It was almost exactly one year ago when Nate was diagnosed with epilepsy. The e-word still makes me cringe, but that's what it is. He was having staring spells at school, which led to an EEG, which did not show an actual seizure but did show "sparks" of seizure activity every few *seconds.* If not for the EEG, I would not have believed he was really having seizures, because when I would say his name, he would come right back out of it. It wasn't causing any damage, but they told me constant zoning out would cause delays, and we certainly didn't want that.
So the plan was to put him on medication for a minimum of two years, then we'd do another EEG, but no one gave us any hope that Nate would grow out of this. We first tried Keppra, and it made Nate pure evil. It was bad. After 6 weeks, we switched to Topomax, which didn't result in any side effects, but the problem was that it came in sprinkle caps. So we had to sprinkle this stuff in some pudding or yogurt twice a day. But Nate has some texture issues, and plus this medicine tasted bad, so every day, twice a day, we had a major battle. Sometimes we would be open about putting it in his food, but then he wouldn't eat it at all. Sometimes we would try hiding it, but he would taste it. And he started questioning everything I gave him to eat, lol. "Are there sprinkles in this peanut butter sandwich?" (Usually there were.) There were a lot of tantrums and a lot of missed doses.
At his 6 month follow up, I reported that Nate had not been having seizures that I could tell (but honestly, I could never tell), but I wanted to know if there was a liquid form of Topomax. I explained the issue. She wrote a prescription for a liquid form, which the pharmacy would have to mix for us every 2 weeks. No problem. Those first two weeks were blissful. Nate would take it by liquid no problem. The next time we went to pick up the prescription, they told us that our Medicaid denied paying for it because it was expensive and contained over the counter ingredients. So that would mean we were paying $80/month for this liquid medicine.
After those 2 weeks without battles, we really did not want to go back to sprinkle caps. We gave it a half-hearted try, and we ended up forgetting (by accident or on purpose) to give it to him at least once a day. But there were no staring spells. Finally I decided that the benefits of taking the medicine (fewer staring spells--even though we hadn't seen a staring spell in forever) did not outweigh to twice a day battle to get the medicine down his throat. So I stopped giving it to him. (Eek!)
Now, I do not condone my behavior in any way, lol. I can't think of more than a couple times I have actually gone against doctors orders for Nate. But in this case, I really felt like he didn't need the medicine. So I gave it a shot. And everything was fine. Four months later, everything is fine. His teachers have not seen one staring spell, and neither have we at home.
So, today was his neurologist check up. (Dun Dun Dunnnnn) I really was not looking forward to reporting my negligence. Dr. Farber is a very nice man who always wears a bow tie. He asked me how things were going, and I said, "I really don't want to tell you this, but I weaned Nate off of his medication." Hmm, I was right. He didn't like it. He understood my reasons, even if he disagreed. At some points, he was using a tone of voice one might use with one of those unreasonable combative moms. :) He asked if I would at least agree to doing another EEG. I told him that was fine, I really don't have anything against medication or any kind of interventions--just this particular medication was not working for us.
So we scheduled an EEG for March 16. Dr. Farber said if it comes back normal or even just slightly abnormal, we'll forget the medication. (Even though they have a pretty strict rule that every kid is on medication for at least 2 years, regardless of clean EEG.) But if it comes back like it did last year, he's going back on medication. We can try a different kind of medication that comes in liquid form, such as Trileptal. We did not try this before because of the side effect of weight gain, which would not be good for Nate's mobility, but he said we could try it and see what happened. So, an EEG it is. Let's all pray it comes back normal! How awesome would that be!
Sidenote: I am always amused at Nate's various non-SB specialists. They always want to talk about the fetal surgery and the Spina Bifida, and they always want to see Nate's feet! Like, his pulmonologist (lung doctor) once asked to see his feet. :) Well, Dr. Farber saw his feet last time, so this time he just asked Nate to run up and down the hallway so he could watch him. Does this have something to do with neurology? I guess so. Does it have anything to do with seizures? I'm pretty sure it does not. I don't mind showing off my little pride and joy though.
Nate's doctor appointment turned into a little Mommy and Son date this morning, and it was nice to be able to spend some time with just him for a change. I dropped Georgia off at the sitter's and took Nate to work with me. He was pretty good except he kept sneaking in the bathroom to play with water in the sink. There were plenty of toys there, but I finally found one he was interested in--a Connect 4 game. Then we went to his appointment, and the highlight for him was getting to run in all the long hallways. He was an angel during the appointment, then I drove him to school, where he was just a few minutes late, and sat with him during lunch. We had lots of good conversation.
I just really like that kid. Love him too.
This blog is to keep family and friends updated on the new and cute things Nate, Georgia and Bo do ... because I can never remember them long enough to tell people.
Monday, February 21, 2011
Saturday, February 19, 2011
Nate's new ride
So you might remember that Santa brought Nate an AmTryke this Christmas. If you're not aware of what an AmTryke is, it's an adaptive tricycle, which they make in different sizes, and an organization called Ambucs will put children on a wish list for these bikes and raise the money to buy them. I first really learned about these bikes at an event last May when some therapists were fitting kids for bikes. I was there for work, but when I saw how cool they were, I got Nate there pronto. And I was a little disappointed that when Nate got on a bike, he wasn't as into it as I was. He sorta thought it was cool, but it seemed like a lot of work. Anyway, so a local group of people, including my boss, worked together to establish a Louisville Ambucs group to fund bikes for all these kids who were fitted for bikes that day. SBAK bought one of those kids a bike right after the fitting, then in late fall, when they had raised some money, they chose one name from a hat to fulfill their wish for a bike. They chose Nate! And just in time for Santa to put it under the tree.
There was this shiny red bike under the tree ... and Nate paid no attention to it whatsoever. I knew I HAD to get a picture of him with the bike to send to the Ambucs people to thank them, but I practically had to wrestle him onto this bike. He said "cheeeeese" long enough for me to take this picture and then immediately started crying. I felt awful! Some little boy who would appreciate the bike could have gotten it instead of him!
Well, because of the weather, we didn't get a chance to try it out until last weekend. He really didn't want to ride the bike until I told him he could go really fast, so he obliged.
Then we got going ...
| Scared face |
| Very unhappy face |
Last night we went out and worked on it again, and we had a turnaround! He LOVED it! We went down to the cul de sac, and I unlocked the handlebars and let him go however he wanted. I was trying to keep up with Georgia anyway. Pretty quickly, he got the hang of steering. We even rode down to the cemetary close to our house and Nate biked around the trail. I held on to the push bar most of the time. (Yes, he was in pajama pants, and there was chocolate on his mouth.)
Part of the reason I made sure we went out to practice last night was cause we had an Ambucs event to attend today. They were presenting 19 bikes, and they wanted Nate and his bike to be there as well. When we got out of the truck, I decided rather than holding both kids' hands in the parking lot and trying to push the bike, it would be easier if Nate just rode his bike from the truck into the event. I pushed him with the bar while holding Georgia's hand. You should have seen him riding on in to this party! Everyone loved it! He thought he was the coolest. We asked him if he'd be willing to get off the bike so they could present it to him while they were presenting bikes to the other kids, and he thought that would be fine. ;)
While we waited, the kids colored, did crafts, and got their hands painted.
Georgia is a cookie monster! "Caw-kee! Caw-kee!"
Nate's more of a cake man.
Ha, by Nate's expression you wouldn't guess this is our buddy, Caden.
When it came time to present the bikes, they presented Nate's first. As soon as they said Nate Payne, he got up and ran across the floor in front of everyone by himself and let them help him climb on his bike. When did he get to be such a big kid?
Then he took off riding!
There were people there ready to fit the bike for him, but it was good how it was.
A LOT of kids got bikes.
We went outside to this little track they had set up for kids to try out their bikes, and it was so great because it was flat. I followed Nate around holding onto his push bar for a couple laps before I realized, um, he's got this. I let go, and off he went.
Check him out! Riding a bike like a big kid! (If viewing on facebook or email, go here.)
I have to admit that when I first saw these bikes, even though I thought they were really neat, I was sort of hesitant or anxious about it, just like I have been with any kind of equipment we've ever gotten. What is he going to look like riding around the neighborhood on this oversized tricycle while all the other kids are riding normal bikes? But today, when I saw him zooming around this track having the best time ever and getting to do something so typical that every little boy wants to do ... there was only joy. Nate really surprised me today by how independent he was, and if this shiny red bike helps him achieve that, who cares if the bike is different? It's still a bike, and my kid can ride one.
Friday, February 18, 2011
Fruit roll ups and the limbo ... a preschool Valentine's party
Party at the preschool! Woop woop!
I just have to get this off my chest. I think it is kind of silly that cupcakes are no longer allowed at preschool Valentine's Day parties. Only healthy snacks. Whole wheat crackers and low fat cheese. Low fat/fat free pudding. Fruit and low calorie whipped topping. Are you kidding me? I appreciate that this school is emphasizing making good food choices, but we can't have a special treat at a special party? Many of the parents didn't comply anyway. :)
After yummy healthy snacks, it was time to LIMBO!!!! I don't think this is a regulation limbo pole by any means, but the kids had a great time walking around this circle about a hundred times. I got dizzy just watching them.
Most of the kids cheated, but no one was really enforcing proper limbo technique.
Then they turned on the crazy preschool dance tunes!
Check out Nate's mad dance skills!
I just have to get this off my chest. I think it is kind of silly that cupcakes are no longer allowed at preschool Valentine's Day parties. Only healthy snacks. Whole wheat crackers and low fat cheese. Low fat/fat free pudding. Fruit and low calorie whipped topping. Are you kidding me? I appreciate that this school is emphasizing making good food choices, but we can't have a special treat at a special party? Many of the parents didn't comply anyway. :)
After yummy healthy snacks, it was time to LIMBO!!!! I don't think this is a regulation limbo pole by any means, but the kids had a great time walking around this circle about a hundred times. I got dizzy just watching them.
Most of the kids cheated, but no one was really enforcing proper limbo technique.
Little video of Nate limbo-ing.
Then they turned on the crazy preschool dance tunes!
| This is Nate's usual spot on the "carpet," next to his best friend Trinity. |
This one has a surprise ending, but only Nate knows what the surprise is.
I got to talk with Trinity's guardian during and after the party. Trinity is just the sweetest girl. Since the beginning of school, she has been volunteering every time Nate needs a helper. I've heard sometimes she helps a little too much, on things that Nate needs to be doing himself. :)
| "My best girl, Trinity." |
My babies can read ... yes, both of them
A couple years ago, a friend was asking for advice about getting a better routine for reading to her little ones, and I was telling her how I read to Nate at certain times of the day. She warned me that it was harder to get in those routines with the second. I didn't doubt her in the least, so it came as no surprise when I saw I wasn't reading to Georgia as much as I always had to Nate.
But there's a big difference here. As a baby, Nate couldn't walk and was happy as a little puppy to just sit in my lap listening to stories for as long as I would read them. Up until recently, she couldn't sit still long enough to get through the shortest of baby board books. Usually at bedtime, I have been reading a few stories to Nate while Georgia wanders around his room looking for trouble, pulling books off his bookshelf, taking wipes out of the box, climbing on top of me, jumping on Nate's bed, etc.
A couple weeks ago, we were at hippotherapy, and Georgia called a horse a "doggy." It was so cute! But I realized she doesn't know the names for any animals except doggies. Memaw reminded me that this is about the age (18 months) that I started reading the Bright Babies First Words books to Nate, so I decided to pull them out for Georgia. Now every night when we are rocking in the glider for a few minutes before I put her in her crib, she asks for "book." But she is hilarious "reading" this book. Each page has a picture of a household object or animal, and I point to it and ask her what it is. Here's how it goes:
Picture of a Girl=Baby!
Picture of a Boy=Nayyy! (Nate)
Shirt=Shut!
Pants=Shut!
Socks=Shocks!
Shoes=Shewwws!
Cup=Miwlk!
Ball=Baw!
Car=Caw!
Boat=Caw!
Teddy bear=Baby!
Banana=Nana!
Cat=PSSSSSSTTTTT!!!!! (Oh no, that's what she thinks a cat is called now, cause that's the noise I make every time our cat is around to get her to stop doing whatever annoying thing she is doing!)
Potty=Paw-ee
Dog=Doggy
Okay, great, so she is doing pretty well with all those first words! Now we move on to the animals ... we have a lot of work ahead of us, lol.
Penguin=Quack Quack
Rabbit=Doggy
Fish=Ish (we actually have fish, so that's why she knows that one)
Goat=Doggy
Butterfly=jumbled nonsense ... pretty sure she's trying to say butterfly
Zebra=Doggy
Lion=Doggy
Macaw=Quack Quack
Tiger=Doggy
Goose=Quack Quack
Kitten=PSSSSSSTTTT!!!
Pig=Doggy
Hen=Quack Quack
.... You get the idea.
Then there's another book about colors that shows a lot of different types of fruits. She calls some fruits (oranges, apples, blueberries) "baw" and all of the other fruits (pears, grapes) "nana". Still scratching my head on that one. But she cracks me up with the enthusiasm in which she answers with the wrong answer.
Well, Georgia is not the only little bookworm in the house. Nate has always loved books, and we always read several before bed. About a year ago, I bought him some BOB books that help children learn to read. Uh, he was three. I was pushing it a little. So every few months I've brought them out for him to look at and see if he had any interest. Last month, he started getting it!!! Now he can read several of these Bob books, and when we pick up a new one, he needs a little help sounding out a few new words, but dude, he is reading!!!! I have a video of him reading an entire one of those books in like a minute, but I guess the video is too big to load on the blog. I'm so proud--I knew my little boy was smart. Reading at 4.5! (Listen, I haven't had too many chances to brag about how "advanced" Nate is in his short little life of therapies and motor delays, so just go with it.)
AND he can draw! This has been an area of major delay with Nate, but today he drew this awesome self-portrait--best I have ever seen from him! AND he can write his name! Okay, I'll stop now.
Anyway, Memaw knows just how much Nate and Georgia loves books, so when she last visited, she brought them a special Valentine's gift--a book that has her voice recorded reading it! Almost every night Nate has asked for Memaw to read him a book, so I bring it out. :) Georgia is very interested and a little confused at this. There's one part of the book where she whispers and then gets really loud, and Nate gets so excited about this part that he shakes and giggles every time.
Okay, in other non-reading news, Nate has been sick this week.
Monday evening he was very whiny ... like moaning and laying on the couch with Blake. When I got home, I saw he was running a fever. The next morning he still had a fever, so Blake and I tag teamed that day so the kids could stay home. Nate layed on the couch almost the entire day. On Wednesday he didn't have a fever, so I took him to the sitter's, but he was still very tired and clingy. I thought for sure he would get over this any minute. Then Thursday he was feeling a little better, but I checked in with the sitter all day because I didn't like the sound of his cough. She said he looked pale but he insisted he was feeling good. (Oh, by the way, he took a nap every day this week. !!! That is unheard of.) They went to the park, and when they got back, he was so exhausted he couldn't stand it. He wanted to call me, and he told me, "Mama, I'm in rough shape." :) I asked if he needed to go to the doctor, and he said yes. So I got him in that afternoon, and it turns out he has the FLU!!! Awww, poor kid! He got some tamiflu, and actually today he felt much better. I only saw him laying on the couch tonight. He kept saying things like, "It's getting late!" and "I'm I going to stay up all night?" Finally I said, "Do you want to go to bed?" and he said yes! That is just not right for a 4 year old. Now let's just all pray Georgia doesn't get it.
One more story. This evening we were all tired and it was getting near bedtime, and I was trying to just sit in my chair and check my email, but everytime I sat down, one of the kids or the dog wanted something. One would want a snack, then I'd sit down and then other would decide they wanted a snack too. Then when I sat down, one would remind me they needed a drink, then Maggie wanted to go out. Finally I said, "Oh, kids, you are wearing me out!" Nate said, "Mama, why don't you just sit on the couch and rest?" Hmm, I hadn't thought of that, thanks! Not 3 minutes later, Georgia was demanding to get down from her high chair, and when I got up, Nate scolded me, "Mama, I thought you were going to rest!"
But there's a big difference here. As a baby, Nate couldn't walk and was happy as a little puppy to just sit in my lap listening to stories for as long as I would read them. Up until recently, she couldn't sit still long enough to get through the shortest of baby board books. Usually at bedtime, I have been reading a few stories to Nate while Georgia wanders around his room looking for trouble, pulling books off his bookshelf, taking wipes out of the box, climbing on top of me, jumping on Nate's bed, etc.
| Who, me? |
Picture of a Girl=Baby!
Picture of a Boy=Nayyy! (Nate)
Shirt=Shut!
Pants=Shut!
Socks=Shocks!
Shoes=Shewwws!
Cup=Miwlk!
Ball=Baw!
Car=Caw!
Boat=Caw!
Teddy bear=Baby!
Banana=Nana!
Cat=PSSSSSSTTTTT!!!!! (Oh no, that's what she thinks a cat is called now, cause that's the noise I make every time our cat is around to get her to stop doing whatever annoying thing she is doing!)
Potty=Paw-ee
Dog=Doggy
Okay, great, so she is doing pretty well with all those first words! Now we move on to the animals ... we have a lot of work ahead of us, lol.
Penguin=Quack Quack
Rabbit=Doggy
Fish=Ish (we actually have fish, so that's why she knows that one)
Goat=Doggy
Butterfly=jumbled nonsense ... pretty sure she's trying to say butterfly
Zebra=Doggy
Lion=Doggy
Macaw=Quack Quack
Tiger=Doggy
Goose=Quack Quack
Kitten=PSSSSSSTTTT!!!
Pig=Doggy
Hen=Quack Quack
.... You get the idea.
Then there's another book about colors that shows a lot of different types of fruits. She calls some fruits (oranges, apples, blueberries) "baw" and all of the other fruits (pears, grapes) "nana". Still scratching my head on that one. But she cracks me up with the enthusiasm in which she answers with the wrong answer.
| Georgia also likes to dress up ... |
| All the time, with whatever she can find. |
| And whatever Nate is doing ... |
| Georgia does it too! |
Well, Georgia is not the only little bookworm in the house. Nate has always loved books, and we always read several before bed. About a year ago, I bought him some BOB books that help children learn to read. Uh, he was three. I was pushing it a little. So every few months I've brought them out for him to look at and see if he had any interest. Last month, he started getting it!!! Now he can read several of these Bob books, and when we pick up a new one, he needs a little help sounding out a few new words, but dude, he is reading!!!! I have a video of him reading an entire one of those books in like a minute, but I guess the video is too big to load on the blog. I'm so proud--I knew my little boy was smart. Reading at 4.5! (Listen, I haven't had too many chances to brag about how "advanced" Nate is in his short little life of therapies and motor delays, so just go with it.)
AND he can draw! This has been an area of major delay with Nate, but today he drew this awesome self-portrait--best I have ever seen from him! AND he can write his name! Okay, I'll stop now.
Anyway, Memaw knows just how much Nate and Georgia loves books, so when she last visited, she brought them a special Valentine's gift--a book that has her voice recorded reading it! Almost every night Nate has asked for Memaw to read him a book, so I bring it out. :) Georgia is very interested and a little confused at this. There's one part of the book where she whispers and then gets really loud, and Nate gets so excited about this part that he shakes and giggles every time.
Okay, in other non-reading news, Nate has been sick this week.
Monday evening he was very whiny ... like moaning and laying on the couch with Blake. When I got home, I saw he was running a fever. The next morning he still had a fever, so Blake and I tag teamed that day so the kids could stay home. Nate layed on the couch almost the entire day. On Wednesday he didn't have a fever, so I took him to the sitter's, but he was still very tired and clingy. I thought for sure he would get over this any minute. Then Thursday he was feeling a little better, but I checked in with the sitter all day because I didn't like the sound of his cough. She said he looked pale but he insisted he was feeling good. (Oh, by the way, he took a nap every day this week. !!! That is unheard of.) They went to the park, and when they got back, he was so exhausted he couldn't stand it. He wanted to call me, and he told me, "Mama, I'm in rough shape." :) I asked if he needed to go to the doctor, and he said yes. So I got him in that afternoon, and it turns out he has the FLU!!! Awww, poor kid! He got some tamiflu, and actually today he felt much better. I only saw him laying on the couch tonight. He kept saying things like, "It's getting late!" and "I'm I going to stay up all night?" Finally I said, "Do you want to go to bed?" and he said yes! That is just not right for a 4 year old. Now let's just all pray Georgia doesn't get it.
One more story. This evening we were all tired and it was getting near bedtime, and I was trying to just sit in my chair and check my email, but everytime I sat down, one of the kids or the dog wanted something. One would want a snack, then I'd sit down and then other would decide they wanted a snack too. Then when I sat down, one would remind me they needed a drink, then Maggie wanted to go out. Finally I said, "Oh, kids, you are wearing me out!" Nate said, "Mama, why don't you just sit on the couch and rest?" Hmm, I hadn't thought of that, thanks! Not 3 minutes later, Georgia was demanding to get down from her high chair, and when I got up, Nate scolded me, "Mama, I thought you were going to rest!"
Wednesday, February 9, 2011
My MOMS story
I was sitting at my desk today when I read that the results of the MOMS study had been released, and they've concluded that fetal surgery repair of Spina Bifida really does improve the outcome for babies who have SB. And not just the decreased risk for the shunt--also in mobility. This is huge. And all these memories and emotions came back from nearly five years ago when we first learned about MOMS.
It was the day after I received the diagnosis at 20 weeks gestation that my baby boy had Spina Bifida. I took the day off work and was on bedrest because I'd had an amnio the day before, but I knew even without medical advice I would have spent most of the day in bed anyway. I remember dragging myself out of bed to my computer to google Spina Bifida, then after a few minutes, crawling back into bed to cry some more. That's the day I decided on Nate's name--Nathaniel means "Gift from God"--and when I got brave enough to drag myself back to the computer, I stumbled across a picture of a little boy who has Spina Bifida holding a cane. Now I wish I remembered the boy's name, but all I remember was that he looked so healthy and "normal." I could deal with this picture. The caption said he'd had fetal surgery at Vanderbilt. HOPE! I found hope! There was something I could DO! This could help!
After some more internet searching, I found a phone number for Mary Dabrowiak at Vanderbilt. I acted as brave as I could and told her we wanted fetal surgery. She asked me when we got the diagnosis and I told her just yesterday. "Oh honey," she said. Then she explained that it wasn't that simple, that there was a study, and if we decided we wanted to join the study, there was still a 50% chance we would be randomized to postnatal. I contacted the MOMS study, and after three weeks of intense phone conversations with them, praying, worrying, and a few glitches that threatened to delay us, we arrived at Vanderbilt for our two-day consultation. I had to pack for what might be a two day stay or a four month stay. If we decided to do the surgery and were randomized to fetal surgery, there would be no time to go back home.
Nate and I had lots of tests--a fetal echochardiogram, several ultrasounds of the brain and spine, and an MRI--a first for me, and the first of many for Nate. But three conversations from those two days stand out the most to me, and they all occurred on the second day. That morning, we were scheduled to meet with Dr. Tulipan, the neurosurgeon who performs the surgery. I was so excited and hopeful to meet him, because he was a pioneer for fetal surgery for SB. Mary and Tracy gave us a vague warning to have questions prepared because he wasn't very talkative. So my first question was something to the effect of, "Will fetal surgery help our son?" Based on Nate's level of L2, he said that even with the fetal surgery, he would need a shunt and would be using a wheelchair by the time he was in high school. Well, I now understand that a shunt and wheelchair are not by any means the end of the world, but at the time, that's what it felt like. I cried the rest of the appointment while Blake tried to ask questions. All my hopes were crushed.
We also met with Dr. Walsh, the neonatologist. He was so kind, and unlike the others in the study who were so guarded and emphasized the risks so much that it seemed like they were talking you out of it, he expressed hope. He told us the risks of prematurity but that if I could make it to 32 weeks, the benefits of the surgery would outweigh the risks of prematurity. I held onto that.
And lastly we met with an ethitist. I'm still not quite sure what an ethitist actually does, but he was a lot like a psychologist. He asked us a lot of hard questions to make us fully think through this decision. The question I remember most was when he asked, "Why do you want to do this surgery?" When I said it was because I wanted to DO something--I couldn't stand the thought of just sitting around waiting--he said, "But what if this thing that you DO actually causes more harm than good?" Ouch. And that was a very good question.
Blake and I went back to our hotel, both of us so exhausted from all the emotions of the day. We had to make a decision that night whether we wanted to join the study. Blake was leaning toward not doing it. "Dr. Tulipan himself said it wouldn't help! Why would we put you and Nate at risk for something that won't help?" But I kept thinking, "But what if it WILL help?" Blake told me he would defer the decision to me. I needed some time alone to pray, so he left to get us some dinner. I prayed HARD--weeping, desperate prayer:
God, we have no idea what to do! This could help him, or it could hurt him or kill him. We can't see the future! How are we supposed to know which decision to make? Only you can see the future--please, show me what to do!
He was merciful and answered me quickly. "Let Me Decide." I didn't hear it audibly, but those are the words that came to me, on my mind and heart. And I felt such peace because I knew exactly what that meant. Join the study, and let God take over from there. I then remembered talking to my dad a couple weeks before about the uncertainty of being randomized, and he had said, "God controls computers too." I didn't cry any more that night. Blake and I felt total peace about the decision, because it wasn't our arbitrary decision that we might someday regret if something went wrong. The one who knows the future made the decision for us, and we trusted him.
The next morning, we sat in the room with the ethitist, Mary, and (I think) Dr. Yang (the head MOMS doc at the time). They asked if we had any questions. No. They asked if we wanted to join the study. We said yes. Are you sure? Yes. It was so surreal; two minutes later, we were across the hall at Mary's computer, and she pushed a button and then up popped the message that we were randomized to fetal surgery. I was not at all surprised. After about a minute, I asked where the bathroom was. Mary asked if I was going to be sick, and I told her no, just pregnant and have to go to the bathroom! It was so strange how calm we were about the whole process.
If you are interested in what happened after that, you can read Excerpts from my pregnancy journal here. But today, as the positive results of this study were announced in national media, I have thought so much about those days of uncertainty. Joining the study was a total leap of faith, and we have never regretted our decision. Not because it wasn't scary, because it was--when my water broke at 28 weeks, when he was born at 32 weeks, when he wouldn't wean off oxygen for what seemed like eternity, when he was forever sick as a baby. But we have never regretted it because we are positive that it's what God intended for us to do with Nate. Since Nate's birth, we've often wondered if the surgery really helped Nate or if this is how he would have functioned anyway. I have always given credit for him not needing a shunt to the fetal surgery, because that was a benefit that had been proven early on. Now they report that fetal surgeries babies are half as likely to need a shunt. As for the walking independently and functioning 4 levels below what he should (should be L2, functions as S1), I wasn't so sure if that was a result of the study or just the particulars of Nate's condition. But now the study reports that fetal surgery babies are more than twice as likely to be walking independently at 30 months. And Nate didn't even help that statistic because he was still walking in his walker when we went back for his 30 month assessment.
What's also interesting is that the study reports that only 15% of people who inquired about the study actually participated, either because they did not qualify for one reason or another or could not commit to the rigorous requirements demanded from the study. And now maybe more people will choose to participate if they qualify, but I truly believe that this is not for everyone. The prematurity risk is very real, and I can attest that it is serious and scary. And some people logistically just absolutely cannot pack up their entire lives for 6 months and go live near one of the hospitals. Especially those that have children--if I had to make this decision for my second child (not knowing what I know now), I'm not sure what I would have done.
I have hugged and kissed on Nate and told him I loved him tonight to the point that he started looking at me funny. I feel so grateful that we were a small part of a historically important medical study that could fundamentally change the future of Spina bifida. I'm indescribably grateful that it made a difference for him. And the whole experience of being at that place of brokenness and finding hope and relying on God was a defining moment in my life that changed everything. (Take THAT, Dr. Tulipan!)
It was the day after I received the diagnosis at 20 weeks gestation that my baby boy had Spina Bifida. I took the day off work and was on bedrest because I'd had an amnio the day before, but I knew even without medical advice I would have spent most of the day in bed anyway. I remember dragging myself out of bed to my computer to google Spina Bifida, then after a few minutes, crawling back into bed to cry some more. That's the day I decided on Nate's name--Nathaniel means "Gift from God"--and when I got brave enough to drag myself back to the computer, I stumbled across a picture of a little boy who has Spina Bifida holding a cane. Now I wish I remembered the boy's name, but all I remember was that he looked so healthy and "normal." I could deal with this picture. The caption said he'd had fetal surgery at Vanderbilt. HOPE! I found hope! There was something I could DO! This could help!
After some more internet searching, I found a phone number for Mary Dabrowiak at Vanderbilt. I acted as brave as I could and told her we wanted fetal surgery. She asked me when we got the diagnosis and I told her just yesterday. "Oh honey," she said. Then she explained that it wasn't that simple, that there was a study, and if we decided we wanted to join the study, there was still a 50% chance we would be randomized to postnatal. I contacted the MOMS study, and after three weeks of intense phone conversations with them, praying, worrying, and a few glitches that threatened to delay us, we arrived at Vanderbilt for our two-day consultation. I had to pack for what might be a two day stay or a four month stay. If we decided to do the surgery and were randomized to fetal surgery, there would be no time to go back home.
Nate and I had lots of tests--a fetal echochardiogram, several ultrasounds of the brain and spine, and an MRI--a first for me, and the first of many for Nate. But three conversations from those two days stand out the most to me, and they all occurred on the second day. That morning, we were scheduled to meet with Dr. Tulipan, the neurosurgeon who performs the surgery. I was so excited and hopeful to meet him, because he was a pioneer for fetal surgery for SB. Mary and Tracy gave us a vague warning to have questions prepared because he wasn't very talkative. So my first question was something to the effect of, "Will fetal surgery help our son?" Based on Nate's level of L2, he said that even with the fetal surgery, he would need a shunt and would be using a wheelchair by the time he was in high school. Well, I now understand that a shunt and wheelchair are not by any means the end of the world, but at the time, that's what it felt like. I cried the rest of the appointment while Blake tried to ask questions. All my hopes were crushed.
We also met with Dr. Walsh, the neonatologist. He was so kind, and unlike the others in the study who were so guarded and emphasized the risks so much that it seemed like they were talking you out of it, he expressed hope. He told us the risks of prematurity but that if I could make it to 32 weeks, the benefits of the surgery would outweigh the risks of prematurity. I held onto that.
And lastly we met with an ethitist. I'm still not quite sure what an ethitist actually does, but he was a lot like a psychologist. He asked us a lot of hard questions to make us fully think through this decision. The question I remember most was when he asked, "Why do you want to do this surgery?" When I said it was because I wanted to DO something--I couldn't stand the thought of just sitting around waiting--he said, "But what if this thing that you DO actually causes more harm than good?" Ouch. And that was a very good question.
Blake and I went back to our hotel, both of us so exhausted from all the emotions of the day. We had to make a decision that night whether we wanted to join the study. Blake was leaning toward not doing it. "Dr. Tulipan himself said it wouldn't help! Why would we put you and Nate at risk for something that won't help?" But I kept thinking, "But what if it WILL help?" Blake told me he would defer the decision to me. I needed some time alone to pray, so he left to get us some dinner. I prayed HARD--weeping, desperate prayer:
God, we have no idea what to do! This could help him, or it could hurt him or kill him. We can't see the future! How are we supposed to know which decision to make? Only you can see the future--please, show me what to do!
He was merciful and answered me quickly. "Let Me Decide." I didn't hear it audibly, but those are the words that came to me, on my mind and heart. And I felt such peace because I knew exactly what that meant. Join the study, and let God take over from there. I then remembered talking to my dad a couple weeks before about the uncertainty of being randomized, and he had said, "God controls computers too." I didn't cry any more that night. Blake and I felt total peace about the decision, because it wasn't our arbitrary decision that we might someday regret if something went wrong. The one who knows the future made the decision for us, and we trusted him.
The next morning, we sat in the room with the ethitist, Mary, and (I think) Dr. Yang (the head MOMS doc at the time). They asked if we had any questions. No. They asked if we wanted to join the study. We said yes. Are you sure? Yes. It was so surreal; two minutes later, we were across the hall at Mary's computer, and she pushed a button and then up popped the message that we were randomized to fetal surgery. I was not at all surprised. After about a minute, I asked where the bathroom was. Mary asked if I was going to be sick, and I told her no, just pregnant and have to go to the bathroom! It was so strange how calm we were about the whole process.
If you are interested in what happened after that, you can read Excerpts from my pregnancy journal here. But today, as the positive results of this study were announced in national media, I have thought so much about those days of uncertainty. Joining the study was a total leap of faith, and we have never regretted our decision. Not because it wasn't scary, because it was--when my water broke at 28 weeks, when he was born at 32 weeks, when he wouldn't wean off oxygen for what seemed like eternity, when he was forever sick as a baby. But we have never regretted it because we are positive that it's what God intended for us to do with Nate. Since Nate's birth, we've often wondered if the surgery really helped Nate or if this is how he would have functioned anyway. I have always given credit for him not needing a shunt to the fetal surgery, because that was a benefit that had been proven early on. Now they report that fetal surgeries babies are half as likely to need a shunt. As for the walking independently and functioning 4 levels below what he should (should be L2, functions as S1), I wasn't so sure if that was a result of the study or just the particulars of Nate's condition. But now the study reports that fetal surgery babies are more than twice as likely to be walking independently at 30 months. And Nate didn't even help that statistic because he was still walking in his walker when we went back for his 30 month assessment.
What's also interesting is that the study reports that only 15% of people who inquired about the study actually participated, either because they did not qualify for one reason or another or could not commit to the rigorous requirements demanded from the study. And now maybe more people will choose to participate if they qualify, but I truly believe that this is not for everyone. The prematurity risk is very real, and I can attest that it is serious and scary. And some people logistically just absolutely cannot pack up their entire lives for 6 months and go live near one of the hospitals. Especially those that have children--if I had to make this decision for my second child (not knowing what I know now), I'm not sure what I would have done.
I have hugged and kissed on Nate and told him I loved him tonight to the point that he started looking at me funny. I feel so grateful that we were a small part of a historically important medical study that could fundamentally change the future of Spina bifida. I'm indescribably grateful that it made a difference for him. And the whole experience of being at that place of brokenness and finding hope and relying on God was a defining moment in my life that changed everything. (Take THAT, Dr. Tulipan!)
Sunday, February 6, 2011
Nate and Georgia and the train show
The Great Train Expo is something that Nate (and let's be honest, Blake too) looks forward to all year long. This is our 3rd year going. Just a few days ago I thought about it and wondered if we had missed it, and when I searched for it online, I saw it was this weekend. I texted Blake: "Great Train Expo this weekend!!!!" He texted back: "I'm so in!" We are dorks. We didn't say anything about it to Nate, but on Friday night a commercial about it came on TV, and Nate got all excited and asked if we could go. Sure! :) From then on, he called it, "The new train show I sawed on TV." If we referred to it by anything else, he corrected us. He was so proud that he thought he was the one who found it.
Today was a very big day. Nate wanted to go to "The new train show I sawed on TV" first thing, but we insisted on church first. As soon as we got to church, we found a problem. Georgia's new shoes were too big on her. To be more exact, one of her shoes was too big. Her feet are different sizes. The one shoe kept falling off, and there was no way she could walk in them. Once we got into church, I took her shoes off and she trotted around with just her tights over her feet. But I knew this would create a problem later. Anyway, it was a great service, and both kids had a great time at church. Georgia is getting to the point where when its time to hand her over to the nursery worker, she actually reaches for them instead of screaming! Wow! And Nate always tells us about the Bible story he learned about and we usually catch him singing a song he learned in chapel.
Anyway, the plan was to go straight from church to "The new train show I sawed on TV" but Georgia's shoe issue created a problem. There's no way we were going to be able to keep her in the stroller the whole time, and I didn't like Blake's idea of letting her walk around the convention center without shoes. But Blake and Nate did not want to waste any train time by going back home to get shoes, so I told Blake he could be the one to deal with a cranky Georgia the whole time. :)
Nate was so excited, he ran the whole way from the car to the show.
Dressed for the occasion.
At one of the layouts, Nate asked the operator, "So, what guage is this train?" The guy said, "This is N-scale." Nate: "Oh, okay." Ha!
At this point, Georgia was still hanging out in the stroller.
Miraculously, I saw a guy selling baby shoes. Shoes! At a train show! Well, they were baby squeaky shoes that had a train on them. I asked if he had any girl shoes, and he pulled out several boxes of pink squeaky shoes! Squeaky, you ask? Yes, every step she takes, they squeak ... intentionally. She was so proud of these shoes. She walked slowly, took big steps, ran ... they all made different sounds. Everyone she squeaked past commented on her squeaky shoes. And yes, after awhile they were somewhat annoying, but she absolutely loves them. And I was happy that she could finally get down and run around and enjoy herself! Look how cute, her saying, "Cheeeeeese!"
Here's the video of trotting while squeaking. (For those seeing this on email or facebook, click here to see video.)
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