Tuesday, July 18, 2017

Continued Progress

Therapy continues for Timmy with PT, OT and Speech on a weekly basis. What is shared with us gets worked on through the week with Timmy and he has been growing and developing well over the last few weeks. 

As far as praises: Timmy is continuing to gain weight even as we have adjusted his feeding schedule and no longer gets feeds through the night. He has a feeding before bed and then gets food in the morning with his 6:00 medications. Even with leaving a 10 hour gap between night time feeds, we are able to get enough food in him to meet his needs and keep him gaining. Primarily, this is because we have gone toward using more real food over the formulas. We can give him a formula and it will persist in his stomach for hours - making him full and unable to take more food in, but when we give him real foods (chicken, avocado, berries, fruits, sweet potatoes, etc) he is able to process the food better and he is able to handle a larger volume of food. The nutritionist set 650 ml as the volume goal for Timmy until our next appointment. As of tomorrow, we will be 5 weeks until the next nutritionist visit, and Jen has Timmy's feedings up to around 730 ml. The closer we are to 1000, to more likely the nutritionist will be to order the whole food enteral 'formula' for Timmy. It is a completely balanced food for people with g-tubes made from real food. We can work on doing that ourselves with blending Timmy's food for him (which we are doing already somewhat), but with Timmy's health needs, a well balanced diet is more important to his growth and development, and the real food formula would make sure we had all the bases covered.


Also, therapy is going well and Timmy is taking off in leaps and bounds. Well, his leaps and bounds include sitting and rolling over, but they make us happy - and apparently they make him happy, too. Actually, this picture of Timmy sitting without being held or being assisted (even if it is for very short periods of time), brings us a lot of joy. We are blessed.


Tuesday, July 4, 2017

Never a boring day, but not much excitement

I do not miss the days of multiple blog posts in a day. I don't even miss the days of daily blog posts. I do apologize for going so long between posts, but between not much excitement (a definite praise), and  never actually being bored, the blog takes a back seat to life.

With that said - there is actually stuff to report. Timmy has met his therapists. Kim for Speech, Katie for Occupational Therapy, and Sarah for Physical Therapy. Speech is concerned with all things oral - speech and eating by mouth in particular. OT and PT overlap a lot at present, but having multiple people working with us gives us more ideas of how to work with Timmy during the week. All three therapists are wonderful with Timmy, seem very competent in their knowledge and abilities, and seem to fit into our home nicely (There probably is a better way to express that, but having therapists that are easy to talk with and are personable makes this whole 'having multiple people into the house every week' thing much easier to handle).

As far as therapy is concerned, Timmy is improving in his sitting, reaching and rolling skills all the time. His full-time in-house therapist works with him and enjoys showing off his victories when Timmy's other therapists come to visit. At times he is vocalizing more, grabbing more things, and shoving things in his mouth (which makes Kim - the speech therapist) happy. In the next week or so, we may even try to introduce foods orally again, so progress on many fronts.

It seems with every advance, we have little set backs. We haven't figured out if it is allergies or a summer cold, but congestion has hit in the house, and afflicted Timmy as well. His breathing is a little more labored and we have a little more added to his care routine, but so far he is handling it all in stride.

I will hope to update sooner next time, but VBS starts up next week, so I will not make any promises. Thank you all for your concern, interest and prayers on Timmy's behalf as well as ours. We can't help but be grateful for the great support we have.

Wednesday, June 14, 2017

A Really, Really Good Day

It is hard to know where to start today. As I mentioned last week, today was the day to head to Rochester for a swallow study for Timmy and to get together with a nutritionist who works with 'tubies' (patients fed with a feeding tube). On top of that, we hoped to stop by the PCCC (Pediatric Cardiac Care Center) where Timmy (and Jen, for the most part) lived for 2 months last year, and we hoped to stop by the Ronald McDonald House Jen stayed at to drop off some more pop tabs and leave a donation for her stay. 

Today, I'll start with the negatives:
1) I didn't bring the checkbook to write the check for the Ronald McDonald House
2) We didn't get to see everyone who provided such excellent care for Timmy (and Jen and I) when we stopped up to the PCCC.
3) . . . OK, I guess that was about it.

So, on to the positives. I'll write them out as a list because writing about them all would make this really long.
1) We had safe travels and Timmy traveled well for us today.
2) The swallow study went well (not the best it could be, but certainly not the worst - he aspirates silently), and we have permission to start introducing tastes orally. (And for the Speech therapist to work on it with us)
3) The swallow study went quickly and Timmy actually swallowed for them.
4) The speech pathologist offered her help with any questions we or Timmy's team might have.
5) We had a friend sit with the kids so Jen and I could both talk with the nutritionist.
6) The nutritionist was VERY helpful.
7) We found out we're supposed to replace the g-tube every 3 months - and it is covered (Timmy's has been in for 6 months without a problem - some people struggle with them lasting over a week!)
8) We found out we are supposed to get a new extension every week - and it is covered (we've been using them for 4-6 weeks - some people struggle to make them last a week!)
9) The nutritionist told us all of his feeding supplies should be covered and I should STOP BUYING DURABLE MEDICAL GOODS! (Oops, I was just getting what Timmy needed)
10) The nutritionist was not only OK with us 'playing' around with Timmy's feeds to see what worked best for him - she was glad we do, and likes our 'flexibility.'
11) When we brought up wanting to move away from formula to something more 'real food' she brought up several options of commercial tube feeds, and even help with a blenderized diet. (Our hope and eventual plan - it is nice to have support, help, and encouragement in it, though)
12) The nutritionist will be working with us on an ongoing basis as part of Timmy's team and not just a one visit thing.
13) Did I mention the nutritionist was VERY helpful!
14) The nutritionist works with a dietitian that helps create recipes for blender diets (crunching numbers to make sure all nutrients are present) and will share recipes they have developed for general use.
15) We were sent home with some samples to help us choose what commercial feed we want to select as a base as we move toward a blenderized diet for Timmy.
16) We saw and celebrated with several of Timmy's caregivers and support team from the PICU (Dr. Jill, Dr. Alfieris, Elana, Liz, Meghan, EJ, Hillary, Jen, Heather, Jessie, and several others whose names slip my mind presently) They loved seeing Timmy and how big he was and how well he is doing!
17) We got to see a few of the people who took care of us at the Ronald McDonald House in Rochester when we dropped off the pop tabs (picture below with Bonnie)


On top of all that, we met Timmy's speech therapist yesterday and were very happy to see her interact well with Timmy and are excited to see what a little therapy will do to help Timmy out. Within the next week, we will meet the PT and OT that will work with Timmy.

All that to say: We are grateful for how God answered our prayers for this visit. God doesn't always answer our prayers the way we want Him to. In fact, I think He more often doesn't answer the way we ask Him to. 

A few examples:
We prayed for Timmy to grow so he could have surgery - God answered with devastating news that Timmy was not a good candidate for surgery.

We prayed that God would do a miracle and heal Timmy's heart - God answered with a heart that still does not function right, but provided a miracle that Timmy is still with us and doing well.

We prayed that God would provide the bare minimum of information we needed to take care of Timmy using a diet or real foods and be able to work toward oral feeding again - God answered with giving us a nutrition team to work with that will provide us with a ton more support and encouragement than we could have hoped for.

You would think I would learn my lesson and just pray that God would do what needs to be done. But somehow, I still think I am smarter than God (at least I act that way sometimes and pray that way sometimes) and try to tell him the best way to do things. In all three of these answers, it wasn't what we prayed for. In two cases, the news wasn't what we wanted to hear. In all three cases, I am glad for the answers we received. 

I don't know why my son struggles with a heart issue. I don't know why we needed a ninth child with an extra level of care needed. I don't know why almost none of this has gone 'as planned.' But the longer I walk this road, the less I feel the need to know. I have seen bits and pieces of why God's answers were better than my request (a non-surgical answer for Timmy was better than the surgical possibilities - and may yet result in a long life for him). And that is not only enough - it is more than enough, and we are blessed!

Thank you each for your prayers! I have heard so many times recently that people are praying for Timmy and for us - it is truly overwhelming at times. And please know that even though God hasn't always (or even usually) answered in the way we wanted or prayed for - He has answered your prayers and ours as a loving Father.



Tuesday, June 6, 2017

Some Improvements Coming for Timmy

Well, even being over a year into raising our ninth child, we still have a lot to learn. Feeding tube feeding plans, speech, physical and occupational therapies, figuring out problems with a child with a different growth curve and different circumstances. Knowing that is the case, and finding out that Timmy should be with us longer than we were led to believe 6 months ago, we have been working to get the help that we and Timmy need lined up.

Next week, we are planning on heading to Rochester to learn about Timmy's nutritional needs and get some advice from some professionals. We will also hope to get a swallow study done to make sure that Timmy is able to swallow foods properly with no physical problems in the way. This will hopefully open the way to working with Timmy on taking foods by mouth and doing some eating therapy.

Today we got a call from the Early Intervention Program coordinator working with us to let us know that they have the therapists for Timmy lined up and the therapists should be getting in touch with us soon to start working on the speech, physical and occupational therapies. For Timmy, it is obviously a big help, and to us it will be a help to learn better how we can work with him to help him in those areas. We have seen him making progress in those areas and are excited to learn more and hopefully see some more progress as we work with him in a more structured way.

As far as recent blessings, one of Timmy's great grandmothers was out to the house recently and was able to see Timmy. The only other time she has seen him was at Great-grandpa's funeral. Unsurprisingly, she does not remember much about that day. She will get a picture of the occasion to remind her. 



We like the happy times. It almost looks like he is clapping, but I think that is just how his hands happened to be held at that moment. He still needs help to clap.


Tuesday, May 23, 2017

Update on several fronts

It has probably been the longest break between updates. In a way, even that is a blessing: We continue to pray for Timmy's health, strength, and healing, but it is nice to not have to be adding requests every day or week for special prayer. 

Timmy has been enjoying playing in his seat, on his mat and even propped up on his tummy on a pillow. Here he is 'helping' Larissa make bread dough (notice the whisk.)


The latest 'problem' is also a blessing. He has been extra fussy and not sleeping really well for the last week. Aside from helping us sympathize more with a friend working long hours and living on little sleep, we have been unable to point to a cause for the added fussiness (staying up late, waking up early screaming, making lots of noises through the night). Since Jen was bringing two other children to the Dr., she called ahead and go permission for him to be seen - nothing 'wrong,' just baby fussiness. While not enjoyable, we'll take a standard baby problem. 

 

This week also brought the results from Timmy's evaluation by the speech and physical therapist. While mostly just technical language and statistics ('standard deviations from the mean' anyone?) it confirms his eligibility for the early intervention program here. We don't expect to learn much this Thursday, but we will be meeting with a woman who will tell us where we go from here. It sounds like they are stretched thin and may not be able to offer both types of therapy that Timmy qualifies for, but being in the system probably gets us on the waiting list when more staff is available.


Many calls have also gone into looking at Timmy's nutritional needs. Since he doesn't eat on his own, and we have been going 7 months now without adjusting his feeds much at all, we have been wondering what sort of adjustments we should be making to his feeding schedule. Our first appointment was going to be for this Friday, but that was made without the scheduler noticing that Timmy has a G-tube, so a new appointment to be seen in the G-tube clinic was made up in Rochester for June 14th. They will be conducting a swallow study to see if we should start working on introducing foods orally (a step in the early intervention work, too), and then consulting with Drs. about Timmy's nutritional needs and where we head with types and amounts of food from here. It will be a long day, but we are looking forward to it. 

We appreciate your continued prayers. It continues to humble us to be reminded by people that they are praying for Timmy. Sometimes the humbling is amplified when we fail to recognize the person who is telling us they are praying for Timmy (which happened yesterday to Jen with a lady she probably hadn't met before). We are also just tickled to be have front row seats to enjoy seeing God's continued answers to prayer on Timmy's behalf. We hope this blog helps you enjoy the blessings and answers to prayer in a more up front and personal manner.

Thanks!

Friday, May 12, 2017

Still Very Thankful

Every CHD (Congenital Heart Defect) patient has their own unique story. Many have a story of surgeries - some starting right after birth, some with one surgery, some with a string of surgeries stretching out before them. Each has their own struggles: many times feeding issues, breathing issues, growth issues, and the list could go on, and on.

Timmy had his well child visit today and was weighed, measured and stuck (lead test and hemoglobin). He is still very low on his growth curve, and very low on his oxygen saturation, but is doing well. The next scheduled Dr. visit is in 3 months. We are hoping to schedule a visit with a feeding clinic to figure out Timmy's nutritional needs, but really appreciate the relative low number of Dr. appointments at this stage in Timmy's life.

One of the CHD families that we keep up on and pray for just landed back in the PICU with their 15 month old daughter. The cause: a cold. Having had two surgeries and her own unique needs, a cold lands her in the hospital. It never ceases to remind me how blessed we are with Timmy. I know, I would see us as blessed if we had to be in the hospital every month, which really makes me glad for where we are.

Here we are!
Yes, a little surrounded by toys. Yes, with the cannula in because his oxygen has been a little low the last few days. Yes, laying still in his crib to help keep his food in him (he has had some regurgitation issues lately, nothing major, but we try to keep him still after eating to give his tummy a fighting chance) And he has the bandaid from the Drs. office from being stuck. 

God is good and we know we are blessed!

Friday, May 5, 2017

Waiting on evaluation results

We had a physical therapist and a speech therapist to the house today to evaluate Timmy. A huge pile of questions and a lot of 'playing' with Timmy over the course of about a half an hour and they told us we would get their report soon.

What we could figure out is that some of Timmy's abilities surprised them, but we weren't sure if any of the areas were areas of concern just yet or not. They gave us some suggestions on things to work on while we're waiting for the reports to be filed and therapy to start. More tummy time for Timmy, and supported kneeling to start working on leg strength. Just he sort of things we want to hear to keep our home therapy on track and continuing to help him. 

They told us most of their clients don't follow their instructions very well and it requires them to be in homes more often to actually do the therapy with the children. Hopefully, they will find us to be a 'good' client that needs very little attention as it sounds like they have a bit more work than they can keep up with already.

All told, it was nice to hear we are doing some good things, and just as nice to hear some suggestions of things to help Timmy improve. We were also impressed with how the ladies interacted and worked with Timmy while they were here. Not everyone works well with children, but these ladies enjoyed Timmy and were very good with him. They may or may not be the therapists we work with (they might only d his evaluation), but at least it says good things about the group we will be working with.