Friday, May 13, 2011

Cars, Surgery, Strollers





I swear I just wrote a post last week but apparently it's closer to last month..wow where does the time go? Since my last post Boo has had surgery to place a port a cath in his chest. This was one of the hardest things to do. We spoke with his hospital team, his regular ER nurses, his PCP and nearly all of his specialists who unanimously agreed it was time. He has virtually no vein access left and has frequent blood draws, iv fluids and they now want to give him TPN if his gut shuts off for more than three days...aka..everytime he gets sick. We decided to place it while he was "healthy" vs waiting for the next crisis to hit. The surgery went well, he was impatient overnight because of a sluggish (but not haulted) gut, we watched Cars 12 times in a row, then 5 min before heading home his port adapter came unscrewed so we got to watch Cars 12 more times while running IV antibiotics and running 24hr cultures which thankfully were negative! Because of that I spent Mother's Day in the hospital but it wasn't all bad. I had my coffee, we went out to the garden and Hubs brought Chinese :)

We also bought a new car...no I still haven't caved into a minivan. We have a lovely gray Chevy HHR which gives us just the extra space we needed while still giving us 24-32mpg which at $4.35 a gallon is already paying for it's self! At 188,000 miles the Passat was all worn out and ready for a new owner.

Now to find a new fullsize stroller to fit in the trunk. I found a stroller that does everything we need for Boo. Huge canopy, adjustable foot rest, full recline, headrest, reversible, table height seat, large enough undercarriage to accommodate his O2 and pump (with the addition of my own custom sewn sling) and less than 30lbs. It's called the "Mylo" but it's $1000.00 and the only store that carries it is 2.5 hrs away. So I got an idea. Called up his devel. Ped and asked if she thought Boo would qualify for an adaptive stroller. Yep she's thought he's needed more than the glorified umbrella Jeep Cherokee Sport stroller for a couple months now (why didn't she say so sooner?) Wrote the script and sent it to our DME. Then I called our private Ins. Case Manager. Our conversation went something like this:
"Hi Jan, how would your company like to save $2000.00? Boo's Doc just wrote a script for a medical stroller and for everything it needs to include it's probably going to cost at least $3000.00 however, I found a retail one that does all the same stuff for $1000.00 how would you like to buy that one instead?" Jan: "That sounds like a great idea thank you for thinking outside the box and trying to keep our costs down. You'll just need to send me the script, PT filled out form listing all the needs and a print out of the retail stroller specs and price compared to the medical one, I think it's a no brainer!"

The best part is she is going to work at getting it approved under the reimbursible medical expense allowance vs the DME allowance so as not to jeapordize our ability to get a fullout wheelchair later! Now to wait for the PT eval next week and send over the papers!

That's all for now :)
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Wednesday, March 30, 2011

Hospital stay #12 pic

One very sick little boy right before we layered the icepacks
Finally feeling well enough to play
Feeling a little better I moved him to my pull out bed to look out the windows
Boo wouldn't look at the camera
Can't seem to rotate this one of the girls zoned out to movie.
Just a few pics of Boo's recent stay.
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Tuesday, March 29, 2011

Viral's and Feeding Intolerance

Well we just finished an eight day stint at DeVos Children's again. Boo caught another viral infection. It started with a low grade fever that we controled at home with motrin and pedialyte. We hoped that by switching to just pedialyte through the gj-tube before the gut shut down would avoid it all together. Well that lasted all of 2 days. Mito kids are so crazy because one minute he was getting better and playing and the next he was burning up and coughing with dark green bile pooring out of the g port. The ER is always traumatic, there is the waiting room with a million germs coughing, running and crying all over the place trying to infect the host next to thhem. Then there is triage where I know they dont clean much if at all between patients.

There is only one advantage to having 17 ER visits in 28 months, the reception nurses know your kid by name and they don't make you wait in the waiting room or bother triaging you. Heck they practically call up to the floor and reserve a room the moment you walk in. Next they call around to page one of only two people allowed to IV Boo. He has only a couple IV spots left so no one messes around with them. Even with them it's getting harder and harder to get one that will stay good and they clot off within 20 minutes if fluids are not started within that time frame. Jon (our best poker) told us again that his veins are so bad we should consider a port. Ugg. He finally got labeled "viral infection with gut shut down and admitted." Because the hospital was full of cold and flu season patients the only open room they could find was in the PICU. Great, try and explain to visiting grandparents that while yes it says "Pediatric Intensive Care Unit" on the floor entrance your child is not actually a PICU patient. Although, Boo started acting picu when his fevers busted through the motrin and tylenol with ice packs being the only way to keep him at 101. He slept all night and was awake for a bit then slep for the next 16hrs. Freeked me out. Thankfully, the next day he was better (didn't need the ice packs, stayed awake a bit more and they moved us to our usual floor. The next several days were a rollercoaster of 2 steps forward 1 step back. He faught off the viral infection but it took another 3 days and the addition of a motility med to get us home. My thumbs are tired... I'll post about the great port debate later.
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Wednesday, March 2, 2011

You Threw Off My Groove!

I don't know if any of you have seen the cartoon "The Emperor's New Groove" but if you have you will get this next bit. If you haven't you should see it, I laughed the whole way through and watched it again.

There is the opening scene where the emperor is describing his perfect life and how one person came along and wrecked it. While I'm making the same rant today. 2.5 years ago I had the perfect husband, two perfect daughters, a perfectly beautiful home in the country, a perfect business and was expecting the perfect son after a perfect pregnancy. Then Mito came along and ruined it all!! I did still have that perfect son but not the perfect pregnancy and my perfect son has less than perfect medical issues. No our perfect little life is upside down and feels especially so after the past three weeks! Let me recap.

Week One: Went to Cleveland and after 7 hrs of driving we where 1/2 an hour from our destination and the alternator blows and the battery dies and our car ends up dead on the side of the turnpike. A cop car, tow, truck, failed attempt at a rental car (who knew the Cleveland Airport would be booked solid on a Tuesday night?!) a private driver and three hours later we made it to the expensive Guesthouse for six hours of sleep (not RMH because of all times they would be full too!). There is a lot more to that story full of super frustration and kind people that really should be it's own blog post but for the sake of time we'll move on. Brochoscopy in the morning that ended with total gut shut down and an overnight admission. Once discharged then it was the GI appointment where we were told to just keep doing what we can to feed into the tummy but no pressure or schedule, this was a good thing under the current circumstances. Then the meeting with Dr. P where we found out that while the muscle biopsy was inconclusive he would treat Boo like he had Mito because nothing else fit and there were enough markers to suggest that he could very likely have Mito anyway. One of our specialist's back home familiar with mito coined the term "Uncatergorized Mitochondrial Disorder" and we've adopted it. Boo does act like a mito kid and responds to mito protocols when ill. We've been assuming he has Mito for months now so while it was difficult to hear that "this was it till more advanced testing becomes available" it was not the major blow of conclusively. That night the sleep study which, because of a forgotten piece of the order, was done with .5lpm O2 on the whole night. All the same it still showed work of breathing, desats and obstructive sleep apnea so we know he needs it. On the way back home Boo started showing signs that he was getting sick, he stopped tolerating feeds and started breathing faster and harder.

Week two: Since we where too far to turn back we continued on to pick up the girls from my parents and then hightailed it for home. Bennet did worse the closer we got. We stopped at the house just long enough to grab a few things and rearranged our packed car to have access to what we would need in the ER. We didn't even get the kids out of the car and headed off again for the ER. When I pulled Boo out of the car he was slightly warm. By the time we were checked in at the desk he was burning and I could feel him get hotter and sicker by the minute. They triaged him 5 minutes after we sat down and he was 103.5 bad news. I started urging them to give him Motrin...like last week people! They took him back to a room and Motrin was delivered. I'm sure if they would have rechecked the temp just prior to giving it he would have broke the thermometer. His O2 sats were low so they turned him up to 2, his heart rate was 180s and breathing so terribly labored :( Still, it took forever for the doc to come in, they sent in a student first. Thankfully we had our newly printed Mito protocol letter in hand just for these occasions. We are losing vein access in many places with Boo and he is usually such a hard stick that it has been taking up to 6-8 tries to place an IV each time. I'd finally figured out after the biopsy to start by telling them to not use his hands, they are shot, use the feet with caution and inner elbow is their best bet. Of course they still look at the hands until I tell them NO, you WILL NOT place an IV or try there period. Then I have to tell them that I need the nurse with the most experience, no training, no offence but he really does need this. Oh and yes we know what a port is but sorry not there yet. So we get the nurse with "nicu experience". The guy listened carefully to me as I explained what did and didn't work, took a couple looks around and went for the elbow, the guy got it the first stick! I could have kissed him. I then had to tell them that if they didn't hook up IV fluids and keep it running they would lose it within 30minutes. Well yes, yes I have done this a few times thanks for noticing! Once the doc came in he took a look and told us he'd been admitted. Then we waited 5 hours to get up to a room. Full hospital. The hospital is brand new, less than two months old so of course the room was amazing! I would have been able to appreciate it more though if my baby wasn't so terribly sick. The Motrin allowed him to sleep but his gut was completely unusable, he still had a very high heart & resp rate and the blood pressure was creeping up. By the next day he was on round the clock Tylenol and Motrin and it was still pushing through. We had to resort to using his J port for meds because they were just sitting in his stomach as was all of his secretions. (Boo can normally digest at least those) He was dumping ketones and his PH was a 6.0 and they couldn't find the source of the infection because his lungs where clear and all the swabs, blood and urine came back infection free. We didn't know what we were fighting...story of my life. This went on for 4 days with me butting heads with a worthless resident and the one laid back attending the hospital had who wasn't following the higher fluid protocols while at the same time claiming the problems we were still seeing could be a result of dehydration! Looking back I should have demanded talking to the attending familiar with Boo and making a bigger issue of it but I was so frazzled by how down right irritable Boo had become that I hardly had a fight left in me. Finally I did call one of our most trusted specialists, Dr.D, who came to the hospital. She immediately recognized the pain Boo was having every time he had to pee (for the past 4 days!) as high calcium and ordered nephrology to come down. Sure enough it was quite high. By this point Boo was starting to turn a corner and was tolerating pedialyte slowly through the J so they decided to hold off on full blown kidney work up and redo the urine in the morning as well as repeat blood draw. The kidney doc, Dr.S, has other Mito patients and this made me love her instantly. She felt the kidney problems were a result of the infection just as his gut was not working right neither were the kidneys and she hoped that as he improved so would they. She was right, once he started getting a little formula mixed in the levels started evening out but his PH was still just a 6.5 and it took Dr. D to save us again and finally up the fluids before it got up to his normal 8. By day 6 Boo had made almost a complete turn around which is nothing short of a miracle!! They sent us home on 24hr feeds rather than waiting for him to return to 18hr feeds and we were comfortable with this. We also monitored his urine at home with strips. He had lost 2 full pounds in 6 days.

Week three: We've slowly upped his feeds back to normal and just plan stayed home to help him fully recover. Nearly every time he's been that sick in the past we've lost a function or seen a medical regression. So far the only change is that he is back on a full liter of O2 continuously vs the .5 we'd weaned him to just prior to the bronch. We are praising God for this in a big way!! At one point in the hospital one of the doctors told us that the longest he felt comfortable with Boo on just D5 was 5 days. After that we'd have to look at TPN. I did NOT want to go there. Boo started getting 1/4 strength formula on day 5, tolerated it and avoided TPN. For how bad his gut had been the day before to suddenly tolerating really was a miracle. So now we are back to a semi-normal routine again and I even took him to feeding therapy today where he ate a new record of 5 fish crackers. I have my always happy baby back :) 

So that was the last 3 weeks with loads left out but you get the idea!

Sunday, February 13, 2011

Result wait

So we have officially gotten the results back from Cleveland and they are "inconclusive". There are some markers for mito or possibly another genetic or metabolic disease/disorder but they do not know which one of course. We have no idea what happens next until we talk to dr. P on the 17th of this month. "undiagnosed land" is so confusing, tiring and right down frustrating lately.
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Tuesday, February 1, 2011

Awaiting Results

So it has been nearly 8 weeks since Boo's muscle biopsy and we've only gotten some of the results back. On the way back home from AR we swung through Ann Arbor for an appointment there with Boo's Neuro. He'd gotten the incomplete biopsy results but didn't know what to make of them as nothing was clearly something. Small elevations here minor deficiences there. Aclycarnitines were probably the most interesting in that his Calculated Aclycarnitines were 44.8 instead of between 300.85 - 1078.55 but again, nothing diagnostic. So we wait for the rest of the results in hope that they will shed some light on the rest of these and give us some answers. All the while we were gone I didn't give the results a second thought. I knew I probably wouldn't have answers until the middle of February anyway. However, having some of them back and revealing nothing I'll fully admit to being discouraged. What if we put Boo through all this for nothing? What happens next? Do we keep searching? aka poking and prodding, xraying and the list goes on? How much do you "hurt" your child in order to help them? Hubs keeps telling me not to worry about it until we see Dr. P and HE tells us what the results do or do not say since the doctors that have weighed in so far don't know mito as well as he does. So we wait again. We have to wait 16 more days until we return to Cleveland for a bronchoscopy, GI follow up, sleep study and of course see Dr. P. The one thing Neuro in Ann Arbor did find out is that it IS possible that Boo has an Oxygen Affinity Disorder given his "without cause" O2 needs. He consulted with a hematologist there and recommended we have some tests done buy Boo's Hemo here to test for it. He thinks it would be secondary to whatever is primary or possibly in conjuction with his Elliptocytosis. Great, one more tree to bark up!

On a positive note today is my 28th Birthday and while I feel more like 48 and just plain hate being this close to 30 I did have a good day. My hubby called my Dad to get the recipe for my favorite childhood "panacakes" (Dutch pancake) and made me breakfast in bed complete with coffee, my dear daughters each made me a homemade card that I love, Boo gave me smiles when he squealed with delight at being allowed outside in the snow for a few minutes and God made me just sick enough with cold and flu symtoms that I had to lay around in bed and drink tea all day but just well enough that I wasn't completely miserable and could read, sleep and type at will. Of course the flip side was that the kids were barely let near me, Hubby took a forced day off work to play with the kids and I sat here praying that Boo doesn't catch what I have because if he did it would mean a lovely birthday overnight getaway to the ER. Speaking of a getaway, provided we have clear sailing, a friend of mine and I are going to go on an overnight next week to a beautiful house owned my some people from our church. It will just be one night but there will be no pumps, beeps, meds, laundry, dishes, alarms or any kids for either of us and we're both looking forward to it. As SN Mom's we need to feel OK doing stuff like this on occasion! For tonight though I'm going to snuggle up from a distance with Hubs and watch a movie.

Monday, January 17, 2011

Blog Failure

I haven't died. Although, I admit it probably seems like I did since it's been forever since I last posted. In my defence I've been busy! I could probably filling a blogging book with all that has been going on lately. In December Boo went to Cleveland Clinic to have a fresh muscle biopsy done. It was originally scheduled for Dec. 16th (They gave us 2.5 weeks notice) but then on Dec. 6th they called us to let us know there was a mistake, a double book and could we please be there on the 8th? Sure no problem we don't have a life anyway right? Away we went. A simple enough procedure but Boo had to be inpatient from the early morning of the surgery to the next evening due to O2 and feeding intolerance issues. It's had it's own lasting effects too as we still have not been able to take him of the O2 as much as we were able to prior to the surgery. Other than that he is back to his old self. In fact, he's doing great! He hasn't had so much as a running nose since his cold in early November.

After the rollercoaster the Cleveland run was we came home to a Christmas season in full swing. Celebrating Jesus's coming to earth is a big deal in our family and we had several parties and get togethers, multiple baking sessions and dozens of cups of hot cocoa. The kids loved it all. We topped it off with a trip to Arkansas where several of my relatives live including my Grandpa whom I love dearly and who's name I bestowed on Boo as a middle name. We've been here for nearly 3 weeks and leave tomorrow (Love having a DH who can work from anywhere!). It has been the best break ever. No doctors appointments or therapy sessions! I'm realizing just how much time they take up now that I have lived without them for awhile. It has also been amazing watching my 82 year old Grandpa play the same games with my kids as he played with my cousins and I growing up. You have to admire a man that will play hide-n-go-seek at that age! Boo is thoroughly attached and I think they are both going to miss each other when we leave. I'm going to miss the coffee and long games of scrabble. I will also miss all the space and sunshine!

One of the little things that made this trip easier was our medical supply company loaned us an Eclipse air concentrator. Let me tell ya folks, I don't want to give it back!! It's SOOOOOO much lighter, quieter and nicer looking than the behemoth that is at home and I took it everywhere we went. Plus, it fits in the car in front of his car seat so has virtually eliminated our need for tanks. We brought 4 small tanks with us as back up but have only used 1 in three weeks as I only used it to carry him into a store and lunch a couple times. The behemoth takes up a good 1/3 of the trunk and in our Passat that is valuable space so having it free made all the difference! I've also had more cruise bookings this week than last fall combined and it's hard to focus on work when I'm visiting with family I rarely see.

While it has been fun being away I am also feeling a pressure to be home. Two of our friends are in the hospital with their kids and neither one is getting great news. I'm wishing I was there to bring a meal or coffee or something. The burden on my heart for them is so great! Sometimes, I wonder how much I can handle when it comes to "bareing one another's burdens" as God tells us too. I pray often and find that doing something to help is what gives me the strength to keep going. I have decided though that I can not handle my four sis-in-law's petty drama! The boyfriend runaround, the "parents don't get it" shpeels, the bad choices AAAAAHHHH!!!!! I want to just slap them up side the head and say "Girls, really?! There is more to life then this!!" I'm cutting it out and even asked my hubs not to pass on all the "news". It has been a great decision.

So there you have it, a very small nut shell of what has kept me away from here. I have a lot more on my mind and heart but sleep calleth my name....