She's Got Skillz (Louisa at Six Months)

[Yes, the title of this post is meant to be sung to the tune of the All-4-One song by the same name.  Yes, I still love my '90's R&B.  Judge if you must!]

Amelia has gotten most of the air time on this blog so far, which is understandable, but I think that it's about time my other girls get a share of this spotlight, as limited as the audience may be!  And what better day to share some of Louisa's recent activities and accomplishments than her half birthday?

So here is what our littlest has been up to as of late.

• Hanging out on her tummy. She enjoys it now that she can roll to her back and then back to her front with ease.

• Observing. She is highly aware of what is going on around her these days. Her favorite subjects to observe are her sisters, naturally, and also our cats, which she has finally realized exist!

• Holding her own bottle.  Such a pro!

• Eating some solids.  So far, just rice cereal and butternut squash, but more to come soon.  And if everyone else is eating but she isn't, she will throw an absolute FIT.

• Sitting up on her own for good chunks of time.  If I'm not within arm's reach, I'll stick the Boppy behind her, but she needs it less and less often.  And when she does tip over, she somehow does it in a slow, controlled manner (usually).

• Smiling at EVERYONE.  She may not want just anybody to hold her, but chances are, if you smile at Louisa, she'll smile back at you.  And she has just the cutest little flirty smile!

• Pulling hair.  HARD.  (Sorry, Grace!)  Also, grabbing ears.

• Chewing on EV.ER.Y.THING.  Favorite items to chew include her clothes and her feet, but any small toy will do in a pinch.

• Drooling.  Teeth may be making an appearance soon, although I continue to hold out hope for a couple more months of gummy smiles. 

Louisa had her six-month well-baby visit today, weighing in at 17 pounds (68th percentile) and measuring up at 27.25 inches (94th percentile).  The smallest of our kiddos at that age, she's still a pretty big girl!  And she has such a sweet disposition.  She got four shots and one oral vaccine at her appointment today, and has both a cold and a diaper rash, but still gave me these smiles during our monthly photo session:

She's such a doll! 

I can't believe that my baby girl is SIX months old today.  We've had so much fun getting to know her over these past six months, and are looking forward to watching her grow and change in the months (and years) to come.

Happy half birthday, Louisa Frances!  We love you.

Surgery #1: Tonsils and Adenoids

Yesterday began bright and early.

Chad, Amelia, and I headed over to Mass Eye & Ear at 5:30 AM to check in for Amelia's tonsillectomy.  (Chad's mom, Audrey, graciously extended her Thanksgiving trip for a week to watch Ramona and Louisa during the surgery, and to help out with the aftermath.) 

All checked in and dressed in her tiger hospital garb -- and not too happy about it...

Before shot of poor Amelia's throat -- we'll add an after once the swelling is down

Two hours later, after answering the same litany of questions for multiple nurses and doctors ("No, she is not on any medications."  "Yes, she has a heart defect."  "No, she does not have any loose teeth."), she was wheeled down to the operating room.  After her reaction to being put under for her MRI (lots of tears and refusing to let go of me), I expected the worst.  The administration of the anesthesia actually went very smoothly, however, thanks to one of the hospital's iPads and Angry Birds Space!  She got to bring the iPad onto the operating table with her and played her game right up until the moment that she fell asleep, with the brilliant anesthesiologist incorporating her "space" mask right into the game.  Phew!

The surgery was finished about an hour later, and Chad and I were taken to the on-floor recovery room to see her.  The first half an hour was messy, while she was coming out of the anesthesia, just like it was after her MRI.  Amelia was crying and clingy and kept trying to cough, poor girl!  I gently suggested (I know that doesn't sound like me, but I seriously was being gentle about it!) that she try not to cough so that she didn't make her throat feel worse.  Her response?  "No, I am NOT going to stop coughing."  At that point, it was evident that she was starting to feel more like herself.  :)

Once Amelia was a little less groggy, and had downed a popsicle and a cup of apple juice, we were released from the surgical floor to her recovery room on the pediatric floor, where we set her up watching Brave on the iPad (thanks to Nonna for the movie!) and all the popsicles and Italian ices she could eat (five).  She also spent some time cuddling with Molly, her Aunt Lindsey's American Girl doll who flew out to help Amelia get better, complete with her own hospital gown. 

Red popsicles make everything better



Purple popsicles help, too

Molly and Amelia watching Brave

When we spoke with Amelia's doctor, he said that both her tonsils and adenoids were even bigger than expected, and that she should experience "significant relief" from their removal. Despite the swelling from the surgery, her voice already sounds improved, clearer. I hadn't realized the degree to which her tonsils were impairing her speech, and I can only imagine how much easier it will be for her to breathe and swallow once her throat has healed.

The view from Amelia's hospital room

Three hours after she got out of surgery, Amelia was doing so well that she was discharged home!  The afternoon and evening involved a couple more movies, lots of popsicles, some tylenol, and even a little oatmeal and mac and cheese.  We tried giving her the narcotic/painkiller that she was prescribed before bedtime, but it made her sick, so I think that we'll stick to tylenol from here on out, unless it seems like her pain level increases.  So far, she's doing well today: more movies, more oatmeal, some yolky eggs, some yogurt, tylenol every four hours, and lots of cuddles!  We'd be in great shape if it weren't for one little wrinkle... Audrey, Ramona, and I all seem to have come down with some sort of stomach/flu bug.  Fingers crossed that it's just of the 24-hour variety!

Thankful

We hope that you all enjoyed your Thanksgiving holiday! 

We had a great time here in Boston with Chad's parents, his sister, Tonya, her husband, Dave, and their two girls, Grace (2.5 years) and Ellie (8 months).  Here are some of the things that we were thankful for:

1.  Cousins!  Our house is not big enough for six extra people, so Tonya, Dave, Grace, and Ellie stayed in a rented apartment during their visit, and there were several meltdowns over leaving their cousins upon parting for naptime or bedtime... I'm glad that the girls love their cousins so.

2.  Snuggles.  Louisa hadn't yet met her Aunt Tonya.  I think it's fair to say she likes her!

3.  PLENTY to eat.  And a husband who can roast a turkey to perfection. 

4.  New babies! 

5.  Spending time with family.  I love this picture of Chad with his sister and their respective youngest kiddos.

6.  Pajama parties.  In matching pjs, of course. 

7.  Playdough.  And the imaginations of children.  Grace made carrots.  Ramona made parachutes and "worm holes".  Amelia made snails.


















8.  Story time!  And a good book.


















9.  Shoelaces?  Maybe...  Grandpas?  Definitely!

























10.  Going for walks with Grandma.  And GINORMOUS Christmas trees!

























11.  Being able to spend time together, since we live far apart and don't get to visit as often as we'd like...

























And that pretty much sums up our Thanksgiving.  :)

In other news, Amelia's tonsillectomy is tomorrow.  We have to check in at the hospital at 6:00 AM.  Fingers crossed that all goes smoothly and that Amelia recovers quickly!

Heart Surgery Update

Last Thursday, I got a call from Amelia's cardiologist to schedule her heart surgery.  (I know, it has taken me a while to get this update posted... Still learning how to manage this blogging thing!) 

Tangent: I was surprised and impressed to hear back from her so quickly, considering that this is a non-emergent procedure.  I was also impressed that the other cardiologist we've spoken with, the cardiac MRI specialist who was present for her MRI on Tuesday, came to speak with me not once, but twice, while I was at the hospital with Amelia, to discuss what they saw and to answer any questions.  I know these doctors are busy people, so it's nice that they've been as responsive and concerned as they have been.

Anyway, the phone call.  Amelia's cardiologists at MGH had consulted with some cardiologists at Children's and the cardiac surgeon who will be performing the surgery (who is also at Children's), and all agreed that she is a great candidate for surgical repair, so she was calling to schedule the surgery.  We had two dates to choose between: January 7th (with a pre-op evaluation on December 17th) or Feburary 4th (with a pre-op evaluation on January 7th).  Neither date is compromised by Amelia's tonsillectomy (which is scheduled for a week from today...), since a four-week recovery period is all that is necessary.  At the pre-op evaluation, we'll get to review the images and talk to the surgeon and the anesthesiologist.  Also, Amelia will have to undergo some bloodwork.  (Given her hysterics-inducing fear of needles, that should be "fun.")  I told the cardiologist that we would discuss the dates and get back to her.

After some back and forth over the dates – Better that she doesn't go back to school after Christmas to decrease the likelihood of catching a cold?  Better to go with the February date so that part of her recovery time coincides with school vacation week? – we decided to go with the later date, to give Amelia's little body some extra time to recover in between surgeries.  (Apologies in advance to my mom, who is already flying to New York for Christmas, and will likely end up flying back to Colorado in January and then back to Boston in February to help us out.)

So Amelia is scheduled to undergo heart surgery on February 4th. 

As I mentioned, the surgeon is at Children's, but the surgery will take place at MGH.  Apparently MGH does a lot of consulting with Children's, and so I'm not sure if this is per their normal course of business, or if this is because I was put in touch with the chair of the cardiology department at Children's through a very well-connected partner at my firm.  In any case, I am glad that she'll have a surgeon from the #1 ranked pediatric heart program in the country.  Can't do better than that, right?

Having a concrete date is at once a source of peace and a source of anxiety.  I am glad that we have the surgery calendared and that this will all be behind us in a few months, but I know that the time between now and February 4th is going to fly...

In the meantime (but probably after the tonsillectomy!), we'll need to prepare Amelia for what she's going to go through.  Does anyone know someone whose child has undergone heart surgery?  If so, I would love to chat with them.  I think the physiology won't actually be too hard to explain – she has a hole in her heart that the doctors need to fix – but I'm not sure how to explain how she's going to feel after the surgery (without scaring her), or the necessity of taking it easy (not a four-year-old's strong suit) for what could be several weeks while she's recovering.  Any suggestions?  While shopping for Christmas gifts online, I stumbled across this adorable stuffed heart, and think we absolutely HAVE to get it for Amelia. 

This has to be the best ever get-well-soon-gift for a kid having heart surgery, right?

Well, that's it for now with respect to Amelia's heart, and we likely won't have more news on this front until her pre-op assessment in January.  I'll try to post about some more cheerful topics between now and then.  With Chad's family in town for Thanksgiving and plans to spend Christmas with mine in upstate New York, that shouldn't be too difficult!

Amelia's Heart

On Tuesday, I posted a picture of Amelia recovering from the general anesthesia she had been administered so that she could undergo a cardiac MRI on Facebook.  The outpouring of concern and sympathy was incredible, and much appreciated.  After responding to a number of emails and phone calls, I decided it made sense to (finally!) finish setting up the blog that I began months ago so that I had a place to post updates. 

So this is the story of Amelia's heart.

It's a long story. 

At Amelia's four-year well-child check-up in August, her pediatrician heard a murmur and wrote us a referral to a cardiologist.  We weren't too concerned about it because heart murmurs are not uncommon in kids.  Plus, I have a VSD (or had one — it couldn't be located recently), and so I know first-hand that they generally don't have much impact on life.  In fact, the only thing that I can ever remember having to do for mine was take handfuls of antibiotics before and after dentist appointments (to prevent infection in the heart), and they don't even have you do that anymore (because way more people had adverse reactions to the antibiotics than developed infections in the heart)!  So, as a result, we didn't follow up right away with the cardiologist.

At the same check-up, though, Amelia's pediatrician also noticed that her tonsils were pretty enlarged.  The rapid strep test came back negative, but she had a course of antibiotics anyway.  When her tonsils stayed swollen, though, and actually got worse, we got a referral to an ENT.  He said to wait and see what happened with them, and scheduled a follow-up appointment for her.  He also said that, before we could talk about removing Amelia's tonsils, we needed to get her murmur checked out, and so we decided to follow up with the cardiologist ASAP in case her tonsils needed to be removed.

At her cardio appointment (in mid-October), Amelia underwent an EKG and an echo, in which they noticed some dilation (meaning enlargement, but not permanent) on the right side of her heart.  Amelia's cardiologist told us that she likely had either a sinus venosus atrial septal defect (ASD) and/or a partially anomalous pulmonary venous connection, and that surgery would be necessary to correct it.  Because they needed to get a clearer picture of Amelia's heart, though, they scheduled her for an MRI, which took place on Tuesday.  Overall, the MRI went well (aside from lots of tears caused by the general anesthesia).  They got good pictures and can see exactly where the defects are and how big they are.  She actually has both a sinus venosus ASD (basically, a hole where the vena cava and one of the pulmonary veins connect) and a partially anomalous pulmonary venous connection (meaning a pulmonary vein is draining partially into the right side of her heart instead of the left).  If not repaired, it will cause permanent damage to both her heart and her lungs.  So she has to have surgery to repair the hole and to reroute the anomalous vein.

Yep, open heart surgery.  On a four-year-old.  MY four-year-old.  It makes me want to cry.  And, in fact, has made me cry quite a bit over the past month!

BUT, we are very lucky that they found it now.   Lucky that our pediatrician even heard the murmur, which the cardiologist described as "unremarkable," and which one of the doctors who checked her out in the PICU after her MRI couldn't hear (God bless Dr. Murphy!).  Lucky that her tonsils are enlarged for some unknown reason, causing us to follow up on the cardiology referral sooner than we otherwise would have.  Lucky that we live in Boston, home to some of the best hospitals in the country, and, in fact, the number one ranked hospital for pediatric cardiology and cardiac surgery.

We should hear back from the cardiologist and/or a cardiac surgeon later this week or next week to discuss the next steps, but we know a little about the surgical process already. She will be in the hospital for 5 to 7 days after the surgery.  The cardiologist said that by the third or fourth day, most kids' pain is managed with tylenol.  Crazy, right?  A week after she is discharged, she'll have a follow-up appointment.  At that appointment, if she's feeling good, she could be cleared to go back to school.  I am amazed that kids can recover from open heart surgery in two weeks.  Anywhere between two and five weeks is standard.  There will be more follow-up appointments, obviously, and it'll always be something we need to watch, but it's very likely that Amelia will suffer no side effects.  Thankful for that.

Oh, and those pesky tonsils? They're scheduled to be removed the Tuesday after Thanksgiving.

Amelia recovering in the PICU after her MRI on Tuesday

Giving Blogging a Go

I really love blogs. 

I love reading about what's going on in my friends' lives (and in the lives of friends of my friends, whose blogs are listed in the sidebars of my friends' blogs), and seeing recent pictures of them and their families.  I love the community that can be developed through the comment function of blogs, as readers share in the writer's joys and sorrows, and offer their suggestions and support.  But most of all, I love the journaling aspect of blogs: I love the ability of blogs to record the important events in people's lives and am jealous of friends who have chronicled multiple years of their lives in this way.

So I decided that I should write a blog, too. 

And I started setting up this blog about six months ago, but I got interrupted by Louisa's early arrival — quite literally, as I was working on it at the office during my lunch break, immediately after which my water broke — and wasn't able to finish the set-up... Since then, I have played with it off and on, but have put off publishing anything because I hadn't perfected what I want the blog to look like.  Having realized that this will never get going if I wait until it's "perfect," I'm just going to go ahead and take the plunge. 

Soooo, we're giving blogging a go!