Thursday, August 17, 2017

Round of Appointments Completed!

Well, our week of appointments are over. When I sit down to write updates, I always think - I should take pictures of Timmy at the Doctor's office, or at the hospital, and I always forget the next time. So you can enjoy pictures of Timmy while he was getting his breakfast this morning.


Last Friday was the cardiologist, and we 'lost' one of his diuretics from his medication list. So far, that change is working and we are glad to see one medicine go. On Monday, Timmy updated his primary care physician on his growth and development. He was weighed, measured and questioned thoroughly about his abilities and what he has been up to. I had forgotten that it had been about 3 months since we had been to see his primary doctor (it was 4 since the cardiologist appointment). When the doctor pulled up the growth curves, Timmy is still hanging onto the absolute bottom of the growth curve. If he were to hit the 5th percentile, it would be a huge jump for him. Kids grow at their own rate, and he had a few months off from growth, so the doctor would love to see him get up higher on the curve, but it is nothing worrisome at this point.


Yesterday was our visit to Golisano Children's Hospital in Rochester. We started out in Radiology to meet with Heather Goetzman. I cannot remember her official credentials or even title at the hospital, but she works with the Doctor who placed Timmy's g-tube. She helped us get ready to come home by showing us how to care for the tube site. She put a new Mic-Key button (g-tube) in back in December when Timmy's tube had come out and we went to the ER up in Rochester. At any rate, we have a real affinity for Heather and appreciate all the help she has been. She looked at Timmy's tube site (the primary reason we made an appointment to see her) and declared that it looked great! There had been some granulation tissue that was there (scar tissue the body produces to try to close the hole) that had been swollen and red and tender. We had been prescribed a steroidal cream to put on it, but it wasn't helping, and seemed to be causing more trouble. We had heard just using diaper cream with allum powder helps so Jen had been treating the site with that for the last week. I guess it was a success.

She came in carrying two boxes with g-tubes in them. She looked at Timmy's tube, decided that it was time for a shorter tube, and swapped out his tube and updated his chart. Our appointment probably lasted a half an hour, with plenty of questions on both sides, advice given, and the 3 minutes dealing with the tube site and changing out the tube. Well, and she also made sure we knew how to get in touch with her directly if we needed to - a pretty common thing to happen with Timmy's caregivers in Rochester.

We had an hour off between appointments so we headed up to the PICU to visit some friends. Not Facebook friends, and not friends that we drop in on or invite to our house, but still friends that greet us with smiles, hugs and are fun to talk with. Not many were in that we knew yesterday, but we saw Dr. Alfieris, Dr. Rubenstein ("If it wasn't for seeing you two, I wouldn't recognize Timmy!"), Elana (the nurse who made Timmy's sign over his crib, among other things), Jessie, Jen, and Chris. All special for different reasons, and all special for the same reason - they all loved on Timmy while he was in the hospital and continue to gush over him when we visit. I think they all got to hold him while we were there and see Timmy's smile. 

Next we met with the gastroenterologist (Dr. Megan Gable) and dietitian (Elizabeth Bonaccorso). Last visit, the dietitian was not in, so this was our first visit with both of Timmy's nutritional care team. They were both very helpful, very supportive and we exchanged a lot of information. We let them know what we have been feeding, what Timmy's feed schedule looks like, and where we are trying to head with his feeds. They gave us direction as to where to head with the feeds, and things to add to his feeds to bulk up calories, to round off his nutrition, and to help things go smoother. It was another fairly long appointment and we gained a lot of good information, and got Timmy's food prescription changed over to a food based 'formula' for his tube. We will still be blending most of his food, but it gives us more wiggle room when we are running short on time or have to be away from home.

The nutritionist wanted to see blood work to see how Timmy's levels of various things were doing, and we asked if we could take care of that at the hospital before we left (save a trip for Timmy). She sent the script down and we stopped to have his blood drawn on the way out. We are not sure of the name of the woman who drew his blood, but 'Mama D' was able to pull it off without Timmy breaking into tears. She entertained and distracted him while holding his arm still and getting the needle into the vein on the first try. 'Mama D' even sang "hallelujah" as she entertained Timmy. The results were available this morning, and most of his numbers look good, at least in my untrained opinion. A few numbers were 'off' but I'm not sure what those mean, exactly, and often the off numbers were met with "We're not worried about those" in Timmy's case. We'll see what the official word is as the doctors look over the results.

Aside from crazy traffic on the way home, it was a good day and we are grateful. Mom & Dad Hadley came down so we could head up with just Timmy this trip, so the rest of the kids had a great day as well. They were still chatting excitedly about the events of yesterday with grandma and grandpa this morning. Yes, we know we are blessed. We feel it often and know our blessing exceeds our needs.

Friday, August 11, 2017

A Week of Appointments

Today started our week of appointments for Timmy. We are in the midst of 3 weeks of appointments for dentists, chiropractor, and eye doctor visits for the family, but Timmy started his big week today with seeing his cardiologist. This was the first cardiologist appointment in just over 4 months! 4 months! We're pretty excited about that. We're also pretty excited about having another good report from the cardiologist. Nothing has really changed - which is a really nice blessing when you have health conditions like Timmy.

Over the past 4 months, some questions had been building. Not life-or-death questions, but musings we had. The big question was how we would know when it was time to adjust his medications (as in increase dosages). The cardiologist increased 2 medications very slightly for us to try, and then suggested taking another medication away! (With the hope to take 2 more away in the next several weeks if this one goes well) 

If you had asked me which one we should do away with, I would have picked the chlorothiazide (Diuril). Several reasons: 1 - the insurance only covers a form of the medication not being made currently, and this one costs $55 a month (not earth shattering, but not just pennies), 2 - the mixture they make of crushed up pills in water does not stay mixed well, even with twice daily shaking, 3 - it always runs out ahead of the 30 days it is supposed to last (because of sludge left in the bottle that won;t mix back in with shaking). Without knowing any of this, the cardiologist told us he wanted us to try to go without the chlorthiazide. His reasons were: 1) Timmy is healthy now and doesn't need 3 diuretic, 2) this one pulls more electrolytes out of the body. I like his reasons, too, but it feels nice to be moving toward a few less doses a day. From 9 medications down to 8 as of today.

Timmy was celebrating the good news by banging out some tunes on his piano.