| It sure seems like a lifetime ago. But, look at the difference in two weeks... All the kids were outside playing in the leaves (which you can see in the reflection). Shawna (and Max) wanted to play too...but it's still a little too soon to be jumping into a leaf pile!! Lori M. Baylor |
Tuesday, October 27, 2009
Has it really only been 2 weeks?
Wednesday, October 21, 2009
Perspective
Our perspective ran into us on Thursday night...literally. I was in route to the cafeteria from the cardio step-down unit. I was rounding to corner to get to the elevators when BAM!! I ran right into some poor women rounding the same corner, going the opposite direction. And there they were... There must of been 30 of them, all crowded into a tiny waiting room outside the PICU. I recognized the Mom from the PICU- (they moved into the room next to us literally 30 minutes before we left the PICU. )There were so many of them... I felt awkward waiting for elevator, like I was invading their personal space. But, they were still there when I returned from dinner. And, they were still there, curled up with blankets and pillows, when I arrived early the next morning. The '30' had dwindled to about 10... but that was still more people than the tiny area could comfortably accomodate. Later that next afternoon, I saw clergy talking with them. They were gone by the time I arrived Sunday morning.
There were so many 'surprises' with Shawna's first cardiology appointment. And I was so angry and frustrated... wondering if I had been intentionally deceived or just been given incomplete information. And now.. I still wonder about those things. I guess that I always will. But at that moment, I was grateful and content. At that moment, I imagined all that I had seen.. in the PICU, at the Ronald Macdonald house, and even in step-down. If I could take all of 'that', toss it in a grab bag, and shake it up... well, I realized that I would reach in and grab Shawna's condition in a heartbeat. Even if it was beating on the wrong side.
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Sunday, October 18, 2009
Saturday, October 17, 2009
The irony
But now, something else has my attention. Audio art. Yep- you read that correctly. Audio art. On the main floor of the hospital, you can take an audio tour of the displayed artwork. Rent a headset, oooh and ahhh at the pretty pictures, and it is just like being at an art museum. Really? Yep. Really. Let's see... I need a passport to get to the closest bathroom, but I can become educated in the fine arts without leaving the building. Weird.
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Day 5
In other good news, she screamed bloody murder when I left the room this morning...and continued to cry until I returned. (Side note: where did I go? Well, the non-patient bathrooms are so far away, they might as well have their own zip codes. Seriously! Who thought of THAT in the design? Yes, of course there is a bathroom in our 4 bed pod. But it's reserved for the patient use only. Hmmm... I haven't seen any patients use the patient-only bathroom... Our pod-mates are 7 weeks, 4 months, and 5 months old. I'm pretty sure they all still use diapers!!) Why is that screaming good news? Well, it means that she is finally alert enough to recognize her surroundings AND have an opinion about it. The past few days, she's just been too tired to care.
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Friday, October 16, 2009
Learning to 'wing-it'
A little background: I'm a "schedule" type of girl. I like to know the who, what, where, and when. And, frankly... I wanted to know it yesterday. We did not take Seth and Sara with us to China. So, our two week trip required a lot of planning and organizing. I may have gone a little over-the-top with the organizing part as I constructed a 35 page wire bound book for our friends/family that included: a daily schedule of events (both theirs and ours). Maps to school. Maps to the store. Bus schedules. Emergency phone numbers. Airline travel info. And even adoption related reading material on china's orphanages and adoption. Frankly, I was pretty proud of my book. It was even color-coded! As you can imagine, I got significant amount of grief from my family regarding my "book" and my OCD ! But darn-it, everyone knew what was going on every second of every day. So, what does this have to do with being flexible..??
Well, our entire China adventure has been an "exercise" in flexibility. First, we were planning to travel in late August. Then, we got 'surprised' with an early LOA ...and our agency wanted us to travel in July. We re-arranged, re-scheduled, packed and planned (and I stressed ) while we waited for our final TA. And, waited some more. Five days before our anticipated departure date, our TA still hadn't arrived. I was stressed out of my mind! But, we finally conceded that our travel wasn't gonna happen until August. So, we replanned,re-arranged, and re-organized again. I guess its also important to mention that both Dan and I work full-time. So, our employers are to be thanked tremendously for their flexibility with our ever-changing travel plans.
Well, we finally made it to China in late August. And nearly everything happened 'on-schedule'. Everything occurred as I expected... Until we got home. A simple VSD turned into DORV and a shlew of other things. Surgery was scheduled. Then changed. Then changed again. Cancelled. And then finally re-scheduled for this past Tuesday. Of course, every change required 10 kabillion phone calls to re-organize our family's schedule! Now, here we are.. Day 4. We are supposed to be 'in house' for about a week and up to 14 days. Tomorrow is Sara's 3rd birthday. Tomorrow, my girlfriends (that I haven't seen in months) are coming to the hospital for lunch. Tomorrow is a busy day, but I've got it all worked out. Four hours ago, they told us that we will probably go home tomorrow. Change of plans everyone. No lunch with girls. No balloons and cake at the hospital. Re-arrange. Re-plan. Prepare for discharge on Saturday. That was four hours ago. And, four minutes ago, they changed their mind. Probably home on Sunday. Sigh. I'm glad that I didn't make a "book" this time.
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Really?
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Thursday, October 15, 2009
A Bow for Shawna
Imagine my surprise this morning... When I arrived, Shawna had a cute little orange bow in her hair!! No- its not from me. And its not from Dan (he stayed with her last night and I went home for some much needed rest).
Its from our nurse last night, Kelley.
Apparently, she gave Shawna a sponge bath and "just couldn't resist." Maybe she read my blog from yesterday!! He he he!
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Day 3 update
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Day 3
But, here we are. And we are coping. And I've only freaked out twice in the last 48 hours. Shawna doesn't have tetralogy of fallot , but its darn close and possible more complicated than ToF beacause of the dexracardia. There is nothing "simple" about her condition. Nothing at all. But we are here. We are coping. Shawna is healing. And I can't imagine it any other way.
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Wednesday, October 14, 2009
Sleeping Beauty
In the midst of all her agitation, I joked that she was trying to escape!! I guess she just gave in.. decided that escape plan was a bust and she should just nap instead!!
The photo is of her resting peacefully... The ponytail in her hair is for my sister (who really thought she needed a bow or something to dress up her hospital look. Well, I didn't have a bow, Jen...so the pony tail will have to do. :-). And Dad... I sent the photo just for you..so you can see the difference that 24 hours will make in the PICU.
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Morning update
Wean... She is on a lot of meds, many of which are given to sedate her. In order for her to breathe unassisted, these drugs have to be discontinued. So, her last dose of Ativan was at 8 am. So far, so good. She is still agitated and cranky, but she's not yanking at her chest tubes!
Extubate... All morning long, her both meds and her breathing support have been gradually decreased. She has responded well and her blood gases look good. So, they will attempt to extubate her within the hour.
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The beginning of Day 2
She's been running a decent fever all night (that FINALLY broke), but in the process of treating it, they had to pack her in ice... Then her extremities got too cold but her fever was still too high. At one point, they had ice packs in her armpits, head, and groin ... And warmers on her hands and feet. Sigh. Poor little thing. Like I said, its been a interesting balance act to keep her sedated AND keep her pressures up.
Overall, it was a decent night. Shawna got a good,solid 4 hours of deep sleep. I got about the same. I've been up for about an hour... Showered, changed, and finished my first cup of joe! Rounds are at 8 so I will know more then.
Lori
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Tuesday, October 13, 2009
She is finally resting
She is responding as expected. She has a fever and her heart rate is high, so they packed her in ice and gave her Tylenol. Her blood pressure was low, so they gave her some more of Dan's blood left over from the bypass machine. (Side note: Dan now claims to be her blood relative!! Cute!!). Her sinus rhythm, which was previously normal, has a few issues (she is missing the P wave). All this is normal or at least expected post surgery stuff.
But the most surprising thing? She is super wiggly. Moving all around, especially when she hears my voice. Good from a bonding and neurological prospective. Bad for healing, primarily because she is trying to pull out her chest tube. So, her meds have been constantly adjusted during the past 4 hours. And she finally appears to have settled a bit. Poor thing.
Dan has left for home and I'm going to try to get some sleep. More tomorrow.
Good night,
Lori
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Surgeon report
Tricky.
Longer than expected.
Details:
-Normal sinus rhythm (ie/ no conduction issues, nerve didn't get in the way of the knife!!). This also means that her heart is beating normally and unassisted! Woo hoo!
-The VSD was obstructed and difficult to access. He actually had to make the hole larger in order to repair the defect with a very large patch (22 mm patch). He also had to remove muscle and the pull down the tricuspid valve to make the repair. Apparently, it was a pretty tricky procedure.
-ASD was a decent size and repaired without issue.
-Pulmonary valve looked good. He mentioned something about a patch in the pulmonary artery or valve.. ? I didn't ask for the details about it because I was getting the "please don't ask anymore questions- I'm annoyed with you look" from the surgeon. I let it go. I was just happy that the pulmonary valve was ok. And, admittedly, I ask a lot of questions.
-Overall, all is good. And he is happy with the outcome given the complexity of her condition. She has some leakage in her tricuspid valve (no doubt due to him moving it) but its minor. There is also some small amount of leakage around the patch. Again- its minor.
His parting comments to us:
" It was a tricky case. Fortunately, I still had a few tricks up my sleeve ...I used a few today. "
We should be able to see her in an hour.
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Sigh of relief
Details: Her pulmonary valve looked great! What a relief. She has a little regurgitation in her tricuspid valve (between the right atria and right ventricle), but it was minor.
We expect to meet with the surgeon after closing (in about an hour). And we will hopefully see our little Shawna by 4:30 pm.
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'Moment of truth' is next
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Beginning Echo
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12:30 pm update
Apparently, things are going well and the surgeon's work is nearly complete. They'll do an echo next. If everything looks good, they will start warming her up in preparation to remove the bypass.
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Taking matters into my own hands...
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10:30 am update
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9:30 update
She went on the heart/lung machine without incident. And, while its really un-nerving to think that her little heart isn't beating anymore, successful bypass is a major milestone in the surgery.
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Still waiting for info
- We met the cardiothoracic surgeon this morning. He's very nice and "well -seasoned". In a case like Shawna's , we really value experience!! Anyway, his wife is still in the hospital, but recovering nicely.
- Dr. M anticipates that her repair will be complete by noon. Hmmm.. We were originally told 3 pm. We'll just wait and see...
- The surgical plan is to repair the defect and orient her vessels into their proper locations. The biggest risk here is damaging the conduction system...if it gets 'cut' during surgery, she'll require a pacemaker. He estimates that it happens about 2% of the time.
-Obviously, one of the biggest challenges with Shawna is her mirror-image organs. The surgeon has to constantly re-orient himself with her heart. Something that I hadn't thought about? They also have to re-arrange the equipment in the OR, he will have to stand on the other side of the table, etc. Fortunately, there is a whole shlew of folks in the room to help.
-Just outta curiousity, I asked Dr. M about how many situs invertus cases he sees in a year. I know that her condition isn't common, but its not completely rare either. His response? Ten in his career. Wow. That's not a lot. The rarity of her condition also explains the exceptionally high number of fellows that we met this morning. Again-- these teaching hospitals get all geeked out about the less-than-common stuff.
Ok- I'm going to go wander around now... Still waiting for our surgical update.
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Ready?
I just left the OR. Shawna is off in la-la land. The let me stay with her until she was fast asleep.
We had a really rough morning ...she screamed from the time we woke her at 5 am until the Versed kicked in at 645 am. After the happy juice (ie/ Versed), Shawna was completely at ease. Blowing kisses. 'Honking' our nose. And smiling!!
Then, they took us down to the OR and put on the anesthesia mask. She drifted off quickly. And just as quickly... they booted me out.
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An early morning...
| Much earlier than expected. 1:30 am. Yep- that's what time I woke up. At 2:30 am, I still couldn't sleep, so I took a shower. And, at 3:30 am.. I'm updating the blog. Why 1:30 am? Well, that's the time that Shawna woke up... screaming. (and she's been sleeping through the night soooo well for the past 2 weeks). The irony? 1:00 AM was the "cut off" for a bottle. Sigh. Lori M. Baylor |
Monday, October 12, 2009
The final countdown
| Well, we are T minus 24 hours 'til Shawna's surgery. We're nearly packed and ready to go (again). My mother-in-law is in route... She will be holding down the fort here while Dan and I do the hospital-home shuffle. Unfortunately, the 'wait list' at the Ronald McDonald house is significantly longer this week... I think we are #11. Sigh. So, they probably won't have a room for us for several days. We (well.. technically just I) had a pretty rough couple of days. Too much to process and not enough things to keep me distracted. AND- I pretty much felt like crap. So, that didn't help matters. Shawna, on the other hand, continues to surprise me. Sometimes good. Sometimes not-so-much. On Sunday, she laid on the floor for hours... short-of-breath and tired. Too exhausted to even sit up, let alone stand, walk, or play. Yes- that's a function of her heart condition (not from lack of sleep). When she has her little spells, she just plops her head down and closes her eyes for a several minutes until her breathing resumes normally. It's quite sad to watch... :-( Well, it'll all be memory soon. I'm going to close out for tonight. But first, a HUGE thank you to all of you for the overwhelming support!! We are so appreciative and need all the help we can get. Please continue to think good thoughts and pray for a successful heart repair. I'll update the blog as often as I can tomorrow.... Good night, Lori Lori M. Baylor |
Saturday, October 10, 2009
Surgery update
I'm still holding my breath. I've become a wee bit crazy with the Purell, so afraid that Shawna will catch something that will derail her surgery. So far, everyone is healthy. Well, almost. I'm up very early today because our CAT is sick. But that's a story for another day. Sigh.
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Friday, October 9, 2009
Uneventful bliss??
| It's been a pretty uneventful week. It's supposed to be uneventful. I've been given strict instructions to hide Shawna from the rest of the world in order to minimize her chance of catching some flighty bacteria or virus which would cause her nose to run and cancel her surgery AGAIN!! I've taken these instructions pretty seriously... no errands or visitors and no trips to Target. Seriously!! And, to really ensure lack of human contact, I've stayed in my PJs for three days. No joke. So, we've been hiding alright!! Yes- I'm thankful for the 'uneventful' for many reasons. First, we don't get to be 'uneventful' around here very often. And, second, when something eventful is happening, we quickly go from "busy" to all out to craziness. (case and point.. we didn't just adopt a child... we adopted a child with a heart condition that is way more complicated than we original thought AND she is scheduled for open heart surgery WHICH has been re-scheduled 5 times in the last 5 days DURING which we had 7 other doctors appointments, a birthday party AND family photos. Did you follow all of that?? ) Well, for those who know us well, you all know... it's never dull around here. Anyhoo.. all of this uneventfulness has led me to one startling conclusion. I don't like it. Nope. Not one bit. Lori M. Baylor |
More good news..
| I talked with Sara's cardiologist today. All is good with the Holter monitor experience. She definitely has extra ventricular contractions... nearly 5000 / day. YIKES?? Nope. I guess that only works out to be 4 extra beats per 100 contractions. And while that still sounds like a lot, apparently it's not a big deal. Phew! One less thing to worry about. Lori M. Baylor |
Thursday, October 8, 2009
It's been a good day...
| Three minutes and 20 seconds. That's how long it took to schedule Dan for a blood donation for Shawna's surgery. I am still in shock. It was way TOO EASY this time. Of course, I didn't speak with "Fran". Maybe that's why... Lori M. Baylor |
Wednesday, October 7, 2009
A new milestone...
| Shawna slept in her crib last night... in her own room. (Well, technically, Sara and Shawna share a room.) Nonetheless, she slept in her crib rather than on the air mattress in our room. The decision to move her to the crib wasn't pre-planned...it was a spontaneous decision. Why? Well, I found Shawna sitting on the stairs at 9 pm last night (having 'escaped' from our room)... just hanging out on the stairs with her sippy cup. Hmmm... Time for the crib! And, other than some giggling at 6:15 am between the two girls, all went well! Lori M. Baylor |
Tuesday, October 6, 2009
The silver lining...
| The silver lining (or at least a part of it) of her surgery being moved to next week .... Dan can donate blood for Shawna's surgery! Yipee- I get to call "Fran" today. Lori M. Baylor |
Monday, October 5, 2009
Plan E (yep- the 5th one)
The surgeon's wife is stable but needs surgery. So, he cancelled all cases this week. Now, we just need to ensure that Shawna stays completely healthy for 7 more days.
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Catching my breath
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Sunday, October 4, 2009
Surgery cancelled.. no, I'm not kidding
| ... the phone rings at 10:58 pm. It's the clinic. This can't be good. For a split second, I thought that it may just be the crazy registration office, calling to verify my insurance. But, no. It was the surgical NP, calling to tell me.... The surgeon's wife was in a car accident... she's in the ER. So, no surgery tomorrow. Maybe on Tuesday. Sigh. Lori M. Baylor |
Surgery re-scheduled for MONDAY!
| The clinic just called.... Shawna's surgery was moved up to Monday. Yes, Monday Oct 5th... Tomorrow. While we are grateful to be the first and only case scheduled tomorrow, we are frantically trying to prepare. I will update the blog throughout the day, so stay tuned. And, most importantly, pray for a successful repair. Lori M. Baylor |
The plan for surgery...
Saturday, October 3, 2009
He still surprises me...
I'm now certified....
A good friend of mine has an amazing ability to keep me grounded. When I'm ready to jump off the proverbial ledge... she talks me off of it. When I'm losing my mind, she produces a glass of Merlot. It helps that she lives next door. That way, the wine is never far away. :-) Well, given the circumstances of Shawna's recent diagnoses, I needed to cash-in on this great trait. In the midst of all of my babbling, she interrupted with "Lori, I know that you think that you're a cardiologist. But, you're not. Trust the REAL cardiologists. They know what they're doing." Fast forward to Monday of this past week. As I mentioned in my earlier post, I spent most of Monday and Tuesday on the phone. It was crazy. In the midst of the ten thousand phone calls with the Red Cross, I was also managing a similar crisis with the pediatric anesthesiologist from the clinic. The gist of the drama was regarding Shawna's MRI, which they decided to cancel. But, the highlight of the entire call happened in the first 28 seconds when the consulting anesthesiologist kicked off our conversation with Her: "Now, I understand that you are physician as well...?? in cardiology??" Me: "Umm.. excuse me? what?" Her: "You're a physician with us (ie/ the clinic) as well??" Me: "Oh- um, me? no. I'm not a physician." Her : "Oh. I um, thought that.." Me interrupting her: "No, I'm not a medically licensed physician (chuckling to myself), but thanks for the compliment!" My first call? My neighbor! My next call? My boss. Since I now have a shiny, new MD degree and practice at a world renowned medical facility, I wanted to ask for a promotion. :-) (Oh- I guess that I should mention this tiny little fact... I am technically Dr. Baylor. But my degree, a PhD in physiology, doesn't license me to practice medicine...but it does allow me to keep up with all the medical mumbo-jumbo most of the time.) |
