Answer to Prayer

I am so thankful for a boring day!!! There is no changes to report. Praying the next change I can post will be that we have a new heart!!!  Thank you Lord for the boring day today.

Monday Evening 6/17/11

What an afternoon!!!As you all know from our last post they were doubling up on her Amiodarone to try and break the atrerial flutter. Well that didn't work either so they contacted the adult pacemaker team hear at Shands about another drug that might break it. After much discussion Dr. Fricker decided that she was stable and comfortable with the flutter and they have her on a Heprin Drip to dissolve and/or prevent any blood clots and thought it was better if we didn't rock the boat at this point. Cause all of you that know Rachel well knows she doesn't like her boat rocked. 


About 4:30, 5:00 pm she went in to a tachycardia event and the pacemaker fired and then she went into a short seizure. All the while the cardiology team is standing outside the door because they had just brought a patient up from surgery to the room next to us.  They did an EKG to see what her rhythm was like and the shock from the pacemaker has broken the Atrial Flutter.  She is back in her OWN sinus rhythm instead of being continuously paced (they had lowered the settings on the pacemaker earlier do to the flutter). Both her and her heart seem to like this very well. 


Praise God for a much needed answer to prayer. Praying he will keep us bored until a heart becomes available.  Thank everyone so much for all the prayers, please keep praying . 

Monday

The latest:  After consulting with the head of the Pediatric Cardiology department, Dr. Fricker, it was decided not to have Rachel go through the procedure under anesthia after all.  They decided to try and "break" her from the atrial-flutter by doubling-up on one of her medications, Amiodarone.  The doctor told us that if upping this particular med did not work, they could add another med to it to see whether or not that does the trick.  He feels that she is doing okay, heart-rate wise, that even if the flutter doesn't break, she should be okay, given all that he has seen this morning.  So, they have started the doubling-up of her med and she seems to be stable for now.
We are SO ready to be "bored" that we can't hardly stand it. 

Sunday

Several weeks ago when we were told that Rachel would be a candidate for a heart transplant, we were told by the surgeon that everything needed to be "boring and frustrating."  Well, unfortunately, it hasn't been boring, especially today.
Rachel has been having "atrial-flutter," meaning that the top chamber of her heart, the atria, had been in a "fluttering" state for several hours in a row.  If the flutter remains, there is a chance that it could lead to a blood-clot formimg.  So, the doctors wanted to do a procedure where they would insert a long tube down her throat with a camera on the end of it to that would go into her heart. This would allow them to see whether or not a clot had already begun to form.  If a clot had formed, they would start her on a Heparin drip (blood thinner) to help desolve the clot.  If there was no clot, they would shock the heart by pacemaker to get her out of the atria flutter, if they could not get her out of the atria flutter by pacing, they would have to use the shock paddles instead.  Howwver, they can not shock the heart, with or without the pacemaker or shock paddles, without the procdure of going down her throat first.  If they shocked her heart and there was a clot there, it could send the clot off thereby causing major problems.
Unfortnately, they had to sedate her before they could put the tube down her throat.  However, she had built up such a tolerance to the sedation, that she didn't fall asleep so they could not do the procedure.  So now, the plan is to take her down to the OR sometime tomorrow and put her under anesthia in order to do the procedure.  The drawback with that is that it causes the heart to supress and given her poor heart function, that can be tricky.  For now, they started her on a Heparin-drip and she is relaxing.
This is so dang aggravating as it seems the longer she is here, the more problems arise.

Determination: The Story of Our Fighter

Every couple, when they find-out that they are going to have a child, want nothing more than to have a healthy baby. Sure, there are other things that are important such as the sex of the baby, maybe finding the right name, but nothing is more important than the health of the baby. In most cases, a baby is born and everything is good and life goes on but sometimes it's not good. A baby can appear, on the outside, to be perfectly fine but can have problems that are hidden from view, like those we experienced with our daughter. She appeared to be perfectly healthy whenever we first saw her, heard her wonderful cry, held her, kissed her, but later learned differently. It is in that moment when you find out that something is wrong with your baby that your world gets turned upside down, that things just don't make sense and you feel completely helpless.

This is the story of one amazing little girl, a fighter. Our daughter, Rachel, has had to fight since the day she was born. She has never known what it's like to lead a "normal" life, never known what it is like to "feel good," never known what is is like to not take medications, never known what is it like to not go to the doctor's office on a regular basis, never know what is is like not to be stuck with needles, never known what it is like not to have heart-caths, never known what is it like not to be hospitalized several times, and never known what is it like not to have had multiple heart surgeries. Her life has been surrounded by adults, mainly nurses, doctors and therapists because she has spent her life in and out of doctor's offices, hospitals and therapy.

We have heard it said that Rachel is "tough" and she is a "fighter" and we couldn't agree more. According to the World English Dictionary, the word tough means, "strong or resilient: durable," and the word fighter means, "a person who has determination," Certainly, these words are perfect descriptions of Rachel. This is why she is truly our hero and we are proud that God blessed us to be her parents.

         
The Fight Begins

September 13, 1992. It's a day we will never forget. For it was the birth of our first child, a baby-girl we named Rachel Smith; a beautiful name for a beautiful baby.

We arrived at TMH shortly after midnight (Sept. 13th) and stayed in the labor and delivery room for what seemed like countless hours. The early morning hours dragged on and finally, after hours and hours of labor, Tammy gave birth to our first-born at approximately 1:58 p.m. on Sunday, September 13, 1992. What a beautiful baby; the prettiest baby ever to be born for sure! We cried with excitement and were both overcome with emotion to see our first child being born. It's a feeling that is indescribable to someone who hasn't witnessed it before. We were both smiling ear-to ear at hearing Rachel cry her first cry, of seeing her look around in amazement at her brand new world and looking into her beautiful little eyes. And did she have a tinge of red-hair? Yep, she sure did! At that moment, it seemed that everything was perfect, but, we would soon find out that it wasn't.

Shortly after her birth, while getting her first "bath" in the nursery, Rachel turned "blue." Initially, we were told by a nurse that as a precaution she would be moved to the Neonatal Intensive Care Unit (NICU) and doctors would be examining her to try and find out why she turned blue. Okay, they probably see this all the time, no big deal. It was later that we learned that our newborn baby, only mere hours old, had something seriously wrong with her. We later found out from the pediatric cardiologist in Tallahassee that our baby had "some type" of heart problem and that she would need to be flown by Life-flight to Shands Hospital in Gainesville for further assessment. You have to be wrong. Please tell us you are wrong!

Questions flooded our minds; emotions took over. Plenty of tears shed. The anxiety of not knowing what was going on scared both of us. How could this be?How could our world turn upside down in a matter of hours?How could we go from being on top of the world as we watched a new life come into the world to a feeling of disbelief and uncertainty? This just did not make any sense. This had to be really bad dream: a nightmare that we expected to wake up from at any minute. Please God, why was this happening to our baby?

Rachel was admitted to the NICU-3 at Shands and remained there for the first two weeks of her life. It was there, in a waiting room, that we found out that our baby girl--- so innocent, so precious, so little --had a congenital heart defect known as "Tetralogy of Fallot" one of the most common cyanotic heart defects and the most common cause of "blue baby syndrome."  (This explained why she turned blue shortly after her birth).  We were absolutely stunned by this news. There had to be some kind of mistake. This is our baby, not someone else's baby. Please tell us you are wrong in your assessment. We learned that Rachel's pulmonary artery as too small to carry blood through to the other parts of her heart.  As a matter of fact, we were told  that her pulmonary artery was almost non-existent.  It was explained to us that in a "normal" heart, the pulmonary artery would be about the size of a pencil, however, Rachel's artery was about the size of a pencil-lead.  Therefore, there was hardly any blood passing through her artery and out to the other parts of her heart.  Also, we were told that she had multiple holes in her heart, with the most significant being a large hole between the two bottom chambers of her heart known as a Venrtricukar-Septal-Defect (VSD). And, finally we were told that she has variety of other problems within her heart that would eventually need to be addressed but for now the most pressing issue was the narrow pulmonary artery. She would eventually need surgery but doctors wanted to wait until she had grown a little more before she had the surgery.

After about two weeks in the NICU at shands, we finally got to bring Rachel home for the first time. For the next 5 1/2 months, we got to enjoy the everyday challenges that comes along with being first-time parents and adjusting to having a baby in the house. We enjoyed every minute of it, including those early morning hours when she would wake up hungry. Eventually though, we knew the day was coming that she would need surgery.

In March 1993, at only six-months old, Rachel had open-heart surgery at Shands. Dr. Daniel Knauf performed the surgery. He would put in a conduit from the right ventricle to her right pulmonary artery with the purpose being to provide more blood flow into the pulmonary artery. The thinking being that the more flow of blood along with her growing and getting bigger, the more the artery would grow with her. Nothing in our lives was as tough as the morning of that surgery. Handing our daughter over to a man that we had only met the night before and trusting that he would not let her die, that he would take care of her is a feeling we will never forget. It's a feeling that no parent should have to encounter.

The night before her surgery, one of the doctors asked us if we had noticed anything odd or different in Rachel's development. We did mention to him that she had always kept her right are drawn-up to her body and that she kept her right hand in a fist, that she didn't use her right arm/hand at all. So, an MRI was ordered. We learned from the MRI, that it appeared Rachel might have had a stroke while still in the uterus. The MRI revealed that the left-side of her brain "didn't form all the way" and this would affect the right side of her body, could effect her speech and language development. We were told that because of this she could be susceptible to seizures. Great! Another thing to worry about in addition to her heart problem!!

From after surgery in 1993 until 2006, Rachel  had numerous heart-cath procedures and visits to the Cardiac clinic at Shands. At one point we were told not to let anyone ever do a cath on her again that our next surgery would be a heart/lung transplant. When she was around five years old, she had surgery to repair her sub-mucus cleft palate as she had also had palatal problems since birth. Rachel eventually began undergoing speech, physical and occupational therapy. Eventually, we learned that Rachel has "Velo-Cardio-Facial Syndrome" (VCFS), a deletion of the 22q11.2 chromosome, also known as "DiGeorge Syndrome." A syndrome is a compilation of abnormalities that affect a person. We later learned that heart defects are one of the more common abnormalities of VCFS. We also discovered that Rachel has a number of these abnormalities including: palatal problems, learning difficulties (she is developmentally delayed), speech/language impairments, hypothyroidism, seizures, scoliosis,and feeding difficulties to name a few.

It seemed that Rachel was constantly in and out of doctor's offices for various reason as she grew from a baby to a teenager. As a baby, she had numerous ear infections which eventually led to her having tubes in her ears. During the winter months, she would always catch a bad cold complete with severe coughing and fever. She began to experience migraine headaches which would, in turn, make her nauseated and cause her to get sick. It seemed like that if anything came along she caught it. For reasons not known, she would sometimes wake up sick during the middle of the night. This would happen off-and-on for several years. Her file at the pediatrician's office was beginning to resemble a New York City telephone book.

In August 1995, Rachel became a big sister to her little brother, Camden. God blessed up with a perfect brother for Rachel. Of course, as sibling they fought like most siblings do and continue even unto this day. But deep down inside Camden has a special place in his heart for his sister and Rachel has that feeling for her brother. Camden has also had to grow up around nurses, doctors and hospitals because of Rachel but not one time has he complained. He has always been there in support of Rachel. So, it has been hard on Camden as well, but in him being around Rachel and seeing her in the hospital so many times it gives him a greater sensitivity for other children who may have difficulties but just want the love and friends like everyone else. He isn't shy about befriending another child with health problems, both seen and unseen. God truly picked a special person in Camden to be Rachel's brother and for that, we are thankful.

In May 2006, Rachel underwent her second open-heart surgery at Shands. The surgery would be preformed by Dr. Mark Bleiweis, chief of  pediatric cardiothoracic surgery. The surgery would entail Dr. Bleiweis replacing her pulmonary artery with a gortex-tube in order to allow enough blood to flow through her artery; to replace the conduit that was put in her when she was six-months old with a pulmonary valve and to close off some of the holes in her heart.  Once again, we had to hand our daughter over to a man that we barely knew and had to trust him that he would take care of her. The surgery was successful and after a hospitalization of about two weeks, Rachel was discharged from Shands. However, our stay at home was short-lived as she seemed to regress after we got home; she had to be re-admitted to Shands about a week later. It seemed that after being re-admitted, Rachel did not get better. After weeks and weeks of no progress it was decided that she would need to undergo an Electrophysiology study (EP study), a procedure which tests the electrical conduction system of the heart to assess the electrical activity and conduction pathways of the heart. Eventually, it was decided that Rachel would benefit from having a pacemaker. So, in late July, while still hospitalized at Shands, Rachel underwent the procedure to have a pacemaker inserted to help regulate her heart rhythm. After nearly four months of being hospitalized, Rachel was discharged and returned to her home.

In November 2006, the weekend before Thanksgiving, Rachel experienced her first seizure. We had no idea that it was a seizure; we assumed it was cardiac-related. She was eventually airlifted to Shands and admitted to the PICU. The doctors determined that it was not cardiac-related and suggested that it could have been a seizure. After a few days at Shands, Rachel was released and we traveled back home on Thanksgiving Day. However, a few days later, she experienced another seizure. Eventually, she was seen by Dr. Ricardo Ayala at TMH and was put on anti seizure medication. Our minds went back in time to the night before her very first surgery when it was revealed to us what the MRI had shown and we were told that Rachel could experience seizures as she got older. Are you kidding?!? Hasn't she been through enough already?? Now she is experiencing seizures too!!

In April 2011, Rachel underwent her third open-heart surgery at Shands. Once again, Dr. Mark Bleiweis performed the surgery. The surgery consisted of Dr. Bleiweis replacing the pulmonary valve from her previous surgery because it had begun to narrow and leak and he wanted to close off the VSD. The surgery was successful but once again complications arose afterwards. We learned that Rachel's aortic valve was leaking more than the doctors realized. We had known for several years that the aortic valve was leaking but it had been categorized as "mild to moderate" and that if it worsened something would need to be done to correct the leaking. A heart-cath revealed that the aortic valve was leaking more than before and in doing so the excess blood from the leaking valve would cause the left ventricle not to relax during the relaxation phase of a heartbeat. The doctors were now faced with a dilemma: attempt to have Rachel undergo a fourth open-heart surgery to try and replace the aortic valve, which would have to be replaced about every two years, thereby putting Rachel through multiple heart surgeries or list her on the national transplant list for a heart transplant.

On June 7, 2011, Rachel's name was officially listed with the United National Organ Sharing transplant list to receive a new heart.  Dr. Bleiweis told us that a new heart would give Rachel something she has never had before: a healthy heart.  He also said that after she receives her heart she will finally experience the joy of what feeling good feels like.

So here we are, waiting on a new heart. 18 years of battles and our little hero, refusing to go down but instead fighting in the next round of her fight with life.  Our little hero, so strong, so resilient and so durable, determined not to give up.  Looking at her, it's as if she is saying to life, "This is the best you can do to me?  Well, I'll show you?  I'll take your best shot and give it right back to you?"

So the next time you hear the words "tough" or "fighter," please remember one very special girl.  A girl who is small in stature but is strong, resilient, durable and most of all, determined.  That little girl is our beautiful hero, Rachel.

P.S. - To every parent: If you have a healthy child, take the time to thank God for him or her. Take the time now to thank God that you don't have to experience seeing your child with a long incision down the middle of his or her chest from having had open-heart surgery; or having to watch your child be hooked-up to so many tubes and wires while laying in a hospital bed; or seeing your child with a breathing-tube down his or her throat; or seeing your child get stuck with needles so many times that you wonder if he or she has any veins left; or having to watch your child take so many pills during the course of a day; or taking your child to the doctor's offices over and over; or seeing your child suffer a seizure; or seeing tears stream down the face of your child because he or she is scared of what might happen next. Take the time to wrap your arms around your child today and thank God for them.

Friday 6/24/11

It has been a while since our last update. Not a whole lot of changes right now. We have had a medication issue but that has been resolved. She is still on the ventilator and will probably remain on the ventilator until she has her heart transplant. Which will give her a better chance at getting a new heart because that puts her as a 1 A status on the list. Talking with one of the transplant doctors Wednesday he said they have been taking calls for her a heart just haven't gotten the right one that matches everything. While it is discouraging that we haven't gotten the right call yet it is also encouraging to know that they are getting calls on possible hearts.

We want to thank all of you for your prayers and support. We ask that you please keep praying for a precious little girl.

Saturday

Not a whole lot of changes the last few days.  According to the doctors this morning, everything looks okay (well, as okay as it can get) blood-work wise and heart-function wise.  She still has a low-grade fever off and on but the doctors aren't too worried about it as nothing has grown out of the blood cultures that they've done.  They seem to believe that it just might be her body's way of dealing with all of the stress its under.  The good news, at least over the past few nights is that she has been able to sleep, which in turn, is allowing Tammy to get some much-needed rest as well.
We want to again thank everyone for all of the words of encouragement through the beautiful cards, gift-cards, monetary donations and most of all, the prayers.

Wednesday afternoon 6/15/2011

She has played catch up on sleep today didn't sleep much the Tuesday night and very little if any Wednesday during the day.  Her fever is back. However not as high and none of the cultures they have drawn everyday for over a week are growing anything. We kind of think the fevers are medication induced and/or the way her body is dealing with all the stress it is under. She had another pic line put in yesterday because the other one was 3 weeks old and if you leave them in too long the risk for infection increases. We have come down on the ventilator settings. The best news of all she actually has ribs on the right side. I say this because all the x-rays up until this morning you have not been able to see but a few of her ribs on this side. This morning we could see all of them. she still has fluid but there is a huge improvement.

We want to again take the time to thank everyone for their prayers for her and us.They are greatly appreciated. On another side note, A huge thank you to all who have provided food and are providing food for Keith while he is back in Crawfordville working and waiting.  That is such a blessing to me knowing he is eating something besides cereal for dinner. 

Sunday afternoon 6/12/2011

Rachel has slept most of the day. We are still battling a mysterious fever. They went down on her lasix yesterday and this morning her lungs looked wetter so they have gone back up on the lasix. All her other numbers look good. They have been able to reduce the amount of oxygen she needs from the ventilator and decreased the amount of breaths it is doing for her. So we are heading in the right direction.

We had great visits from some friends yesterday. It was great to see some familiar faces and to hear about things going on back in Crawfordville.

A very heart felt THANK YOU to the special family  for the gifts we received yesterday. There are no words to truly express our appreciation adequately. We consider you all family and we love you all.

Friday afternoon

Here is what we have found out today.  They had to put the breathing tube back in yesterday and her oxygen stats did not come up right away, however, after a while, they did.
This morning in rounds, one of the doctors said that it was decided that another heart-cath should be done today to determine whether her having to go back on the ventilator is a lung or heart-function issue.  They could tell yesterday that her lungs were very wet but did not know if this was due to her aspirating or whether some pneumonia had begun to set in.  So the question before the doctors was is she having difficulty maintaining on her own due to issues with the lung or because of very poor heart-function.  A couple of the docs believed it was heart-function, one doctor believed it was lung related and one was undecided.  So they decided to have a heart-cath done today for the purpose of measuring the pressures in the right side of her heart.
The cath-doctor did the heart-cath around noon today and he reported to us that he believed that it was a lung issue rather than heart-function.  He was guessing as to the cause, whether she aspirated, whether or not it was an infection or pneumonia.  When asked, he said that to him, if a heart became available, he felt that it would have to be turned down because her lungs are not healthy enough right now and that they have got to her lungs stronger.
A while later, another doctor stopped by and said that he believed it was cardiac-related.  He said that he and Dr. Bleiweis (surgeon) both believed it was cardiac related and not necessarily all lung-related.
So, we requested to meet with Dr. Bleiweis, who knows her the best, and he believes that it is due to her heart failing.  He said that with her very poor heart-function, her heart being in such bad shape, any little thing such as aspirating or pneumonia or an infection of some kind can "tip her over the scales" to where she can't maintain on her own.  He also said that they are having to take a "shotgun" approach to cover everything, meaning they are treating for any possible infections, and doing everything they can do to draw the fluid out of her.  They have her on a lot of diauretics to keep her from overloading and causing more problems.  When asked if he would take a heart if one became available in the next few days, given the way she is currently, he said without hesitating, "absolutely." 
Now that she is back on the ventilator and they have her on drugs for her heart, she is now currently listed as a 1a status on the transplant list rather than 1b. 
He said for now, they will keep her on the ventilator for as long as possible because she has shown that she can not maintain on her own for too long b/c of the weak heart. 
So, our prayer is that a heart will become available soon, really soon.

Friday afternoon 6/10/11

Please Check back later for update. We are waiting to talk to the surgeon who is in surgery about the results of the heart cath she had done this morning.

Tuesday Afternoon 6/7/2011

She is doing so much better this afternoon. We think she aspirated while throwing up but giving her heart issues they were covering all their bases (which is a very good thing). She is still on the high flow nasal canular but the oxygen is now down to 50%.

In all the commotion this morning I failed to let everyone know she is officially on the transplant list. However we need prayer that when they rerun the antibodies blood work that it comes back all clear. The first test had some concerning results that may limit her already limited chances for a heart because of her blood type even more. We are praying that it results are false and are do to the way the blood test was processed.

We would like to thank all of you for your support and prayers.

Tuesday 6/7/2011

Having a rough start to the morning. She woke about 6 vomiting and then in the blink of an eye her oxygen levels dropped to the mid to low 80's. She is back on the high flow nasal canular, have started an epi drip, given her an extra dose of lasix and going to transfuse her with 2 units of blood.  They did  a chest x-ray and an abdomen x-ray. The Chest x-ray looks about the same as it has been so thankfully no fluid build up in the lungs. However when fluid it starts to build up the GI tract is one of the first organs to take a hit and they think this is what is going on therefore the extra dose of lasix will hopefully help. The abdomen x-ray was to make sure her feeding tube is still in the intestine and thankfully it is where it should be.

She seems to be resting better now with her oxygen levels staying in the low 90's  with 80% oxygen in through the canular. Praying things improve as the day goes on.

Saturday (06/04/11)

Not a whole lot of change from the last several days, which is a good thing according to the doctors.  She sat-up in the chair for almost two hours this morning and she looked really good and even smiled several times.  She had a spa day--hair washed, bath and she took a long nap.
The surgeon said this morning that she seems to be doing okay on her own and the goal is try and keep from having to re-intubate again.  He said that her last chest x-ray looked good and she is getting a lot of nutrition through her feeding tube and overall the "numbers"  (again, its all about the 'numbers') look pretty good.
So, we remain in a kind of holding pattern and will be until we get a call that we have a donor heart.  So please pray that will happen sooner than later because the sooner it happens, the sooner she can recover and heal and the sooner she can get out of the hospital.

Thursday 6/2/11

We want to thank the people responsible for the anonymous gifts from Greensboro, North Carolina. It was a very touching and thoughtful gift. It is greatly appreciated.

She had a pretty good day today.  We took three very short walks today. We didn't go as far as yesterday as we over did it yesterday. We have started her on Ensure Enlive which is a high calorie, high protein apple drink to go along with her being tube fed around the clock. We also found out that she will officially be put on the heart transplant list Monday. So Monday our waiting officially begins. Thank you all for your support and prayers during this time they are all greatly appreciated. 

Wednesday Afternoon 6/1/11

Three short walks today.. We went a little farther on the last one and she got to have a chair ride back to the room. Now she is really tired. Over all a very good day.