MeAndHannah.jpg

July 06, 2008

Note To Self Plus Video

Note to self:  Do NOT write about the kids being asleep while you type a blog.  They can sense it in their bones.  It wakes them.  See previous entry Sound of Thunder.  Within five minutes of finishing, they awoke, separately.  Tag team the Daddy.  Daddy must not sleep.

Yes, Dad's a bit punchy on the last of four consecutive early morning nursing shifts.  We're acclimating to our new four nights on/three nights off schedule.  If I haven't dropped by to read your blog lately, I will do so soon when I'm a bit more lucid.

On the plus side, we had a wonderful 4th of July, fireworks and all, with family.  Hannah also had a new first experience today, but I'll leave that one for Mom to blog out (hint:  think big chlorinated bath tub).

I've also posted a new video over at Vimeo for those who are interested.  It is a video of Janette's and my early anniversary trip to Newport, OR.  You'll see the pandering to the kids' humor throughout (hey, if they're going to make us watch it on continuous loop, they can at least have some planted scenes to laugh at).  Hope you enjoy:  Newport, OR video.

-- Dad 

July 04, 2008

Black Hole

Three weeks ago, Hannah had a post operation appointment with her ENT (Ear, Nose and Throat Doctor). He was the person who had made her trach hole originally, and he was the one who stitched it up. Things were going well. Unfortunately, Hannah has been attempting to breath through the hole in her neck still. So it hasn't closed completely.

The doctor examined it and said, "It looks great, but there is the smallest of holes." He went to the counter and pulled out a long stick.

"What's that?" I asked

"Silver nitrate," he said matter of factly

Internally, I was scratching my head. At home, those sticks were used to burn off
granulomas. Granulomas are these bloody bumps created by big holes in a person's body. They are essentially tissue the body is trying to heal itself that the tubes interfere with.

"What are we doing?" I asked quickly as I got a more protective grip on Hannah. That last time I let one of those things be used on her she screamed like it was extremely painful. I hadn't anticipated or told Hannah there would be pain that day. I like to warn her.

He looked at me casually. "Oh, I'm going to rough up the edges in there so maybe we can heal the hole without having to stitch it up."

That made sense. I looked at Hannah, "This might hurt" I gripped her tighter in the chair that had no way of supporting her.

He stuck the stick in, and the hole blackened. She didn't scream or even squirm.

"Ok, I want to see her in six weeks." said the doctor.

I looked at my father in-law and children. Everyone was in a good mood The appointment had been maybe five minutes. The day was beautiful, and we had drove all the way to Portland for it.

So I said, "Let's go to the zoo!"

Gabriel cheered.

Zadie was helping me out because I'm not ready to leave Hannah alone in the backseat of the car for over ten minutes. She needs a medically trained adult next to her. So I can't drive and take care of her at the same time.

When we got to the zoo, Zadie unloaded Hannah and mentioned something about tarnishing. I got us our tickets, and we went inside. For some reason, people were giving us a wide berth: wider than normal. I went to wipe Hannah's face of drool and noticed why: she was bubbling black stuff out of her trach and spreading it with her saliva.

She was in a great mood and felt fine. It just was a little alarming of a sight.

 

silvernitrateneckleak

 

That night, Robert said, "Hannah has a black hole in her neck." We proceeded to wonder what the properties of a neck black hole would be. Yes, we are nerds: through and through.

--Mom

July 03, 2008

Sound of Thunder

Sitting in the office on this morning's nursing shift, listening to the sound of thunder rolling in the distance.  A warm night here in Hillsboro, OR, particularly since our air conditioning decided to take a break.  We've popped open the windows, turned on the fans, and settled in.

Hannah is sleeping well in the next room (a bit surprising because the warmth makes it a little more difficult to get comfortable - she tends to run toward the cool side).  Gabriel sleeps, too.  I actually over-slept the start of my nursing shift due to the warmth, and Janette gave me an extra half-hour or so of make-up sleep (thanks!).

Outside of the thunder and sleeping schedules, we're gearing up for the 4th.  Plan to have family over and an abundant collection of firework fountains, etc..  Being that we aren't using oxygen with Hannah (outside of nighttime in bed), she'll have her first opportunity to enjoy fireworks at our house (she saw them a bit last year at a friend's).  We'll see how that goes....

-- Dad

P.S.  Yes, if I can get away with a song title for the blog title, I will ;-) 

July 02, 2008

One of those nights

Sometimes I think I'm getting myself together and the universe slaps my arrogant thoughts away.

Robert and I are now having less help with Hannah at night because she is doing really well. This means more all night-ors all week long. Hannah still has not figured out sleeping with out medical support at night yet.

I started the kids getting ready for bed early tonight. My hope was to get a few moments to myself. Well the little darlings thought otherwise.

The neat thing was Hannah babbled Mommy sweetly to me. She asked to go to the potty. She tried to get me to have a conversation with her. In the breaks in between Gabriel was doing all the same things. It's genetic or I'm a real soft touch. Most likely a little of both.

I finally used the stern mommy voice on both of them and said go to bed.

Hannah of course grabbed my arm and smothered it in kisses.

 Big Hug  Kisses 

--Mom

July 01, 2008

Quick Snippets

Quickie snapshots from our last two days:

  • Hannah got her new wheelchair Monday.  It fits her much better, and, believe it or not, it has her name embroidered in yellow on the seat!  I guess they figured we'd waiting long enough that they'd throw in something "extra."  Pictures forthcoming....
  • Overheard at the dinner table:
Mom:  "Dad was thinking about going to get some fireworks, Gabriel.  When do you think we should go?"

Gabriel:  "We could go tonight... as a family."

Dad:  "Good idea, Gabriel."

Gabriel:  "I love my genius mind!  I wish I could hug it!" 

The things he comes up with!  Hannah is also keeping up.  Today, for instance, she clapped when Gabriel suggested she could go "half naked" (without a shirt).  This is Gabriel's summer preference, so he thought Hannah would like it, and she did.

I'm sure more stories coming soon from these two creative "geniuses."

-- Dad

June 29, 2008

Chef Gabriel

cookingcookies
Mom

Agenesis of the Corpus Callosum

As Hannah downsizes her technical supports: the trach tube, the ventilator, and other equipment, we are (often) asked what Hannah's prognosis and diagnoses are.  The prognosis one always stumps me.  This question is often code for exploring Hannah's worst possible outcomes.  Will she ever walk unassisted?  Will she ever talk in a way that people other than her parents can understand?  Will she eat by mouth rather than by g-tube?  Are you parents being realistic about her life's trajectory?

Of course, Janette and I usually answer this question by pointing to Hannah's love of music.  Her prognosis, we hope, is to become a rock star (rather than a groupie).

The diagnosis one, once we get through the transparent diaphragm (corrected), the cleft palette (corrected), etc., is really agenesis of the corpus callosum.  This is the condition that will inform Hannah's life, but not define it.  Hannah's wonderful nursing company's director, B., referred us to a podcast and webpage called A Day In the Life... Meet the IngersonsNatasha Mitchell's blog about her podcast interview and about the diagnosis include additional information and links.

The podcast interview is wonderful.  Janette and I found ourselves comparing notes, finding similarities and differences in the Ingersons' experience, but recognizing many of the same themes.  In addition to the Ingersons' narrative, I appreciated Dr. Sherr's excellent layman's explanation of agenesis of the corpus callosum.  I learned more from that explanation than from any of Hannah's doctors-to-date.

Anyway, if you are interested in learning more about the Ingersons' experience (and, indirectly, Hannah's), I encourage you to check out the podcast.  I found it invaluable, and I'm sure I'll be punching through many of the resource links on the All in The Mind page, too. 

-- Dad 

June 27, 2008

Today was an amazing day

Gabriel was invited to a birthday party out of our normal area. Where we live doesn't have a synagogue, so we go to one about 45 minutes away, and that is where Gabriel went to Sunday school. He had a really good friend there whose mother and I exchanged phone numbers. We never got around to getting together. Then she called and invited us to her son's birthday party.

The day was balmy and golden. Northwestern sunny days are rare, but when they do happen, they seem perfect. The air was warm with a cool breeze, and the trees made a shush sound in the air. The party was at a park. In the middle of this park was a huge grassy hill. The park attendants had stretched a plastic tarp down the hill and ran a hose over it. When the mother had mentioned slip-n-slide, I was thinking it would be the normal flat sprinkler sheet of yellow plastic perpendicular across a yard. This was something more.

I had brought a blanket for Hannah and me to sit on. So I settled us down and started her noon feed as I watched Gabriel run off with his friend and go stand in line for the humongous slip-n-slide. Hannah watched and clapped with enthusiasm. It took me about twenty minutes, but I realised something: people who stayed sitting up on the slide didn't get their faces and, importantly, their necks wet.

Hannah's neck still has a small hole in it, so water entry through there could still be dangerous. I realised Hannah, though, could do this without risk is she remained sitting. Unfortunately, I only brought back up clothes for the kids, not me. Then I considered Gabriel. He is six. He's pretty strong. His understanding of the importance of safety with Hannah has blossomed.

So when he wandered over I asked him, "Would you take Hannah down the slide?"

His eyes lit up. I think he craves big brother things to do with her. "Oh, yes, please can I?"

"Let's see." I looked at Hannah. "Hannah do you want to go down the wet slide." She smiled and clapped. I think there was a "Yeah!" thrown in there, too.

So I unhooked her g-tube. I grabbed a towel and a wash cloth and walked over to the line. I explained to Gabriel that he needed to keep her sitting up and hold onto her. I sat her between his legs and let go. I walked down the side as they made their progress. Hannah giggled and Gabriel laughed, "She likes it!"

They made it down in one piece, and Gabriel asked if they could do it again. So I asked Hannah and she screamed "Yeah!"

So up the hill we trudged again. They loved it; Hannah signed for more. But I was out of breath. She is around 36 pounds, and it was a big hill. The line on the top was pretty long too, so I copt out. Hannah was furious.

She did, however, also get to ride a merry-go-round and the swings.

It so sucks that I forgot our camera.

 Surfer 2 Sprinkler

--Mom

PS. Gabriel wants to let the world know he threw up off the merry-go-round. A girl came and spun the merry-go-round really fast. He told her he was getting sick, and she didn't believe him and spun him faster. Hopefully, next time she will believe whoever tells her they are sick.

June 26, 2008

Carnival Time!

Two blog carnivals have included us in their latest editions.  I think you'll find both carnivals many entries great reads (and a fantastic way to find new favorite blogs):

Change of Shift - nursing career diversity:   Braden has done a great job of assembling a wide array of viewpoints and experiences by nursing specialty.  If you've every wondered what a Flight Nurse (think Lifeflight helicopters) goes through verses what a typical day is like in the life of a Public Health Nurse, check out this edition of Change of Shift.

Carnival of Family Life - welcome summer edition!: JHS at Colloquium gathers together everything from family finance tips to family humor for our summer reading pleasure.

Hope you enjoy the links!

-- Dad 

June 25, 2008

Our Unexpected Nursing Career

For the record:  I never wanted to be a nurse.  I am not particularly squeamish.  It's just that I had my fill of doctors, nurses, and all-things-medical growing up.  Picture a family tree dressed in diagnoses like spina bifdia, hydrocephalis, weak connective tissue, severe asthma, epidural and subdural hemotomas, Rheynauds Syndrome, color blindness, and probably several things I'm forgetting.  We were a diagnoses-rich family; our medicine cabinet flowth over.

When my daughter, Hannah, was born, however, nursing found me and my family.  Hannah moved from eight hours observation to two weeks in NICU.  Janette and I took her home two weeks later with a tank of oxygen, an apnea monitor, g-tube and feeding syringes, and the best wishes of the hospital.  My wife, two-year-old son, and I were going to raise Hannah at home, but we were going to all have to learn a new vocabulary and intensive medical skills to do it well.

Within six months, we added new diagnoses and equipment to the mix:  a trach, 24/7 ventilator support, surgeries completed and scheduled for the future.  Also at six months, we joined Oregon's MFCU program.  MFCU is a Medicaid-wavier program that provides in-home nursing in place of what used to be permanent, institutionalized care.  We signed the dotted line, promising to be a parent-nursing partner within the program, carrying our weight both as parents and parent-nurses in the care of our daughter.  Thus we launched our nursing careers.

We were lucky.  We met many people over this period who had kids with significant medical needs who, because they were not ventilator dependent, did not qualify for in-home nursing.  We had one-on-one nursing for our daughter sixteen hours a day, on average.  We provided the other eight hours of nursing, learning by working beside nursing professionals.  We learned to suction.  We replaced g-tubes.  We reinserted trach tubes (many, many times).  We were experts in the medical care of one patient:  our daughter Hannah.

Being both parent of child and nurse of patient was a wild ride, punctuated by both humor and terror.  In neighborhood get togethers, our peers noted their children's developmental progress in steps walked and words talked; we, in minutes, then hours, breathing without ventilator support (quite the show stopper, by the way, in a room full of non-nurse parents).  When crisis hit, we took the necessary medical steps, pushing parental concern to the back while bringing our nursing knowledge and experience to the front. 

We met people over the years who were also medical experts in their children.  They were parent-nurses, but they had little to no additional professional supports.  While we were swapping best practices with our daughter's team, they were doing the same, often wonderfully, but without the support network we enjoyed.  We connected up with these families when we could, and we all swapped stories.  We traded tips.  We compared doctors and medical histories, often finding new links to explore.  Our connections to nurses and other families became our community.  Much like nurses who work together in a hospital, I imagine, we now found our friends in the lay and professional nursing networks we found ourselves in.

Jump forward now to a month ago when we packed up Hannah's ventilator and bid it good-bye.  Hannah's trach tube had been removed.  She was breathing completely on her own.  We no longer needed the ventilator.  We were transitioning.  Nursing and medical needs had overshadowed our parental role for at least half of the last four years; now the scale was tipping strongly in the other direction.

Soon we'll be losing two-thirds of our nursing hours as Hannah transitions out of the MFCU program.  We will see the nurses that we've all bonded with over the last four years less often.  Then they will go away.  Once they are gone, however, we will retain our nursing knowledge (and some of our nursing duties, still).  We will move our focus more strongly to PT, OT, and advocacy for our daughter.

Every so often, Janette and I play with the idea of returning to school and earning a professional degree as RTs or of beginning a medical foster home (okay, that's not Janette's - it's mine).  Somewhere in the background, we want to take advantage of our four year's experience and build on it.

But in the meantime, we are returning nearly full-time to our other jobs as our children's parents.  We're putting the suction machine up on a high shelf and pulling down the reading and math flashcards instead.  We're preparing to set aside some of our intensive nursing training, at least for a little while, and enjoy something of a respite with our kids, proud of the time and progress we've all made together, content to be mostly healthy, happy, and intact as a family.

-- Dad Gabriel and Hannah try on 3D glasses

June 24, 2008

Return From Respite

Sunset Viewed From Our Hotel Room
Janette and I just returned from a two-night, we-parents-only respite Hannah's nursing company arranged for us (thank you, thank you, thank you!).  This was the view from our Oregon coast hotel balcony.  Putting off thoughts of returning to work tomorrow by looking at the sunset again and again.
 
-- Dad 

June 19, 2008

Mezuzah Madness

Last week, I finally got around to hanging the Mezuzahs around the house. We've only been living here 6 years, and we bought the Mezuzahs 4 years ago. So last week, the day before we were interviewed by a reporter for a Jewish Newspaper, Robert and I decided it was time to hang them.

The Hebrew word Mezuzah means "doorpost". In our tradition, it is placed on the doorframes except the bathrooms. It is a casing that contains a scroll with the words from Deuteronomy 6:4-9 and Deuteronomy 11:13-21. They contain the  words of the main prayer of Judaism. It is called the Shema. We do this because of the biblical commandment to write the words of the Shema upon the doorposts of our houses.

It is a symbol that we are a Jewish home.

Robert showed Gabriel the general practice of people to touch the Mezuzah with their hand then bring their hands to their face and kiss them out of respect for the words of God. They do it every time they enter a Jewish home. It is a cool practice. Gabriel has taken it up. He has also started yelling at me because I don't do it.

I'm using it as an opportunity to teach him religious tolerance and Judaism. Wish me luck. I'm trying to split hairs on what is a practice and what is required by God. I'm also trying to teach him that respect and deeds are the most important thing:  not whether or not a person just does what everyone else is doing.

Hammer HeadScrollIt's A Beautiful Thing

--Mom

June 18, 2008

Sheepdog and Wolf

Hannah woke promptly at 2 a.m. as I took over from Janette.  It reminded me of the Warner Bros. cartoon with the sheepdog and the wolf, both clocking in together, initiating the daily routine of wolf-tries-to-steal-sheep and sheepdog-tries-to-stop-him.

"Hi, Hannah."

"Da."

We both clocked in.  I checked Hannah and her bed; both were wet, wet, wet.  Taking care of Hannah at night is probably familar to anyone who has raised a child.  We're still in the everything's wet phase of early childhood development.  Add an all-night, continuous feed and mouth breathing, and you've got wet, wet, wet.

I took Hannah out of bed while I changed sheets, shirt, and diaper.  I gave her a breathing treatment (she has gotten whatever virus Gabriel was sharing).  I turned on a soothing video and then returned her to bed.  Wide-awake, she watched the video while I disengaged to give her some time to sleep.

She popped up into a sitting position in bed and gnawed on a bed rail.

"Hannah, lie down, please."

She smiled at me.  Compliance was unlikely.  She had gotten my attention.

I helped her back into a sleeping position, and I ran to the kitchen to refresh my coffee.

She popped back up into a sitting position.

"Hannah, lie down."

Now video time was over.  The radio was on instead:  one of her many cues that it was time to go back to sleep.  I gave her back her pacifier and we rinse-wash-repeated this routine for a few more cycles.

Now Hannah's eyes are shut, but she's tossing and turning, still trying to avoid sleep as her body begins to agree with me.  In our sheepdog/wolf world, we are just about ready to clock out for a few hours' nap.  I'm just not sure which part each of us are playing:  who is the sheepdog and who is the wolf?

-- Dad 

June 17, 2008

Sick Revelation

As has been previously mentioned on this blog, Gabriel was really sick all last week. There was a moment in the turmoil that actual made me laugh out loud.

I was arguing with Gabriel for the zillionth time, trying to get him to swallow anti-fever med. His nose was dripping snot (which was traumatising him). He stared at me dead pan. "There is an answer for all this misery. It is chocolate."

I nodded my head in agreement and got him a chocolate donut.

 DonutSicklySickly

--Mom

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