Tuesday, July 27, 2010

Health Update

Noah's recent blood tests revealed he does NOT have Celiac or CMV. YAY! We still have to do his stool sample and a follow up panel in 6 weeks but we are that much closer to solving the mystery of Noah's chronic diarrhea.

But it has been confirmed that he does NOT manage his body temp. He doesn't seem to have a hard time making heat (and staying warm in cold temps) but he can't get rid of heat. This causes his internal body temp to raise when he is in hot temps. For example, he was outside in the shade just walking around, nothing strenuous, when it was about 85* outside. After an hour, he seemed really warm and when I checked his temp it was 100*. Normally he is about 97* when playing inside.

So we have to do more tests and possibly see a Neurologist to figure out what the cause of this might be. He will also need to have restrictions on how long he can be outside or in hot conditions. I also need to get him a cooling blanket and other tools to help keep him cold.

If you have any idea where I can get a medical cooling blanket please let me know. My initial searches online have not been fruitful.


It Was Our Home Away From Home

This is a video that shows the magic of The Ronald McDonald House's in Denver.


Wednesday, July 7, 2010

How We Got Here

We've come a long way in the past three years. Today Noah is a spunky three year old who loves to throw balls, jump on the tramp, swing for hours, and watch Curious George. He loves his Nanny and Poppy and asks to go to their house every single day. There were many times since he was born when I wondered if we would ever get to this point though.

I had been induced 4 weeks early due to some worrisome results after a stress test. It was suspected that preeclampsia was causing my placenta to shut down. What started out as a normal induction quickly became serious when Noah wasn't getting enough oxygen. I was put on oxygen and told to lay on my side and when that didn't help the room was filled with Dr's and nurses within minutes and I was told that I had to push him out now, even though I was only dilated to an 8 or I would have to have an emergency c-section. I pushed him out in just a few pushes and I thought all was well because they let me hold him for several minutes. What came next was a whirlwind.  I can still remember going into the nursery to see Noah for the first time after he was born and seeing the Neonatologist, from the children's hospital next door, listening to his heart. "Your son has a heart murmur and its not the normal kind of heart murmur. We are going to take him over to Primarys and run some tests. Don't worry Mom. We'll take good care of him." Then I watched as the Life Flight team wheeled him away. That night, after many tests, Noah was diagnosed with Critical Aortic Stenosis. The next day specialist tried ballooning his aortic valve and when that didn't work we waited to find out if any doctors would agree to perform a Ross-Konno procedure. No one would.

Noah was very sick. His Billirubin level was lethally high, his oxygen level low, and the pressure in his lungs climbing every minute. My grandparents came to see him one day while Shane and I were meeting with the Doctors. The nurses told them that he was one very sick little boy.

One day a Fellow assigned to Noah's case informed us in passing that there was nothing left to be done, they were out of options. He gave us the impression that we would have to let our son die. We were devastated. We rushed to the waiting room where my family was and cried in each others arms. Soon after we met with the Attending Cardiologist who gave us another option. Noah would need a Heart Transplant to live.

The Transplant Cardiologist at Primary Children's Hospital had transferred to Pittsburgh the Friday after Noah was born, leaving the transplant program at Primary's on hold. If we wanted to try and get Noah a new heart we would have to go to a hospital out of state to get it. We were given two options to choose from. We could either go to Loma Linda in California or to Denver, Co. I called around and talked with their on-call transplant coordinators, I even spoke with a local family whose son had a heart transplant at Loma Linda. I did research online and everything we saw said Loma Linda. We tentatively made up our minds that we would go to California. The next day we sat in a secluded corner of the hospital and prayed together. the most overwhelming feeling came over us that we should go to Denver. We went over it again; Denver was harder to get to, rougher weather if we had to travel in the winter, we had never been there and they hadn't been doing pediatric heart transplants as long as Loma Linda. But when I had called the transplant coordinator, Alison, had been so much kinder and was more helpful. They had less babies waiting with the same criteria and most of all, it felt right. We rushed back to the NICU and told them we were going to Denver.

We quickly packed up some stuff and drove through the night to meet up with Noah who went ahead of us by Leer Jet transport. We met with the Transplant Coordinators and got the necessary testing finished up to get Noah put on the UNOS waiting list. The next twelve days were so hard. Noah wasn't doing well and he had some complications. He was so sick that we were given a few other options than just a "routine transplant". He was also listed as ABO Incompatible, meaning that instead of only being able to get a heart with his blood type, he was sick enough and young enough to be able to get a heart with any blood type. TCH was also part of a study that allowed them to offer DCD (death by cardiac donation). Then, on Thursday July 5th Noah had a Heart Cath to put in a stent and even possibly have a Hybrid. The process was long and took a lot out of Noah.  I was so worried and lonely that I called Shane and asked him to come out that weekend even though his next planned visit was a week away.

Back in the CICU Noah was headed down hill. His tummy was swelling, his vitals were bad and he was losing strength. I knew we didn't have much time.

Friday came without much progress. Everyone was worried and all we could do was wait. I spent the day at the hospital then headed back to the Ronald McDonald House to pump and eat dinner before heading to the airport to pick up Shane. I was sitting on the floor against the door of our little room, pumping, with my phone on one side and the pager from the transplant team on the other when my phone rang. It was Alison, she had come back on call that morning for the first time since we had arrived. Noah was getting a heart.

It was divine intervention that made it possible for Shane to be there that night. I know without a doubt that I was prompted to have him come when it wasn't in the plans. I am so grateful for that. Noah went into surgery at 8:30 am on July 7th, 2007. I waited in a private family room while Shane waited at the Ronald McDonald House with Lilly. Alison gave me updates every hour. I was surprisingly calm. I tried really hard not to think about what was happening and I felt strengthened with a strength beyond my own as I did the entire time I was in Denver. At 3:55pm I was brought into the CICU to see Noah for the first time with his new heart.

He had the corner bed and every space was busy with someone doing something. Dr. Campbell paced at the foot of his bed whistling "Downtown" by Patsy Cline the entire time. His tubes were draining and the pacer leads were keeping his heart beating while he was drugged and sedated. I had been warned about what he would look like when he came out after the transplant. I expected to see all the wires, and tubes, and the incision down his chest. I was glad I had been prepared, it made it a bit easier but at the same time, it was so awful.

It took Noah a long time to recover enough to be transferred out of the CICU (Cardiac Intensive Care Unit)  to the CPCU (Cardiac Progress Care Unit). I knew it would since he had been so sick before. When the day came, I was scared. A new set of nurses and Doctors who were taking care of several patients at once. He wouldn't have one on one care anymore and because I had Lilly at the RMH with me, I couldn't stay at the hospital night and day. Luckily we were blessed with many loving nurses who took very good care of Noah and when I wasn't there and they couldn't hold him there were many volunteers who came and loved on him.

Noah was finally released toward the end of July. I brought him over to the RMH on a Friday morning and we celebrated Lilly's 2nd birthday. By Sunday he was screaming not stop. When I took him back on Monday for his first clinic appointment I could tell Alison was not pleased. It was decided to readmit him. He was put back on IV antibiotics for a suspected infection of his incision. He was having a lot of ectopy (missed heart beats, fast heart beats, etc.) One day while I was holding him his heart rate spiked. A nurse rushed in but it had returned to normal. A few moments later, he went into Vtac. His heart rate spiked to almost 300 bpm. The CICU team was called up and when several different tricks to return him to a normal sinus rhythm failed, he was given a drug to stop his heart. After a few days back in the CPCU, his nurse Ben reported his color off and a low crit level so a blood transfusion was started. That night I received a call about 3am. Ben was calling to tell me Noah had a bad reaction and was taken back to the CICU.

When I got there the next morning nothing could have prepared me for what I saw. Noah was back in the same bed he was in when we first came to Denver. He was on the ventilator and was swollen and red from head to toe. The Dr was digging around in his arm to get a central line and it wasn't working. His lungs were filled with fluid and he had hives inside and out. He was dying.

He ended up having a lung collapse twice and after a few days of no answers he was taken to the cath lab to take some biopsies and check for rejection. What they found was that Noah's blood pressure was dangerously high. Too high for even an adult. He was being taken down to get an MRI of his brain. Dr. Pietra told me that with pressures that high he would be surprised if there wasn't a brain bleed.

That wait was awful. Noah had already been through so much and had come so far... I felt sickly composed on the outside and frightfully out of control on the inside. Much to everyones surprise, the scan came back normal. The next day it was decided to treat Noah as if he was having rejection. The high dose steroid would also help the suspected TRALI (Transfusion Related Acute Lung Injury) that was attacking his lungs. He slowly began to improve.

The ectopy improved and his blood pressure went down and eventually he was released again. Once he was off all the sedation he did cry... a lot. I had to give him large doses of Benedryl to knock him out every single day. He also had really strange diarrhea. Other than that, he was doing well. We continued clinic appointments several times a week and counted off the days until we could go home. Shane visited every other weekend and my parents and sisters even came out to see us once. While they were visiting Noah almost had to go in for another cath to check for and repair a suspect CoArch of the Aorta. The pulses in his feet were faint and at one clinic appointment with another coordinator they couldn't be felt at all. I was so nervous I was nutty. The day of decision I took Noah up to the CPCU to find Dr. Pietra so he could feel for a pulse and make the decision. He grabbed his foot and called off the cath.

The day finally came when we were discharged and sent home to Salt Lake. Now that the day had come I was scared. But it was time. I arranged for enough oxygen canisters to get us through the 8+ hours of driving and I packed up the room that had been home for the past 4 months. We brought Noah home for the first time on October 30th, 2007.

Over the next few months we adjusted to home life again and tried to find a new routine. It was much more difficult that I would have expected. But we were finally together as a family and having Shane in the same house was all Lilly and I needed. Being apart was so much worse than I can even describe.

Noah had lots of clinic appointments and continued to do well other than his strange poop and crying fits. One day he pooped white curds and after several ER visits and insisting on seeing a surgeon we finally figured out what was going on. Noah had gall-stones. He went in for surgery on December 10th to have his gall-bladder removed and his appendix taken out (since Shane had his taken out it was a precautionary measure).  I saw his gall-bladder after, it was about the size of 3 M&Ms and the 3 stones filled it to capacity. It was scarred and shriveled and it was a good thing it was removed. While his diarrhea has never gotten better, he did stop screaming and has never had white poop again.

It was sometime after his last surgery that things started to calm down. We found a routine and eventually life went on. It took a long time for me to deal with all of the buried emotions I had been suppressing. They expressed themselves in the form of panic attacks and eventually took a physical tole on me. But through faith and prayer and many several spiritual experiences I have worked through the trauma. And here we are, three years post transplant. We go to clinic every 4 months, sooner if he gets sick. He is active and lively and preparing for preschool in the fall. His speech is getting better and he is learning to express himself. He's growing and learning and loving and living life. Many people and all of his doctors always say you could never guess he had a heart transplant by looking at him.

The road has been rough but he made it through. And while there are days where he wears me out and in true three year old fashion tries my patience, I am so very grateful for every single moment of every single day.

Monday, July 5, 2010

Noah's Transplant Story

Originally posted July 11, 2007

Thursday July 5th, Noah went to the cath lab to have a stent put into his atrial septum (the hole in between the left and right side of the heart). His heart was so swollen from the increased pressure, the Drs were hoping to relieve some of the pressure and help it shrink down (I saw the x-ray, his left side was SO big it touched the far side of his ribs completely collapsing his lung). As I sat in the Surgery waiting area, I felt so lonely. I saw all these other families waiting for updates on their loved ones. They had each other to talk to and help distract them. I don't think I have ever felt so lonely in my entire life. Then I had a thought. Shane wasn't scheduled to come out for another week because he couldn't take time off work. But it just so happened he had Saturday off anyways. I decided he needed to come out this weekend, regardless if the ticket was more money since it was short notice. He needed to be here. I called him and convinced him to come. I used the hospitals computer and bought him a ticket.

Noah's surgery took over 7 hours and when they were done, Noah was very sick. Over the next night, his stomach began swelling. By the next morning, the Drs were concerned that his bowls would rupture. He needed a heart so badly. The procedure had just taken so much out of him. It was suppose to help make him last longer in case a donor wasn't available for a while but it made him much sicker. I left the hospital scared but with renewed strength knowing I would see Shane in a few hours and that would help me be strong.
I went back to our room at the Ronald McDonald house to get dinner. My phone rang at 5:18 pm. It was the hospital. When I answered it, it was Allison the Transplant Coordinator. When she told me that, the thought came to me... "Do you have any idea what you do to me when you call???" She sounded very reserved and almost preoccupied. Then she said the last thing I expected to hear. "We may have a potential Donor for Noah." I was so shocked I think I actually asked her if she was serious. She told me it takes a while to work this sort of thing out so there was no rush. To go get Shane from the airport and then come on over. I hung up the phone. I looked and Jen and she asked me if he got a heart. All I could do was nod and then I started to cry. My baby was getting a new heart!!

I called Shane. He was on his way to the airport. When he answered I told him we got the call. He didn't understand what I meant. All he knew was that I was crying. He panicked and asked me what was wrong. I told him... WE HAVE A HEART!!!

We got to the hospital about 10. Around midnight, they figured it would still be a while so they told us to go try and get some rest. We came back to the room and while we were laying down, Lilly woke up and saw her Dad. She then stayed awake for the next 3 hours. She finally fell asleep and then the hospital called and said to come back around 4am. He was suppose to go in about 5:30am but it kept getting postponed. We could never find out if they had actually seen the heart or if there was a possibility it could get called off. Around 8am, we heard they still hadn't seen it then 5 minutes later, they had and were on their way. Talk about a Roller coaster!!
Noah was wheeled into the operating room at 8:30 am. We waited in a family room and the transplant coordinator came and gave us updates every hour.

He did really well and we got to see him at 3:55 pm. He looked so sick. So many drainage tubes and wires. But here was our baby with a NEW heart!

He has had his new heart for 5 days now. He's doing about as expected. He was so sick before that now that he has a healthy heart, we have to wait for the other things to heal (like his lungs and his stomach) and wait for the heart to recover from being cold for so long. The Drs are confident that he will start making major progress within the next few days and he'll be released to the Ronald McDonald house soon. Then, if we don't have any rejection episodes, we will get to go home to Salt Lake in October.
I am so thankful my little man has a new healthy heart and that Shane was here when he got it. I am thankful for all the prayers and faith on his behalf that got us this far. And I am eternally grateful to our Donor Family and difficult decision they made to help save my baby's life. This past month has been a very surprising rocky experience. One I never would have imagined that I would experience. But it has strengthened my faith and enriched my gratitude. And when Noah grows up, I will forever tell him the story of how he was in the prayers of so many and received the greatest gift ever before he was even one month old.
Happy Birthday Noah!! Your first month has been so tough. But your strength has taught your mommy so much and you have already made my world a better place. I love you so very much sweetheart and I can't not wait to hold you and kiss you and give you all the love you deserve.

1 Month old and a new heart! You truly are my miracle!

Minutes after Noah was born. This was the first time I ever got to hold him.

Only a few days old.

While at Primary's we weren't allowed to hold him or disturb him.

When he got to Denver the first thing they did was let me hold him.

He had only been in Denver a few days; he was so strong.

Several days after getting his new heart. The drainage tubes had already been taken out and his color was looking so much better.


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