow, need to go probably Monday instead. I didn't catch what his IGG was (she talked to Travis), but it's only been 2 1/2 weeks since he got it in the first place. That's a record of an unfortunate variety. At least we have a great nurse who stays on top of his blood work, even when we have it done locally.
I feel like I'm upside down this week with busy-ness. Next week is Travis' 3 day class at Bethel (T, W, Th) and was going to work at Mack M, F. Apparently Monday will be hospital day instead.

Had enough of this drain!

2011-09-13T20:43:00.003-04:00

Update: The drain gets to stay in Indiana tonight :) LOL. We have to go down this week, but don't know when yet.

Well, the drain continues to make our life more dramatic. The stitch holding it in place has come out, so technically there's nothing holding it in. We've used tegaderm (think very thin very sticky tape) to tape the length of the tubing to his shoulder so it won't get pulled. It could go either way... they could just say, alright, well as long as it doesn't come out, you're good. Or they could say, come down ASAP and get it fixed (I know, couldn't be more different!) The being 4 hours away doesn't help of course.
Sent some emails tonight (everyone gets emails on their phones, so hopefully they'll get them). If they don't get back with me tonight, darn. We'll see what happens... They're not happy with this drain, but he needs one, so it's hard to say what they'll do!

Happy Birthday Micah!

2011-09-11T10:48:00.005-04:00

Drain drama...

2011-09-10T19:52:00.003-04:00

We've had enough of this drain (to our defense, it's been almost 3 weeks!) It's been possibly infeected, and now it seems to be coming out. We've been on hospital notice since Thursday, waiting for more signs/symptoms of infection. Now it seems to be coming out, or maybe it's just that the swelling has gone down so much we can see (what's supposed to be) the internal part of the drain. If it's infected, it's a trip to Cincy, pull the drain and probably at least some IV antibiotics.

*dramatic sigh*

We'll see what state we sleep in the next few nights... I'd be so bored if I had a healthy kid. (I'm joking).

Happy Birthday Micah!

2011-09-08T11:54:00.001-04:00

We celebrated Micah's birthday on Saturday... I'm a little (or a lot) slow on getting the pictures up, but they'll be here someday!
We're actually getting the internet this week, so hopefully that'll make it easier! (We've not had the internet in the 4 years we've been married!)

Home!

2011-08-30T09:07:00.001-04:00

We got home yesterday about 4pm.

We go back Thursday, LOL. So goes the life. He's going to the OR to get his stitches out, get his drain replaced and get an airway scope.

Twiddling our thumbs...

2011-08-28T21:17:00.003-04:00

We are earnestly, sincerely hoping that at 6:30 tomorrow morning they are going to say, "see you next week! (We already know we have to come back Friday or Tuesday or something).

We've been trying to kill time... and kill time... and kill time. Spent some time in the playroom.

Spent some time in the wagon.

Spent some time roaming the hall floor.

Spent some time throwing balls.

We're all pretty ready to get out of here.

I'll share a little story I put on FB. Never got the picture, but you better believe it was super cute.

There's a probably 5 year old girl on the floor with her stuffed dog. The dog apparently can't come into her room (in her mind) so he's sitting outside. So, the nurse took two of those ugly patient tubs and put them together, cut out an opening and made a dog house! She covered it with the comics from the newspaper. The little girl was SOOO happy!

The mom was just tickled as well. It was the highlight of our day. The girl had a trach and asked if Micah had one too. She was probably here for a capping trial (put a cap on the trach and see how they do, a step before taking the trach out). Boy... she'd talk your ear off. Her voice was very raspy and breathy, but I got most of what she was saying. She literally would talk until she couldn't talk and then gasp for air. Apparently not too used to being capped!

Anyways... if you don't hear from us online after 10am, we're probably on our way home.

Happy Birthday, Grandma Linda!

2011-08-27T08:48:00.003-04:00

Wishing Grandma Linda a happy birthday! Sorry we can't be there!

Try me...

2011-08-26T11:21:00.002-04:00

So, on rounds this morning they confirmed we're stuck here til Monday, and even after that the question was whether we can go home or stay local. Seriously, if we're stuck here I'm really thinking about going to the zoo! Of course, Micah's super swollen slightly black and blue face might get some looks (I didn't remember his big and floppy hat), that's nothing out of the ordinary.
Seriously, it's like watching a faucet drip. And just as irritating.
The drain is barely even working, so there's a hole in his neck and it's dripping down his clothes. They're bringing in Interventional Radiology to see if they have any ideas. To be fair, Dr. Elluru told us "2-10 days" to expect to be down here. 2-10? Really?!
All this and we have to be back probably the 6th to get the stitches out. I'm guessing not the 5th, since it's Labor Day.
We're still waiting on some of his bloodwork to see if he'll get that 4-5 hour infusion before we leave. I can't imagine we'll get out of here without it, he doesn't have a good track record in IGG land.
The highlight of my evening was chatting on facebook with a handful of moms that have kids with LM's. We decided we could do our own reality tv show, "The real housewives" if you will. :) We'll show them drama! Or, instead of "The Office" We could have "the Doctors Office". The spinoff could be "The Therapy Office". :)

2011-08-25T19:41:00.001-04:00

We finally remembered to get Micah the balloon we kept meaning to, and it was a big hit!

College essentials?

2011-08-25T12:17:00.000-04:00

Seriously, I went to college at the entirely wrong time. :)

Grumble, complain, whine, moan, etc.

2011-08-25T12:09:00.002-04:00

We're here til Monday, folks.

Could you guess who doesn't want to be here til Monday?

This is the best pic we've gotten today (mainly because we haven't had Travis and I in the same room for more than a few minutes).

His eye swelling is going down, but his lower half of his face is still really swollen. It's almost like his mouth is swollen open... the tissue is so tight. I'm hoping that's all it is. He doesn't seem like he can move it. Thank goodness for feeding tubes!

I know it's probably not something most can relate to, but I'm so glad for familiar faces around here. We've got the herd of vascular malformation people which visit at least once a day. Our first night when we were in the PICU we had a night nurse we'd had a few times before... she's nothing short of AMAZING. Today, in walked our favorite PCA (i think it's equivalent to a CNA, sort of.) His name is Jarvis and he's always fun. He was excited to see Micah, and he's a lot more fun than your average PCA. He got Micah a very "boy" blanket for his bed... It's the little things really!

A pretty good day

2011-08-25T06:13:00.003-04:00

Yesterday started out a little rough. The first few times we tried to sit him up he was essentially a little boy weeble. By mid afternoon he was out of bed playing on the (mat on the) floor. I tried to get pics but he wouldn't hold still long enough!

His head looks entirely different. Now the right side of his head is completely flat compared to his left. Basically all that is left is skin on bone. And of course, there's lots of swelling around that, but not in that spot. I'm hoping that as the swelling goes down it'll look more even. Doc things we'll have to inject some fat into that area to make it a little more even someday. I'm not sure Micah has any fat to spare!

We dared to ask what the parameters are for getting out of here... and it kind of depends who you ask. I've got the Nurse practicioner on the floor and the NP from clinic pushing for a hasty exit Friday. (Or at least to the Ronald McDonald House, which we got into, yay!). We'll have to be back at the 2 week mark to get stitches out, but it would be nice to go home for a week or week and a half in the meantime. They want to see his drainage decrease (it iddn't last time for 10 weeks and even that's probably because of the rapamycin!) so we'll probably go home with a drain. No big deal. We have yet to see if he will need another round of IVIG. As active as he was yesterday I might vote to do it overnight (I wonder if that's possible!) so he doesn't have to sit still for 5 hours. We're also supposed to be getting him to eat by mouth... ha! He barely does that anyway!

Well, I was up at 5:30 with Micah and figured I'd stay up til 6am rounds, where are they? First day they were at 6:30, yesterday set my alarm for 6:15 and they were here at 6.... Just can't win with this crazy ENT crowd!

Wednesday morning

2011-08-24T09:09:00.002-04:00

His eyelid is still moving, he's just so swollen he can barely open it. He's overall very swollen, so it's hard to tell what it'll look like once it comes down (it'll probably take weeks to get a final look).
We're really here because of drainage and pain control. We'll come home with a drain almost inevitably. Even last time he was draining 4-5 ounces a day, so I'm not sure what their cut off will be this time (I don't think they know). It's frustrating to not know how long we'll be here! I'm hoping for leaving Friday, because we all know nothing happens around here on the weekend! If his pain is under control and his drainage is at acceptable levels, i don't see why we can't at least be at RMH (if we ever get in there, I guess... haven't heard a thing yet!)

About his surgery results, the doc thinks there's a chance the area in front of his ear might actually be more flat than the other side since they had to take out all the fat on that side. The difference is striking, really! I know it's hard to see in the picture.

It's probably dangerous..

2011-08-24T02:44:00.002-04:00

It's probably dangerous to blog at 3 am, but oh well. They just gave him another round of meds and they have to draw blood in another hour, so why sleep? (We finally got the cocktail of drugs figured out!)
I was thinking about all of "this", and realized... Not in a million years would I have come up with this being the way I thought my life was going to turn out. Sure, as some of my friends joke, I seemed "ripe" to have a special needs kid (I've been working with SN kids since I was a kid!), but this???
It hit me today as I was walking back to the hotel, thinking that it was nice he was only in the ICU for less than a day. Most parents never see their child in the ICU, ever. Some parents don't even see their child in the hospital, ever.
I never would have thought things would be like this, but I find it oddly comforting. I know that God isn't sitting around wringing his hands,wondering what is going to happen next. He's not surprised, and he certainly isn't sitting around asking why. I don't mean all this in a terribly cliche way, I promise I hate Christianese more than most.
I'd like to know the why's of life, but I have to trust I will find out someday.

In the meantime, I'm praying they'll get his blood draw from his IV. They barely did last time. 4 am labs are the worst. :(

LOOOONNNNGG day.

2011-08-23T21:01:00.003-04:00

I think last thing I posted was about switching rooms... Since the sedation wore off we have had a really hard time controlling his pain. Morphine every two hours would work for about 45 minutes, then we'd be back to square one. Now he's got a cocktail of morphine, codiene and tylenol and he's finally resting for the first time in 6 or 7 hours. His heart rate is 110, and most of the day- even asleep- was 140-170. Normally when he's asleep he's 80-100.
We have what appears to be a super nurse that's on top of things. Probably helps there's only like 4 kids on the unit that holds like 10! We had a great nurse last night too. You really want the good nurses at night... We can manage during the day.
I'm so beat today, and am really hoping to get more than 45 minute blocks of sleep tonight! Pain meds alone will come in around every two to three hours, not to mention the stupid 4am CBC and his antibiotic. Hopefully the nurse will combine, combine combine!

Champ!

2011-08-23T11:45:00.002-04:00

It's hard to catch him with his eyes open, but the good news is that his right eyelid is functioning at least a little! He's extremely swollen but you can see a big difference already! As the swelling goes down over the next few days to few weeks, hopefully we'll see more and more progress!

On the way....

2011-08-23T05:56:00.002-04:00

Things are looking good for us to be headed out of the ICU today. They started weaning him off his sedation at 4am (this isn't one of my favorite things to do... unhappy child!). Hopefully they'll decide they can pull some extra tubes/wires/etc and get us on a less critical floor.
He did alright overnight, although we had quite the time getting him the right temperature. Goldilocks he is NOT! Doesn't help when there's air practically blowing on on his face from the vent! BRRR!
Hopefully this morning I'll get to see his face without the dressings (if only temporarily) and figure out more about his eye situation.

2011-08-22T21:03:00.002-04:00

He got out of surgery about 5, and all moved in at about 6. They decided to put him in the ICU and keep him sedated all night. That was a good possibility all along.
He's stable and off the ventilator, but requiring oxygen. That's not too unusual since he's sedated, at least he did that last time.
The long story short is we have to wait and see what nerve function is left when he wakes up. They looked for an hour for the main branch of the facial nerve to no avail. It's an ugly part of this disease. The main part that was left was controlling his eyelid opening and closing... Probably needless to say that's a really, really important one to keep.
He's sleeping soundly now, all tucked in with all his tubes and wires. (Literally 6 of them total, wow!) Hopefully he'll get good sleep so I can sleep some. Oh, hospital sleeping, how I haven't missed you!