Happy 3rd birthday!

Shot Nerves

Written 5/11/2010, posted today 6/2/2010

Bo's first line lasted 20 months before he outgrew it. He is on his second line: it is now 15 months old. While it has been infusing beautifully, we could not draw blood for labs on Sunday. So the nurse came back Monday morning. Still no draw. So, all day Monday, I coordinated with his GI's office, the infusion company, the nursing company and the hospital that runs the labs to get supplies to get the line to draw and to get labs run. We instilled TPA (aka CathFlow, Genentech's Altapase) for 30 minutes. Nothing. We waited another hour and a half. Blood! I spent the day on pins and needles and when it finally drew at 8pm, we were all so relieved. It's not like Bo wasn't in the hospital for his first 7 weeks of life, and we were told he wouldn't live, and that he needed a very risky transplant that would itself kill him, and that we should consider hospice if we refused transplant. It's not like we had an easy time setting up diaper service, a nursery and layette supplies, wondering how long we would need them. It's not like I didn't have a convertible car seat that made me cry every time I looked at it, wondering if we needed it at all. Or that every time he refluxes my hair doesn't stand on end, leaving me to wonder if we will be getting admitted back to the hospital. It's just that yesterday was a brutal reminder of all those things at once. Without being able to draw labs might mean the need to replace the line, or a line infection, or no new TPN or using the last week's TPN formula (best case scenario). But we got lucky. The doc had no problem calling in the order, the infusion company reassured me that they sent this out to homes all the time, the nursing company was comfortable having our nurse instill the enzyme, and my brave husband did the final aspiration and blood draw. Besides working the phones, all I did was try to keep the toddler from bouncing up an down to the Wiggles. That's all, good night.

Rinse lather repeat while they were at DeVos for an infusion just a week later. Thankfully, the next scheduled lab draw was a total non-event. And Bo will turn THREE tomorrow. I cried in the car all the way to work this morning. None of his diagnosing physicians expected him to make it to this day. I wonder if this is what other parents feel when their troublesome teens finally walk across the stage and grab the diploma? High school, college, grad school, wedding, grand children. Those will all be a non-event compared to today.

Intestinal Failure/Rehab 2010 Chicago

Hopefully, the new baby's temperament and my ability to sleepwalk will allow us to attend this conference in Chicago in September!

Unprepared

I am unprepared to divide my time between 2 kids. I am unprepared for Bo not to be the favorite anymore, and even more unprepared if he is? Oh, therapy. I see years of it ahead, which I am also unprepared for. I am unprepared for night nursing (I did pump around the clock for Bo, and I know I really like sleeping through the night, as a result of that). I am unprepared for, but anxious to have a "take home baby." I am unprepared for the cord blood registry expense, but reallyreally think it's something we need to do (any comments from our community of the medically fragile?). I was totally unprepared for gestational diabetes. I'm totally unprepared for another Gemini, but am resigned to the fact that this child will not make it to its original due date, and will be, like Bo, an air sign. God help me.

Somehow, with a double stroller in the garage, I feel calm and hopeful that we will have another natural birth, that maybe I can avoid insulin by swimming more, and that my pelvic pain (symphasis disorder) will abate. It's already feeling much better. And I am oh so grateful to the gods of fashion that flats are back "in."

Bo, by the way, has a drippy nose; hoping it's not allergies. He is into playing tea parties and shopping, learning about currency and horse-trading. He is naturally a better negotiator that I. "One more book before bedtime." Who could say no to that?

Premonitions, Discretion and Doubt

I've had trouble writing anything lately. Shortly after my last post, we had a sudden death in the family, and the ominous foreshadowing of that missive contained all the emotions I would have included anyway. We went to the East side of the state to be there for the bereaved. Not that there is anything I can say to take the bewildering absence away. In fact, I'm sure I said a lot of things that were the opposite of helpful, but with the best intentions. I'm not so good at the "shut-up" part of consoling. Hopefully Bo's cheerful demeanor and charm were a source of solace, if not distraction.

We were able to make it out there with a wagon full of medical supplies and still forget a few essential things: power strip, enough saline flushes, paper tape, enough heparin, germex, detachol. We were able to supplement or replace what we had forgotten at the local pharmacies, and have an additional delivery from our infusion company. Additional, because we had our week's supplies sent there, before we called for the additional stuff we forgot to ask for. Oops. Luckily, this location was actually a good hour and a half closer to them than our house, so they were able to oblige promptly and with little complaint.


Whereas the odds of a crisis arising for Bo would certainly have been higher than this particular incident, I can't say that facing all this during Holy Thursday, Good Friday and Easter felt anything less than putting too fine a point on an essentially human condition. That this life is one destined for and designed to encompass death and dying, healing and rising, rebirth and hope in the face of cruelty and pain. Miracles despite, and really because of, the travails that we face on our paths full of stones and roots, predators and pain. The hope for sunshine, the succor of a light rain, the reinvention of life itself. And we keep walking. Partly out of hope, partly entitlement, partly out of lack of anything better to do.

And turning the prism of that drive to move forward in my hands I can see sunlight streaming through this notion of entitlement, changing it, reshaping it into its refined self: faith. Faith that there is a tomorrow. Faith that there will be something better for Bo. Faith that I am the recipient of unconditional love and adoration. Faith that I can be the source of unconditional love and adoration. Faith that this love will drive us to be better than our basest selves, and do better and live better and help better. Hope. Love.

Faith, hope and love. And the greatest of these is Love.

Building Faith

Everyday, we dodge the bullet. Each day is another miracle. Sometimes, our miracle has become so ordinary, we wonder at the insult of the world's sense of normal. And somehow, it is so hard to remember that just because we lose our friends or family members anyway, just because we and those we love may stumble under our personal demons and afflictions, and just because we feel our hearts breaking over those losses, that our broken hearts still have the capacity to fill with awe and love at the miracles we continue to be blessed with.

One of the major downsides of all this information accessibility faces us when we unearth obituaries that we would have otherwise known nothing about. In years past, someone disappearing from our lives from long ago would leave us to wonder. Maybe create imaginary adulthoods, alternate lives for our long lost friends. Now, once or twice a year, it occurs to you to try and find someone. And you don't get anything. And one day, there it is. And even though it's seven years after the fact, you read that she died at 29. And because you are just finding out, it is exactly like it just happened yesterday. And the immediacy of that grief and heartbreak is so foreign and so close. Maybe that is what it is like to actually unearth an artifact. An old fragment of pottery. Someone's hands formed this vessel, carried it, held it. Their lips touched it and received succor.

And when this happens, I never know what to say or how to feel. The truth is that when someone you love dies, no matter how young, how old, how accomplished, how haunted, how close or distant you have become over time, there is grief. And after the heart break, there remains an ache. With all the aches and pains and scars on our hearts, it is an astounding trick that our hearts continue to beat and fill with love and hope.

Comment on Japanese Regenerative Medicine: Intestines

While I see hope that medical advances may provide, if not a cure, a partial reprieve from some of Bo's medical complications from his condition, I felt a need to comment on the recent publication that seems to be making the rounds. This technology is great, and may prove to be a cure for those with gross anatomical short gut: kids whose intestines were removed due to NEC, or volvus, or even pseudo obstruction. However, for those of us whose kids are on TPN due to genetics (MID, Hirschsprung's, tufting enteropathy, etc.) this technology's usefulness only comes into play when a second step can be successfully accomplished: gene therapy. I for one don't think Bo needs more centimeters of the same non-absorbing surface that he currently has. And really, if that second step is possible, you might even hope you could bypass that step of needing additionally created artificial intestine and just apply the gene therapy directly (like the gene therapy that has returned some vision to blind patients whose conditions were genetically caused http://www.reuters.com/article/idUSTRE57B5PN20090812).