Sunday, October 14, 2007

A lot to be thankful for

Sorry to those dedicated bloggers that are frustrated with us for not posting an update last night. Brayden was here and we wanted to give him our undivided attention. Believe me we've already heard about it from several people.

So, about Ava's progress... She is doing well. Yesterday her heart rate was all over the place. Meaning that it would bounce from the 150 range to the 230 range within a matter of seconds. This was only moderately concerning to the cardiac staff. They knew that if it continued they could just put her on a rhythmic medication to regulate it if they needed to. We are learning that there is a drug to fix almost everything at U of M. However, when they went to give it to Ava she broke out in a rash and they assumed she was allergic. A little Benadryl took care of the rash and they decided to just watch the heart rate overnight. It seems that with Ava she often just needs more time of "watching and waiting". This morning her heart rate was back to normal! What do you know?

They also "sprinted" her (took her off the ventilator) yesterday four different times for an hour at a time. They also did it twice today. She did very well so they decided to extubate her (take her off the ventilator/breathing tube completely. For those of you who read my husband's posting that is what he was talking about, I hope it is now more clear. Anyway, they warned us that many kids don't do well with this and not to be surprised if she ends up right back on the ventilator. This can be because it is too much work and she is not ready or because her throat is irritated so much from the tube being there for so long that it can swell and cause bad oxygen flow to and from the throat. Well, they put a high oxygen tube in Ava's nose to help support her. She was still in control of all her breaths and had to do all the work but oxygen was being shot into her nose. She hated this. It was very confusing to her, you could tell. She wasn't sure what to do with her mouth or her nose. Her blood gas afterwards was not good. They were discouraged and thought for sure she'd go right back on the breathing tube. There was one more thing to try. It is called C-PAP. She has a little oxygen mask on her nose which not only shoots oxygen through her nose but also shoots pressure to expand the lungs too. She was doing well on this when we left at 10:00. Her blood gas looked "stellar" the respiratory therapist reported.

So this is where we will stay for a few days. They think that getting some more fluid off of her will help her lungs expand better so that she could go on high flow or, better yet, normal flow of oxygen. They will probably put her on a diuretic again to reduce some of the fluid. She's been urinating very well but is still carrying some puffiness in her chest and abdomen. This will keep us in ICU longer than expected but I guess that's not necessarily a terrible thing. We love the nurses over there and she gets more one on one care. We knew this was the next big hurdle.

A HUGE THANK YOU to my Howard-Ellis family for all of the wonderful gifts, food, supplies, gift cards, money, etc. Your overwhelming generosity to our entire family is so greatly appreciated. I feel so incredibly fortunate to work with such kind and caring people. We have already, eaten, worn, and used many of the items. The gifts are so uplifting which is just what we needed right now. It was like Christmas as we opened everything in the hotel room on Saturday! Even Brayden had several "big brother" gifts to open. Ava is so lucky to already have the love and support of so many people that haven't even met her yet.

Speaking of love and support: I gave a young lady (maybe 18-20 years old) a ride over to the hospital today from the Ronald McDonald House so she wouldn't have to walk. She had a baby girl by c-section ten days ago (so she's still healing) and her baby will have heart surgery tomorrow. She is from Ohio and is here by herself! My heart ached for her as I know that this experience is so incredibly difficult even with tons of support from family and friends. Of course I gave her our room number and told her to call if there was anything we could do to help her. I am asking that you all keep her baby daughter in your prayers along with Ava. I'm not sure of her name because I forgot to ask, but God will know.

Brayden is here and we are so glad. Tonight as I was crying on the phone to Heather (I sometimes just need a release once in a while) he told me "Big girls don't cry". We immediately all started laughing. He also likes to sing the phrase "I want to be a rock star" over and over again. Okay, so maybe he's spending a little too much time with Aunt Heather and his cousins (HA, HA)

Thank you Emilee, Janelle and Sara for visiting today and letting me show off my sweet Ava. It was so nice to see the three of you.

Jamie and I feel so incredibly lucky these days to have two beautiful children, a wonderful family, great friends, and so many other caring people in our lives. We appreciate all of your prayers, kindness, and support each and every day.

7 comments:

Anonymous said...

I just wanted to say that I check on Ava and her family every day and I completely understand if you are not able to report to us on a daily basis. Jamie she is soooo beautiful! I just want to squeeze her cheeks! I am so touched to here how Brayden has just fallen in love with his sister! Caitlin asks about you and Ava all the time and says that she misses you! I will continue praying for Ava and your family. Love, Missy and family!

Anonymous said...

Jamie and Jamie,

Thanks so much for letting us come and see you. We couldn't stop talking about how beautiful she was the whole way home and what a special family you have. I personally can't stop thinking about her lips! They are gorgeous! Dad better watch out, there are going to be lots of boys wanting to smooch them!

It was just so good to see you and hear you laugh. I am glad that things went well with removing the tube. I can imagine that that would certainly be very confusing for her, and scary for you I might add.

Keep up the good work and thanks for the update.
Love,
Emilee

Anonymous said...

Hi Jamie & Jamie,
Boy this little one sure keeps you on your toes! I am so happy to hear about her progress everyday and I am looking forward to coming to see her again, and of course you guys to. I'm gonna talk to mom today and see if she wants to split the gas with me and maybe come up Wednesday or Thursday. Do you want me to bring anything?
Just let me know.
Hope to see you soon. Give Ava a kiss from Aunt Trace ans Uncle Mark.
We love U!

Sara Grishaber said...

Jamie and Jamie,

Thank you so much for letting us share some of your Ava time with you. She is so precious! It was so nice to be able to sit and talk to you guys and see that you are doing well.

Boy Jamie- We didn't stop reminding Emilee how disappointed you were. Just look forward to having a great dinner when you get home!

Can't wait to see you all again! Give Ava a kiss for us!

Love,
Sara

Anonymous said...

Jamie & Jamie,
We just wanted to let you two know that Ava has been in our thoughts and prayers. Stay strong for your children and for yourselves. We are all here for you. You have a very beautiful angel, can't wait to meet her!
Love, Brian, Chelie, Caiden, Sean, Aunt Kathy & Bob.

Anonymous said...

Jaime,
I have been on your sight often checking on the updates for Ava. She is a beautiful little girl. Paxton and I just wanted to let you know we think of you often and hope you will be able to take your precious little girl home soon! Thank you for sharing your story...it is building relationships as we all share your story.
Love,
Cherie and Paxton

Anonymous said...

Jamie (x2),

Our family checks your blog every night. The girls and I "ooh" and "aah" over the latest pictures you post. Ava is absolutely gorgeous! I keep thinking about all that you have gone through to get to the point of having a family. (Dr. D would be very proud of you). Now, you are truly blessed with two beautiful children who were given to you as special gifts. Little
Ava has already touched so many and Brayden has shown everyone what being a big brother is all about. You should feel very proud.
Love,
Beth A.

Ava with Mommy & Daddy

Ava with Mommy & Daddy
Isn't she beautiful!

It's A Girl!

Hello everyone and welcome to Ava Christine's Blog.
First a little info about the new edition to our family.
This beautiful little girl comes to our family after many years of trying on her parents part as well as her being the first girl in 19 years. Yes 19 years! So to say that she is going to be a little spoiled is putting it very lightly.
Ava Christine was welcomed into this world on September 29 2007 by her mommy Jamie, Daddy Jamie, big brother Brayden, grandparents, aunts, uncles, cousins, and numerous friends. Shortly after Ava's arrival the wonderful medical staff at Memorial hospital of South Bend found what they called a murmur in Ava's heart. After some testing little Ava was transported to Motts' Children Hospital at the University of Michigan in Ann Arbor. Jamie and Jamie were informed that little Ava has a heart defect that could be life threatening and that she needed to undergo open heart surgery to fix the defects. So, on Tuesday October 2 2007 Ava was operated on by the wonderful medical staff at the U of M. What this team of doctors did to Ava is incredible. First of all Jamie explained to me over the phone today just what problems Ava's heart has endured. Ava's heart has a couple of different problems. The first is known as Interrupted Aortic Arch. The following info about interrupted aortic arch is best explained by the U of M Cardiac website, "Interrupted aortic arch is a very rare heart defect that occurs when the aorta does not develop normally while the baby is in the mother’s womb. It comprises about 1% of all congenital heart defects. It usually occurs along with other heart problems such as truncus arteriosus, ventricular septal defect, transposition of the great arteries, and aortic stenosis.The aorta is the large blood vessel that arises from the left side of the normal heart and takes red blood out to the body. The first part of the aorta, called the ascending aorta (1) arises upwards. It then curves leftward forming the aortic arch (2). The aorta then curves downward towards the lower body, and this part is called the descending aorta (3). Three blood vessels exit from the aortic arch and supply the head and arms with red blood. These vessels are called the innominate artery (4), the left carotid artery (5), and the left subclavian artery (6).In babies with interrupted aortic arch, there is a complete blockage between the ascending and the descending aorta (1). This means that there is no direct way for red blood leaving the heart to reach the body parts that are "downstream" from the blockage. The site of the defect varies (2) and may or may not involve the take-off of the head and neck vessels. In most babies with interrupted aortic arch (70-90%) there is also a large ventricular septal defect (3).In newborns with interrupted aortic arch, the only way for blood to bypass the blockage is via the patent ductus arteriosus (4). Prior to birth, this small blood vessel permits blood to by-pass the baby’s fluid-filled lungs. One or two days after birth, this vessel usually closes on its own. In a baby with interrupted aortic arch, if the duct closes, blood can no longer reach the lower body. This can cause the baby to suddenly become very ill. Therefore, after the diagnosis is made, a medicine called prostaglandin is used to keep the ductus arteriosus open until surgery". (http://www.med.umich.edu/cvc/mchc/parint.htm)
So how did the doctors fix this? "Interrupted aortic arch is a serious heart defect that requires surgery soon after birth. The goal of surgery is to create remove the blockage. This used to be done in a two-stage operation but is now done most of the time in one stage. The two ends of the aorta are sewn together (1) and the patent ductus arterious (2) is tied off. Sometimes a patch is needed to reinforce the repair. If present, a patch is sewn over the VSD (3)". (http://www.med.umich.edu/cvc/mchc/parint.htm)
In #1 of the picture below is the part of Ava' heart that was repaired.

Before surgery

Before surgery

The Next Step

The next step in repairing Ava's heart was to fix what is known as Truncus Arteriosus. Truncus arteriosus is "characterized by a large ventricular septal defect over which a large, single great vessel (truncus) arises. This single great vessel carries blood both to the body and to the lungs". (http://www.americanheart.org/presenter.jhtml?identifier=11073) Below is a picture of what Ava's heart was like before surgery.

Before Surgery

Before Surgery

After Surgery

After Surgery
The above picture shows what the surgeon did to repair Ava's heart. "Surgery is required to close the ventricular septal defect and separate blood flow to the body from blood flow to the lungs. This is generally done early in infancy to prevent high blood pressure from damaging the lungs' arteries. A patch is used to close the ventricular defect. The pulmonary arteries are then disconnected from the single great vessel and a tube (a conduit or tunnel) is placed from the right ventricle to these pulmonary arteries. This is sometimes called a Rastelli repair". (http://www.americanheart.org/presenter.jhtml?identifier=11073)