Tuesday, December 18, 2012

Please pray for Max.

I have been updating Facebook because it is a lot easier but I thought I should quickly update my blog since some people read it and not Facebook.  I don't have a lot of energy or eloquence tonight so I am just going to explain the situation as best I can.

Max has been having a lot of 'secretions' (snot, mucus etc) really since come off the ventilator initially but it did not seem to be compromising his breathing.  We thought it could just be related to having had a breathing tube down his throat or from increased fluid needed to maintain his new kidney.  He seemed ready to come off his ventilator and was breathing all on his own with just a canula to give him some extra oxygen this weekend.   On Sunday we started noticing that he seemed to be working hard to breathe.  He kept his oxygen up but it seemed like hard work for him.  We weren't sure really what was wrong and hoped he just needed to pee off more fluid.

At the hospital they can very quickly check Max's blood and see how much oxygen is in it, how much carbon dioxide is in it and what the pH is and they have set parameters for what they want those numbers to be.  Through the weekend everything looked fine.  But Monday morning, the amount of carbon dioxide in Max's blood was creeping up.  And it continued to increase and reached too high of levels, regardless of moving him to CPAP, a machine that gives him more oxygen and support.  He was just not able to breathe effectively enough to keep his blood at the levels it should be.  So they went ahead and put him on a ventilator.

Initially after surgery he was on a ventilator to heal and as a precaution.  Now he is on a ventilator because he couldn't breathe on his own.  Which is an entirely different and much more serious situation. 

We weren't sure why this change had happened.  Until we got the positive RSV test back, which really makes it good news because we know what is wrong now.  RSV is a respiratory virus with cold like symptoms like runny nose, congestion and lots of mucus.  You have probably had RSV and as an adult you would just have a yucky cold and go through a lot of Kleenex.  But on smaller children, it can cause so much inflammation and secretion that it blocks their airways and prevents them from breathing effectively.  It is most dangerous for children under 1... or kids whose immune systems are compromised, like Max. 

So Max will likely stay on the ventilator for a few days while we wait for the infection to clear up, which will take longer than normal due to his weakened immune system.  If he has a machine breathing for him, we do not have to worry about his airway getting blocked and him stopping breathing.  The two concerns while he is on the ventilator are that we manage his sedation and prevent him from getting upset and actually clamping down and blocking his vent as he did earlier today.  And that the secretions in his upper airway do not end up in his lungs causing him to get pneumonia.  So we pray that he doesn't have any further complications from the RSV and that it will just be a matter of time and patience waiting for his body to heal.  We are also really keeping a close eye on his kidney, which has done better today, and praying that it does not get damaged while he is sick and his blood pressures are lower than ideal.

Addie is still able to come out as thankfully she recieved an RSV vaccine.  She will not however be able to see Max so we will be doing separate birthday parties.  I am just so relieved I still will get to see her.  We could really use a dose of Addie sunshine.

Thank you all for praying for Max and for the continued love and support.  The texts and emails and Facebook comments have really encouraged me today.  If you shared this link asking for prayer for Max for his surgery, please feel free to share again as he needs prayer very much right now. I will mainly be updating Facebook but will try to keep this blog updated as I have new news also.

Saturday, December 15, 2012

Hope in a place and time of tragedy

We knew going into this that things have to be worse before they can be better and that Max would look sicker and sadder before he would look healed.  We knew there would be long days and the moments when you think 'what were we thinking?!'  Still, you know that and it still is hard living it.  We took Max to the OR smiling on Monday and brought him back on a breathing tube sedated and spend the next 72 hours sitting by his side when he LOOKED so sick.  He wasn't, he was healing.  But lying there not interacting with the ventilator humming it would be so easy to forget that this is a step of hope, not a step back.  My spirits would get heavy as I missed Addie terribly and I missed seeing Max's smile and kept having a hard time remembering THIS IS GOOD when it did not look good. 

I never found the NICU to be depressing the way I find the PICU to be depressing.  In the NICU the babies are tiny and early and the parents are scared but most will get better, they just need a medical womb and some attention to get them there.  There are some very sad cases but a lot of new parents kangaroo caring their little ones, a lot of smiles through the tears.  I felt like it was a hopeful place, babies getting better and going home with normal full lives ahead.  Emotional, yes but tragic, only rarely.  But the PICU is different.  When Addie was admitted to the PICU last December, there was a night when we couldn't leave the room for hours because 4 children who had been shot by their father were being rushed in.  There are drownings, there are abuse cases.  Kids fighting against RSV for their lives.  Babies, toddlers, teenagers on ventilators who just hours before would have been running around.  When I am in the PICU, I get sad for the children and the families surrounding us.  I am always aware of how much tragedy there is.

And then yesterday, of course, we were all made ever more aware of how much senseless tragedy there is in the world with the shooting in CT.  As a mom and as a teacher, I was shocked and devastated for those families and the school.  I wished I could have seen Addie to hold her extra close.  I couldn't even think too long about how awful it must be for them because I would not have been able to handle thinking through that grief while sitting next to Max still with a breathing tube, getting better but still facing his fair share of hurdles.  I prayed for everyone involved for a peace that I certainly cannot understand and for love and support for them during this time.

I also looked at my circumstances differently.  I looked at sweet Max on his ventilator and remembered that he is not here in the PICU because of a tragedy, he is here because of a gift his dad gave him.  He is not here because something suddenly threatened his life but rather because of a planned pathway to hope.  His breathing tube was allowing him to heal and get ready for a better life than ever before.  I realized that in this place where there is so much tragedy and on this day where there was so much tragedy, that sweet Max is sweet wonderful hope.  And we are blessed beyond words to be here, hard of a process of this is, on the pathway to a better life for Max.

I wouldn't be normal if I didn't admit that there are days when everything we have been through feels like tragedy to me.  When it feels awful and unfair.  The 8 months in the NICU, the 20+ surgeries, the close calls with Max styopping breathing at home, the brain injury and CP, the hearing loss.  I can lose my persepctive on days and feel that our family has experienced tragedy.  And then sometimes I just need to remember what tragedy really can look like and realize that my babies are alive and smiling.  They have overcome.  Ours is not a story of tragedy but of healing and hope. 

I spoke to the media director here one day this week who is arranging photo shoots and possibly the news to come cover Max and Addie's birthday party which we are quite excited about.  He kept saying 'this is a wonderful story of hope for Christmas time' and it was such a great reminder to me this week.  This year all four members of our family have had major surgery.  We got Max's CP diagnosis.  And we are leading up to Christmas with Max still having a ways to go to get out of the hospital and with my not having seen my Addie in a week.  It doesn't FEEL always like the heartwarming Christmas of my dreams.  But then I sometimes just have to look at it from another perspective and see what tremendous miracles have happened this year and what a wonderful place we are ending this year.  Sometimes I have to ignore the voice that reminds me all of all the things we still have to battle and deal with and just celebrate myself this hopeful beautiful story of two precious babes who beat the odds.  To embrace the story of hope in a time when there is a lot of tragedy. 

I pray today for all the families grieving, in CT and in hospitals around the county, and I thank God once again for saving my babies lives.

Wednesday, December 12, 2012

Post Op Day 1- Healing after Successful Surgeries!

Yesterday was a long but very successful day.  Al went to surgery nice and early.  He was in the operating room around 7am.  I spent a few more hours with Max and then took him down right around 10.  And then we waited.  And waited.  And waited.   We finally heard around 130pm that Al was done.  He had a tricky lumbar vein that made getting kidney out a longer than anticipated processs.  Then around 230, we heard that Max had the kidney in him and was peeing already! Which is of course the news we had been hoping for all day so we were elated.  We then had to wait another 3 hours to see either of them.  Finally about 530pm we saw Al who was awake and talking and in great spirits.  And around 6pm, we saw Max who was sedated, still on his breathing tube but looking peaceful and had good coloring. 

I ended up not staying the night because I got really sick during yesterday.  I had a cold when we left Houston and then got really messed up on the airplane with my ears blocking up really badly.  Then with all the extra stress it somehow developed into a sinus infection and by Monday night I was miserable.  I stayed at the hospital but hardly slept.  As soon as Max's doctors and nurses walked in, they were like oh you look bad.  Of course i was in the best place in some respects as Lynn, our PA, immediately got me on an antibiotic and checked on me throughout the day, giving my Tylenol when I then started running a fever.  Once we saw that both boys were stable, I was convinced I should leave the hospital for the night and get some rest.  I stayed with our transplant coordinator who took care of me and I got 10 hours sleep and at least feel a little better today, although still not well. Al's parents stayed with the boys to make sure they were ok last night.

Al is already wanting to get discharged and seems determined to be the best donor patient ever! He is certainly making me look pitiful- I am super glad I went first!! He is texting me funny videos and making jokes and enjoying eating lots of popsicles.  He does feel pain where his incision is and finds walking uncomfortable, as is expected.  But being an amazing patient.  Max is much the same, quite puffy from all the fluids he has been recieving and pretty relaxed with some heavy duty tranquilizers on board.  He is running occasional fevers which is pretty standard for Max but that is being followed carefully.  He will stay on the ventilator all day and hopefully just rest and pee.

Thank you so much for all the prayers for us.  It was such a long day but we are thrilled to have it past us.  Please continue to pray for Max that he will get stronger and better each day and closer to looking and feeling like himself.  I don't think I will include a picture of him yet as he is a bit sad with his breathing tube and puffiness but as soon as he is looking more like himself I will include pics of the brave boys.   

Monday, December 10, 2012

Max's last night on dialysis! Please share, pray and send us your love for tomorrow!

By my calculations, tonight will be Max's 530th night to spend on dialysis.  Since June 27, 2011 he has spent 15-22 hours a night hooked up to dialysis.  He has struggled on it with discomfort, reflux, vomitting and feeling chronically full.  He has been such a trooper and waited so patiently and tomorrow his day is finally here! Tomorrow Max gets his dad's kidney and he gets to pee and be freed from dialysis! When we did this in May with Addie, we were not sure just how much better life with a kidney would be.  Now Addie has shown us just what an amazing difference it makes.  And so we are so pleased that Max's day is here.  We do ask for lots and lots of prayers to surround Max, and Al too tomorrow.  And of course in the days that follow. 

We are blessed beyond words that we were both matches for our babies and tomorrow we become a one kidney family- a process we have been working towards for a very long time.  It was one of the greatest privileges of my life to give Addie my kidney and I know Al feels the same about doing this for Max.  Al will go back for surgery around 7am tomorrow (which is 9am Houston time and 2am Melbourne time).  He is having his surgery done laproscopically, instead of open like mine was. Max being much bigger than Addie was has made this less invasive technique possible and although he will have a sizeable incision and plenty of pain, his recovery should a bit easier, especially for walking etcetera.  The surgery is also fairly long and the surgeon predicts he will be in surgery for around 5 hours.  Max will go back to get started before Al is done, probably around 10am (noon in Houston, 5am in Melbourne).  And he will also have a several hour surgery.  They will both come back groggy and riding some pain meds tomorrow.  Max will remain on a ventilator for several days. 

We would appreciate prayers for all the details of tomorrow, for safe anaesthesia and surgery experiences for both of them.  That Max would begin making urine on the operating table, as his sister did, and for protection over his lungs and heart in the days following surgery.  We would appreciate prayer for minimal pain for both of them and effective management of pain meds for them.  And while you are praying, please say one for those of us waiting... for me and Al's parents here in California and also for Addie and my parents in Houston.  It is a nerve-wrecking day for all of us and we will all be feeling better 24 hours from now to have this past us.

Please feel free to share the link to this blog or just their names on Facebook or at work or with your friends.  If you have not send a message for Max, it is definitely not too late and messages tomorrow would certainly encourage us or just knowing that people are praying for them and thinking about us. It is so different being on the caretaker side and not the donor side this time and I will definitely be anxious tomorrow and will appreciate messages and support throughout the day.

We saw what a wonderful miracle transplant was for Addie and we love seeing what life it has breathed into her.  So tonight we pray for Max's miracle and that tomorrow will be the start of so many new adventures for our little man.   Thank you to everyone who has and continues to pray for my precious babies. 

Pictures of my heroes:

Saturday, December 8, 2012

All under one roof...

Addie and Max are fast asleep.  Al is finishing his packing.  I am all packed and distracting myself by watching Season 2 of Grey's Anatomy on DVD and trying to enjoy this last night for a while of my family all being together here in our home.  Tomorrow morning my parents pick up Addie and then Al and I load the plane with Max and meet his family in San Fran.  Tomorrow it all begins and I have spent today soaking up this beautiful calm before the storm.  Addie was particularly cheerful and delightful, laughing and smiling and making my heart so happy and at the same time so sad to be leaving her.  Max has been rosy pink and full of smiles, completely unaware of what is coming.  It has been a lovely day and it's hard to believe how long it will be before we have another one like it. Actually we will never have one exactly like this, we will have ones much better because when the boys are back and we are all reunited it will be without dialysis and with two healthy babies.

Sometimes in life you have to do something really hard to get to something totally wonderful. People ask us if we are so excited for Max's transplant.  We are so incredibly excited for what Max's transplant will do for him.  We are so excited for life after he has healed and what a wonderful change it will be for our family.  So, yes we are super excited for the end point.  But I can also tell you we are not excited for these next two weeks.  I am not excited for 2 weeks away from Addie.  She is my sunshine and my joy.  My heart is sad to be without her for 12 days.  Do not get me wrong, she is in great hands.  She will have a wonderful time.  Leaving her here with my parents is the selfless choice because it is completely what is best for her.  But for me, it's going to really hard. I am excited for what this surgery will bring about but not excited for surgery itself, for seeing both of my boys in pain, for long days and nights at the hospital, for the inevitable fears and concern.  It's a hard process for a wonderful purpose.  I pray that the next two weeks go quickly and that before I know it we will be through the hard scary tiring part and entering the exciting part of seeing Max better than ever. 

I know lots of people are praying for us.  Please pray for our travelling tomorrow and that Max and Al will both stay healthy the next two days leading up to surgery.  Of course we will be asking for lots of prayers on Tuesday but I will post again on Monday night with specifics about Tuesday.  Please also pray for Addie.  We are praying for protection of her health during her time away from me.  And please pray for stamina for my mom (and dad) and good restful sleep at nights as she has full time care of Addie these couple of weeks.  And for Al and I saying goodbye to Addie and getting nervous for Max these next couple of days.  We all need an extra dose of strength and resilience.

I have lots of wonderful photos of messages for Max that I am hoping to spend some time next week putting up on Facebook for everyone to enjoy.  I have been soaking up my Addie time and working hard to get school stuff together so I haven't put aside time to do that yet but I will have plenty of time next week.  If you haven't sent one, please still do.  Or post it on Tuesday on Facebook and tag me.  A lot of people did that last time and it really lifted our spirits on the day to log on and see all these pictures. I will post again Monday night a short specific prayer request/update on times etc for people to share.  I know last time lots of people shared our story the night before and I know all those extra prayers showered upon Addie and I were answered.  So stay tuned for a pre surgery update. 

And for now, back to my fake medical drama to distract me from all the real medical drama coming up soon.  And back to enjoying the peace of having all my little loves together with me under one roof.