Catching up (again)

I wrote this last week, intending to finish up the photoblast by the end of the week, but as you know, some stuff happened and I didn’t have time. So I’m posting the belated update on Leah’s ABR as well as pictures to begin catching up to the present.

Here we go:

Leah had her auditory brainstem response test last Tuesday morning, so we had a little visit with LeahBug’s pals in PICU. We got to see a lot of Leah’s nurses, as well as the very sweet guy who delivered the hospital breakfasts and lunches to the PICU and Peds rooms. Even the folks who maintain the rooms remember LeahBug – she makes friends everywhere she goes! There were some nursing students there as well, and their professor thought Leah was just precious.

By coincidence, PICU put us in the room that was vacated last Monday by one of Leah’s little friends. Both babies (Leah and her buddy) were in NICU and PICU together, and the other little girl transferred to a different type of facility on Monday so she can try to transition back home after her recent return to PICU.

The test Leah had Tuesday was meant to determine whether she has genuine hearing loss or whether her failure to respond to some auditory stimuli is a matter of learning to tune stuff out after nearly 7 months in the ICU with alarms constantly going off. The test is done while the baby is unconscious, which can either be via sleep or sedation. Since Leah was wide awake, they proceeded to place an IV, and it took them three attempts and four nurses and a student, including the charge nurse and a NICU nurse. That’s our tiny-veined Bug! She screamed so hard from the whole ordeal that she wore herself out – and they wound up beginning the test without sedation because she was fast asleep. How’s that for irony? In any event, she started to stir, so they did have to go ahead and give her the drugs so they could finish the test.

The results haven’t yet been read and interpreted by Leah’s ENT, so we don’t know for sure what this will mean for Leah, but the tests showed that Leah’s hearing was largely normal, except that 1) her right ear is more firmly in the normal range than her left ear; 2) she does have some left-side “mild high-frequency loss at 4kHz only.” Additionally, the DPOAE test was successful in her right ear but not her left, which can sometimes indicate a hearing problem, but in Leah’s case it probably just reiterates what we already know: Leah’s left ear canal is particularly small and possibly oddly-shaped and that can interfere with physical examinations.

Here are some pictures from last month – I have more to share but this will have to do for now.

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This goes in my “Babymoticons” folder under, “Really? Really?”

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Um… I think this one does, too.

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We are liking our high chair lately!

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We’re trying to stay neutral in the great baseball team debate (because Grandma likes the Red Sox and Grandpa likes the Dodgers) but Leah seems to be expressing her own opinion. I guess we’ll need to get her a Red Sox jumper so we can determine whether she prefers the Red Sox or just dislikes baseball entirely. Personally, I prefer figure skating. I’m just saying.

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Just a little flashback to the first time Leah wore this jumper…

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She’s calmed down a little bit, at least.

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Goofy baby

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Baby toes are the best toes, but Mama knuckles are the best knuckles.

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Mama fingers aren’t so bad either.

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But babytoes are still the best.

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Somebody loves her Mommy very, very much.

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Hint: It’s a SILLY somebody.

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Forehead kisses!

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“ACK. MOMMY!”

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“ERM, Mermy, yer squershing mer ferce.”

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SuperBug contemplates her next move.

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Aaaand it’s her unbeatable SMILE-leg-kick combo!!

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“Cellophane, Baby Cellophane…”

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That’s a lot of effort for one tiny baby face.

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But it paid off!!

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We are just like our Aunti Staci – NO SOCKS FOR FEETS!

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Bendy Baby does leg lifts.

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NOM.

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We might have the sweetest baby on the planet.

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No socks for feets. Socks for mouths.

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As I said… sweetest baby on the planet.

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We love our veggies, even if we only get to nom on them.

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Watermelon is pretty awesome too.

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Dainty baby

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Goofy baby – again.

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Pleased-as-punch Baby

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Couldn’t think of anything to put on her face for Passover so she got frogs. ‘Cause they were in Pharaoh’s bed… and on his head…

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Bendy baby doesn’t need no steenkin’ diaper.

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Our first Pesach! Seder at Auntie Kimmy’s.

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Definitely BFFs right here.

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“Mama, what’s Dayenu?”

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Let’s get this meal started already!

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Our little family!

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Sweet froggy cheeks

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Valley girl selfies.

Here we are again!

Leah had her dilation Thursday morning, and we were back at home by the early afternoon. It was very hot at home and Leah was pretty cranky – and before we knew it she had worked herself up to a fever of 101.6. At its highest it was 101.9, but somewhere in the mid-100’s I started trying cooling measures. When after 45-60 minutes her fever had not decreased, I gave her Tylenol and called the Peds clinic as instructed on Leah’s discharge papers. The advice nurse told me to take Leah to see a doctor locally just so she could be examined, but a few minutes later she called me back and told me she had paged the doctor who did Leah’s dilation and he wanted her back at the hospital to be admitted for overnight observation. The fever could be from the heat or maybe from the anesthesia, but it could also be from an infection arising from an esophageal perforation.

Once she was admitted to the hospital, they did a chest x-ray (which looks fine) and a blood culture. Today they did a viral swab and urine culture as well, to rule out regular baby stuff. Initially it had sounded like they were only going to keep her overnight for observation, but ultimately the doctor decided he wanted to keep her for the full 48-hour blood culture, which means we will likely be here until Sunday morning. As the doctor put it, the risk of a perforation / infection occurring is very low, but the risk to Leah’s health if it does occur is very very high, so although it will likely turn out to be nothing, it’s better to err on the side of caution.

On the bright side, Leah had a visit today from her great-grandpa as well as her great-uncle and great-aunt, who live on the east coast and met her for the first time today. We were supposed to have dinner with them tonight but Leah had her own plans, so it turned into a hospital visit instead.

Speaking of Leah’s having her own plans… our tiny bug is turning a year old in less than a week!! How did that happen????

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Baby jail again, Mamas?

More photos coming soon. It takes time to sort and upload them, and those captions don’t write themselves, ya know. Well, some of them do…

We’re still standing…

The past couple of weeks have been… OY VEY.

Just a quick summary:

– As you know, we spent Leah’s 11-monthiversary in urgent care and the ER. Good times. The general consensus was that she had a bit of atelectasis (lung not opening all the way) following her April 3 procedure.

– At Leah’s last dilation, on April 17, the doctor was pleased to report that her esophagus was a tiny bit more open than usual. He was able to pass the scope through the stricture prior to dilating, and estimated that it was at about 5mm, which is better than the 2-3mm it had been at before. He did see some white calcification spots that he attributed to the steroid injection the week before. They will do another injection on Thursday.

So, now for the OY VEY. Leah has been super, super fussy for the past week or so. Starting the day after her last dilation she started running a low-grade temperature on and off throughout the day, and she was having a hard time sleeping. She would fight off sleeping for so long that she would get overtired and cry even harder because she was too tired to sleep. Oy vey! She does fine at night – it’s mostly during the day that this was happening, and I think the hot weather has been a big part of it. She has also been spitting up here and there, and by Monday had added some projectile vomiting to the mix. She threw up 3 times on Monday (April 21), and was gagging for a great deal of the day. On Tuesday she gagged on and off throughout the day. On Tuesday evening I called the advice nurse to ask if maybe we should give her some Pedialyte to replace the lost fluids from throwing up, since she seemed very fussy. The advice nurse’s general protocol with a kid as complicated as Leah is to tell us to bring her into the ER – but it didn’t seem appropriate under the circumstances (and who wants to expose her to that if it’s not necessary?), so I kept trying to find a way to talk to somebody who knew Leah. I got SUPER lucky and her primary care doctor happened to be on the floor in peds Tuesday night, so he was able to call me back and talk with me about what was going on. We decided to keep an eye on her and give some Pedialyte if she continued to lose fluids.

On Wednesday Leah was in great spirits, and was a tiny bit gaggy but didn’t throw up at all, though she did have a slight fever as she had in the days before. By Thursday morning, the poor kid could not stop throwing up. We took her up to the hospital for some appointments, and she had her tympanogram in preparation for her ABR next week (if it’s still happening!!), but after the seventh episode, I made an executive decision and cancelled her speech appointment and made a beeline for the pediatrics clinic. My dad was with us and got there a little bit early to make an appointment with them.

Leah saw another new doctor who isn’t familiar with her case, but he reviewed her notes and spoke with one of the gastro docs who has done some of her dilations, and their hypothesis is that our BabyBug has… a baby bug. They put her on Pedialyte for 24 hours and made a follow up appointment for the next day. By the time we got home, her temp was 101.9, so I gave her some Tylenol as well. She seemed to do okay on the Pedialyte, and only threw up once, on Friday morning (though we saw a lot of gagging). We went back for the follow-up appointment and the doc seemed to waffle on the idea of a bug since Leah has only been vomiting and hasn’t had problems, well, on the other end. They did a chest x-ray and her lungs look fine, so despite the waffling he returned to his original conclusion that it’s likely a bug.

Of course, nervous Mama is now asking around to see what the symptoms of esophageal perforation are, since this all started when she got home from her dilation, but calmer Mommy suggested maybe she picked up a bug in the hospital last Thursday. We will ask about the possibility of a tear, but I think her fevers would be higher and she would be in more discomfort. It’s more likely she picked something up in the hospital. For the time being, Leah is on reduced feeds on a continuous basis. We will watch her over the weekend and see how she tolerates increased feeds. We’ll see how to proceed come Monday – Leah has two procedures scheduled this week, one under twilight sedation and one under general, and I’m thinking they won’t be doing either if she is still sick.

I’ll take a baby bug over a surgical complication, but I wish there was a way to be sure that’s what we’re dealing with.

I’ll post photos soon. Our bug is getting better and better at sitting up for a few seconds without tipping over! There will be video coming soon as well. 🙂

Playing catch-up

Whew, what a week!

Leah had her surgery one week ago, and came home Saturday morning. The procedure went well, and everything is tucked back into place. The hernia was definitely a congenital defect, and we were told it was quite large – but they were still able to repair it laparoscopically, thankfully. There was another small defect they found that did not need to be repaired – I can’t remember what the surgeon called it.

The docs had initially told us to anticipate a 3-5 day hospital stay, but after the surgery her surgeons felt it had gone smoothly enough that if she did well with overnight observation she could go home the following day. Leah spent nearly the entire day sleeping, and was super-fussy when she was awake. We got a few weak smiles out of her, but she was mostly just wanting to sleep. She got pretty puffy by Thursday evening, and they had to give her an extra dose of Lasix (she hadn’t gotten her meds before the surgery Thursday morning). Leah spent most of Friday sleeping as well, but when she was awake she went back and forth between moderately cheerful when still and red-faced and screaming when moved.

On the bright side, by late Friday morning, Leah’s numbers were good enough that the surgeons felt comfortable discharging her as soon as her pain was under control. Since she is tube-fed and has oxygen at home, there wasn’t a whole lot they could do for her in the hospital environment that we couldn’t do at home, aside from administering IV pain meds. So once she was able to transition from IV morphine to “oral” (g-tube) hydrocodone and acetaminophen, she was good to go. We wound up leaving the PICU around 6:30PM or so, but not before delivering a pie to the nice food service lady who brings the evening meals. It was pretty funny. A few days before Thanksgiving, Mandy’s brother had told her he would bring her a pie from his work, and then we were discharged before he could do it. She forgot ages ago, but he remembered that unsliced promise. When he came to the hospital Thursday night, he came bearing cookies for the nurses (because he’s cool like that), and yes, a PIE.

That wasn’t the only special delivery we made in PICU on Friday! We also brought up the blankets that Binkeez for Comfort sent for the kids of PICU. They each have a tag that says something to the effect of, “We are officially Binkeez Buddies! Love, Leah Valerie.” Pretty cute. We delivered those to the child life specialist, who will distribute them as needed. It was cool to be able to do something nice for the PICU kids. I hear the NICU babies get all the attention.

After our special deliveries, we went back to the Ronald McDonald House for the night so we could be near the hospital in case there were any issues. Thankfully there were no big issues overnight. Leah was still in a whole lot of pain, which is understandable, because abdominal surgery is pretty miserable even with just laparoscopic incisions. She managed to get through the night with only one set of heart-wrenching screams at about 4AM when Mandy had to change her diaper.

The hernia repair wasn’t Leah’s only procedure on Thursday. They also did another esophageal dilation with steroid injeciton. Leah’s stricture continues its refusal to cooperate. The docs were able to dilate up to 12mm on Thursday, but unfortunately, at the outset the stricture had already tightened to about 2-3mm, so the odds are pretty high that Thursday’s 12mm will be 2mm again by the next procedure. They have said they will keep dilating biweekly for three months along with the steroid injection, and if that doesn’t work then we are likely looking at another major surgical repair. We’ve been told there is about a 50% chance that the dilations will work – which means there’s also a 50% chance that they won’t. (Hey look, I did math!) To me these are not good numbers. I do not like them, Sam I am. (Seriously. Smile and nod. Very little sleep over the past few days.) It’s particularly disconcerting because we’re told the procedure they would recommend if they have to repair the esophagus only has about a 50% chance of success itself. More unpleasant numbers!

So yes – we came home Saturday after a shorter-than-anticipated stay at the Ronald McDonald House and PICU. We don’t love being at the hospital, but since we had to be there, it was really nice to see friendly and familiar faces. Leah had lots of visits from her PICU nursie buddies and other PICU folks, and in the cafeteria on Friday morning I ran into a family we knew from NICU last summer. Their little girl had surgery on Friday and it sounds like it went well, so yay. We saw some familiar faces at Ronald McDonald House, too, although we didn’t get to see everybody.

We left Ronald McDonald House around 9:30AM on Saturday, aided by our dear friend J, who came to our rescue and helped us shlep 7 days’ worth of packed suitcases back to our house. Had we known we would only be there for three nights we could have packed a heck of a lot less!!! But it’s okay – I’m just glad we got home early. Leah was in surprisingly good spirits for the rest of the day. You could tell that she was uncomfortable, but we were able to hold her, and she took a nice long nap in her Gran’s arms. We gave her a little sponge bath, washed her hair, and even let her sit in her special high chair at the dinner table. She had her moments of owie-ness, but overall she had a pretty good day, and continued to improve a little bit each day. She was a tiny, tiny bit wheezy as well, and although it has improved, it’s still a little worse than usual.

I wrote the first draft of this blog a few days ago. Since then, we’ve had a bit of an adventure. Leah has been hiccuping and gagging more than usual all week. I have been communicating with her surgical NP to keep her apprised of Leah’s status, but it seems those symptoms are not too abnormal considering that she just had surgery on her diaphragm. However, on Monday and Tuesday Leah started spitting up a little bit, and on Tuesday morning she had spit-up on her face and outfit when we woke up. Later in the day she spiked a little bit of a fever – it was up to about 100.6 when we gave her Tylenol around 2:15PM, and went up to 100.9 before starting to come back down. Not too terrible, I know, but considering the recent surgery and the even more recent spit-ups, we decided we might as well have her checked out. I had mentioned the fever to her NP and asked when we should bring her in to see her primary care doc, and once she knew Leah had a fever she said now would be a good time to check in with primary care. We made an appointment for Wednesday afternoon, but when Leah would not calm down and her fever started going up instead of down, we decided we wouldn’t wait and would just bring her in to urgent care. We left the house around 3:30 or so, and got to urgent care a little over an hour later. They made an appointment for her at 5PM, the first appointment available for after-hours urgent care.

During her appointment we got to have the fun new experience of introducing Leah to a doctor who was not at all familiar with her history. The conversation started with, “What are the little stickers on her cheeks?” and ended 11 months later with a referral to radiology for a chest x-ray to check for potential aspiration. We trekked down to the next block for her x-ray and then trekked back to await results. The doc came in a while later and told us the radiologist had seen something small and subtle on the x-ray and they wanted to run it by surgery – they took her off of feeding at that point in case she was aspirating due to reflux. Her last feed had ended around 4:30 or 5 and by now it was 6:30 and she was starting to get hungry, but he advised that we wait until we heard from surgery. He observed that everyone he talked to seemed to be very familiar with Leah. Yep. She goes way back with these folks. Maybe half an hour later he said surgery wanted to examine her, which meant we had to walk across the street and bring Leah to the emergency room, since that’s the means by which a person can see surgery after their clinic hours. Thus began the second half of our BabyBug 11-Month-Birthday Adventure. I think we all know that 90% of the time in the ER is spent waiting, waiting, waiting. So here’s how the evening went:

Wait.

Speak with surgical resident, who IS, thankfully, quite familiar with Leah’s case. (Not that there was anything wrong with the doctor we saw at the peds clinic – he was very nice. It’s just a lot easier working with docs who know Leah’s history since it requires so much explanation.) He had not had a chance to review the x-ray results but wanted to examine her. She sounded fine. Yay.

Wait. Wait. Wait.

Surgical resident comes back with the ER doc on duty and tells us that radiology’s interpretation of the x-ray was possible aspiration, possible atelectasis (in which the lungs don’t open all the way). It is a pretty common complication after intubation, although they see it mostly in adults. They don’t want to resume feeds until they have a chance to speak with the attending.

Wait.

Get frustrated over neighbor’s IV, which beeps for 10 minutes. The staff do not seem to notice. Someone finally turns it off. I thank him. Several minutes later it starts beeping again. *facepalm*

Wait.

Meet our cool nurse with shiny butterfly earrings. Surgery wants her to draw blood for a CBC but she thinks maybe an IV might be better just in case they decide to admit her. I tell her Leah’s veins pose a challenge. She goes to find the charge nurse, who is reportedly excellent at placing IVs.

Wait.

A guy comes in and says he’s going to get the same charge nurse.

Wait.

At some point, yet another guy comes in, sees that the baby is sleeping, and leaves.

Wait.

The nurse returns. Apparently guy #2, who didn’t identify himself, was the charge nurse but didn’t want to place the IV because the baby is sleeping. HELLO. PLACE THE IV. We have been waiting an hour for this lab. The sooner she gets blood drawn, the sooner we can leave.

Wait.

Attempt to shield my sleeping baby’s ears from the barrage of profanities that streams from a room down the hall, where a patient has decided he prefers the previous nurse and would like the current nurse to leave. It’s not the ER if there isn’t a screaming patient in another room and what appears to be a homeless guy sleeping it off on a gurney down the hall. Said homeless guy is the one with the beeping IV. The evening is complete.

Wait.

Nursie with shiny butterfly earrings (Leah is a big fan of these) gives up on the idea of an IV and draws blood herself. Baby has a history of poor bleeding from heel pricks so she draws from the fingers instead. It takes so long to get enough blood that the blood clots before it reaches the lab. Lab sends it back. They have to draw again. This time they get it from the heel. Now we know – her heel gives blood again. Woo.

Wait.

Wait.

Wait some more.

Surgery was in the OR but they finally come down and tell us the labs are good and we can go home, but we should space out her feeds to prevent aspiration, and watch for any more fever or vomiting. We can resume feeds. He goes out to prepare discharge papers.

Wait.

Someone comes into our room. Ready? Nope – he just wants something from the cabinet.

Someone else comes into our room. Now? Nope – she wants something from the cabinet too. Suddenly our room is very popular. Someone else starts to come into our room but changes her mind.

FINALLY, we get our discharge papers and leave. It’s close to midnight.

Soooooo. That’s how we spent Leah’s 11-month birthday – with an 8.5-hour trip to the hospital. I’m glad that they didn’t keep her overnight, but it was still a very exhausting day. It sounds like they do think she’s experiencing atelectasis, and they said it is something that should self-resolve over time. Leah did pretty well yesterday, but today she had a projectile vomiting episode in the morning. The previous episodes had been just regular baby spit-up, but this was full-on spewing of her feed. My only consolation is that maybe, possibly, perhaps this means the esophagus is still open. Please?

I know I already posted this on Facebook, but I just want to say that we are SO grateful to all of you for your sweet messages, comments, thoughts, prayers and encouragement this past week (this past year, really, but you know what I mean). It’s not easy to see that beautiful, sweet, tiny face all scrunched up in pain. It really does help us to know that people are thinking about her and sending positive energy in her direction.

In thanks, I shall shower you with photos. Behold, photos!

<3

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“Yeah? You got a problem?”

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This is the face of a sleepy Bug.

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A few minutes later…

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Our little rock star at therapy! I wish they still made this toy – the one they make now has different songs and they aren’t as fun.

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“Just a baby eating her toes. Nothing to see here, people. Move it along.”

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Selfie time! Duck face for Aunti Staci, sparrow face for cousin Anya.

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The sweetest baby I ever did see. Also… eyelashes.

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Watching Cool Auntie Erin’s band practice. Or, you know… sleeping through Cool Auntie Erin’s band practice.

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And to think, mornings used to have no redeeming qualities.

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Somehow the baby grew a cat nose and whiskers.

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“Timber!”

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A brief moment of interest…

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…followed by a competition for Mommy’s attention.

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Oh great – now everybody has to get involved.

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Family selfies! “Mommy, you are SO WEIRD.”

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“Mommy, where did your tongue go???”

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“You see what I put up with? These two…”

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Reading the book that somebody bought from LeahBug’s wishlist. There was no name on the packing slip, so if you’re reading this, THANK YOU!

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It’s a no-dresses day! Time for our friend B’s birthday party.

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BabyBug chilling with Auntie Faithie.

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Tuning out the party.

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A day at the park means we wear a hat! Leah says: “HAT. DO NOT WANT.”

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“Are you kidding me with this thing?”

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“MOMMY! WHAT DID YOU DO TO TIGGER? Don’t worry Tigger! I’ll save you!”

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Raspberries

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Happy Bug

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She’s just too cute.

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That smile!

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BabyBug Beak. She has been making this silly face since her NICU days.

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A screenshot of my very favorite moment from the swinging video. That is pure baby joy!

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Wheeeee!

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MamaBug and BabyBug

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MamaBug’s nails provided entertainment for the whole ride to RMH. Good times.

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“They’re doing WHAT to my diaphragm tomorrow?”

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“Is there any chance I can talk them out of this?”

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“Oh well. Let’s play!”

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Silly baby

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SuperBug all ready to fly off to surgery. This picture brought us incredible support during Leah’s surgery. The Special Miracles – Down Syndrome page shared her photo and roughly 18,500 people liked it on their page. A little over 800 people shared it on their own walls. Another 13,700 saw the picture through Leah’s Facebook page. The Butterfly Fund, the org that so generously shared Leah’s wishlist, also posted it and over 600 people liked it. This means that at minimum, almost 33,000 people saw the photo, not counting the friends of the folks who shared it. It received well over 1,000 comments wishing Leah good luck and sending her positive thoughts and prayers. These numbers just completely blew us away. We’re grateful for the continued support of our family, friends and community, and also amazed at how many people cared enough to take a moment out of their day to send good wishes to a baby they don’t even know. The constant flow of positive energy really kept me sane during Leah’s surgery and later when she was sleeping off the pain. I know she felt it too.

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Mom’s Superhero!

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This cape was made especially for LeahBug by Tiny Superheroes and was sponsored by one of Leah’s friends on Facebook who also has chronic health problems. Leah is definitely a tiny superhero!

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Several friends and family members sent us sweet pictures of themselves in their Team LeahBug shirts on Thursday. Pretty sure little Josie’s was the cutest one. 🙂

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Auntie Z’s little boy Ry Ry made this special gift for LeahBug in day care!

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LeahBug does love her toes.

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Just a girl and her GloWorm.

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Puckering up. She’s been doing this a lot lately. I think it’s because I make this face at her so often.

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We have everything we need – Binkeez, GloWorm and toes. Armed and ready for surgery!

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Leah was VERY fussy and uncomfortable after the procedure, but after a while she finally fell asleep. Poor bunny. They told me to try holding her but I felt like that made things worse after a few minutes, so I put her back and let her rest in bed.

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Gran and Bug

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Always with the wires!

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Saturday morning, after a night of morphine and sleep.

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Leaving PICU at last! Bugs for dinner!

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Toes. I love it when her tiny feet just randomly poke out of the stroller.

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Do we look cool or what? They let us take her home in the gown so she wouldn’t have to have tight clothes against her sutures. We added some flair.

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Uncomfy, but managing a smile for Mama nonetheless. Our little superhero.

Popping in for a quick update

Good afternoon, everyone! Shabbat Shalom! I just had to say hello and be grateful for a moment. The Butterfly Fund recently posted LeahBug’s Amazon wishlist, and several people we’ve never met have sent Leah gifts, including some new diapers and covers (because she’s outgrowing the old ones), a sweet outfit, a toy, some books, and medical supplies – AND somebody sent her the ARK Z-vibe, a therapy tool aimed at oral stimulation to help with speech and feeding. We are super-psyched to start working with this as it comes highly recommended by other parents of children with Down Syndrome. Just need to do some reading first as there are specific exercises that help with particular issues.

This past week has been a reminder of how truly awesome people are. Not that we needed a reminder – we are grateful every day for your support and generosity and it continues to amaze us.

<3

So many photos! So very many!

Whew! How did I manage to go so long without blogging? Here is what has been going on in LeahLand:

-Leah had a dilation last week and made a little friend in the hospital. A little girl (maybe 6 or 7?) had been staring at LeahBug in the waiting room, and she was called in a while before we were. When we went in, we could hear her crying that she wanted to leave and go home. I wanted to bring Leah down to her little “cubicle” to say hello, but I didn’t want to bother them. Gran, being more gregarious than Mama Lisa, brought LeahBug down and introduced her. The little girl perked right up, and asked about the baby, and we didn’t her her cry again after that. We waved at her and she waved back as they rolled her off for surgery, and we saw her being wheeled out afterward to go home and her mom said she had asked how the little baby was doing. 🙂 Very glad our sweet Bug was able to bring a little sunshine to another little girl’s otherwise yucky day.

-We celebrated our first World Down Syndrome Day as mommies with our friends Jess, Toni and Wesley. Wesley is 20 years old and has Down Syndrome, and he just graduated from a cool program at UCLA for students with developmental disabilities. What a great model for our little BabyBruin! Mama Jess made a beautiful Shabbat dinner and Wesley held Leah for the first time! Pics below.

-Leah will not be having a Nissen fundoplication next week after all. They will be repairing her diaphragmatic hernia and putting her little colon back where it belongs. I do think that is causing her some discomfort, and it seems to be affecting her little poops too – usually she has one every day but lately it’s been every few days. Regarding the fundoplication, there is some speculation that the reflux may not be the primary cause of the stubborn stricture, and a Nissen is a huge step to take if there’s a pretty good chance it won’t work. Instead, they will continue with the dilations for a few more months, and if they don’t work then we may be looking at a surgical fix; it’s possible that the scar tissue is just too severe to be repaired. That is the main reason they aren’t doing the Nissen – if Leah needs another surgery to deal with the stricture, they need to preserve as much of the esophagus as possible, and a Nissen would create more scar tissue and damage to the area and would give them less native esophagus to work with. So they will hold off on that procedure for now.

-Leah had an echocardiogram and the cardiologist still feels confident that Leah does not need heart surgery right now. Again, the jury is still out on whether she will need it later down the line (like, in a couple of years) – she does have the increased blood flow to the lungs, and the VSD has not improved. But he doesn’t feel that immediate intervention is indicated.

-LeahBug had her very first play date with a couple of other babies who live within our general area and also have Down Syndrome! They have to be the region’s three cutest babies. I’m pretty sure of it. Pics below.

So, that’s what’s what! Let’s break out the pictures!

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Out cold

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Ladybug Toes! It’s so much easier to polish toenails when the baby is asleep!

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Going on a trip!

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We took Leah to the pier to see her first sunset for her 10-month birthday. This is her looking very excited to see the ocean for the first time.

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The beach is so pretty!

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Mama and Mommy love a nice ocean sunset!

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Mommy and Buggy and sunset (oh my)

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Leah woke up in time to see all the pretty colors

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Mama and Bug

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The Monkey Queen

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Faithy’s birthday!

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More monkeys!

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Sweet monkey

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Silly monkey

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Goofy monkey

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Working hard in PT

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Play date with BFF once-removed, Ry Ry (see how big he’s gotten????). He’s giving Leah some sort of turtle sticker.

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Staring at the Team LeahBug ladybug on Ry Ry’s t-shirt. She loves that ladybug.

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Ry Ry’s sweet face!

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Ry Ry teaches LeahBug how to play after bath time.

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Sleepy Bug

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Just because. Can’t handle the cute.

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Baby staring wistfully at Gran’s soup. She’s started making wishful noms when she sees us eating. See below, for example:

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The eagle has landed! We have a thumb in the mouth!

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Poor cheekies! Heal, cheekies, heal! We tried the hat, but we wound up having to use tape anyway, so we’re back to the Tender Grips. We’re trying to keep them a little higher up on her cheeks.

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Dilation day! Sweet Buggy having a nap with Mr. Glow Worm.

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I told her to smile for Aunti Staci.

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Ladybug toes under the bright hospital lights.

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Our little acrobat – she was half-drugged and still trying to grab that red foot.

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“MOMMY!”

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Well, here we are again! They kept Leah overnight for observation because of her breathing, and wound up discovering by accident that she has a diaphragmatic hernia. Good times.

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Mr. Monkey knows this hospital well!

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We got out of the hospital on March 14. It was Pi Day. After a long and difficult day of waiting with a hungry baby, we felt we deserved to celebrate Pi Day with pie. Well. Really, it was Leah who deserved pie. Someday we’ll be able to give her pie!

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Home sweet home for this silly bug!

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We were so cheerful the next morning!

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Can you handle the cute?

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Mama Baby Selfies!

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Raspberry in progress! Grab the umbrella!

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Fingers for breakfast!

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Later that day… we went to meet with Sue of Binkeez For Comfort, who sent Leah the sweet polka-dotted blanket you always see with Leah when she goes to the hospital. Recently they made a special lovebug Binkeez in honor of Leah (pictured above), and we will be delivering some to the children in the PICU just as soon as the blankets arrive. Sue delivered Leah’s special Binkeez by hand as she was already in Los Angeles to visit Children’s Hospital LA for another special delivery. Leah loves to stare at the cute bugs on this special blanket! Thank you, Binkeez! Sue took this sweet picture when we met her at the hospital. Then we had a nice visit – we went to get frozen yogurt, and then we drove Sue back to her hotel via the “scenic route” (i.e. Hollyweird Blvd!). Such a fun day!

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Posing with Sue – but mostly trying to grab her hair. And maybe her glasses too. <3

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We went to an event for Mandy’s work and there were lots of people there. You do what you gotta do, right?

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I know there are millions of pictures of this kid asleep in her car seat, but isn’t she just so sweet? I can’t help it.

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The next day, Leah celebrated her very first Purim! It is customary for children to dress up as the characters in the story, so Leah dressed up as Queen Esther. Cabbage Patch Queen Esther.

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She was in a much better mood than she was the last time she wore this dress… it fits her a heck of a lot better, too!

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Serious Queen Esther

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Grandpa Bill came over to visit and to bring us hamentashn from the best Jewish bakery in the Valley, because he is SO COOL like that. We decided to surprise him with little Queen Esther.

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“HOP! MAYNE HAMENTASHN!”

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Grandpa Bill saved BabyBug from the sillyprecious hat, but Mama insisted on one last picture with the sillypretty flower. I can just see the “SIGH. MOM.” on her face.

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“Mama says I can’t put my hands in Grandpa Bill’s beard anymore? Fine then! I’ll just pull it with my toes!”

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Gran and BabyBug stirring up trouble in the cafeteria!

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“Gran, I have a foot!”

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“Whatup, Gran?”

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Sweet girl!

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Silly time at speech therapy

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“What is it?” Leah’s speech therapist suggested that we try a sippy cup for tiny tastes since she doesn’t seem to do that well with the bottle.

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“Huh. Okay. I can try that.”

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“Uh…” It was a little bit too much for her, but it was fun while it lasted!

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Big appointment day!

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“Oh, don’t stick out my tongue? Don’t stick it out like this?”

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Leah was pretty tired when she got home from the hospital after a long day of appointments. She just wanted to relax on the couch…

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Mommy has been giving LeahBug tiny non-nutritive tastes. She even let her lick an orange slice.

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“OH, I LIKE THAT! MORE PLEASE!”

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Little Purple Riding Hood

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Baby Burrito!

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“Look, Mama, I’m a baby! I need some therapy!” (At which point Mama immediately broke out the disinfectant.)

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“Well, this is new! Thanks for the cool chair, Gran!”

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FaceTime with 94-year-old Great-Grandpa and Aunti Staci! Ain’t technology grand?

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We play hard and then we sleep hard.

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And here we are again! Another dilation day.

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Eating our Binkeez for breakfast.

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Our first World Down Syndrome Day! Break out the funky socks! Not quite sure how that started, but we’ll play along!

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Mama feet and Babyfeets

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We celebrated our first World Down Syndrome Day with Jess, Toni and Wesley! Leah and Wesley had lots to talk about.

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“Cheeeeeeese!”

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Jess and LeahBug!

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Jess and LeahBug and Mommy!

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Nakie Baby getting ready for bed!

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“Five more minutes!”

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Leah had enough dresses for one week – time for some overalls!

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Nummy fingers!

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Fingers are the best breakfast.

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“Well hello there, strange and interesting creature!”

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Our first play date with a baby around our own age (well, a couple of months younger)! And she also happens to have Down Syndrome! Neato, huh?

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“Listen, kid, I’m old and experienced, so let me tell you how the world works…”

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“But before I tell you how the world works… could you please tell me how you sit up so well?”

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Tiny feet x 2!

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“Fingers, fingers are delicious. You understand?”

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Baby A showed LeahBug how the whole head-holding-up thing is done.

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Along came Baby D! It’s a baby party!

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“There’s another baby? There are three babies in the world? I’m learning all sorts of new things today!”

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Baby party: Birdseye view

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Leah was the first to fall asleep, but the kids were nice at this party and nobody played any tricks on her.

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Later, we went for a play date with Great-Grandpa!

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Yay Great-Grandpa!

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We love Aunti Staci, even though she has a funky scorpion painted on her arm. What’s up with that, Aunti Staci?

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LeahBug finally got to meet our dear family friend Andi. Happy birthday, Andi!

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Aunti Staci’s brilliant idea! Dress-up!

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Somehow this makes me think of vaudeville.

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Pokey tongue!

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Besties!

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Sweet face with antennae.

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Smiles!

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“CHEEEEEESE!”

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The world’s tiniest cat burglar?

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More dress-up!

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We LOVE dress-up! Sometimes.

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Baby Bug and Baby Sister (Mama’s)

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Sweet smile

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Sleepin’ on Grandpa Bill.

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Snuggling with Great-Great-Auntie Joan for the first time!

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“I love Great-Great-Auntie Joan!”

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“GGAJ, tell me a story!”

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I couldn’t resist. This is our roommate’s doing. We asked her if she’d mind putting away a ball of yarn that Mandy left out so we wouldn’t find him knitted into it. She told us we were too late.

Medical update

Things have been pretty hectic around here, so I’ve fallen behind on pictures. I’m working on a photoblast, I promise!

Just a quick “diary” paragraph and then I promise I’ll get to what you’re really waiting for: the surgeon’s update.

On Leah’s 10-month birthday (March 8), we took her to the pier so she could see her first sunset. She slept through it, of course, but she did wake up in time to see all the pretty colors, and it was her first time seeing the ocean, so that’s pretty cool. That day I also painted her little toenails like ladybugs while she was sleeping. I’ve gotta have my fun, too! The following day we went out to dinner with our dear friend Faith and her family and some friends for her birthday, and LeahBug met her little friends Storm, Cady and Iris for the first time. Miss Cady brought Leah a little ladybug finger puppet. Very sweet. This past week we also visited a bit with Leah’s buddy Ry Ry, his mama Auntie Z (Mama’s BFF), and his dad “Bob.” (Not really, but I couldn’t resist). In the waiting room at OT the other day, we ran into one of Leah’s old NICU roommates and her mommy. I don’t think Leah’s seen so many other kids since she was in NICU! In other news, Leah’s g-tube popped out twice (uneventfully, thankfully), and she continues to make wishful noms when she watches us eat. So sad and yet so cute. And finally, LeahBug experienced (read: slept through) her second earthquake. This one was a bit larger than the last one she didn’t feel; the last one was around 3.0 or so and was in the middle of the day, and this was a 4.4 magnitude rocker at 6:25 AM. Sooner or later she will actually notice an earthquake, but I’m in no rush for a quake large enough to register with her!!

If any of that didn’t make sense, you can blame it on the fact that I was up at 6:25AM looking up the magnitude of the earthquake that woke me up.

Okay – now, what you’ve been waiting for. Yes, Leah is going to have another surgery. She will continue weekly dilations on March 20 and 27, and will go in April 3 for a Nissen fundoplication and a hernia repair.

As it turns out, it appears Leah actually has two hernias: a paraesophageal hiatal hernia (likely a result of her initial esophageal repair), and a Morgagni hernia, a type of congenital diaphragmatic hernia (CDH) that makes up about 2% of all CDH cases (which themselves occur in less than 5 out of every 10,000 births). In this case it’s a lucky thing that Leah has the more rare form. In many cases, congenital diaphragmatic hernias create problems with fetal development, as the intruding organs in the chest cavity can impede lung growth. Overall, CDH has a mortality rate of about 40-62% of live births, the primary reason being that the lungs have not been permitted to develop fully due to the presence of other organs in the chest cavity. So we are very grateful that Leah’s CDH is the type that has a better prognosis.

Nonetheless… it needs to be repaired. I mean… the kid has a loop of colon in her chest cavity. Really.

The big concern right now is Leah’s acid reflux, which appears to be the cause of much of the scar tissue in the esophagus. Leah’s surgeon wants to avoid having to redo the esophageal repair; he said if it didn’t work the first time, that doesn’t bode well for a second repair. He feels that a Nissen fundoplication is the best way to keep her reflux at bay. (Here is a longer and more technical article.) It’s always been on the table as a future option – I just kind of thought the future would be a little bit further down the line. But here it is.

Leah also saw her cardiologist today and he remains confident that Leah does not need heart surgery in the immediate future. He says the jury is still out on whether she will need it in a couple of years. She does have increased blood flow to the lungs, and the VSD has not decreased in size – but it hasn’t increased either. If it doesn’t improve then Leah will need heart surgery eventually. Let’s hope her heart patches itself up! Go BabyBug Heart!

Pictures soon, I promise!

Thirty Eight Hours…

When we arrived at the hospital at 6:45AM yesterday (Thursday), we expected to be home around 2PM. It’s now 8:47PM on Friday night and we are awaiting discharge from Peds.

Leah’s procedure took a bit longer yesterday – I think she was in the OR almost 2 hours or so – because they injected steroids into her esophagus to help with the inflammation and scarring, in the hope that it would keep the stricture from continuing to tighten. Prior to the procedure, Leah’s temp was a TINY bit high (98.8) and she sounded a TINY bit junky, but since she hasn’t been sick, we went ahead with the procedure.

Afterward, Leah was super-fussy, as usual, but this time they wouldn’t let us feed her until she was transferred from the recovery area to the discharge area. When she arrived at the discharge area she was feeling a little bit warm and her temp was about 100.3. They were getting ready to discharge us when I noticed that she seemed to be retracting a little bit – using her abdominal muscles to breathe. They called the anesthesiologist over to look at her and he suggested that she might be agitated from being hungry, so we could try feeding her and seeing if that helped with her breathing. She was also sounding a little junky (in her lungs), and was having a tiny bit of wheezing on exhalation (I wouldn’t call it stridor but it was going in that direction). We fed her and tilted her neck up at the doctor’s suggestion, and that seemed to help with the retractions, but after a while they started again, and her fever went up to 100.6 (don’t worry – that’s as high as it got). After a long chunk of time had passed, she was still pulling a bit to breathe and still sounding a little icky and still had the mild fever, so with all of those little things plus the fact of this being the first steroidal injection, they decided to keep her overnight for observation and also to do a chest x-ray to see if aspiration was causing the “junky” sounds from her lungs.

Well. The peds unit was short on rooms at the time, so Leah wound up having her chest x-ray in the discharge area. We spent a good several hours in the discharge area waiting for a room to open up on “the floor” (as they call Peds). While we were waiting, Leah’s GI doctor came by to discuss the x-ray results with us. Her lungs looked fine, but the radiologist had seen something suspicious in the upper GI area and wanted to run another x-ray in case it was just a poor film. So we waited another couple of hours, and they took the second x-ray just before they brought her up to Peds. For reference’s sake, Leah’s surgery was at 8:30AM, she got out about 10:45AM or so, and Leah was rolled up to Peds at around 5PM. We did a lot of waiting yesterday!

We had a pretty mellow evening and got to see some familiar faces; Leah’s RT had treated her many times in PICU, and her overnight nurse had also cared for her several times. It wasn’t a bad night. They stopped Leah’s feed at 4AM, with the plan being to run a contrast study some time around or shortly after 10:00AM to determine what was going on in Leah’s chest – the second x-ray was not particularly helpful in determining whether something was wrong.

Well. 10:00AM turned into 1:30PM, which turned into 2:30PM, which turned into 3PM. I went to radiology with Leah and kept her entertained during the breaks; they had her ingest contrast, so they had to take breaks to give the dye time to move through her bowels. For most of the study they didn’t see anything wrong, but in the very last “take,” they finally saw what they had been looking for. Leah has a diaphragmatic hernia, which means that a segment of her bowel is poking through her diaphragm.

That’s about all I can tell you right now. We have many questions, particularly because this is usually a congenital defect that is detected either prenatally or immediately after birth when the newborn goes into respiratory distress. It is also possible that this is an acquired diaphragmatic hernia caused by trauma to the area, e.g. abdominal surgery (because yeah, that happened!). We really have no answers right now beyond the diagnosis. They are sending us home tonight since Leah is stable and relatively asymptomatic, and we will see Leah’s surgeon in the clinic on Monday to discuss plans going forward. The repair is surgical, and the big question is whether they do the repair now or wait.

So. Now, we go home!