Wednesday, November 30, 2005

Clare's Angel, A Shameless Plug

Before Clare's surgery, I posted about a piece of artwork my Aunt Sara created entitled "Clare's Angel." This is a special "girl" Sara created for Clare Therese. We have since received our own Clare's Angel in the mail. It is gorgeous. The photo I posted does not do the print justice.

I bought a special frame for my Clare's Angel and hung the print in our living room. I like having the angel in a prominent spot in our house because seeing it daily reminds me that Clare has many angels looking over her and that she is an angel on earth. Clare has brought joy, love, hope, and inspiration to so many people.

If you are interested in checking out Clare's Angel, please visit Sara's website at: www.saragarska.com
We also keep a link available to the right of the posts on this blog.

Tuesday, November 29, 2005

Back Into Our Routine

Clare started her occupational therapy again today. She has physical restrictions until she's six weeks post-op (no tummy time, cannot be picked up under her arms), so her therapist is going to take this time and concentrate on starting solids.

Clare lost weight in the hospital and, as of last Friday (the 25th), had not gained any weight back yet. Her cardiologist said she would have liked to see Clare gain weight by two weeks post-op (which was the 22nd), but that didn't happen. Clare refuses to take a bottle, a sippy cup, anything else right now, so that's going to be a big goal with therapy. I don't really care if Clare takes a bottle (there's really no point to it now since she's 8 months old - it would just be another thing to wean off of), but taking solid food is very important, for her growth and development and as a means to get extra calories into that little body!

It's nice to be getting back into our normal routine. We still have many doctor's visits and other appointments, but to us, that's normal life. If all these mean Clare is staying healthy, I will take it!

Thursday, November 24, 2005

Thanksgiving


S~ Well, as many of you can guess; we are thankful for so much this year. But I thought we would put a list up.

  • We are first and foremost thankful for Jamie and Clare.
  • We are thankful for surgeons and their delicate and skillful hands.
  • We are thankful for nurses who make us feel at home in a cold hospital.
  • We are thankful for our parish and all the prayers we receive from them.
  • We are thankful for our family, we could not have been able to get through this without their help.
  • We are thankful for Heffalump kisses and the giggles that come with them.
  • We are thankful that Teresa can stay at home and raise the kids.
  • We are thankful for my job which allows that to happen.
  • We are thankful for good news after an echo.
  • We are thankful for Clare's "Special Friend" and the pink snowsuit!
  • We are thankful for the unexpected Stampin' Up cards from all across the country.
  • We are thankful for our faith and the grace we have received from it.
  • We are thankful for our friends and all the help they have given us.
  • And, most importantly, we are thankful for all of you who support us through this website!

Teresa, Jamie, Clare and I are so thankful to all of you. This has been a tough year for us, but it has also been a year where we have grown closer to each other, closer to God, and have really come to an understanding of what is important. So, take today to be with each other, tell people why you are thankful for them, tell God why you are thankful for Him, and spend time with each other. From our family once again, Thank you for all your support. Have a Happy Thanksgiving!

(P.S. We are thankful for the four inches of snow that is being dumped on us today.)

Wednesday, November 23, 2005

Good News

We finally had a good echo! Clare had her afternoon of tests yesterday with her pediatric cardiologist here at home. Her heart looks great! Her aorta is the size a normal aorta should be, and her pulmonary side even looks good. There is almost no pressure change across her aorta and a very mild one across the pulmonary branches where her stents are. Her cardiologist said that if Clare continues along this path of progression, she will not need another cath for 5-6 months. We were elated at this news! Now Clare does have a history of progressing faster than expected, but I will be happy to even get 4 months down the road! It would be wonderful to make it past Clare's first birthday at the end of March before she has to go back to the hospital.

Sunday, November 20, 2005

Recovery

Clare continues to do well at home. She is having a bit of an adjustment with her sleeping, but she had this issue after her last stay in the ICU, so I know it will work out eventually. We also are adjusting to being back at home and staying on top of Clare's recovery. A visiting nurse is coming in twice a week for incision care, medication and feeding issues, and weight checks. Clare lost a pound in the hospital (which is a lot for a 14-pound baby), so the nurse will help us keep track of her weight and make sure she is gaining.

I am a scrapbooker, and as well as blogging, have been including Clare's hospital stays in her first-year scrapbook. So I have been taking photos to document Clare's progress. When Clare was in the ICU, Shawn and I debated whether to take photos of her hooked up to the ventilator. It was a scary sight for us, and we didn't think we would want to remember it years later. Honestly, I will never forget that sight, photos or not. We decided to take some photos because we want to show Clare down the road what a strong baby she was and what she went through. We are so proud of our little girl! The bottom photo is from Saturday, November 12 - Clare was four days post-surgery. She actually looks pretty good in the photo compared to how she looked immediately after surgery. The top photo is Clare five days later, November 17, after we were transferred to the cardiac floor. It is amazing what a difference five days make! Clare's recovery is unbelievable. She was such a sick baby when she first came out of surgery. Less than two weeks later, she is smiling, playing, eating, and at HOME!

Friday, November 18, 2005

Saints Clare and Therese


FIrst off, we are home! And so glad to be home. Clare fell asleep on the car ride home. When she woke up, she was in her car seat in the living room. She looked around and gave the biggest smile I have ever seen from her. She knew she was home! She has been the happiest little camper this afternoon. Thank you all for your continued prayers in bringing our baby home safely.

I know Clare's patron saints, Saint Clare of Assissi and Saint Therese the Little Flower, were watching over Clare during her hospital stay. Our pastor and a group of fellow parishoners were doing a pilgrimage in Italy these past two weeks. Shawn and I find it very interesting that the length of this pilgrimage coincided exactly with our time in the hospital. Each morning on the pilgrimage, Clare was offered up in the intentions of the Mass. Shawn gave a picture of Clare to one of our friends going on the pilgrimage. Clare's photo was placed at the foot of where Saint Clare's preserved body lies encased in glass. This same friend and his wife (thank you, Bob & Phyllis!) brought us back a statue of Saint Clare from their visit to Assissi. The statue was blessed by Pope Benedict XVI at a general blessing the group witnessed in Rome. We are blessed to have such friends who are thinking of us and praying for us even as they are enjoying a trip around Italy!

The day of Clare's surgery, my grandmother Teresa discovered a white rose had bloomed in her garden. She sent us a photo of this rose to let us know that St. Therese was looking out for Clare Therese during her surgery and recovery.

Going Home

We are going home! We don't know what time, but it will be today. We are ecstatic and very antsy to get out of here. Although it will be an adjustment going back to "normal" life, we cannot wait. I can't believe we're getting out of here so early.

Clare's progress on the cardiac floor has been fabulous. She has not had any more "episodes" with her heart rate. The doctor removed her pacer wires from her chest yesterday as well as all her stitches. She had to be monitored for one hour after they did this, and did fine. She has been feeding as normal and her weight is going up again. Clare has been playing a little and I've seen some smiles. We are blessed to have our baby back!

Clare's echo yesterday went well. She tolerated the sedation process beautifully. So good in fact, that her cardiologist here cleared her for sedated echos in the future - we'll see if her home cardiologist agrees! The good thing about being able to do sedated echos is that they get a more accurate picture of Clare's heart when she is sedated (crying and moving can have an affect on her numbers), so hopefully we won't have the scares we've had with her past echos. Her echo showed that her ascending aorta and aortic arch look like a typical aorta. Her descending aorta is still a little small, but it's not at a degree where it poses a danger to Clare right now. Her pressures are high in the pulmonary side of her heart, but that is expected. She is definitely on her way to having another cath, but hopefully it will not be until after Christmas. The cardiologist was actually excited about the results of Clare's echo, which made us excited!

So we are on our way out of here! Our big thing today is to learn about Clare's new meds and dosing schedule. She is still on methodone and is being weaned off it very slowly so she does not go through withdrawal. Clare will have a total of 12 doses of medication a day with all her various meds, so I am ready to draft her dosing schedule with help from the nurse!

Wednesday, November 16, 2005

Our New Way of Life

To those of you who have gotten used to me posting daily, our new way of life prevents me from that luxury now. Not that I am complaining! Things are more "low-key" here in that Clare does not have a nurse constantly by her side, and I do much more of the caretaking. So my posts may start to become more infrequent. Tonight, Shawn is here and he is having his Daddy time with Clare, so I got to slip out for a little while.

Clare has settled in nicely to life on the cardiac floor. We had a great night's sleep last night (first night that I slept with her in the room) and a fairly good day. I belong to an e-mail list for the Williams Syndrome Association and have been told many times by experienced parents to expect "two steps forward and one step back" with any procedure, recovery, etc. I am finding that is so true. Clare made two big steps forward today in that both her oxygen cannules and feeding tube were removed. She is finally tube-free on her face! We were both very happy with that development. Her nursing is still slow, but she is doing much better. Her weight gain and fluid output (a.k.a. diapers!) have been sufficient enough that she no longer needs supplemental feeds through the tube.

Clare's step back is hopefully a minor one. She had two moments (one today and one a couple days ago) when her heart rate plummeted for about two seconds then went back to normal. The first time it happened was in the ICU. The nurse thought it might just have been a glitch in the monitoring system, and since it didn't happen again, didn't think twice about it. Then it happened again today while Clare was sound asleep. It was a scary moment for me because I was sitting next to her listening to her snore softly while I read. Suddenly there was complete silence, followed by a loud choking/gasping noise by Clare, and she woke up crying. The alarms on her monitor were going off from this episode. Her cardiologist believes this occurrence is due to her new blood pressure medication. The drug slows her heart rate so her heart does not work as hard as it did pre-op, thus lowering her blood pressure. The doctor explained to me that when you hold your breath or bear down, your heart rate normally slows down. He said it sounded like Clare might have gagged on her saliva while she was sleeping and, since she still had the feeding tube and oxygen in her nostrils at the time, she actually stopped breathing for a second. Under normal conditions, this would cause her heart rate to drop. Due to the drug, it makes the drop even more pronounced. Since the tubes are now gone, they are going to watch and see if it happens again (she is monitored 24/7 anyway). If so, then the doctor will change her medication.

Tomorrow Clare is having a sedated echo so her surgeon can see how heart looks more than a week post-op. I am praying for good news!

My Lovely Wife Part 2

S~ Okay, those of you who know me might be thinking I am just kissing up for more Christmas presents, and while that is true, I have gained a deeper respect for Teresa this week by being a single Dad here at home. So I wanted to share this newspaper article that Teresa's Dad sent her. It made both of us cry and I thought I would share it with allof you. This is Teresa to a tee!

Written by Erma Bombeck Published in Today Newspaper September 4th 1993

Most women become mothers by accident, some by choice, a few by social pressures, and a couple by habit. This year, nearly 100,000 women will become mothers of handicapped children. Did you ever wonder how mothers of handicapped children are chosen?
Somehow I visualize God hovering over Earth selecting his instruments for propagation with great care and deliberation. As he observes, he instructs his angels to make notes in a giant ledger.
"Armstrong, Beth; son; patron saint, Matthew. Forrest, Marjorie; daughter; patron saint, Cecelia. Rudledge, Carrie; twins; patron saint... give her Gerard, he's used to profanity!”
Finally, he passes a name to an angel and smiles. “Give her a special needs child.”
The angel is curious. "Why this one, God? She's so happy."
“Exactly," smiles God. “Could I give such a child to a mother who does not know laughter? That would be cruel.”
”But has she patience?” asks the angel.
“I don't want her to have too much patience or she will drown in a sea of self pity and despair. Once the shock and resentment wears off, she'll handle it. I watched her today. She has that sense of self and independence. She'll have to teach the child to live in her world, and that's not going to be easy. This one is perfect. She has just enough selfishness.”
The angel gasps! “Selfishness? Is that a virtue?”
God nods. “If she can't separate herself from her child occasionally, she'll never survive. Yes, there is a woman I will bless with a child the world perceives as less than perfect. She doesn't realize it yet, but she is to be envied. She will never take for granted a spoken word. She will never consider a step ordinary. When her child says ‘Mommy‘ for the first time, she will be present at a miracle and know it! When she explains a tree or a sunset to her child, she will see it as few people ever see my creations. I will permit her to see clearly the things I see -- ignorance, cruelty, prejudice -- and allow her to rise above them. She will never be alone. I will be at her side every minute of every day of her life because she is doing my work as surely as if she were here by my side.”
“And what about her patron saint?” asks the angel, his pen poised in midair.
God smiles. “A mirror will suffice.”

Tuesday, November 15, 2005

Out of the ICU

The prayers worked. Clare's IV was put in last night, her central line removed, and we are finally on the cardiac floor. Yea! It's been another long day, but it was MOVING DAY!

For the first time in a week, Clare is out of her bed. She is patiently sitting in her stroller watching while I type this, so I am not going to write a long post. I have been promising her a walk all day once we were settled in, so we're off to take that walk.

Prayer for an IV

I have a simple prayer request tonight - pray for an IV!

We are still in the ICU tonight. Clare did great during the day with her NG-tube. As much as it pains me that she needs this tube to eat, you could tell she was feeling better with a little food in her belly. The IV nutrients will give her all she needs to survive, but they won't fill her tummy. She also nursed a little before bed (and nursed longer than before), so I know she won't need the tube for long. Auntie Chrissy came to visit today, and she entertained Clare by singing to her. Then Clare entertained Christina by chatting up a storm. She even smiled at Christina! She played a little today, too, so I can see our Clare slowly coming back.

Now that the feeding issue is squared away (as far as the ICU is concerned), of course, something else has come up. The teensy IV in Clare's foot failed today. It wasn't the greatest IV to begin with, but it was an IV. And they won't let Clare leave the ICU without another IV in. Tonight's mission is for the IV therapy nurse to get another IV in. So when you say your good-night prayers, please add a special intention for Clare's IV! It may not seem like much, but right now, that's what's standing in our way to get out of the ICU.

Monday, November 14, 2005

Working Our Way Out

Clare is working her way out of the ICU. From a heart standpoint, she is ready to go. However, she is having trouble feeding, so that is what is keeping her put for now. It's crazy how complicated everything can get.

Clare has an IV (a central line) in her jugular in her neck. This is the only way she can receive IV nutrients, such as carbs, lipids, etc. But if she's not eating by mouth and not eating by NG-tube (the nurses have tried for two days to get a tube in - the night nurse tried again last night and it made Clare vomit), then the central line has to stay in so Clare continues to receive nutrients. However, she cannot be transferred out of the ICU with a central line in because it is too dangerous if something went wrong with that line. The IV in her arm went caput, and an IV nurse was finally able to get an IV into her foot two nights ago. Yet as Clare's nurse told me, "It's in the smallest vein I've ever seen an IV go in!" (Clare is a VERY hard stick - partly because of that adorable baby pudge, but mostly because she has been stuck so many times that there is much scar tissue in the way). So that foot IV is pretty much useless except for an occasional blood draw. The IV team are going to try and get another, better line in before they take out the central line (and I say, good luck to you!).

The issue with feeding is that Clare is having trouble nursing. She shows signs of hunger (and should be hungry since it's been 7 days since she's eaten), but is not nursing well. It could be due to the position of the central line (hard to get into a comfortable nursing position), all the sedatives she has been on that she is still very tired, and a sore throat from being intubated. Today, the nurse was finally able to get an NG-tube through her nose by giving Clare some Reglan (a drug often given to babies with reflux) beforehand to relax her GI system. The Reglan did its job, so now there is the option of tube feeding Clare as well. While she has the NG-tube in, I can still nurse her (and she is being fed only breastmilk through the tube anyway).

So after a lot of shuffling around and experimenting with different things, I think the plan is to continue to try nursing Clare, but to primarily feed by NG-tube for now. We may be stuck in the ICU one more night to be sure Clare is doing well with the tube. If that goes well, her central line can come out, and she can be transferred out of the ICU. Once we're on the cardiac floor, Clare won't have that central line and hopefully she will have more energy. Then she can start nursing more and feeding through the tube less. I don't like the idea of Clare being fed by a tube, but if that's what it takes to get her strong and healthy again, then that's what it takes.

Sunday, November 13, 2005

Ups and Downs

Today was an up and down day. The biggest up was when Clare had her breathing tube removed. She was such a happy camper for about 30 minutes afterward. But then that ended. If I had to name a benefit of having to see your child sedated, it's that you cannot see their pain (because they really don't have any when they're knocked out!). Clare had a hard time settling in today. And, as parents, we had a hard time watching her. We're fairly helpless when Clare is in the ICU. Her terrific nurses do all the work, but you take it personally as a parent when you cannot comfort your child. They're trying to wean her off her painkillers, but she obviously has a lot of discomfort. She is not on continuous morphine now, but the doctor did put her on an occasional dose of morphine, along with the methodone. However, this still was not working for her today, so she also got a dose of ativan (a nice happy anti-anxiety drug!). The ativan did the trick, and she settled right down. Then she was fairly content for the remainder of the day, except when she was being fidgeted with. As much as I hate seeing all these different meds pumped into Clare, I know she needs them. If she gets too agitated, it affects her blood pressure and respiratory rate, and she cannot rest and continue her healing process. As it is, the doctor has put her on hypertension medication because her blood pressure has been 20 points higher post-op than it was pre-op. She may go home on this medication, but hopefully it won't be a permanent addition.

The other big up today was that I got to hold both of my babies. My mom brought Jamie to the hospital (he spent the weekend with my parents, and then went home with Shawn this evening). Shawn and I had agreed to not let Jamie see Clare until she was transferred to the cardiac floor. However, the nurses encouraged us to let him see her in the ICU once her breathing tube was removed. All he would see was the oxygen cannules in her nose and tape holding the tubes to her cheeks. The rest of her would be covered by blankets. One of the nurses said that you would be surprised what a 3-year old can imagine, and it would be better to just let him see that she's all right. Jamie has asked constantly for Clare and was quite upset on Friday when we wouldn't let him see her. So we decided to let him in the room. He was great - saw Clare, gave her a kiss, then happily played with the Ninja turtles Clare "gave" him for a present - all was right in his world again. We definitely made the right decision letting Jamie see her. I was able to spend about an hour with Jamie in the playroom at the hospital, and we had a great time. He wanted hugs and kisses and to be carried around, so I loved every moment of it.

This evening, Clare had her arterial line removed from her wrist. Once that was out, I got to hold her. It was precious. She was upset by the removal of the line (it was stitched in place into her wrist), but calmed instantly in my arms. We both missed each other! I didn't hold her for long since it is difficult to manuever because she is still hooked to IVs and other pumps and monitors, but the ten minutes I had was wonderful. One of my downs today was that I saw her chest incision for the first time. The nurse had to clean it and change the bandage and said I didn't have to watch, but I felt that I needed to see it (since I am going to have to do this at home). I can't describe how it feels to know your baby's perfect skin is gone forever. I know it's just a cosmetic thing, but I never liked the idea that they were cutting my baby. The incision is about three inches long a little to the right of the center of her chest. It didn't look as nasty as I thought it would, but it still hurts me to see it. She also has the four sites of stitches from her chest tubes that I saw for the first time. It is so hard to see your baby covered in cuts, bruises, needlesticks, and stitches. But then I had the up of nursing her for the first time post-op. She only nursed for about two minutes, but it's a start. And she kept it in her tummy, which is a big thing. So it's been a long, emotional day for us! If all goes well tonight, we're going to be transferred out of the ICU tomorrow. That will be a big up!!

My Lovely Wife

S~ Okay, two posts in a row. No Teresa is fine but there was something more I wanted to say. For those of you who don't know, today is Teresa and my sixth wedding anniversary! So I wanted to take some time to tell all of you how lucky a guy I am. When I met Teresa nine years ago, I noticed her immediately. She was this spunky girl that ran around the campus of our college going by the name of Tree (a nickname I still use to this day). She had a boyfriend that first year and I had a girlfriend. My senior year we started dating, and it was a little rocky the first few months. But we persevered. Then I graduated and moved to Rhode Island, Teresa still had two more years of college to go through. I had some doubts that we were going to be able to survive the distance. But God had a plan. We survived the first year and the start of the second year I proposed to her (the smartest thing I ever did). I was so nervous I could barely get the words out but she said yes! Then a year after that we were married. I will never forget standing at the front of the church when the music started playing and watched as the doors opened to a beautiful angel dressed all in white. I remember my knees going week and I choked back tears. I thought how could a clown like me every deserve such a treasure. Now six years later we are spending our anniversary watching our daughter in the ICU recover from a difficult surgery. I can't tell you how lucky I am to have a woman like Teresa as my wife! She is so wonderful in so many ways. Her strength during a crisis has helped me so much these past seven months. She is strong when I can't be and vice versa. She constantly makes me laugh and is the most wonderful dedicated mother. She has done such a tremendous job raising Jamie and Clare, and sacrificed a lot in the process. God has granted me with the greatest gift he could have ever given me, and that is my wife. I am not worthy to have her, but knowing that, I find myself honored that she also chose me. I remember in my very first post (Daddy's First Post, June 23rd) I made a comment about wondering how our marriage will hold up under all this stress. Well, now going through the most stressful seven months of our lives; I know that God has helped us grow closer together. He has made us a much better team and much better parents. So on our sixth anniversary I want to celebrate my wife Teresa. I ask all of you to leave her a special comment to let her know how much you all love her. Happy Anniversary, Tree!

Free at Last!

S~The big update of the day...(drum roll please)... Clare is off the breathing machine. At about 8:20am they took the breathing tube and stomach tube out of Clare. She, of course, hated that but soon settled down. She can now have her binky and Mom and Dad can have her beautiful face back! She looks so sweet now sucking away at her binky. The plan for the rest of the day is to take out her arterial line (a thin tube inserted into the artery in her wrist that measures her blood pressure directly from that artery) and keep her as comfortable as possible. She will be in the ICU for at least one more night as they want to make sure her breathing and oxygen levels are all fine. I believe they also want to try feeding her orally, not really sure of the plan with that. She has been receiving proteins, carbs, and other nutrients via her IV. (The tube feeding plan ended up not working because one of her nostrils got blocked, so her stomach acid tube had to be placed in her mouth again and now there is no access for tube feeding.) But, once again, Clare is doing great. When I left she was watching "You're a Good Man, Charlie Brown". Her nurse put it on but Clare was definitely enjoying it, so I won't say a thing about a 7 month old needing to watch TV. Besides, it allows us to watch those beautiful baby blue eyes!

Saturday, November 12, 2005

Weaning Off the Vent

Clare's day today is focused on weaning her off the vent. In preparation, she is being given another blood transfusion (to increase the amount of oxygenated blood in her system). She is also being taken off her morphine (which causes some respiratory suppression) and put on methodone instead. The methodone will also help her come off the strong painkillers, so she does not go through withdrawal. If all goes well today, then she will be extubated in the morning.

Making Progress

Today was a great day. Clare made some real progress. Five of her tubes were removed(including the chest tubes), and she's down to only six medications. I look back over how far we've come since Tuesday. She still has a long way to go, but her progress is amazing - she's an amazing baby. It was a rough mid-afternoon for her with all the tubes coming out, so she slept all afternoon and early evening. She is on a strong dose of morphine, so that certainly helps with keeping her asleep! But Shawn and I did have a couple moments this evening with her when Clare seemed to know that we were there.

Jamie visited the hospital with my family today, and I loved seeing him. Although I've been talking to him daily, it's been five days since I've seen him. He was a little weird with me (very clingy to Auntie Erin), but I know that is just his way of adjusting to all that is going on around him. I was content with, as my mom puts it, to just feast my eyes on him.

Tomorrow's plan is to continue weaning Clare off the ventilator. If she has a good day tomorrow, she may be completely off the ventilator by Sunday. Then we can begin the transition out of the ICU.

Friday, November 11, 2005

Baby Blues

I saw Clare's baby blues this morning... I slept again in the parent dorm last night, and when I arrived at Clare's bedside this morning, she had made great strides overnight. She was completely weaned off her vent pressure and the paralytic and had already stirred a bit. She is still heavily sedated and on morphine, but she does open her eyes and try to look around, especially when the nurse is doing something on her. The nurse said she can hear my voice, so I've been talking to her and telling her about all the people who love her and who are praying for her. She is somewhat agitated when she is "awake," which of course causes her blood pressure to rise, so we've been trying to keep her content and asleep. But it was wonderful to see those beautiful eyes.

I met with Clare's surgeon this morning. Her chest x-ray showed more improvement over yesterday with the fluid in her lungs. His plan this morning is to remove the leads that are directly on her heart. If that goes well, then he will remove the chest tubes (tubes inserted into her chest to drain fluid from around the heart) and stitch up those incisions. He said she "has turned the corner" and is doing great. He said there may be a possibility of doing another cath while she is in here to do some work on her pulmonary side, but that will be up to her cardiologist. She will at least have an echo to see how her aortic patch looks, and they can look at her pulmonary side then.

Jamie's Journey

S~ I wanted to write a few words about Jamie. As this website is truly designed to discuss Clare's Journey with Williams Syndrome, the syndrome really affects the whole family. For those of you who don't know Jamie, or for those of you who have not seen Jamie in awhile, he is a wonderful kid. Of course, he has his typical 2 1/2 year old moments, but for the most part he is a really, really sweet kid. He says please and thank you about 90% of the time, he loves to tease us and his Mimi. He loves to wrestle and kiss his little sister. Teresa and I have tried very hard to shelter Jamie from what Clare has been going through. We have explained the long Mommy Absences as Clare has a Boo Boo and she needs to go to the hospital to have it fixed. That has seemed to work pretty well and we thought he really didn't have an idea on the severity of Clare's disease. However, Tuesday during the surgery we called over to his friend's house, where Jamie was spending the day, to see how he was doing. After he asked Mommy what she was doing and then talked to Daddy he asked to talk to Clare. I told him that Clare was with the Doctor and he was making her boo boo better. He started to get really agitated about talking to Clare. I handed the phone to Teresa who answered with her best "Clare" voice and said "Hi Jamie, It's Clare. What are you doing?" His only response was "Hi Clare! I love you, Bye!" It was so sweet but it also made me realize that he does understand, in his way, the severity of Clare's disease. He may not know about the surgery but he knows that his sweet little sister has a bad boo boo that his kisses won't heal. I pray that all we have to deal with is not going to affect that sweet little kid I know and love. I don't want him to think that he is ever second to Clare's disease. So Jamie, if you read this years down the road I want you to know that Daddy and Mommy are very proud of you and we love you with all our hearts!

Thursday, November 10, 2005

Closing Time

Clare's chest is closed! It happened sooner than expected, and she did awesome! No major bleeding, no major blips in her stats. Her clotting is still somewhat iffy, so she is receiving Vitamin K injections to aid with that. (Please don't ask me what all this does - I try to soak up as much information as I can from the doctors and nurses, and then forget half of it! I've started writing stuff down, so I can at least repeat it somewhat intelligently to Shawn.) The nurse gave her a little sponge bath, and took the suction tube out of her mouth and inserted it through her nose instead (her ventilator tube goes through one nostril, and the tube to suction acid out of her stomach was inserted into her mouth, but now both tubes are in her nose). She has nothing in her mouth now, so Clare looks much more peaceful and absolutely beautiful!

Hanging in There

We're all hanging in there, especially Clare. She has had one expected obstacle to having her chest closed today. Due to all the anti-clotting medications she has been on, now that they have stopped those, her blood isn't clotting on its own. This isn't critical right now because she is not bleeding, but she does need her blood to be clotting before the surgeon closes her chest. So we are waiting for lab work results and hematology to come see her. She will most likely be given a transfusion of frozen fresh plasma to restart her clotting. After the transfusion, all the labs will be run again, and, if Clare is clotting well, then her chest can be closed. Hopefully this will happen sometime this evening.

The doctor warned us that after her chest is closed, Clare will experience some rocky moments again. This is 100% expected because of the trauma of going back into her chest, closing the breastbone, then suturing her incision closed. Because she has been stabilized for well over 36 hours now (and it will most likely be 48 hours once the surgeon actually closes her chest), the doctors are confident that they can help her get through these rocky moments.

Her chest x-ray this morning showed that the fluid in her lungs has decreased, but only slightly. Once her chest is closed, she can be weaned off the pressure in the ventilator, then weaned off the paralytic, but she will still be on the ventilator into the weekend because of the fluid. Once she's off the paralytic, if she is making good intestinal sounds (since her digestive system is paralyzed right now), then they are going to try tube feeding Clare breastmilk to see how she does with food in her belly. So these are our goals right now (in order) - blood clotting, chest closure, pressure off, paralytic off, tube feeding. Whew!! If all goes well today, then hopefully they can accomplish all these goals by tomorrow evening.

The rest of the family are hanging in there, too. Shawn went home last night to be with Jamie. Jamie wanted to sleep in Mommy & Daddy's bed (a first), so Shawn let him until he fell asleep. Jamie is definitely feeling our absence, but he is also having fun with Auntie Erin right now. Shawn is working from home today, so Jamie can see him whenever he wants to. Tomorrow, Erin is planning on bringing Jamie to the hospital so I can spend time with him in the playroom. I miss my boy!

I have been spending my time between sitting with Clare and taking walks around the hospital. Last night, I slept in the parents' dorm. I could have slept on the bed provided in Clare's ICU room, but she is constantly being worked on in some way by the nurse, so it would not have been a good night's sleep. When Clare was in the ICU overnight after her second cath, I was encouraged to go sleep elsewhere. However, I could not bring myself to leave her side, so I slept (kind of) in the room. I have learned that to be there for Clare, I have to be a little selfish and take care of myself as well. I offer this advice to any parent dealing with a similar situation. Since Clare is not nursing, I am not needed to be present overnight. I feel it is more important to get some rest while I can, since once she's transferred back to the regular cardiac floor, I will not get the same sleep. I have to admit that that has been the only perk to being here - it's been seven-plus months since I've slept through the night. (Well, almost through the night because I still have to pump.) Little blessings!

Wednesday, November 09, 2005

24 Hours

We've made it 24 hours post-surgery. That was a big goal for Clare. She continues in stable condition. She has made more progress today towards recovery, mainly that the pressure in her ventilator has been decreased (the amount of pressure needed to inflate her lungs so she continues to circulate oxygen throughout her body), and she is doing well with these slow pressure decreases. This is one of the measures that was put in place last night to get her out of trouble. She will slowly be weaned off this pressure, and then will just be on the ventilator without any pressure at all and her body will do the circulation by itself. So it's good news that she is tolerating the weaning process. There is still fluid in her lungs, and we have to wait until her chest x-ray in the morning to see if the fluid has decreased at all.

Another big step is that her doctors are pretty sure any swings in blood pressure now are due to sedation. Her nurse noticed that Clare's pressure went high every time they fiddled with her - check lines, change medications, etc. Therefore, they believe that she is not under enough sedation and can feel these changes in her environment. So they have added another sedative to her long list of medications to see if this makes a difference in the blood pressure changes. If it does, this will be great news because it means Clare's pressure changes are not due to any problems with her heart (which was the cause of the concern last night).

She is still very sick, but is making her baby steps towards getting better. Hopefully tomorrow, her chest x-ray will show that the fluid is going down, and her surgeon will feel it is safe to close her breastbone and chest incision. From there, the next goal will be to come off the ventilator.

Thank you as always for the continued prayers, love, and support.
"Cast your burden upon the Lord and He will sustain you." --Psalm 55:22

Good Morning

Clare is in stable condition. She had a rocky night with some more episodes, but this time, the doctors had already figured out what medication worked best for her and could stabilize her much faster. She is still having periodic blood pressure swings, but we have been assured this is just her body's way of recovering from surgery. She also has fluid building up in her lungs (another result of surgery), so her chest will remain open longer than previously expected (in case they need to get in there quickly). She is facing a longer ICU stay than originally anticipated due to the complications.

We're hanging out in the ICU for the day, just being with our baby. It's going to be a long day, but Clare is heading in the right direction, albeit slowly. We've talked to our sweet boy, and he is having a blast with his auntie today. We are more peaceful.

Rocky Moments

Warning: Some of this is tough to write and may be tough to read. But one of our goals of this blog is to be cathartic for us, and I need to get it out. Another goal of this blog is to be a "guide" to other families going through this experience. You can never be totally prepared for every possibility that may come up. We hope we have a "success story" to share someday, but that story comes with some rough roads. And you do get past them.

It's been a rough day and an even rougher night. Clare did great during surgery. She made the transition on and off bypass smoothly. The surgery, from an aortic standpoint, was successful. The surgeon was able to use all of Clare's own muscle tissue to patch her aorta. However, tonight has been tough.

I am writing this after about two hours of intense crying and praying. These next 12-24 hours are rocky for Clare. Given the complications due to her Williams Syndrome and the condition of her blood vessels, the doctors are walking a tight line with keeping her body functioning. Clare's two obstacles post-surgery are bleeding from her surgical site (because the patch on her aorta is so extensive) and maintaining her blood pressure. The doctors have a fine balancing act keeping her blood pressure at a good rate while keeping her heart beating and her circulation going. This is harder than it sounds. If her blood pressure gets too high, she will start bleeding. If her blood pressure gets too low, she will have problems with the blood circulating throughout her body, which would have an impact on the other systems of her body.

When we first got to see Clare post-op in the ICU, she looked, quite frankly, terrible. She had tons of wires, tubes, lines, monitors, and 15 different medications being pumped into her body. Her chest was still open because the surgeon did not close her breastbone due to the risk of bleeding. (This was not as gruesome as it sounds because her chest was covered by a betadine bandage.) She had two nurses working steadily on her, and we were updated by the ICU cardiologist. Our family came in one-by-one to have a peek at her. It was hard seeing our little girl like that, but everything seemed in control. Then it all changed. Suddenly, Clare was a "Code Blue." Doctors, nurses, and special techs with scary-looking equipment came rushing in. Shawn and I got shoved to the side, not out of rudeness, but because everyone was focused so intently on Clare, they just didn't see us anymore. Finally, one of the doctors came over to talk to us. Clare's heart rate had dropped and her blood pressure increased. She was in trouble. The team of specialists were trying to gain control over her system again. She was put on an external pacemaker, among other machines. I can't even begin to explain what all they did to her because I don't know. And I don't know if I want to know. It became too much for Shawn and I, and we left. This was the hardest decision. I was so scared to leave my baby, but I couldn't stay there and watch helpless not knowing what was going on and in the way. The doctor explained that this was expected to occur post-op due to the Williams Syndrome and the multiple vessels involved in Clare's surgery. Plus, although the patch will correct her aortic problems, the pulmonary side of her heart is still very sick. He explained that the doctors were trying anything and everything to get Clare stable again. He said this might happen throughout the night as they worked to get her through this. None of that made me feel any better. I can't put into words the conflicting emotions between staying and going, but finally Shawn and I decided to go. We were no help to Clare in the condition we were in.

We came back to our hotel, cried, prayed, and held each other. I tried to go to sleep. Eventually, Shawn told me he was going to go back over to the hospital. Clare's nurse was going to call us if we were needed, but it was too hard to just sit around. I did not go with Shawn because I was so physically sick from all the emotional stress. When Shawn came back 30 minutes later, he brought good news. Clare was back in stable condition. She was back to only having the two nurses with her. Her amazing team of doctors had gotten her through that rocky moment. Shawn gave Clare a kiss and told her that Mommy and Daddy love her very much and were praying for her. I am so glad Shawn went over there. Although I did not see Clare, I don't have that last terrifying vision of her as I go to sleep tonight. I am sure there will be other rocky moments tonight and tomorrow, but Clare has us shown again and again that she is a fighter. And God has shown us again and again that He is taking care of her.

Clare's not out of the woods yet, but she is in good hands, physically and spiritually. If anyone is checking the blog late tonight, please say a special prayer for Clare and her doctors tonight. And for us, too!

Tuesday, November 08, 2005

Surgery Update

We are in hour four of Clare's open heart surgery and just received word that Clare is successfully on the heart-lung bypass machine. There are two very crucial points in her operation - going on the bypass machine and coming back off. So we are past the first crucial point. We have not been given too many details except that, so far, she is doing well.

While she's on the bypass machine, the surgeon is repairing her aorta. Once he's done, they will begin the transition off the machine and Clare's heart and lungs will have to function for themselves again. Then they will close her up and send her to recover in the Cardiac Intensive Care Unit (sounds like a breeze, but we're talking hours here!). We have been told that she will be in the CICU for 4-5 days, with the first 1-2 days on a ventilator and other machines (possibly including a G-tube for feeding), so her heart does not have to work so hard.

Thank you for the continued prayers.

Monday, November 07, 2005

Another Moment of Prayer

Well we have not even been admitted and we are already on Hospital Time! Clare's surgery has been moved from 8:00 am to 10:00 am. So if you read this in time, we would like to have everyone pray together at 10:15am. If you do not read this in time, and pray at 8:15am, thank you, we will take all the prayers we can get, no matter the time!

Sunday, November 06, 2005

Moment of Prayer

We are asking our faithful companions to have a moment of prayer for Clare on the day of her surgery, Tuesday, November 8. We are planning on doing it ourselves at 8:15 am (this is around the time Clare's surgery will start). Please join us, for the power of prayer of many is great.

"I can do all things through Christ which strengtheneth me." - Philippians 4:13 (the quote from my daily scripture calendar for November 8)

"May today there be peace within. May you trust God that you are exactly where you are meant to be. May you not forget the infinite possibilities that are born of faith. May you use those gifts that you have received, and pass on the love that has been given to you. May you be content knowing you are a child of God. Let this presence settle into your bones, and allow your soul the freedom to sing, dance, praise and love. It is there for you!" -St. Therese's Prayer

Friday, November 04, 2005

Control Freak

I am somewhat of a control freak. I say "somewhat" because I am not totally inflexible, but I do like things my way (just ask Shawn!). And I come by this honestly (not naming any names).

The things I like my way the most are in my domain. And being a stay-at-home mom, that primarily means my kids and my house. It has taken me four long years, but I have finally (and somewhat graciously) relinquished control of the office in our house. (Anyone who has been over our house in the last four years knows what I am talking about.) The office used to be the bane of my existence when it came to house cleaning. But when your house is small, your husband works from home, and you really cannot help him clean up his space because you don't know what's important and what's not when it comes to his work stuff, you eventually have to concede defeat. Which I have done.

But I am having a lot of trouble giving up that control elsewhere. This has been on my mind a lot lately because of our extended hospital stay coming up. I have to give up one of the most important parts of my domain - Jamie. I have to relinquish my control (and by that, I mean care) of him over these next 1-2 weeks. Yes, we have a schedule planned out, and Jamie will spend his time with Shawn and others that love him and will take good care of him. But it is so hard for a mommy to let go. I am so bad that I am nervous about letting Shawn pack his suitcase to spend the weekend at Grania and Grand Dad's house. But I have to let Shawn pack his suitcase because I am already packing his suitcase (two days in advance) so Jamie can stay at his friend Ethan's house on the night of Clare's surgery, and I won't be here to then unpack that suitcase to repack it for the weekend. It's driving me bonkers! (And don't even mention the lists I have made for everyone about Jamie's snacks, sleep schedule, etc.) See how sick I am!?!

I am fairly in tune to my psyche, and I admit that part of my control problem (besides that it is in my personality) is that I do not have this control over Clare's life. I should have known I had lost the control from the day of her birth. She was on her own schedule coming into this world - 9 days late and had to have labor induced when I was really ready for her to come, then she was delivered when I was only 7 cm dilated and not ready at all! A parent knows that someday they will not be in control of their children's lives anymore. I just was not ready to give a lot of that up in Clare's infancy. But we have been forced to. So much of what happens to her is out of our hands. So I am reluctant to give up that control when it comes to Jamie.

This journey we've been on has taught me some important lessons about life and my perception of it. One of those lessons lately has been the old saying, "Let go and let God." I think I can truly say that when it comes to Clare, I am there. I have to be there and let God have her life in His care or I could not function from day to day with the worry and stress. It is in the other areas of my life that I am having trouble with that.

I want to slightly change the saying to one that has also become crucial in our lives now - "Let go and let others." We couldn't walk this journey without the incredible support of the people walking it with us. From our parents and siblings who wait at the hospital with us during Clare's procedures to our dear friends who rack up countless hours watching Jamie to the generous financial support from loved ones to the people across the country praying for us. It has been hard for me to admit that we need help. But we do - we can't do this without them either.

I am not all the way in my journey yet, but I am working on it, and God is working on it with me. At least I am ready to let Shawn pack Jamie's suitcase (I think).

Thursday, November 03, 2005

Gearing Up for Surgery

We came home on Tuesday around noon (our shortest hospital stay thus far). As most know, the catheterization went incredibly well. When we received our hourly update at 10am, we were told that the doctor had balloon dilated Clare's left pulmonary arteries again, but that no additional stents were needed at this time. Shawn and I were elated - we had been told the night before that more stent placement was a very real possibility. And this would mean another trip to the ICU, a longer hospital stay, more drugs, etc. The nurse informed us the doctor was getting ready to go into the right arteries, and we would hear from her in an hour. When she called back at 11am, we were mentally prepared again for the news. Or we thought we were.

Shawn and I were on the edge of our seats during this last catheterization. Clare's first two caths were full of nasty surprises for us. We were so unprepared for most of what happened during those procedures. I told myself I was not going to let that happen again, so I braced myself for the worst. When the nurse said that Clare was done, she was extubated, she was out of anesthesia and in recovery, I thought I heard wrong. I couldn't believe that it was over. I hung up the phone, told Shawn, and started to cry. I just couldn't believe that Clare was done, that she was okay. You would think we would be "old hands" at this stuff now. I thought it would get easier once the first one was done, but it doesn't. I think, in some ways, it gets harder. Because now you REALLY know what can go wrong.

I thank God for this last procedure. I am still a little in shock over how "easy" it was. Clare did so well during the cath. Her body tolerated everything much better this time. The doctor only dilated her arteries and no additional stents were needed in either side (which means that, although Clare's arteries are continuing to narrow, they did not narrow enough to need more stents and the stents she has in there are doing their job). Clare did not need a blood transfusion or extra meds (except for the old standby of Heparin). She was only under anesthesia for two hours, rather than the normal four. All of these factors equate to the fact that Clare was discharged before noon the next day (a first for us!), and she is already back to her normal sleeping, eating, and other bodily function routines. Which means our happy baby is back! We literally had NO adjustment coming home this time. (Another first!)

This last procedure was a blessing. I was dreading Clare having her cath one week, then coming home, and having to go back into the hospital a week later. I just wanted to get everything over with. But by having this last cath over and a success, it means that Clare has no recovery before her surgery. She is going into her surgery as healthy as she can be right now.

A Special Comment

S~ Teresa and I are always touched by the love and support that we get back from this blog. We read every comment. The comment below really touched us so we wanted to publish it for all of you to read. Thank you to this anonymous commenter for lifting our spirits.
-So thankful that the procedure went well for Clare yesterday! I have heard of Clare's story from a relative of yours and have been keeping you and your family in my prayers. As I read of this "journey" through your entries in the "Clare's Journey" blog, I am usually brought to tears. So many, like myself, have been touched through Clare's life and through the faith, love, strength and determination of you and your family. I know God can use tough situations for His good - and I see more and more how much this is not only a journey for Clare, but it is also a journey that the Lord is bringing your entire family through. I am humbled by your faith and love -- it's brought me to my knees in prayer for your darling daughter. Keep looking up -- the Lord has a mircaulous plan for your family and for Baby Clare! Through this tough situation, I pray you continue to see the victories and miracles of His hand in your lives and in the life of your beautiful daughter!In my prayers-
So once again, thank you for all your lovely comments . It is a comfort for us to have all the love and support.