Wednesday, June 30, 2010

Three, it's a magic number!

Whether in the sandbox...
... or on the couch...
THREE, togheter, is awesome!

Tuesday, June 29, 2010

The Cow Says "Mmmm"

Our babies are growing up! George and Olivia can clearly tell you what a cow says (kind of :) )! They can also choose the item you ask for out of a pile of toys, tell you not only where their own belly button is but also everyone else's, give a high five, and sign "more" until the sun goes down. Wow. I'm blown away by how big they are getting!

What about Samuel, you ask? Well, he is growing every day too... but right now I'm going to brag about his ability to recover! Yep, had a little blip this past weekend... I'm not willing to call it a step back because it was kind of user error rather than Samuel wearing out. Long story short, once on the HME/thermovent he was getting way too much oxygen... after four days of that, he let us know. Quick to act, and with the support of his pulmonologist, we let him rest on the ventilator almost all weekend... at that point we didn't know why he was acting up. On Monday, with the help of his home nurse and our home respiratory therapist, we put the clues together, analyzed his O2 when on the HME, and it all worked out! Samuel isn't quite himself yet, but he is well on the way :)

What's crazy is, now that I know why he was acting up, I'm so glad we were able to fix it... for Samuel, too much O2 means CO2 retention, which is what put him back in the hospital the last two times. I'm sure his CO2 was high on Friday, but due to good advice he was able to rest and blow it off during the weekend... and then great troubleshooting on Monday resulted in a blip, rather then a step backward. Onward!

Lots of new activities in our house... and lots of thanks to the creative people in our lives :)

Look familiar?! It's the crack table... with only two of its four legs :)

Samuel loves it just as much as his brother and sister!

Apparently just playing with the tupperware available wasn't good enough... either George wanted to make sure there wasn't anything extra special hiding in the back of the cabinet, or Olivia talked him into climbing in and was about to shut the door behind him. Ha ha!

Painting with food! Unfortunately, during our first attempt all we had to paint with was vanilla yogurt, oops. But you better believe there are some great painting sessions to come!

I think Samuel likes it too :)


What better to do after painting with food... then head back to the tupperware cabinet! Woo Hoo! George, the yogurt in your hair looks just fabulous :)

Friday, June 25, 2010

Little Fish

Our babies love the water! One of George and Olivia's best words is bath... when you say "bathtime!" they start saying "bah, bah, bah" and charging down the hallway towards the tub. Possibly one of the cutest things I've ever seen :)

These days we have added the big swimming pool, the sprinkler, and the beach to our list of water fun, and we are loving that too! George and Olivia have finally taken the 1-2-3 dip under the water... a little coughing, but no tears. Yea! They seem to get better every time!

We went swimming with our friends Josh and Kristen a few weeks ago, and Josh took some great pictures. Here are just a handful...

Ready, Set...

... Go!

George splashing mama is fun!

Mama splashing George is even better!

Um... how exactly do you un-teach this one?!


George and Kristin :)

Samuel gets in on the swimming action too

The small pool seems to be a hit.
In case you were wondering, the difference between a bath and taking a swim is the intent of the activity. Above, no intention of cleaning... just of having fun :)


The bigger pool seems just as great!

Wednesday, June 23, 2010

Who Turned Down the Volume?

SAMUEL DID! If you have been to our house, you know what I'm talking about :) If not, let me paint the picture...

Samuel's machines make quite a bit of noise... here are the players involved:

- The concentrator is what provides Samuel his higher level of oxygen. We breath 21% oxygen, Samuel needs about 30% oxygen. For traveling we hook up to an oxygen tank, which is silent but not realistic to use for day-to-day needs. So generally we hook up to the concentrator. It hooks up to the vent, the trach collar, and the HME.

- The ventilator is the machine that provides the pressure support, humidified air, and at night actually provides rhythmic breathing. We hook up to the concentrator for a higher level of oxygen.

- The trach collar is what allows Samuel to be off of the ventilator, so no pressure support, but still provides humidified air and hooks up to the concentrator to provide a higher oxygen level. We watch him carefully to be sure his oxygen saturation stays up and his work of breathing stays down :)

- The thermovent, or HME (heat moisture exchange), is similar to the trache coller but so much better! It looks like a little barrel and has little filters that provide the heat/moisture exchange. It attaches directly to the end of the trache and has a little place to plug in the oxygen concentrator. Like the trache collar, it provides humidified air, but not as much... our noses humidify the air we breathe, but because he breathes through his neck, he would get extremely dry air.

When Samuel first came home, he was on the ventilator and an oxygen concentrator 24/7. The concentrator was heavy duty, with the ability to go up to 10 liters of oxygen. Samuel generally needs anywhere from 2 - 4 liters, but they wanted us to have the ability to get higher numbers, just in case. (I hate "just in case," but I am so thankful to feel prepared :) ) About two months ago, we got a new concentrator... ours was having issues, and when the new one came they felt we could go down a notch to a concentrator that tops out at 5 liters. Yea! The added benefit was also a reduction in the noise - BIG TIME! We thought we had hit the jackpot! I can't even describe the difference!

Here's an example... when we had the heavy duty concentrator, we had to turn the volume on the radio up to at least 20-25 in order to sing with our kids. With the new concentrator, we can have a dance party at a volume of 12-15! Although we still turn in up to 20 for Kookaburra :)

Then came the trache coller... so excited to start coming off of the ventilator for a few hours per day! Then we turned on the trache collar... I love it for my baby, but oh my goodness, it's louder then the ventilator! Back up to at least 18-20 on the radio volume.

We worked our way up to eight hours on trache collar per day! WOO HOO! Then, it got better :) At our last pulmonology visit, we were prescribed the thermovent/HME and told to attempt turning off the concentrator (no extra oxygen) for a few hours per day. AGH!!!! I almost fell on the floor... instead I just got teary. We are making progress!

Last week we started turning off the concentrator for up to four hours throughout the day. So far, so good! His O2 saturation's are great, and he doesn't seem to mind at all. It is CRAZY!

This week, we started using the thermovent/HME, and it is AMAZING! No ventilator AND no trache collar while we are using it! We could probably turn the radio down to 5 and still hear it :) Plus, Samuel seems to love it... he has been so happy the last two days! He generally starts to tire out around 6:30pm and we do everything in our power to keep him awake until his bedtime... since the thermovent/HME, he is a rock star even at 7:30pm.

I feel like there is a calm feeling in our house that hasn't been there before. I still worry, I am still thankful for every day that Samuel is home and our family is together, and even though I don't have too much time to over analyze, I am terrified of Samuel going back to the hospital. BUT, the good news of pushing ahead with Samuel's breathing, combined with the new low volumes at our house, changes the atmosphere in our home.

Didn't mean to write so much, but got going and couldn't stop :) Here are a few visuals...


The ventilator - trach connection and tubing

The trach collar - trach connection and tubing

The thermovent/HME - trach connection and tubing
(and all 150 of his beautiful teeth!)

Saturday, June 19, 2010

Reminders

This week I had a few wonderful conversations about how far the babies have come... in particular how far Samuel has come in the weeks he has been home. Of course I am thrilled that everyone is home and doing well, but seeing the three of them together does remind me of all that Samuel still needs to learn. The great news is that we can even begin to think about this!

I know that sounds bizarre, but before the last few weeks our concerns for Samuel were almost entirely on him breathing... on him living. Now, while we certainly have quite a road ahead, we are more confident in his medical state and have started to focus on some relatively normal baby concerns like learning to eat, developing protective responses in order to sit independently, and getting more tummy time! I suppose they're not normal concerns for an almost 17-month old, but what does "normal" mean anyway :)

I do spend moments every now and then wondering if we are progressing, and at an acceptable rate. My conversations, and reassurances this week were so perfectly timed :) From people who have played with Samuel, worked with him, even simply visited with him, I hear how amazed they are at the progress he is making. The examples are the proof in the pudding... from tiring out after 15-minutes of assisted sitting to weeks later sitting for 3 and 4 times that long and with only a safety net for tipping over... from mimicking smiles to mimicking just about everything... from vent 24/7 to trache collar stints and no extra oxygen trials... the list goes on, and I LOVE IT!

Our cutie-patooties :)


George has gone from loving to be pushed around by his sister and parents... to demanding it! The boy will sit, or stand, in the Radio Flyer forever waiting for someone to come back and give him a ride. If enough time goes by, he starts singing to attract attention :)

Minutes later...
Yes George, I see you and I see how cute you are...

Even more minutes later...
Yes George, I still see you :) DB, George is ready for some turbo!

George isn't the only one who loves the Radio Flyer! I'm not quite sure if Olivia was trying to share the toy, or kick George out so she could get a ride. Judging from the mischievous smile, I'm guessing it's the latter :)

No passenger means Olivia can forget the walking and run!

George, can you give Samuel a kiss?
This is what you get when you ask the question... from across the room George's face pops up, looks for Samuel, and he starts crawling. If he doesn't get too distracted, minutes later George is by Samuel's side :)

No story here... I just think she's beautiful :)


No better place to take a rest then with dad :)

Samuel's original seat at the table :) Since this was taken he has a highchair... but I think he might actually miss the bumbo. Too bad he would start laughing at his siblings and almost rock the bumbo right off the bench! No more bumbo for dinner time.

Guilty much? I wonder if she's hoping I don't notice that she's been playing with the suction machine tubing or the fact that she has a saline bullet in her mouth :)

Boys and their toys...

... I could watch them play together all day :)



Pretty sure those dimples are getting cuter by the day!

Monday, June 14, 2010

Stages

Things have been cruising right along at our house... and everyone is so busy that I am doing my best just to remember what we did yesterday, much less the last couple days! I feel like the babies are doing more and more every day, which is exciting, but I also want to remember what each stage was like... although I'm beginning to think that's almost impossible. Each stage seems to last anywhere from 24-48 hours :)

Some days there are things we've been waiting for, like turning the pages of a book, going under water for the first time, or taking multiple steps without falling. And some days there are things that we never knew to look for, like learning to fake laugh when you feel it's socially appropriate to laugh, trying new dance moves, or learning volume control... wait, we're still working on that one. We love trying to keep up with all the craziness!


Olivia is still walking whenever she chooses to, which is more and more often... but still not always when we want her to :)

Going CRAZY!
I really need to figure out to post video... this photo just doesn't do it justice.

Hi Samuel!

Hi mama!

One of our newest toys... an old school car garage... we love it! (Thank you Cathryn!) And so do the babies! George is still trying to figure out exactly how the ramp springs back into place after each car goes down it.

Ah ha! George is caught standing all by himself :) Too funny, he will only stand on his own if he's too busy to realize he's doing it.

Holding on again... this time to figure out exactly how the car works, or maybe how the person stays in the car even when upside down :)

All three, exactly as they like to be :) George, inspecting each detail... Olivia, chewing... Samuel, turning the toy in circles.

Time for World Cup... or still celebrating DB's soccer victory :) DB coaches a girls high school soccer team and they were state champs this spring! YEA! Quite a story behind it, including many trips to the championship game, but this is the first girls soccer state champ team in school history! Plus, DB just got a coaching award from the local newspaper AND one from a state-wide high school sports organization. Congrats, DB :)