Saturday, January 5, 2013

Jayson's Blog

We have created a new blog for Jayson that will have all of the old posts since his birth as well as any updates.  Eventually, this blog will once again turn private and will be filled with boring pictures and info about our family.  :)  Thanks for reading and for your support.

Please visit and follow:
littlejsjourney.blogspot.com

Saturday, December 15, 2012

Happy Birthday Baby!

My Greatest Gift, My Miracle, My Love


Happy First Birthday Jayson! (click on link to view video)

Friday, December 14, 2012

Bad News

December 14, 2012
Today was the day.  The day we would get some answers, even though they were answers we knew we would not want to hear.  I spent most of the night researching terms like "chiari" and "hydrocephalus" so I could have some background knowledge to help me understand our conversation we would have with the neurosurgeon.  Poor Mike worked from 7AM-10PM last night, drove to the hospital from Lehi, stayed for an hour, then drove home and woke up at 5:45 AM to be back to the hospital.  We were told the neurosurgeon would be here in the morning. That typically means before clinic, which is 7-8ish AM.  So Mike made sure he was here bright and early.  Too bad the doctor wasn't. 

Jayson had a rough night full of strange episodes involving seizure like behavior, muscle spasms, gagging and choking.  He didn't get settled to sleep until almost 3 AM again.  He kept us on our toes this morning by having a fairly high resting heart rate of 188 and a fever of 101*.  Then he vomited five times and his fever increased to 101.5.  The poor monkey also had diarrhea and was not happy or comfortable.  The doctor team was uncertain whether these changes were related to his brain stem compression, or if he was contracting an illness.  We realized that we would be spending Jayson's birthday in the hospital this year.  No biggie.  We weren't really surprised.  We've spent Valentines Day, St. Patricks day, the day after Easter, Halloween, the day after Thanksgiving and now his birthday in the hospital.  It's how we roll.  Honestly, I don't care.  His birthday is about celebrating him and his amazing life and journey.  That can be done anywhere.  I know it will be a special day regardless of where we are.  

Well, the neurosurgeon finally made his appearance at 11:30 AM.  I hoped he would come in, take a seat, draw some diagrams and make me feel at ease.  That's not quite how it went, but it was still okay.  I could tell he had limited time.  He had two students/residents with him observing.  He kept rushing me along as I described symptoms that had surfaced since we saw him last.  I immediately forgot about asking half of the questions on my list simply because I knew they would not fit in our short time frame.  He did pull up the 6month MRI and the 12 month MRI to compare them.  He showed how much they had changed in a short period of time.  Jayson's new MRI pictures of his brain looked just like the pictures I saw when I did research on Chiari.  Sure enough, that is what he has.  His lower brain and brain stem is being forced into the spinal column because things are so tight and compressed in that area.  This puts a lot of pressure on the brain and constricts the flow of the spinal fluid.  I asked the neurosurgeon about hydrocephalus and he said that he doesn't seen signs of hydrocephalus at this time.  YAY!!!  There is no fluid on his brain.  He said his Chiari is a type I right now, although he's showing lots of symptoms of type II.  He believed that the compression on the brain was causing a lot of his symptoms that have been getting more complicated lately:  apnea, breathing problems, swallowing problems, gagging, muscle spasms, muscle weakness, fevers, vomiting, fussiness and irritability, eye deviation, sleepiness, rubbing eyes and head, seizure-like episodes.  Given this fact and the life threatening apnea episode, he thinks something needs to be done soon.  He said that it seems that Jayson's heart beats, it's pulsating the spinal fluid which could cause pressure and these life threatening events.  He said he usually doesn't rush into these things, and he likes to wait until the child is older, but he feels the risks of NOT doing the surgery right away outweigh the risks of the surgery.  He said, however, if we felt as his parents that we should wait and watch for a while longer, we could.  I asked him a difficult question that had been on my mind.  I've been told so many times, "Well, you have a monitor and know CPR, so you should be good."  I asked, "So, if he stops breathing due to brainstem compression and spinal fluid constriction, will I even be able to revive him with CPR?"  He chuckled in response to my question.  I could immediately see why friends said he does not have good bedside manner.  He responded, "Well, given you had to even ask that question, I think we should try and schedule him for Tuesday.  We would HOPE that you could revive him, but you shouldn't have to have that be a major concern on your mind and worry about reviving your son again.  Are you guys available on Tuesday?"  I was surprised.  Tuesday.  That's soon.  That's 4 days away.  That's a big procedure for 4 days away.  That's right before Christmas.  Wow.  I hesitated and said, "Yes."  I asked about the procedure.  First the doctor will make an incision in the back of the skull and neck.  He will open up the dura, which is the covering of the brain.  Next he will remove bone from the back of the skull and remove the back of the first C1 vertebrae.  Next he would make sure there was normal fluid flow by shrinking the cerebellar tonsils, which is a non-functioning piece of tissue.  Last, and most importantly, he will put a graft in there, instead of just closing the dura edge to edge, it will turn a small constricted area into a bigger area which will allow the spinal fluid to flow more normally around the front and back.  I asked about the C1 vetebrae problems.  He looked back at the Catscan we took in October and said that the vertebrae concern comes secondary to the compression issue.  He will not fuse the C1 vertebrae at this time.  He wants Jayson to be older and more stable.  We will go back in sometime between ages 2-4 and do that procedure.  By removing part of the C1 vertebrae to open up the compressed spine and brain stem, it may cause his neck to be even more unstable. He may need to wear a collar brace sooner rather than later.  I asked about recovery.  He said that kids usually stay in the hospital 2-3 days afterwards and go home and recover well.  He said it is likely many of issues will improve immediately.  I asked about the risks and he mentioned there are not many more risks than typical surgeries.  Risk associated with anesthesia, risks of infection, etc.  With this procedure there is a risk of chemical meningitis, however it is easily treated with steroids.  Uncommonly, while opening up the dura there are pockets of venus blood, like lakes, that can be opened up.  It's easy to repair them, but at times there is a lot of blood loss which requires a transfusion.  The doctor explained things quickly, clearly, concretely and confidently.  Under normal circumstances, I would have been drowning in a puddle of tears while hearing all of this traumatic and awful news.  But I had full confidence in our surgeon.  I felt it was the right thing.  I knew it needed to be done to preserve my son's life.  Because of those facts, I almost felt relieved to hear this information.  We had a cause of many of his symptoms and problems.  We had a plan to resolve these problems.  We had a timeline.  We could get through this.

I began calling immediate family to inform them of the new information.  A couple of hours later, his nurse practitioner returned to tell us that our doctors schedule was full for Tuesday.  The soonest he could get us in was... January 7th.   Wow.  That's a long time to wait after hearing how necessary this procedure was.  I asked her what I was supposed to do in the meantime and she said, "Well you have a monitor and you know CPR."  Awesome.  My favorite response.  I looked at the calendar and realized that if his Tuesday was full, he was likely taking the next two weeks off for the holidays, and the 7th was the first available surgery day he would have.  I am terrified to take my unstable boy home.  He just stopped breathing for crying out loud.  But I tried to focus on the positive.  He'll be home for Christmas.  We'll have time to prepare mentally, physically, and emotionally for this procedure.  We'll have time to gather a lot of prayers and well wishes for Jayson.  Our doctor won't be on vacation immediately after the surgery, so if we need him he'll be there.  I can work from home and keep my eye on him day and night until then.  And yes, I have a monitor and know CPR.  Most of all, I know that God has led us to this point.  He knows this is what Jayson needs.  If Jayson needed it on Tuesday, it would have happened on Tuesday.  I know God will take care of little Jayson until we can have this procedure done.

Currently, Jayson is still not comfortable.  He's still have unusual episodes and his fever has spiked to 102.5.  He hasn't vomited since this morning, but he has felt nauseas demonstrated through his occasionally peaking heart rate and claminess.  It does not look like we will be going home in the next 24 hours.

Tomorrow is Jayson's birthday.  He is going to be one year old.  I don't know that there are words to describe the feelings I have in my heart right now.  There were many days where I feared Jayson would not be on this earth to celebrate his first birthday.  I have had many fears about the condition Jayson might be in when celebrating this day.  Yes, He may be in the hospital, he may be facing a big, complex surgery, he may have nearly lost his life, but he is doing well.  He is doing amazingly well.  He has a huge smile on his face.  The hospital room echoes from his baby giggles.  He grabs his toes and kisses his mommy.  He hollers and squeals.  He reaches for daddy and snuggles his blankie and stuffed animals.  He rolls to get what he wants and he cries when he can't.  He fights every single day.  He will never give up.  He has a mission and he is determined to fulfill it.  He touches lives of people all over the world every single day.  His story is shared with moms, dads, friends, family, strangers and medical staff internationally.  Jayson has changed the lives of many in one short year.  All who have met him, all who have heard his story are forever changed.  He inspires, teaches, and encourages all who see the sparkle in his eyes.  He is truly a miracle.  Imagine what he will do over the next 12 months.  Imagine who we all will become over the next year.  We have all become better people by knowing and loving Jayson Michael West.

Thursday, December 13, 2012

Reliving My Worst Nightmare

Thursday, December 13, 2012

Sunday morning Jayson started having some severe tummy pains.  He was constipated and I had to assist him in having a bowel movement.  Even after two bowel movements he was still uncomfortable.  He was crying, fussing, arching his back and bringing his legs into his tummy.  I felt so helpless.  I tried to give him a suppository in the afternoon and it didn't seem to help.  I didn't think he was constipated anymore.  I had vented him 8-10 times out his G-port throughout the day and I got a LOT of yellow frothy liquid out.  Not normal at all.  At 6 PM I turned off his feeds to give his tummy a break.  Shortly after he stopped fussing and started playing.  He was really uncomfortable.  I emailed my Special Care pediatrician.  I had no idea if she would read her email on a Sunday evening, but I really didn't know what to do.  To my surprise, she emailed me back.  She advised me to put him on Pedialyte overnight and give his tummy a rest after being constipated.  Jayson seemed to tolerate the pedialyte just fine.  He was able to relax and get some sleep.

Monday morning Jayson seemed to be doing better.  He slept well and didn't seem to have any tummy pain.  I changed out his pedialyte for his formula and began his feeds.  He seemed to do pretty well for about three hours.  Then he woke up in pain, crying, fussing, arching and bringing his legs in to his tummy.  No bueno.  I turned off the formula and ten minutes later he relaxed and went back to sleep.  Clearly, I couldn't keep this up.  I started his pedialyte again to keep him hydrated and called the pediatrician.  I think he needed an xray of his tummy to check the tube.  He also started rubbing his ear, so I thought it wouldn't hurt to have his left ear checked.  We got into an appointment at 4:10 that afternoon.  I started getting ready for the appointment two hours early knowing how long it would take me to get him and myself ready and in the car without any help.  I felt strongly I needed to pack a hospital bag and prepare Jayson's diaper bag for a hospital stay.  I hate when I have those feelings, but only once have I been wrong.  Even thought I started preparing early, I was running about frantically trying to leave on time.  In my frantic state, I dropped my iphone on the floor and the screen shattered.  I couldn't help but shout a couple of bad words and wanted to sit on the floor and cry.  I decided that it was time to call for help.  If only my cell phone wasn't broken...  I picked up my phone and got shards of glass in my hand.  I tried dialing my neighbor, and it worked!!!  My next door neighbor who came over and helped me load up the car and get Jayson settled in the car.  I threw my phone in a plastic ziplock to protect me from the shards of glass and headed out the door.  My sister met me at the doctor's office to help me get Jayson inside.  The pediatrician gave him an exam and thought he looked pretty good.  He said he doesn't know why he wasn't tolerating feeds, but he didn't think it was tube related.  He recommended adding some formula to the pedialyte later that night and slowing transitioning his feeds back to formula.  He also gave us a can of expensive EleCare formula that is sensitive on his tummy in the case that our plan doesn't work.  I asked two more times about an xray.  I really felt he needed an xray.  The doctor suggested we try a couple of more things before getting an xray.  He didn't see any reason for concern about the tube.  I tried to put my parental instincts aside and trust my doctor.  It seemed reasonable.  On my way home, the GI doctor's nurse finally called me back and told me to try something similar.  He told me to try 1/4 formula to 3/4 pedialyte for 12 hours, then 1/2 and 1/2 for 12 hours, then 3/4 formula and 1/4 pedialyte for 12 hours and then back to full formula feeds.  At ten that night, Mike and I mixed 1/4 formula with 3/4 pedialyte.  Jayson was moaning throughout the night and was bringing his legs up to his tummy, but he didn't wake up crying so I let the feeds keep running.  We woke up at 3 am to Jayson's machine going off.  We thought maybe his feeds ran out, but it said there was no flow.  We checked for a kink in the tube, but found nothing.  We discovered that Jayson's cream colored bed was now bright orange.  His machine fed the bed for who knows how long.  It was a sticky, nasty mess!  Mike tried flushing the tube.  Nothing moved.  He worked at unclogging the tube for 20 minutes without success.  I tried for another 20.  Barely any water was getting through.  I decided to just try running straight pedialyte.  The mixture of milk and pedialyte was thick and somehow clogging the tube.  We changed out the feeding bag again and ran the pedialyte.  It seemed to go through even though the tube was still partially clogged.  I spent the next hour and a half researching online trying to get an idea about what was going on.

Tuesday morning I woke up and started making calls to our pediatrician and GI doctors again.  I googled all sorts of questions trying to see if anyone else had this problem.  I posted questions to the online support groups for parents of special needs children I belonged to.  I sent in requests to join new support groups.  I called my nurse friend and emailed my Special Care doctor.  I frantically searched for an idea about what was going on.  Our pediatricians nurse returned my call and suggested we try the new formula.  Some of my online friends suggested trying a very slow rate of watered down Similac.  I thought it made more sense to try and see if Jayson would tolerate his own formula before switching his diet completely.  I watered down his forumul and ran it at 25 mls per hour.  It only took five minutes for him to show signs he wasn't going to tolerate it.  After 15 minutes, he was hysterical.  I shut off the feeds feeling very frustrated.  I called my pediatrician's office back and asked for them to send in an order to Primary Children's for an xray.  I really needed that x-ray.  I started packing again, certain we weren't coming home.  I decided to try some of the new formula with Jayson while I packed.  To my surprise, he quickly calmed down and seemed to tolerate the food!  I called our nanny Shelby who came to our rescue and helped get us ready and loaded for the hospital.  We headed on our way to Primary's and went right to Radiology.  He was called back and they took two abdominal xrays.  I went to a waiting area and called my pediatrician's office to let them know the xray was taken and we would be waiting for a call about the results. About ten minutes later, our doctor's nurse called.  "Well, Jayson's mom, he's really backed up, I guess he's constipated, and well, the tube isn't in the right place."  I echoed, "The tube isn't in the right place?"  "No."  It was silent for a couple of seconds.  I didn't know what to say.  She said, "So I don't know what you are to do right now.  Probably see somebody."  Yeah.  Probably.  "We're still at Primary Children's.  We'll just head right over to the ER.  Thank you."  I immediately got sooooo sick to my stomach.  If the tube isn't in the right spot, that likely means that they'll choose to switch out his tube.  Which we just learned can be risky and threatening at this point in time.  I felt terrified for the first time in a long time.  I called Mike and told him to leave work right away and come to the hospital.

We arrived at the ER and they got us back to a room quickly.  The doctor pulled up the xrays and surprised us with her reaction.  "His tube is in the right place.  It seems he has a kink in his tube."  I stood up and went to the computer.  Sure enough, in the upper part of the intestine, there was a distinct kink.  That explains why his feeds had a difficult time going through.  This explains Jayson's discomfort.  This explains my feeling that something was wrong with the tube.  And this is much better news than the tube is in the wrong place.  I was still worried about the solution they might come up with, but I suddenly felt more comforted and calm.  I didn't feel this was going to be the crisis I feared.  I informed her of what my pediatrician told me and she pulled up the official report.  My pediatrician must have misunderstood.  There was a kink, and his fluids were moving slow through his intestines due to the kink.  That was likely causing his discomfort.  We waited for a ridiculously long time to hear our options, and then the decision of the team.  Initially the resident returned to inform us that our two options are to try and pull part of the tube out to remove the kink, or to replace the entire tube.  They were calling the GI doctor on call to get his thoughts.  I knew we could just try to pull it out and unkink it.  I didn't feel they would need to replace the tube.  I didn't feel as fearful.  Sure enough, that was their decision.  Let's try and pull it out 3 centimeters.

We weren't prepared for what happened next.  The nurse said, "okay, let's do this.  I've never seen a tube like this before.  It looks like it's taped together.  Let's have you start working on taking the tape off and then we'll have Dr. Dad pull the tube out three centimeters."  What?  Really?  We're doing it right here?  Not in radiology in case something goes wrong?  Without a doctor?  Mike is going to do it?  Mike used scissors and his steady hands for fifteen minutes to take the tape off of the tube.  Yes, his feeding tube is taped together.  Quality work.  I assisted Mike where I could, but I held Jayson steady so he didn't pull on the tube.  While Mike was hard at work, a couple of thoughts came to mind.  Why isn't the nurse or a medical official doing this?  Because they don't know how.  They don't want the responsibility (or liability) or pulling the tube completely out or messing something up.  They hadn't seen this tube before and didn't even know where to begin.  That is so reassuring.  We are in the hospital working on our own son.  I wondered if we were being billed for a procedure we were doing on our own.  That would be amusing.  I wondered how Mike was feeling inside.  I think he felt a little nervous, but almost relieved that this delicate situation with the tube was in his hands instead of these clueless nurses and doctors.  I was right.  He whispered, "I'm kind of glad I'm doing this instead of them."  I could tell we must have been having similar thoughts.  There were layers of tape, two different types of tape.  Just as Mike got the cap to the port free, he tried to open it to find that there were layers of tape on the inside of the cap around the tube as well.  It might be jimmyrigged, but at least it was done up right! haha  After another few minutes it seemed the tube might be free to move.  The nurse said 3 centimeters.  There were numbers on the tube, but it was clear they were not measurements in centimeters.  The nurse tried to look up information about the tube on the internet to tell us out to measure 3 centimeters, while Mike figured out the system himself and explained it to her.  She said, "Oh, you're probably right.  So you're going to want to move it to the dot.  No, the number.  No, the dot after the number.   Hmmm... well, let's just move two numbers.  Hopefully that works."  I just put my trust in Mike because this girl was cute but completely clueless.  I felt relieved that Mike was in control.  He slowly pulled out the tube, little by little, until he reached the goal number on the tube.  I helped Mike TAPE the tube back in place.  We used one type and one layer at this moment to see if the kink was gone before adding more security to the tube.  The nurse commended Mike and I gave him a big smile.  I was so proud of him.  The nurse said, "Well now we're going to turn on his feeds at full rate and see how he tolerates them.  Then you can go home."  Hmmm... how will we know if the kink is gone?  Mike was feeling pretty good about himself.  He started going through cupboards and drawers. looking for medical supplies we needed to get him ready to go home, since Mike was now Dr. West.  He started ready medical facts that were pulled up on the computer screen in his professional doctor voice.  We entertained ourselves for a long period of time and ate some cafeteria food in the room.  At this time, Jayson seemed happy, playful and content.  I hadn't seen this all day.  Finally a doctor came in to say it seems like he's tolerating feeds and we can go home.  They would start filling out the discharge paperwork.  I asked her if we were going to do another xray to confirm the kink is out.  She said not at this time.  We were to go home and see how he does, and if he has anymore problems we can come back.  Awesome.  I felt like we'd probably be back.  I asked her if there was anything else we could do to test and see if we think the kink is out, since his machine would run for a while with a kink before it would refuse to run.  She said nothing came to mind and left.  Suddenly, I realized that it is apparent that these ER doctors and nurses have no clue about GJ tubes, or tubes in general.  I was the expert.  I could figure out a way.  I realized I could try flushing to tube.  If it goes easily and without resistance that would be a great improvement.  That would lead me to believe the kink was gone.  Mike checked the cupboards and drawers as Dr. West for some sterile water and we flushed his tube.  Awesomeness!!!  It flushed so easily.  I felt much better.  I once again arrived to the point mentally that I usually do while in the hospital-- I was ready to go home.  It was clear that Mike and I knew more about Jayson, his conditions and his issues than the medical professionals.  I just wanted to go home before they did something to screw it up.  We signed our paperwork, and we hit the road.  My nanny Shelby rode with me, and we followed Mike home.

While on the freeway about to exit, Shelby realized Jayson's head was completely forward and he was asleep in his carseat in the backstreet.  How strange.  That's difficult for him to do with his neck control and quite an uncomfortable position for him to fall asleep in.  I asked her to lay his head back to support his neck and open up his airway.  Shortly after, Jayson's monitor began beeping.  More often than not, it goes off because it's not a good reading.  The signal was good and Jayson's oxygen levels were in the 80's.  Sometimes he obstructs while breathing, and when his airway opens up his oxygen goes back up.  Nope.  I quickly cut off a car and pulled off into a closed car shop parking lot.  Shelby and I hopped out of the car and went in the backseat to check on him.  He was breathing loudly, but his airway was open.  I couldn't tell why he wasn't getting oxygen.  I checked his tank.  It was a little low, but there was plenty to get us home.  I turned up the oxygen and stimulated him.  He stirred a little bit, opened his eyes, closed them again and his oxygen went back up to the 90's.  Shelby and I got back into the car, and I was about to pull out when the alarm went off again.  It was in the 70's.  Good signal.  Bad sign.  His O2 levels tanked fast.  Shelby and I jumped out of the car super fast and my heart was racing. I carried the monitor into the back seat and watched it drop.  64.  Flashing.  Beeping. Jayson was pale, unrepsonsive.  Not breathing.  I shook his belly.  Shelby rubbed his legs and grabbed his toes. We shouted his name.  Shelby smacked the bottom of his feet.  I lifted up his head, which fell forward.  He was unconcious.  I pinched his cheeks and looked at the monitor.  61.  Flashing.  Beeping.  I was yelling now, begging Jayson not to make me breath for him.  He wasn't listening to me.  He wasn't there.  I got his seat belt off as quickly as I could.  It was difficult because he was so limp and floppy.  I kept watching his lips.  I wanted them to open.  I wanted them to move.  I watched his nostrils.  I hoped he would suddenly take a deep breath.  I started pulling him out of his carseat to begin CPR when I felt an abdominal muscle tighten and I heard a moan.  Still no breaths.  I rubbed his shoulders then held his face and yelled at him to breathe.  He started crying.  Still no breaths in, but I was feeling relieved.  He gasped and took two large breaths in and cried.  The most beautiful sound in the world.  He was crying, breathing, living.  My baby boy was alive.  Floods of memories filled my mind and I can't remember the first minutes following the episode.  I saw myself back in our bedroom, holding my floppy baby's body screaming to the ENTs on the phone to hurry.  I remembered laying my baby on the floor ready to give him CPR.  I remember the fear, the terror, the feeling that my heart had stopped.  I just relived my worst nightmare.  At some point, I snapped out of it.  Shelby was on the phone with Mike the entire time.  I was scared for him.  I told him to come to our parking lot right away.  I called my nurse friend.  I assumed we would be going back to the hospital, but he was breathing now.  We were just there.  Would there be a point in going back.  Jayson had stopped crying and looked like he was in a daze.  Tired, confused.  In shock, maybe. My nurse friend didn't answer, but she sent me a text.  I text her what happened and she said we definitely needed to go back.  Mike arrived and he checked things out.  The monitor was on and functioning.  The oxygen was running.  He switched out the tank for a new one so we'd be sure to have enough oxygen to get back to the hospital.

We analyzed the situation and realized that Shelby needed to go home, and Mike and I needed to be in the same car so I could ride in the backseat with Jayson.  So Shelby rode in the back with Jayson while I dropped her off, and we stopped by our house to transfer everything to Mike's car.  Mike sped his racecar to the hospital and we rushed Jayson inside.  In the meantime, Jayson just sat in his carseat, in a daze.  His oxygen levels and heart rate were stable.  The nurse checked us in and we sat in the waiting room.... for 30 minutes.  I was shocked that a child can quit breathing yet it's not seen as an urgent enough problem to avoid a long waiting room visit.  We finally got into a room and I relayed the terrifying experience four or five times to four or five different medical personnel.  They got us up to a room surprisingly fast where we would stay the night for observation and come up with a plan in the morning.  In the room I spoke with a doctor about my concern for this being related to his vertebrae issue.  Our neurosurgeon told us that if his breathing or swallowing ever got worse, we would need an MRI right away.  Jayson had his head forward, and then shortly after moving it back he had his apnea episode.  I felt like they might have been related.  He sent in a request for neurosurgery to come by in the morning.

Wednesday morning, bright and early, a neurosurgery resident came by.  He got my whole story and was concerned.  He said we would need to get some more flex xrays of his neck and we could compare them with the xrays from October.  He didn't think they would look vastly different, but if there was a difference it would tell us we need to look into an MRI.  We got the xrays in the morning and waited for results all day long.  No word.  FInally, at 5 o'clock our nurse told us she received a call saying the xrays were different enough that Jayson needed an MRI.  Dang.  That means anesthesia, right after a life threatening apnea event.  I don't like the idea of that, but it was what I really felt would happen.  So given that information we knew Mike couldn't miss a whole additional day of work, so I needed to go home with him and get my car.  And a shower.  I won't mention how many days I had gone without one.  Our nurse for the day coincidentally ended up being someone from our stake I had met at church a few weeks prior.  I never ever leave Jayson at the hospital, but I trusted her to care for Jayson, and I called my sister and asked her to come stay with him when she could while I left.  

I was literally shaking and struggling to breath from the panic attack I brought on just by leaving Jayson.  It felt wrong.  I couldn't handle being at home without him.  I saw his things everywhere and I started to pray that I would never have to come home for good without my baby.  The pain would consume and destroy me.  That was for certain.  I couldn't even enjoy my shower or my meal.  I had a big day at work planned for Thursday that I had to get covered, and I had to create a couple of documents and send some emails.  Finally, I was able to head back to the hospital.  I felt so calm walking into the building doors of the hospital realizing I was once again in the same building as my sweet baby.  My sister said Jayson was active while I was gone and they had a lot of fun playing.  He had some strange activity, similar to his seizure-like activity, that I had also seen earlier that day.  I spent the later evening playing and cuddling with my little man.  His strange activity developed into seizures around 10.  Nurses came in to observe him and were debating whether or not they should call in a neurologist.  They were mild and not incredibly noticeable.  He was in a daze, bobbing his head, his eyes deviated, and he wouldn't blink.  He had some tightening of muscles as well, with some fussing.  He had short clusters that lasted for about a half hour.  Then he was drained and exhausted and fell right asleep.  He had a rough nights with episodes.  He kept jerking and waking himself up.  He woke up crying and screaming a couple of times due to the fear of waking up after a severe jerk.  I was awake until about 3:30 rocking and comforting him back to sleep after his episodes.  Finally I was able to get a couple of hours of sleep.

On Thursday Mike had to work, and I was at the hospital on my own.  Jayson slept a lot of the time and I tried to keep my mind occupied by writing this journal entry and watching my favorite show- Boy Meets World.  The BMW seasons have become my hospital companion.  Jayson had a couple of his strange new episodes while awake that I got on tape.  I got him a birthday balloon and staring and playing with it even brought them on.  His MRI was set for 3 PM, but they were ready for us at 2:40.  I was super emotional at the time he was getting transferred to a new crib.  I was nervous about the anesthesia, and I was even more worried about the news we would get after the MRI.  I had a feeling it would be bad.

I went downstairs with him and held his hand until he fell asleep.  His poor face was covered in sparkles from my lipgloss because I couldn't help but drown him in kisses.  I put on a courageous face and went upstairs to wait in the waiting room.  The MRI took a little longer than expected which made me a little uneasy.  Finally I could go back and see him.  I was relieved to see the smile that appeared on his face when he saw me.  He didn't require much anesthesia for the MRI so he was awake and alert.  Jayse was pretty happy as we resettled into our room, and he and I spent some time playing.  I tried to hold on and treasure those last few moments before knowing the truth, the results.  A resident doctor came in with the news.  Brief.  Without explanation.  Cut like a thousand knives.  "This MRI was significantly worse than his last MRI.  Things are really tight around his spinal cord and brain stem.  There isn't a lot of spinal fluid getting through.  You definitely won't be going home.  The neurosurgeon will be by tomorrow to talk with you about your options."  And then she left me alone, with my thoughts, fears and worries.  I felt consumed in my emotions for a moment, and my head was spinning.  I forced myself to think about my true feelings.  I already knew this, deep in my heart.  I know the heavenly spirit was telling me it would be okay, and comforting me.  We were meant to get admitted and find out this information.  It probably saved my son's life.

I called Mike and had to be the one to share this awful news with him while he worked late.  I wanted so badly to hug him and cry.  I know he felt the same.  A neurosurgery resident came by and relayed the same information.  He said this does not constitute an immediate emergency to be taken care of today or even tomorrow. But we needed to address this problem sooner rather than later.  He asked me if I had questions and I just laughed.  I told him my head is flooded with them, but I need to sort through them and I can ask our neurosurgeon tomorrow.  He asked me if there were I couple I could ask, and he could try and address them.  I asked him about the affect on Jayson's brain if the spinal fluid is not freely passing.  He mentioned the condition 'hydrocephalus' which is fluid on the brain.  Oh no.  He said that Jayson looks great right this moment, but his life is threatened by this constriction on the brain.  Our doctor is still trying to think of our options and the risks involved with doing something right away and the risks associated with waiting a little longer until he's a little bigger.  He several times referred to Jayson as a "Chiari kid" and I recognized that term from my personal research.  I asked if a collar would help out at all, and he said it would help stabilize the C1 vertebrae, but it wouldn't help with the tightening.  He explained that the pressure being put on the brain is causing his swallowing and breathing issues, and maybe even the seizure activity.  I thanked him and he left.

That's where we are now.  I'm in a bad place.  I know bad news, but not enough information to appropriately process it.  I'm just sitting here, rocking my baby and letting the tears flow freely onto his curly head.  I know he feels my fear, and I want so much to be able to hide it.  But tonight I can't.  Jayson can read my soul.  We have such a special bond.  In my moment of weakness, he sat up straight, lifted up his unstable neck, opened his mouth and threw his face at me.  My face is now moist from tears and baby kisses.  He told me it will be all be okay.

Thursday, October 25, 2012

Vertebrae Disarray

We had our long awaited neurosurgery appointment today.  I've never had more anxiety for a doctor's appointment in my life.  Jayson has many symptoms and conditions, and some doctors seem to think they're isolated.  I've been waiting for a doctor to make sense of everything.  I wanted answers, particularly for some of the weird, concerning things happening like Jayson's nystagmus (eye spasms) and seizure-like episodes.  I felt like our neurosurgeon could be that doctor to make sense of it all.  We had concern for a condition revealed in his MRI in June:  Hypoplasia (underdevelopment) of C1 ring.  The neurologist didn't seem too concerned, but our special care pediatrician and geneticist did.  Our geneticist said she had a patient very similar to Jayson who had Hypoplasia of the C1 ring, and woke up one day paralyzed.  I knew there was more going on than just some breathing issues, and my mom instincts were going CRAZY waiting for this appointment.

A couple of weeks ago, I heard from many mothers who have children with disabilities that our neurosurgeon was a complete jerk.  He was said to have poor bedside manner, disregard mother's concerns, and not recognize a mother's instinct.  This greatly increased my anxiety.  I feared that this appointment might not give me answers, and we might receive another, "Interesting, I'm not too concerned.  See you in another 6-12 months."  I thought about switching doctors, but it could add to our wait time and I heard our surgeon was the best.  I prayed really hard, and I fasted hoping we'd get answers and a compassionate neurosurgeon.  I also asked Mike to take some time off work to go with me to the appointment.  I know how powerful a man's presence can be.  I performed weeks of research and tried to get some basic understanding of the spine, brain, brainstem, and vertebrae.  I wrote down all of my questions in an orderly fashion, and I wrote down all of Jayson's symptoms and conditions in order of relevancy to his C1 issue.  I cued up my videos, prepped his medical binder and went to bed much later than I should have.

Mike met me at Primary's and we checked in for our appointment.  We got called back and anxiously waited for our doctor to come back.  When he walked in, he definitely fit the description my friends had described: handsome and confident/arrogant.  He sat down and asked, "So what's going on with Jayson?"  I knew this would be how it would begin.  No evidence of looking at his file.  I listed off his symptoms in order of relevancy and he started writing, looking in his file and pulling up the MRI on the computer.  The list of symptoms alone seemed to be enough to concern him.  He checked out the MRI and said he thinks he knows what's going on, and he wants to be sure.  He believes that Jayson's top vertebrae is in two halves, instead of one complete vertebrae.  The MRI wasn't enough to confirm his suspicions, and we needed a CT scan and a couple of x-rays.  I was nervous that we'd have to get x-rays another day, and schedule another appointment to come back.  Instead, he told us to get the x-rays and CT done right away, and come right back.  We'd discuss the results and come up with a plan.

There was a 45 minute wait for the CT scan.  Enough time to drive me crazy with anxiety.  Just seeing the doctor's sense of urgency made me sick to my stomach.  Jayson did incredibly well for his CT scan.  If kids don't stay calm, they sometimes have to sedate him.  Fortunately, he took a nap during our 45 minute wait and was well rested and happy.  In fact, he smiled and giggled nearly the entire time they did the CT.  That's my boy!  He inspires and teaches me so much about attitude!


He didn't enjoy the x-rays as much, but the radiology techs sure enjoyed him and his curly hair!  They made a big fuss over him, and found him a special Tarzan loin cloth to protect the goods during the x-rays.  We headed back to the doctor's office and impatiently waited to see the doctor, wondering what we'd hear.  I didn't even know what to think, but I knew something big was coming.

The nurse took us back, and the doctor came in with two other doctors or residents.  The words out of his mouth were words a mother never wants to hear from her son's neurosurgeon, "Well... it's what I was afraid of."  He went on to show us the x-rays and CT pictures.  Jayson's top C1 vertebrae was a mess.  It was divided in half, instead of a complete ring.  Now, children's rings become a complete ring around the age of 2.  Until then, they're fragmented.  Well the space between his two halves tells us his will not be a complete ring.  And the other fragments should be symmetrical and be like puzzle pieces that will all fit together, with equal amounts of small spacing between them.  This was not the case with Jayson's vertebrae.  His were unevenly spaced, unsymmetrical, difference shapes and sizes.  The doctor said, "There's just not a lot of bone holding things together.  There's not enough strength and stability to hold the head on the neck.  Things move too much, it gives out.  It's clean what is going on.  The C1 is constricted, which places occasional pressure on the chord.  It may stabilize on its own, but in my experience, most kids don't.  Jayson will need some type of stabilization procedure by the age of 4.  2 1/2-3 years would be the earliest I'd consider it.  It's a high-risk procedure."  He went on to explain that things in that area are tight and narrow, and the spinal column is narrow.  His bones in that area are immature for 10 months of age.  He such have much better bone quality, and bigger bones.  He said, "He's just a dinky kid.  Small size, small bones, and very much on the fragile side."  He said there is a risk of paralysis, due to the tightening.  He said where Jayson isn't moving much now, it's not as big of a concern.  But once he begins walking, we'll likely put him in a neck brace.  Until then, we have to watch him constantly.  He can't ever be out of an adult's sight.  He needs to be supported while sitting, and we need to try to inhibit his neck and head falling forward or back.  We have to watch his symptoms closely.  If we have another rough patch, like we did in August, we don't call, we just come in.  He said to come in right away and order an MRI and come right to his office.  This situation with his C1 vertebrae and narrowing around the spinal column can affect his breathing, apnea, and swallowing.  So if any of those things get worse, we're supposed to come in.  This also likely explains his seizure-like episodes that worry me so much, as well as his hypotonia (low muscle tone) and maybe even his nystagmus.  I was shocked at what the doctor said lastly.  "One of my other patients had surgery this week with nearly exactly the same condition in his neck.  He has Marshall-Smith Syndrome."  He went on to imply that we might want to look further into that syndrome.  What???  It's soooo incredibly rare.  The likelihood of another doctor even knowing what that is, is rare.  The likelihood of that being brought up again is just crazy.  And I thought I got rid of a lllllll thoughts of Marshall-Smith after August.  I hated that it came back up again.  I hated that it's still a possibility.  I hated that I knew this wasn't the last time I'd hear about Marshall-Smith.  (See blog post 'The Entire Summer in a Post' towards the end for more details about this syndrome).

All of this was a lot to take in.  No mother ever wants to hear her son needs to have spinal surgery, especially around the brain stem.  But it felt really good to have some answers.  I once again felt relieved, as I have when I've received other pieces of bad news that result in treatment plans.  We had a plan.  We will see him in six months and get more x-rays and likely another MRI.  We'll also likely get the neck brace.  If we're worried in the meantime, we get an MRI and come to his office.  If his symptoms get worse again, he may operate, but we're trying to wait until he's at least 2 1/2.

It would be nice if we had some time to let this all sink in, but we don't.  Tomorrow is surgery day.  Jayson is having his GJ tube put in (Hallelujah) and tubes in his ears, as well as a bronchoscopy, laryngoscopy, and botox injections in his salivary glands.  Poor little man will be hating life, but these things should all help him greatly, and hopefully keep him out of the hospital for the duration of the winter.  It seems like it's always just one thing after another.  I'm hoping that after surgery things might calm down a little bit, and we can just sit at home and cuddle the little man under a blanket while the snow falls outside.  That is my dream.

Wednesday, October 17, 2012

Baby Torture, A Healthy Heart, and a Feeding Miracle!



September 5, 2012- FEES Study
One more test before we move forward with a G-tube… and this has been the one I’ve been most nervous about.  He doesn’t need anesthesia with this one, but I’ve heard the FEES study is tortuous and traumatizing.  That sounds like about the last thing we need.

Jayson, Shelby and I made our long trek to Primary Children’s to visit Dr. Meier for the first time at this location.  We typically see him at Riverton.  We got called back and a speech pathologist greeted us in the room.  We already had met during a previous swallow study.  No surprise there.  The hospital halls are filled with familiar faces these days.  She explained the procedure.  Jayson would have a scope with a camera down his nose to his throat. We would feed him foods of different consistencies and watch the camera to see how he’s swallowing.  The swallow study uses an x-ray to watch the food go from the mouth to the stomach or the lungs.  The FEES study will have the camera that films Jayson’s anatomy as he swallows.  It will show us what his body is doing when he tries to swallow.    

The room soon filled with people: ENT Dr., his nurse, a resident,, the speech pathologist, Shelby and myself.  They asked me to hold him.  Great.  I hate that.  Let mom hold him down while he kicks and screams.  Although I despise being a part of a tortuous procedure with my boy, and I don’t want him to think I would ever harm him, I do those things because I know I can help calm him.  He knows how much I love him, and I know I will be gentler with him than any nurse.  I will also be right in the middle of the action in case I need to intervene on his behalf.  So I reluctantly agreed, and I was outfitted in a nice yellow robe.  They said it would get messy and he may throw up.  Poor baby.  I sat down on a chair and held Jayson sitting up in my lap.  I had a nurse and resident standing near me on each side of me, also holding him down and staring at the screen.  The speech pathologist was at my right ready to feed him and the Dr. was standing on the other side of the room staring at the screen.  

The speech pathologist first used the pudding-like consistency I mixed up with stage 2 baby food thickened with oatmeal.  She added blue dye so we could easily see it go down.  Jayson of course hated the scope going down.  He started freaking out.  He also hated so many people surrounding him and holding him down.  Then while he’s freaking out, the speech pathologist started shoveling food into his mouth.  When a baby is hysterical, he does not eat well.  However, we celebrated as it seemed the food went down without problems.  After two bites, we moved on to a syringe with honey consistency blue food.  After a quick squirt, blue thick liquid went all over Jayson and myself and apparently some ended up in his mouth and seemed to go down again.  Amidst the kicking, screaming, choking and gagging going on in my arms, it seemed like complete chaos—the medical staff guessed, hypothesized and sometimes even conflicted with one another deciding whether the food was going where it should.  One thing was certain--  Jayson had one messed up epiglottis.  It was big, long, floppy, and dysfunctional.  Even the Dr. seemed surprised and expressed he now knows why Jayson is struggling so much with his breathing and eating.  At least we know his epiglottis is crazy.  

Jayson was given a bottle which he tried to suck, but little of the nectar consistency would go down due to his hysterical condition.  Out came the syringe and his face was flooded with liquid once again.  With the choking, gurgling, and gagging I spoke up, “Hey, I think he aspirated.  That’s what he does at home.”  Again, voices and arguments filled the room and I couldn’t tell one statement from another, nor did I know if Jayson had passed the nectar without problem.  The Dr. stated, “We can watch that again and find out,” as the resident interrupted to mention the monitor was not set to record.  None of this was on film.  The resident tried explaining the doctor simply needed to push a button and name the video to begin the recording, and it would retroactively save the data we had collected so far.  He couldn’t be bothered.  “No, we’ll be okay,” he replied.  Well without knowing whether my son could handle a couple of milliliters of nectar consistency, we pushed down some half-nectar down his throat.  I freaked out and said he was aspirating.  I knew it.  I knew it with the nectar, but I couldn’t take anymore.  It was coming out his nose, he was starting to choke and vomit.  I felt a huge feeling of guilt for doing this to my poor baby.  The doctor claimed he could tolerate some half-nectar.  Inaccurate.  No way.  The speech pathologist chimed in to express she wasn’t really sure how he did, and I made a suggestion against my better judgment as a mommy.  I wanted to be done, but it seemed to me that all of this was done in vain without good information.  I suggested they go back to the thicker liquids now that he aspirated and had been eating more.  He’s not going to aspirate the first 2 mls of something he eats.  And I explained that it appears to me that once he aspirates, he just can’t recover, regardless of consistency. 

 I had him calmer than before, and we gave him honey consistency.  Sure enough, he aspirated.  I was right.  I’m his mommy, and I knew he couldn’t tolerate half-nectar.  The room started to settle down and I started to calm down my blue smurf baby.  Once his gown was off, he began smiling and squealing.  He is such a trooper!  I admire him so much.   I was not okay, however.  I was still upset, anxious, and my head was spinning.  I had never seen such chaos in my life.  So much happening at once, and no one could agree on just what WAS happening as my baby was trying to swallow.  Although it was really neat to be able to watch him swallow and observe his dysfunctional epiglottis, I felt like I got more clear information from a swallow study.  And in a swallow study they give them more volume, so I feel more comfortable stating he can or cannot eat a particular consistency.  This test just confused me and tortured my little man. 
 

Everyone sat down and looked right at the Dr.  They all were thinking the question I was about to ask, “So what are we going to do with his epiglottis?” The Dr.stumbled for words.  He grunted, hesitated, paused, began to speak, stopped, and thought some more.  He said that he hoped it would have corrected itself by now.  In most cases of laryngomalacia children are growing out of their conditions at this age.  But give its large size and the way it folded over itself, he isn’t sure it’s going to correct itself.  He claimed it’s clear that it’s closing off his airway, and getting stuck from the secretions.  He said another surgery would just complicate it and likely make it worse.  He said in other oversized epiglottises he can tack them up to the back of the throat, but do to the issues with Jayson’s, it would make his aspiration and swallowing issues much worse because he wouldn’t be able to protect his airway.  He said we don’t have a lot of options.  A tracheotomy is an option if it’s going to prove to be life threatening, which it has.  He said he hates to go backwards, but it might be necessary.  He asked how positioning has been going and I informed him that since I’ve been sleeping Jayson on his side and tummy, he’s been doing much, much better.  My statement made the Dr. feel more comfortable.  He said, “I would like to wait a little longer, if you think we can.  If we can stay on top of the positioning and avoid life-threatening apnea episodes, I think we can avoid a trach.  What do you think?”  I agreed.  Of course I don’t want Jayson on a trach, but we’ll do whatever we have to in order to keep him alive.  For now, I think we’re okay.  I am very anxious about winter and illnesses however.  That’s truly what threatens his life.  We’ll see what happens this winter.  People slowly filed out of the room and I was left with my whirlwind of thoughts and my giggling baby.  I wish I could dismiss the trauma as quickly as he can.

We headed home and pulled into the driveway, emotionally drained and exhausted.  I hobbled in my house on my crutches as Shelby was getting Jayson out of the car.  I heard her saw, “Oh no.  His tube came out a little.  It got snagged or something.”  She brought him inside and I took a look.  It was nearly all the way out.  His tape had come off partially and the tube pulled through the tape.  I pulled it the rest of the way out, which only included about an inch of length.  I wanted to just sit and cry.  It had been an awful day at Primary Children’s and now I had to go back.  Jayson had been tortured beyond belief, and now he had to endure more.  My heart ached.

We turned around and revisited the route I feel I could travel with my eyes closed.  I was relieved that this ER visit would be within normal business hours so we should be able to get in and out of radiology really quick.  At least that’s what I thought. Two and a half hours later, we were still waiting in an ER room to go back to radiology.  I finally voiced a complaint that my child had been without food for nearly 4 hours and we were quickly approaching a hospital stay due to dehydration.  Finally, that got the ball rolling and we immediately got taken back to get the tube placed.  Unfortunately, it was not an easy placement.  The radiologist was good, but he was having a difficult time.  It took him 15-20 minutes to place the tube.  Jayson did really well, but I felt sick thinking about all he had been through.  Finally, the job was done and we spent another 45 minutes waiting to be discharged from the ER.  I was so relieved to get my sweet boy home after an incredibly long, awful day and snuggle him the rest of the night.



September 19, 2012- Cardiology and GI Appointments
I have been incredibly nervous for this appointment.  To be quite honest, I never wanted to have this appointment.  I was worried about what I might find out.  We’ve been concerned about his bradycardic episodes, which have been escalating again lately, but we’ve never suspected a major heart problem.  However, many genetic syndromes involve a heart problem.  I don’t know how I would handle anything being wrong with his heart.  That is the ultimate in my opinion.  I went into this appointment with no expectations.

We got taken right into a room for an echocardiogram.  The technician was very serious and not-so-friendly.  She kept telling me to keep my son under control or they would have to sedate him.  He was doing really well!!  He started fussing when he was tired.  I tried playing his favorite show Yo Gabba Gabba on the i-pad but internet signal was interrupted often.  She asked if there was something else I could figure out to keep him still or entertained.  I was not told that I would need to do that for his echo.  He finally went to sleep and she was able to finish the echo easily.


We were then taken to an exam room where a nurse took Jayson’s vitals.  As usual, they had a difficult time getting his blood pressure.  The nurse tried 4 times and left a welt on his leg from the cuff.  Jayson didn’t even make a fuss.  The heart doctor came in and I absolutely LOVED her!  She was so sweet with Jayson, so patient, so thorough and explained things to me clearly.  Jayson has never had such a thorough examination.  She gave me the greatest news any mommy could ever hope to have—Jayson has a perfectly healthy heart.  I felt like I might pass out from happiness!  I seriously felt light-headed.  It was so amazing, I cried.  She expressed there might be one concern that could result in an inability to get an accurate blood pressure.  She tried to get his blood pressure old school style and was successful.  She confirmed she had no concerns for Jayson.  She feels his bradycardic episodes are respiratory related and his heart rate drops when he struggles to breathe.  I informed her of the one time at the end of July when he had a tachycardic episode while sleeping, and his heart rate went back to normal when Shelby woke him up.  She said that could be evidence of a condition, but whereas it happened just once, she wasn’t too concerned.  The Dr. said if it ever happened again I should call her.  In fact, if I ever had any questions I could call her.  She said Jayson was being discharged from the cardiology clinic “forever” but if I ever wanted him examined, all I had to do was call.  And she gave me a direct number.  What an amazing doctor!  I felt so comfortable and confident leaving her office.  Jayson had a healthy heart.  And mommy had a happy heart!

We had a dysphagia GI appointment that afternoon.  I thought it was at 2 so Shelby and I were taking our sweet time in the cafeteria at Primary Children’s.  At 1:30 I thought I should check the time to be sure.  That’s when I noticed my appointment was at 1:00!!!  Oh no!!!!  I felt so stupid!  I was just down the hall, and had no reason not to be to my appointment on time!  To give myself a little credit—I HAD a dysphagia appointment the previous Wednesday scheduled at 2:00 but the nurse called and asked me to cancel and reschedule because the doctor team was not prepared for my doctor appointment.  So that’s why I had 2:00 in my head, and really THEY were the ones who weren’t prepared, so hopefully they’d be forgiving of my tardiness.  I hobbled really quickly down the hall on my crutches to get to our appointment.  There was a LONG line of people waiting to check in, reschedule, and pay their copays and there was only one receptionist.  Even more, the “system” was down so we were in total gridlock.  A nurse came and grabbed Shelby and Jayson and took them back while I waited at the counter for another 15 minutes.  Finally, she told me she would just bill me later and I was able to get back to Jayson.  

I was anxious for this doctor appointment.  We should finally hear what type of surgery we were doing for Jayson and hopefully get it scheduled!  After the PH probe showed practically no reflux, I expected to hear Jayson’s reflux issues were resolved and we could do the G-tube.  Well, I was surprised to hear his reflux was clinically significant according to the impedence probe study.  And due to his aspiration issues, he was at risk.  He needed to stay on the Prevacid and we still had no idea what to do.  The doctor said it was not a clear decision, nor was it her decision to make.  I think she was implying it was my decision???  I’m not the health specialist!  I don’t know about these things!  She explained if we wanted to be purists, the nissen ensures that he won’t aspirate reflux EVER.  But he could still aspirate oral feeds and his own saliva and secretions.  She said a GJ would likely prevent him from aspirating reflux, but it wasn’t 100%.  And lastly, a G tube is risky, but she felt like it might be worth a try to just do the G-tube and then we can change it if necessary.  She then went on to explain that Jayson is the first patient who qualifies for this medical study that is nationally known.  He has a neurological condition, and he had conflicting data from the two probe studies.  She wants him to get a G-tube and be observed with the expectation that he will likely struggle sometime in the future.  At that point, he would be randomly selected to receive either a nissen with a G-tube or a GJ tube and then the observations and study would continue to see how a neurologically challenged child responded to each treatment.  I obviously felt uncomfortable about the whole thing, but especially the random surgery part.  She told me that I could select which one I wanted since he would be the first patient to qualify, but we’d need to begin with just a G-tube surgery.  The only part that really appealed to me was knowing that the doctors would take very good care of him if he was the ONLY patient who qualified for this study.  They would monitor him closely, and that seemed like a good thing.  But I really didn’t want my son to be a guinea pig to the medical science field, especially where he’s such a fragile little guy.  Really, I didn’t want to have to make this decision at all.  I thought that’s why I put Jayson through so much pain, torture and procedures so that we’d have answers.  And now we don’t.  And I have to make the decision based on my limited knowledge.  My GI doctor recommended I talk with my pulmonologist and see what she suggests with the condition of his lungs.  Our appointment with her was in two more weeks.  I really hope she provides us with a clear answer because I want to get this surgery done!  Flu season and RSV season are fast approaching and I want Jayson in and out of the hospital as soon as possible!!

 Jayson had fun playing in the paper.


September 20, 2012- Feeding Therapy Surprise!
Today was an amazing surprise!  I have so much to do to get ready for Jayson’s early birthday party that I really didn’t want to go to his feeding therapy appointment.  He just started eating some dissolvable solids and he needed more time.  We weren’t ready to take more steps forward, so I felt that this appointment was going to be a waste of time.  I couldn’t have been more wrong!!

I love our feeding therapist.  She is seriously my hero.  She helps us in so many,  many ways and our therapy appointments are always so enjoyable.  She went over the report from the FEES study with us.  I was shocked to see such an organized report from such a chaotic situation.  The report said that Jayson MAY be able to tolerate half nectar consistencies.  I explained how the whole FEES study played out, and the feeding therapist agreed that we should keep it safe with honey and pudding consistencies.  I was so relieved to hear she supported me.   I informed her about our decision to have an early party for Jayson.  She asked if I was going to have a cake for him.  I hesitantly responded, “Well, yes.  But I don’t think he’ll eat it.  I just want him to play in it and put his hands in it.  If he puts his hands in his mouth, I’ll pull the cake out.  I’m interested to see what he’s going to do.”  She said, “Me too,” and walked out of the room.

She came back with a high chair, animal crackers, applesauce and graham crackers.  I had no idea what she was going to do.  I put Jayson in the high chair and she poured applesauce on his tray.  She dipped some animal crackers in the applesauce and put them in Jayson’s mouth.  He smiled and tried to nom on them.  He even bit a piece off.  We were ecstatic to see him chewing and swallowing.  There was a little choking involved.  The animal crackers were not quite soft enough.  We put his hands in the applesauce on the tray and helped him put them in his mouth.  We watched him sucking on his finger and making the mental connection between food and how to get it into his mouth.  With minor assistance, he was able to get the applesauce in his mouth.  We then stuck a graham cracker in the applesauce and put it in his mouth.  He got so excited, bit off a piece, chewed and swallowed and dove for more.  He took another bite.  And another.  And another.  By this time, my therapist and I were crying.  She told me this moment and one other moment with one of her special kiddos were the greatest moments in her career.  I couldn’t help but feel so fortunate that our therapist cared so much for Jayson and his progress.  I just let the tears flow, and I had a hard time closing my jaw.  I was so shocked and surprised at the progress Jayson had made.  He loved food.  He wanted to eat everything.  And the therapist told me he could eat cake.  I never had the expectation that Jayson would eat cake on his real birthday, let alone on his early birthday.  I was over the moon happy and couldn’t believe I almost cancelled this appointment.  Jayson sure had a surprise for us, and I have a feeling he has plenty more coming!










Just as we were about to leave, our therapist asked us about Jayson’s head shape.  She asked if we had a helmet yet.  I told her I hadn’t heard anything about a helmet since he was 3 months old, and we have many doctor appointments.  She said that children with plagiocephaly (flattening of the head) typically go in helmets between the ages of 6 months to a year.  He was nine months, which was late in the game to get a helmet.  Really???  Why hadn’t anybody said anything??  She asked if her physical therapist in her department could come check him out.  She knew a lot about these things.  She came and measured his head and said he definitely needed a helmet, but it may be too late for him.  She asked if there was any reason why a doctor might be against a helmet?  I said that we haven’t had a doctor even bring it up, but I might want to wait until Jayson sees the neurosurgeon on October 26th about his hypoplasia of the C1 ring.  The therapist said that can be a big concern for helmets and for therapy.  She asked if we were receiving physical or occupational therapy and if we were working on head movement and positioning.  I said that we were.  She said that could be a big problem and may cause him harm.  She suggested holding off until we see the neurosurgeon.  She works with some children who have C1 and C2 ring issues and she has to be really cautious about what she does with them during therapy.  Great.  Why is it that I tend to learn critically important things regarding my son’s health from my feeding therapist instead of one of our 10 specialists that we see????  Why???  What would I do without our feeding therapist watching out for my son???