Saturday, April 30, 2011

I should be writing thank you notes!

I sat down with the purpose of writing thank you notes, but thought I'd take a minute (or two) to update on the Smith family that is VERY SOON to be a family of four.

Luker-duke: I think we're headed in the right direction with this boy's cough. I couldn't tell you if it was the Azithromycin or time, but his sparkle is coming back a bit. His energy is coming back a bit and blessedly, he didn't cough one time last night. This bug seems to be moving from his chest back to his nose. Yesterday and today, his nose is pretty gunky, but I think we all prefer that over the cough. His voice is still raspy, but it is stronger than it has been. There were a couple of days when I wanted to retract my "oh-his-voice-is-so-sweet" blog comment ... it was like a constant whine. But it has since transitioned back to being cute =)

We are gearing up for Luke's next big cardiology check-up on May 11, and as always, we covet and cherish your prayers for Luke's heart health and for Dr. Stefanelli's wisdom as we await the Fontan.

Baby girl: She is definitely (and literally!) headed in the right direction. At my OB appointment on Wednesday, she was low, head down, at I'm dilated to a 1-2 (I have so often wondered why we women can't dilate all the way to 10 this way!). I am having tons of Braxton-Hicks contractions and getting more uncomfortable by the day. Her movements are so strong and as much as I remember Luke being incredibly active, I don't remember some of his kicks feeling like sucker punches! I'm okay with that as long as sweet girl is happy in there! I can't believe I'm 37 weeks. I can't believe that I need to get my bags packed. I really need to get my bags packed.

Luke definitely can sense this little one is nearing her arrival. For a few weeks now, he has been super clingy and nowhere near as independent as he has been in the past (I'm sure part of this has been him feeling under the weather for so long). He is constantly checking in with me and Rog ("Mom? Dad? Where are you?") and will often bring his activity to whatever room I'm in. He even has balked at going to preschool this past week, which he hasn't done in months. Because he's four, I'm assuming that he understands that big change is upon us, but can't quite verbalize what he's feeling. And as much as everyone around him pumps up how cool it will be to be a big brother, it is still change. And one thing we do know about Luke is that he is not the most laid-back kid when it comes to change. He needs lots of explanation and lots of affirmation. He is also needing a bit more discipline these days. He's not in my favorite phase he's ever been in, but we keep reminding ourselves to extend grace as well as consistent discipline. The thing about kids is that they are so smart. I know he knows I'm not at the top of my game, so he's going to push me more than usual.

Did you moms with older children see this type of behavior BEFORE the baby was born? I didn't expect it until after!

Luke found a picture the other day of his "birth" day. It captured him the moment he came out and of course, there was some blood covering him. He was looking through pictures and brought this one to me. "Is this blood, Mom?" I explained that it wasn't blood from an owie, but that he had just come out of my tummy and they hadn't cleaned him up yet. I then showed him the next series of pictures where he was all clean. He took the "bloody" one back and opened one of our kitchen drawers. "I'm just going to put this one riiight here."

Maybe no med school in his future??

If not, he can always fall back on cute school:

Friday, April 22, 2011

As I was just about to exhale

We've been off the second round of Amoxicillin for 4 days and I thought we were in the clear. But what do you know, Luke woke up coughing this morning, along with a runny nose and hoarse voice. I honestly couldn't believe it. Everyone warned us about the first year of preschool, but I didn't expect these consecutive illnesses to happen in the spring!

Being Friday and not wanting to frequent Convenience Care again this weekend, I took Luke in to the peds office this afternoon. We saw a new doc and I really liked him. He was so thorough and I felt like he actually read through Luke's chart and recent history before he came in to examine him. He knew we had seen Dr. Stefanelli last week, knew about our recent E.R. visit and what the doc before had diagnosed.

He agreed that what Luke is fighting is probably multi-factorial. Could possibly be some allergy stuff going on, but could also possibly be a bacteria going around called a microplasma. This bug affects the upper respiratory system, but left untreated, can cause pnuemonia. With Luke's heart condition, he wanted to err on the side of caution and start Luke on a stronger antibiotic, Azithrimycin. So back to our pharmacy we went and we'll start Luke's 5-day course tonight. He also wants us to start an over the counter antihistamine.

I know we've been lucky with how healthy Luke has been overall these past years, so this is just very different for us, to have back-to-back-to-back sicknesses. You heart mamas may understand when I say my mind automatically went to the health of Luke's heart. Is Luke's heart function to blame for not being able to kick these bugs? Is this in any way cardiac-related?

So I did what I always tell newer heart parents to do: ASK! If it will give you piece of mind, ask the questions. So I called our beloved cardiologist and his response definitely put my heart and mind at ease: "I am confident this is not related to Luke's heart. In fact, Luke is in a prime position to get sick and build up antibodies right now. As frustrating as this is, it's actually a good thing for Luke's immune system."

Bleh. Good thing or not, I don't like it!

Okay, one thing I do like, since I am trying to look for the good in all situations: his raspy voice is about the sweetest thing I've ever heard.

Monday, April 11, 2011

Fish friend

We BBQ'd Luke's catch last night for dinner and I wasn't sure how Luke would feel about eating his buddy he liked to visit out in the fridge. Things didn't look promising when Rog was seasoning the fish and Luke said, "I think I miss his face."

But unlike his mom, Luke loves to eat fish and he clearly got over any qualms he had about eating his catch!

Sunday, April 10, 2011

Gone Fishin'

After three doses of Amoxicillin, our little man was feeling up to his planned fishing adventure today. The 7th Annual Kids Fishing Derby would see in attendance Luke, Papa Bill and Nana Tutu. This trio has never been fishing before ... Should we chalk it up to beginner's luck, or undiscovered skill?

Luke managed to haul in a 6 pound 13 ounce trout to take home, along with a "Big Fish Award" trophy!

Rog would tell you Luke and Papa's success was due undoubtedly to the intense casting and reeling practice (see how I throw those words around like I know what I'm talking about?) held this morning in our driveway before the Derby.

Whatever the reason for the big catch, it was a great day with minimal coughing!

Papa Bill showing Luke how real fishermen do it. My dad is such a pro, in fact, that you can see the tackle box is actually Luke's plastic toolbox.
Love the tongue action

A nice man helped my dad and Luke net the fish so it wouldn't be the one to "get away".

The pride (on both of their faces!)

My stepmom said Luke didn't let go of his catch in the garbage bag the rest of the event. He even dragged it all the way back to the car.

That is one big fish! We told him that's about how big sister is going to be when she is born!

Friday, April 8, 2011

The remodel is nice, but it's still the E.R.

Our pediatrician feels like if Luke is fighting a sinus infection (most likely reason for his symptoms), his course of antibiotics wasn't long enough and put us on another 10-day course of Amoxicillin. Let's pray this round kicks some virus booty. I am tired of Luke not feeling very good, and I know he is too!


Almost four years after our last stint in the E.R., we were back on Wednesday night. Remember the endless coughing I posted about earlier? Well, that had seemed to clear with a 10-day course of Amoxicillan. We finished his last dose Monday night and by Tuesday, his cough had started to come back slowly but surely. Tuesday night we heard it intermittently through the night, but figured it was just residue from his upper respiratory infection. Wednesday afternoon, Luke seemed a bit off to me, but again, I didn't give it too much thought. We put him to bed Wednesday night and within 30 minutes, he had woken himself up with a giant coughing spell, resulting in a vomiting spell with lots of mucus. After we showered, Roger and I felt like if he needed a stronger antibiotic, or a longer course, we should get that going as soon as possible, so we headed to our Puyallup Convenience Care clinic around 8:45pm. We also feel like whenever a cough is involved, we want Luke's chest listened to as much as possible.

What we thought would be a quick listen, sat check and prescription turned in to a 4 hour visit to the (beautifully remodeled!) E.R. The doc at convenience care heard crackling in Luke's lower lungs and felt very strongly that we needed a chest x-ray. "Okay, we will call our cardiologist and he will probably order us a chest x-ray for the morning." The doctor obviously didn't like this plan and proceeded to tell us that we needed to get to the E.R. tonight and did we know this could be a possible symptom of congestive heart failure? Now there was no part of us, knowing our son the way we do, that thought these symptoms were cardiac related, but when an M.D. is telling you to drive straight to the E.R., you drive straight to the E.R.

After a few minutes of computer games and a few Sun Chips, we were called back to the intake room, where again Luke was hooked up to a sat probe (low for Luke at 74), his chest was listened to (sounded clear to this nurse) and his temperature taken (normal). We were sent back out to the waiting room where we checked out the fish tanks before we were called back to our room, where you guessed it, Luke's sat's were checked again and another nurse listened to Luke (she couldn't hear any crackling or wheezing either). Everything was moving so quickly, we thought this might be the quickest E.R. visit in history, but then the waiting began.

A lot of time was spent on this magnet game:

And even more time was spent taking pictures with my phone:

Finally, the x-ray tech came to take Luke and Daddy to the torture chamber. This truly was the only part of the night that brought Luke to tears. He was such a superstar for the time of night it was and for how many people needed to touch him. I was so, so proud of him and I couldn't help but think of the healing that God has worked on his emotional heart. I feared for a long time after his surgeries that Luke would always deal with doctor anxiety, but as long as you assure him there won't be any shots, he does really well, even with doctors he doesn't know.

Luke and Rog came back to the room around 10:45 and we didn't see the doc with the results until about 12:30am. This doc, along with the radiologist, both declared Luke's lungs to be clear and even though his sats were running low (anywhere from 74-80 throughout the night), the doctor felt really comfortable sending us home, seeing his color looked good, he wasn't laboring to breathe, etc. But first she needed to confirm with the cardiologist on call that they were comfortable with those sats. So we waited a bit longer to get the final "go home". Luke must have heard us talking about how nice the rooms were compared to the old E.R. because when we were starting to check out he said, "I think I want to stay here. The rooms are just so beautiful!" Love this kid. This enthusiasm was after two hours spent fielding the "When can we get outta here?" question.

Four hours in the E.R. and we headed home (after saying goodbye to the fish) with a diagnosis of an upper respiratory infection and instructions to follow up with our pediatrician in the next day or two.

Yesterday, I called Dr. Obayashi (the cardiologist who was on-call Wednesday night) to ask him if he could take a look at Luke's x-ray and possibly compare it to his last couple. He called back and told me that his Wednesday x-ray was beautiful and was unchanged from his last four chest x-rays.

Lesson re-learned: Pediatricians who don't know Luke will always err on the extreme side of caution. I'm not angry at this doc (well, I was, but I've worked through that =), this is just part of having a child with a complex CHD. She did what she felt was right and we were glad, even after the fact, even at 1:30 am when we were driving home, that we went to the hospital that night.

And Luke? He calls it our big adventure and he's pretty proud that he stayed up, "almost til morning!" He is such an aware kid who doesn't want to miss anything. Of course he couldn't fall asleep in the E.R. but fell asleep within two minutes of being in the car.

Luke is still coughing a bit and we will follow up with his pediatrician today and his cardiologist next Wednesday. I'm hoping the pediatrician will have some ideas on why this is hanging on so long and if there's anything we can give him. I promise you, I will not shed one tear when this cold and flu season is finally over.