Monday, 22 February 2016

January 30 - An Elegant Evening for Anna

I haven't known where to begin with this post. To see the outpouring of generosity and support for our Anna has been incredible. At the dinner to see the room full of people - from friends, family, church family was so overwhelming. We have never felt like we were alone on this journey with Anna. The Lord has supported us through so many of you - whether it just be words of encouragement, gifts, meals, child care, etc, etc. This dinner was an opportunity for so many of you to get to know our little Anna more through the speeches and powerpoint video that was made. I decided to post them below - as I know not everyone was able to attend the dinner.

Welcome Speech



We would like to welcome everyone to an Elegant Evening for Anna: dinner & auction.  Thank you all for coming to show your support to Ryan, Lorissa and their family.  Back in 2008 many of us came together to witness Ryan and Lorissa’s wedding.  We heard them promise to be true in good days and bad, in richer and poorer.  Now today we are together again to help them in their vows to each other and the Lord.  God, in His infinite wisdom gave to Ryan and Lorissa a very special girl, and through Anna we see His working in all our lives.  The outpouring of help, prayers, gifts, and food has been phenomenal.  Words seem insufficient to express how very thankful we are for this.  Communion is an expression of the Lord’s work in our life and it is through the Lord’s words in Matthew 6 that we know this- Therefore do not be anxious about tomorrow, for tomorrow will be anxious for itself. Sufficient for the day is its own trouble.  Many people who live with a child with special needs tell us not to look too far down the road, to take one day at a time.

When we (Ryan, Lorissa, Tracy, Debra, Michelle & myself) started with our Trach training, in order to bring Anna home, it became very evident to us that Ryan and Lorissa would need some financial help over and above what they will receive from OHIP or private insurance.  We then started brainstorming about doing a dinner.  Through a lot of work and by our greater community support, this evening quickly became a reality.  We asked Candice VanLeeuwen to be our “chef” for the evening.  Candice does not want to be called out of the kitchen for a “formal thank you” so if you see her (she’s super tall (compared to me), with long hair, make sure you thank her for all the work she and her kitchen crew have done to help make this dinner possible.  The proceeds of this dinner will be devoted to Anna’s care both now and in the future.  It is impossible to say how much Anna is going to need as she grows, however, one thing is possible.  Ryan and Lorissa do not need to worry.  The love and care that is shown to them tonight is proof of that.  We thank the Lord that he has brought us all here to show by word and deed the Love that He first showed us.



What is all needed for Anna & the family?  Anna’s world needs to be made as germ free as possible.  The old drafty window in her room has to be replaced.  Dusty carpet removed and wood flooring installed.  Shelves & cupboards need to be installed to hold all of Anna’s supplies; Airvo unit for Anna’s teach needs to be purchased; A Travel “go bag” assembled that they need for any trips; Trach and G-Tube supplies.  A special fortifier for her food has to be added with each feed. And the list goes on and on…

After some discussion with Ryan and Lorissa, it was decided to move up the reno of their kitchen.  The original kitchen was very small with very limited counter space and no dishwasher.  As Anna’s health is of vital importance it was decided that the change should happen prior to her coming home with all the dust and dirt that would happen when renovating.   This renovation is now complete due to the tireless help of so many people.



Anna’s arrival home has been delayed, which was a huge disappointment to us all, but it is our prayer that we may have an enjoyable evening together, show Ryan and Lorissa our support and join in prayer for them and Anna. 

After Anko opens with us the dinner will be served family style beginning with a salad; after that the main course which will be butter chicken, beef korma served with rice and naan bread.  Once the dinner is done dessert will be on the buffet tables with a choice of pavlova or mocha cake.   During dessert there will be a short powerpoint presentation.  Following dessert the auction will begin. Again, we thank you all for coming.

Video about Anna


Speech about Anna


What exactly is Cri du Chat and what does it mean for Anna and the family?  Another name for Cri du Chat is Cry of the Cat or 5p -.  The 5th chromosome is shaped like a P.  With Cri du chat the short arm of the chromosome has sections missing.  With Anna she has about 30 of the 48 sections missing.  What all does this mean to Anna and her future is somewhat unknown.  The most common way that cri du chat is diagnosed at birth is the babies cry.  Their cry sounds like a cat.  With Anna the diagnosis was delayed because Anna doesn’t vocalize.  Her vocal cords are not paralyzed but she never made noise.





Anna has many doctors & specialists that she will need to see because of her syndrome.





        Feeding


     G-tube


     Feeds require a pump and other equipment.


     Uses very expensive fortifier (neocate) which is covered by drug card


     She does not swallow well so for now all her feeds are through g-tube. We continue to do just drops on her tongue to ensure she doesn't get oral aversion.


        Trach (ENT - Ears, Nose, Throat)


     Special training to know how to take care of it


     Has posterior Tracheal-malatia


     For most of her day she will be hooked up to a heated mist humidifier or Airvo unit.  This unit is not covered by OHIP, ADP, CCAC, or private insurance.  ADP will only cover a cold air humidifier but the doctors and specialist do not recommend this at all.  The hospital doesn’t even use cold air.  This air goes directly into the trach and down into her lungs.  For trach babies they need to stay as healthy as humanly possible so to have the air going into their lungs at body temperature is the most optimal.


        Tethered Spinal Cord (Neurology)


     Will require surgery to untether her spinal cord at a later date


        Patent Ductus Arteriosus (PDA) and Persistant Pulmonary Hypertension of the Newborn (PPHN) (Cardiology)


     Will require surgery to close her PDA at some point. Trying to avoid until she is bigger so there are more options that are less invasive. She is on a couple of medications to try control the shunting of blood through this duct. (Since the Dinner this surgery has been done and was successful)


     Anna’s PPHN comes and goes with sickness, stress, surgery. It may flair up at any time so we always need to be watching for the symptoms of it.


        Hypo-Pigmented Fundi (Ophthalmology)


     Means her vision is not perfect and that she is a little more sensitive to bright light.


        Severe Bilateral Hip Dysplasia (Orthopaedics)


     Both of her hips are very dislocated.


     She may require surgery and a body cast or brace for a few months.


     It is possible they will leave them displaced because if they try to fix it and the hips doesn’t locate properly it can cause a lot of discomfort or pain




     Her ureter tube is mostly blocked by the entrance of her left kidney


     They are just monitoring it for now but they may shunt it at some point.


        Inguinal Hernia (General Surgery)


o        This will be fixed in conjunction w/ another surgery (Done with the PDA Ligation!)





When we get home Anna will be visited at our home by the following:


        Nurse - we will qualify for around 40 hours a week


        RT (respiratory therapist)


        OT (occupational therapist)


        PT (physical therapist)


        Dietician
and eventually a ST (Speech Therapist)


We will also have clinic appointments for all of the above departments at McMaster (as well as complex care team and growth & development clinic) plus appointments with her paediatrician in Guelph.





There are many things we don’t know with Anna - will she walk? will she talk? will she always need the Trach? will she be able to eat by mouth? and the list goes on and on. With cri-du-chat we will always be struggling with her growth and development. Every small accomplishment we will celebrate! When she can hold her head up herself, sit up, etc. All these little accomplishments will require hours of practice and often special equipment.Through all of these questions - we keep returning to our heavenly Father who knows all the plans he has for us and our little Anna.

We are so appreciative of the organizers of this event! It was alot of work - in such a short amount of time and it went of without any hiccups. I'm sure it is safe to say that everyone enjoyed Nello, the auctioneer! He did such an amazing job and kept us laughing the whole way through! We are so completely overwhelmed and thankful to report that this event, along with donations, has raised $17,000 to help us care for Anna. This allows us to get anything that we need for Anna presently and on-going regular supplies she uses, but also to plan for the future. Some examples of equipment Anna may need in the future include - standing frame, gait trainer, wheelchair. We aren't sure what the future may hold, but it is so wonderful to know that we do not need to worry about price tags! This amount totally blew us away - and just shows that already the plan our Heavenly Father has for Anna. Through her - he brought so many of us together to celebrate and support her life.

As for the rich in this present age, charge them not to be haughty, nor to set their hopes on the uncertainty of riches, but on God, who richly provides us with everything to enjoy. They are to do good, to be rich in good works, to be generous and ready to share, thus storing up treasure for themselves as a good foundation for the future, so that they may take hold of that which is truly life. 1 Timothy 6:17-19


February 3 - February 17, 2016 - We are HOME!

Anna's surgery started only about an hour late, which I'd pretty much consider on time in "hospital time". They wheeled her into the OR just before 2pm. Then we got to sit and wait... Surgery was supposed to be done around 4pm, but it was almost 5pm before the doctor came out to report how things went. Everything had gone well with both the PDA ligation and hernia repair. The delay was more caused by the anesthetists trying to get an arterial IV line, in which they were unsuccessful.

Once Anna was back up in the NICU it was just a matter of controlling her pain and also watching her blood pressure. Often when older babies have their PDA closed, they struggle with high or low blood pressure as their heart adjusts to the change. Fortunately this did not end up being an issue with Anna.



Ryan and I checked into the Ronald McDonald House again, so we could be close by, It has been such a blessing to have this be an option whenever we've needed it. This was our 5th stay!
Thursday was just figuring out what level of pain and sedation meds Anna needed to be comfortable. By Friday, they started to wean these pain meds and she was completely off all medications by Sunday midnight. She was also able to continue to work her way off of the ventilation settings as she came off of the sedation medications. By Sunday we were able to hold her again and by the afternoon she was just on humidity with 25% oxygen.
They do not plan on worrying about weaning her oxygen right now, as it will take time for her pulmonary hypertension levels to come down.










Anna continued to do very well recovering and was back to her normal self quickly! The doctors looked at what her breathing trending looked like and she was doing very well all week.
On Thursday we had a family meeting to discuss taking Anna home! The date decided on was Sunday, the 14th - Valentine's Day! We were very skeptical whether this would actual happen, but hoped and prayed it would. She will be coming home on 25% oxygen, so we needed to get things in place for oxygen use all the time (instead of just in case of emergencies). She will likely stay in oxygen all winter as they don't like to make changes during RSV season.





We took Anna for a car ride on Friday. Just as a practice for what we need to take whenever we travel with Anna and also what to do in various scenarios. Travelling with Anna is anything but light. Everywhere we go with her, we need to take: a suction machine & supplies, an oximeter (sat monitor), oxygen tank(s), feeding pump & supplies, "go bag" (emergency trach supplies)... plus all the regular gear for a baby.


Ryan and I decided not to tell anyone we were taking Anna home - until she was home with us! So it was a surprise for our kids, family, etc when we messaged them a picture of Anna in our house! She spent a total of 162 days in the NICU at Mac.


We are a little sad to leave behind all the friends we made in the NICU. It was our other home for the 5+ months Anna was there. They provided amazing care for our little Anna. She was known by pretty much anyone who worked in the unit - be it nurses, doctors, rt's, specialists, or even the cleaners! She had many visitors every day - who just had to check in that she was doing well.

Settling into home has been going well so far. The kids are absolutely thrilled to have Anna home! Ryan is off part of this week, helping us find a new home routine. We have had lots of visits from the various places that supply Anna's equipment, as well as those that support her care. On Tuesday, we had a nurse in for her first shift overnight. This was great as the 2 nights Ryan and I had done on our own were quite tiring. Anna requires frequent suctioning, someone to get her feeds going and then just the regular baby love. She isn't exactly sleep trained either yet - with her whole life being in the NICU. We are covered to have a nurse in 6 nights a week (Sunday-Friday) from 10-6. We get the same nurse Sunday-Thursday every week and then one other nurse is doing the Friday night shift weekly.










Thank you all for your continued prayers! It is so great to finally have our girl home and to know that all of you would be rejoicing with us! Anna's development will be slow, but we will try to share with you all of her little victories!

Anything your curious to know? Feel free to post a question in the comments. I don't always think of things that our everyday to me - but probably not to most of you.

Rejoice always, pray without ceasing, give thanks in all circumstances; for this is the will of God in Christ Jesus for you. 1 Thessalonians 5: 16-17

Tuesday, 2 February 2016

January 23 - February 2, 2015

Since the last blog post, we have tried a few things with Anna. We upsized her trach again, this time in diameter (a 4.0 Ped) hoping that it would help get by the malatia in her airway. This did help somewhat, but she was still needing oxygen to keep the number of desaturation spells low. This made me think that her Pulmonary Hypertension had returned, as I'd seen her similar to this shortly after she got her trach. 


On Friday they did another ECHO to see what her heart was doing and it was just as I suspected. Her Pulmonary Hypertension had returned, but the most concerning part was that her heart looked different than it did on the previous ECHO. On Monday, they decided it was best for us to ligate (close) the PDA before we take Anna home with us. 


We just found out today that the surgery will take place TOMORROW at 1 pm! Please remember Anna in your prayers. As well as the doctors - that His hand may guide them and surgery may go well. They ligate the PDA by doing a 3 cm incision inbetween her ribs on her left side. They then find the PDA and clamp it closed. The risks are blood lose (they are reaching in right by the aorta) and possible damage of the nerve that goes to the vocal cords. 

They are also going to repair her inguinal hernia at the same time. That is just a quick little fix that will do, pending she is stable, etc.


Please pray that Ryan and I may have the patience and strength we need as we continue on this journey with Anna - especially during her surgery tomorrow. Waiting for them to come out of the OR is so hard! Pray that the surgery may be successful and get us on the road to home (again) with Anna.

I hope to cover the wonderful "Elegant Evening" we had for Anna in the next post - just don't have time tonight!!

sought the Lord, and he answered me and delivered me from all my fears. Pslam 34:4

Friday, 22 January 2016

January 8 - 22, 2015

Since the last blog post, we were very busy with plans to bring Anna home!

Not only did we have trach training classes twice a week, but we were also working on renovating our kitchen and Anna's room. It was a little crazy here with just a little over 2 weeks left to prepare for our girl's homecoming!

Anna did not have a whole lot going on during this time. She just continued to charm all the nurses into cuddling her, talking to her, or exercising her. She has quite the crew of regular nurses that take of her and of course, since we've been there this long, she knows all the cleaners, doctors, RT's, PT's, dieticians, etc. 


Yvonne and Anna - another primary nurse

Cardiology did decide to stop her medications for her heart, just to see if they were actually being effective for her or if they were needless meds. Within a couple of days, Anna started to have deep and long desaturations, so they quickly restarted the meds. 

They also did another small round of antibiotics as they found a bit of a bug when they sent some secretions to be cultured. They wouldn't have treated it if she hadn't been so close to heading home, but just wanted to be on the safe side.

Trach training classes became more than just knowing the skills, but testing them in emergency scenario situations. Anna's airway is so sensitive and small, that we need to be prepared if anything were to happen. We also learned how to use all of the equipment we will have at home.

In the midst of all this busy-ness, little Miss Kae turned 2!! I can tell already that this little princess will be my big helper with Anna. She is all about baby's, etc.
Started her birthday off with a pee on the potty!
(Time to train her once we are home!)



This past weekend we did "Care by Parent" for 2 nights at McMaster. Basically a dry-run to make sure we are comfortable looking after her, with lots of helpful personnel right there if we need them. This was a nice break from our craziness of trying to get everything ready for Anna. We were able to just sit back and enjoy her! 


Anna was able to go for her first coffee date with Grandpa & Grandma visiting! She also met lots of her cousins on her walks outside the unit!








On Tuesday at about 5 pm - we got the very difficult news that they didn't think Anna was ready to come home yet on Wednesday. The monitor we will use at home (and used in care by parent) is a more sensitive monitor and it was catching more desaturation episodes. They were not comfortable sending her home until they know why she is having these spells still. This was such a let down after doing so much preparation and looking forward to being home together as a family! It has been a trying week emotionally - as I carry on travelling back and forth to McMaster.

To figure out why she is having these spells - they put up a couple of video camera's. One taping Anna and one taping 2 monitors - the hospital one and our home monitor. They were able to review the data last night and there initial thoughts are that they were obstructive. So they brought ENT up today to scope down her trach to see how things look there. She still had posterior tracheal malatia below the trach. So they put in a 3.5 Peds trach, instead of a 3.5 Neo trach; which is about 6mm longer. We are hoping and praying that this fixes these episodes!! ENT said there is still a little bit of malatia below that longer trach, but hopefully this one is far enough down that it is bypassing enough of it.

Unless her spells are totally gone with this trach change, they are planning on sending Anna for a sleep study at Sick Kids in Toronto. From this, they will find out if her spells are being caused centrally (sleep apnea, etc).

So we don't have a new time line as of yet for going home :( Not until they are sure why she was having these spells and what they can do to fix it.

Please keep praying for us! This week has been really tough and frustrating! Pray that we are given the strength and patience we need to continue on. Pray that our little Anna won't have any more desaturation episodes, so she can come home soon!

Answer me when I call, O God of my righteousness!You have ggiven me relief when I was in distress. Be gracious to me and hear my prayer! Psalm 4:1