Category Archives: Medical

The Limits of Medicine

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One of the most common complaints I hear is, “it’s seems like the doctors aren’t even trying to find out __________”.  Believe me, I understand where they are coming from. However, I also recognize that there are limits to medicine and sometimes it is more art than science. Maybe I have a different perspective because I grew up around medical professionals. I have also grown up around teachers, and they will always tell you that works for one child does not always work for another. Sometimes doctors don’t know and there is no test that can find the answer.

Now, I also understand how frustrating it is. Even knowing that doctors do not always have the answer, sometimes it really gets to me as well. This is how appointments go with Lyra:

  • Genetics: “We have no idea what the future will hold for her. She is an interesting case. She will have disabilities, but we have no idea what those will look like.”
  • Cardiology: “Well, her heart isn’t normal, but it seems to be functioning okay. We are just going to watch it and see.”  Me: “What does that mean in the long term/ bigger picture?” Cardiology: “We have no idea.”
  • Urology: “Her urethra is dilated, but she isn’t refluxing into the kidneys.” Me: “So what does that mean?” Urology: “We don’t know, but we will just have to monitor it.”
  • Ophthalmology: “Her optic nerves are enlarged.” Me: “What does that indicate/mean?” Ophthalmology: “We have no idea.”
  • GI: “We have no idea why she doesn’t tolerate her feeds. It makes no logical sense.” (BTW, I actually really like her GI doctor because he is bound and determined to find a solution, even if it isn’t logical.)
  • Neurology: “Well her brain isn’t normal and we don’t know why.”
  • ENT: “I feel like we must all be stupid. Like we are missing something. It just doesn’t make sense.” (These were his actual words)

There are a few more, but you get the idea. To be honest, sometimes I leave these appointments and cry. I try not to do it in front of Lyra. Even though she is a baby, she doesn’t need to see how sad this makes me. I want to be able to fix SOMETHING, but I can’t. I want to know what to prepare myself for, but there are no answers. I want to know why one day she eats a few oz by mouth, and the next day she pukes if I have spoon in my hand.

Trust me, the doctors aren’t being lazy. They talk to each other and to other members of their departments. I think almost everyone in GI at the hospital knows Lyra’s case at this point. I see the look on their faces that says, “how can I tell this parent that I have no answers for her?” I always tell them it’s okay that they don’t have answers. No one does. But it still breaks my heart a little bit.

Right now we are back in the hospital, and we have been for a few days. Once again, Lyra isn’t tolerating her feeds. We even put in a new tube called a GJ (a link with an explanation is below). We feed directly into her intestines, and yet she still throws up. She throws up enough stomach bile that she actually manages to become dehydrated. She is doing okay, but we can’t quite get her feeds up to the point where she is fully hydrated or getting enough calories. We have no idea how long we will be here. No one has answers, but everyone is trying. The GI nurses who see her outpatient even came by to say hi and check on her.

I guess my point is, it’s not easy, and people need to remember that medicine doesn’t have an answer for everything. Sometimes we just have to keep trying and hope that eventually something works. Or, keep watching and hope that everything works itself out.

CHOP – Low Profile GJ Tube

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Wagon ride down to the cafeteria for lunch with Mommy and Daddy

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The Things People Say

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This week is Feeding Tube Awareness Week. In honor of that, I have been trying to educate those around me.  I asked a number a group of caregivers (parents/grandparents/foster parents) to share some of their stories with me. Today’s topic is about the things people say to us and to our children. Even when people mean well, their words can be incredibly hurtful. These things have been said to us by strangers, family members, friends, and medical professionals:

  • “Have you tried letting them get hungry?” or “If you just stopped using the tube I am sure they would get hungry enough to eat.”
    • Many parents posted versions of these two comments. Some of us (myself included on this one) watched our children almost die because medical professionals didn’t believe us that our child wouldn’t eat. They don’t necessarily get hungry,or when they do, our children don’t eat enough to survive. If it was that simple, they wouldn’t have a tube.
  • “Did you try breastfeeding?”, “So you don’t breastfeed?”, or “If you just breastfed your child wouldn’t have ended up needing a tube.”
    • Breastfeeding is a VERY sensitive topic for this crowd. I think I can safely say that almost all of the moms who were able to tried to breastfeed. If we couldn’t do that, we at least tried to pump to give our children breast milk. Some of the moms spend months pumping. Some, like me, had no choice but to switch to formula. We all feel like the whole “breast is best” thing has been shoved down our throats, and we feel incredibly sad and guilty that we did not to experience that with our children.
  • “Have you tried giving them _____?”, “I had a picky eater. I gave them _____ and they started eating.”, “I bet I can get your child to eat.”, “If you just gave them kid food, they would eat.”
    • Don’t you think if it were as easy as giving them a different type of food we wouldn’t have ended up with a tube?
  • “So when are you taking out the tube?” or “Can you please remove the tube for family pictures?”
    • For most of us, we have no idea.  The answer may be never. That is okay. Our child is here. Isn’t that enough?
  • “This is disgusting. You shouldn’t be doing that in public.”, “Can you please feed your child at home, before you come over?”
    • I was amazed at how many parents said they had heard this when feeding their child in public. Breastfeeding moms, you are not alone.
  • “What is wrong with your child?”
    • This is one where I know people mean well and are curious, but there is a better way to say this. One mom explained perfectly why this is so hurtful.  Her daughter is a little older and when people say this her daughter hears, “something about me is bad/wrong.” These kids already know they are different and many struggle with confidence. Instead, you can ask the parent or child what the tube is. You can ask why they have a tube (many people are more than happy to educate about their child). Bonus points if you throw in a comment to the child -if they are older- like, “I bet that tube helps make you big and strong!” Make it a positive thing, not a negative one.
  • “The tube is just such an inconvenience.”
    • This “inconvenience” saved our children.
  • “I wish my kid had a tube. It would make dinner time/giving medications/etc. so much easier.”
    • There is nothing easy about having a tube and none of us have a happy story about ending up with one. Also, there are many other things that come with tubes: reflux, vomiting, chronic constipation or diarrhea, etc. While tubes have saved our children, we do not wish this upon anyone. Although, a little piece of me does recognize that it is nice that my 9 month old does not spit her many medications back at me.
  • “I will pray that he/she gets better.”
    • This is one I personally do not have any experience with, but a number of parents posted it, so I am sharing. From what I understand, their problem with this comment is that, in the parent’s eyes, the child is just fine how they are. They are happy and loving kids who are just different. Some of them won’t “get better” because they have a genetic disorder. There is no cure for genetics.
  • “Your child looks so healthy. Are you sure they need a tube?”
    • The tube is why they look healthy.
  • “I think the tube is just a crutch.”, “If you just took the time to feed your child, they wouldn’t need a tube.”
    • Yes, we are such lazy parents. That is why we never sleep more than a few hours at a time(feeding also happens all night for many of us), we are always running to doctor and therapy appointments, we spend days in hospitals/ERs with our children, and hours researching/asking other parents for solutions to challenges we are having. Yep, that’s it. We are too lazy to take care of our kid…
  • “If she eats by mouth, why do they need a tube?”
    • Some kids, like Lyra, simply don’t eat enough. They are working on it, but until then, they need a tube. Also, some kids have medical conditions where they need medications that only work correctly when delivered directly into stomach or intestines.
  • Saying nothing at all and just staring.
    • Our child is not a sideshow. Either ask us a question or stop staring.

Okay.  Enough with the negative stuff.  This isn’t everything, but you get the idea. Here are some positive things to say, especially if you are curious:

  • “Can I help you? Do you need an extra set of hands?”
    • Especially when something is going wrong during a public feeding, this is SUCH a blessing. You have no idea how much it would help to have an extra set of hands when setting up a feed in public. Most of time I end up feeling slightly frazzled when doing it, so I would love it if someone offered to keep something from falling/spilling.
  • “What is your child’s story?”
    • The vast majority of us are happy to educate you about feeding tubes and how our children ended up with them. Our kids are little fighters and we are proud of them.
  • “Is it safe for your child to eat by mouth?” – “Do they eat anything by mouth?”
    • This is always a great question before offering a child food (like at a family dinner). It’s just respectful and keeps everyone safe/happy.
  • You are allowed to be curious. Just ask us about our children. Like I have said before, we are happy to educate.

 

 

Just Photos

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Photography is a hobby of mine, but I have had technical difficulties for the last few months. All is resolved, so I thought I would share some of the pictures from my camera. They span September to now.

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The Third Night

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I don’t know why, but I always find the third night in the hospital to be one of the hardest.  Mark and I trade off nights, so it’s not like I have had three nights in a row. For some reason, I just find myself a little more restless. Yes, Lyra is back in the hospital. We ate breakfast Christmas morning with the family, opened presents, then drove to the ER.  It’s not like we knew she needed to go to the hospital when we woke up Christmas morning, but we knew she wasn’t doing great. She hadn’t been doing great for awhile. However, once she was throwing up when we weren’t feeding her at all, we knew we had to go in.

So, here we are again.

At this point, some of the nurses on the floor know us from our last stay. At what point do you get a parking space? We were just here a month ago.

This time it looks like the doctors may try something new. The hard part is, no one really has an answer for us. We have no idea why Lyra stops tolerating her feeds. We have no idea why she won’t eat by mouth. The answer we most commonly get is, “she just needs to get bigger.” But, how can she get bigger if she just keeps throwing up? It doesn’t seem like anyone has a good answer for that. As frustrating as that is, it seems the team we are working with now wants to do more than just get her to “stable enough” and send us home to figure things out for ourselves. We may be changing the type of feeding tube she has (if she is big enough), and they aren’t going to send us home without solid confirmation that she is tolerating her feeds really well. As much as I would love to be home, this is where she needs to be.

And we really did have a wonderful Christmas morning.

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Sitting on Aunt Kristi’s Lap before Breakfast

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Sleeping on Daddy in the Christmas quilt after getting her IV

Lyra is __________

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I have recently noticed that I often describe Lyra by her diagnosis. When I introduce Lyra I frequently only mention her age and the negative things: she doesn’t eat, she is very small, she had a feeding tube, she has two rare genetic disorders, etc. I think this is in part because I spend so much time introducing her to doctors. They want to know all of things about her.

But Lyra is more than her diagnosis. She is more than her complications.

Sometimes as a mother I get so focused on what is wrong with Lyra, I forget to focus on what is right. She is a happy, loving, joyful child. When she smiles, she does it with her whole body. She scrunches her face, arms, and legs all at once. She loves her daddy and is mommy’s little girl. She is curious and carefully watches the world around her. She soaks it all in and loves to be around people. While she comes with a long list of difficulties (many of them not unique to her), Lyra also brings joy to our lives.

So one of my many goals is to do a better job introducing Lyra and not her diagnosis. She needs that example. As she grows, she needs to know that she is more than what is wrong.

Fed is Best… and Beautiful

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I have finally found a community of moms/parents I can share stories, ideas, and challenges with. It is a virtual group: a page on Facebook. But it is my lifeline and a place of comfort. Today a mom posted that her baby just came home from the hospital and part of her is devastated that her baby is tube fed. How brave of her to post what ALL of us have felt/are feeling. We all had hopes, dreams, and plans for how we would feed our babies. I wanted to be a strict breastmilk mom. While pregnant, I dreamed of bonding with Lyra while breastfeeding her. It was going to be my selfish time with her. Something only I could give her. While I was able to pump for 2 months and at least give her breastmilk, it ended up being that my milk was not what was best. As I have written previously, I was heartbroken.

Not being able to give my daughter a bottle. Praying that she keeps her formula down. Being covered in puke for the third or fourth time in a day. All of this has brought me to tears many times. All of the parents I have exchanged with in this group have been there, or are there. Some days are easier for me, and some days just suck. These people have helped me see one thing: Fed is best.

While this term has been used most recently to try to calm the formula vs. breastmilk and bottle vs. boob battles, it has special meaning to tubie parents. While part of us will always feel sad that this is how we have to feed our child, we also become overjoyed that we CAN feed our child. Because of these tubes, our children are with us. As tubie parents, we should take pride in the time and care we put into feeding our children. We know EXACTLY how much they have had to eat that day. We carefully measure each drop and monitor every bag, bottle, and syringe. We lovingly mix formulas to exacting calorie counts, prepare blended diets, or do a number of other things I don’t even know about yet because Lyra isn’t there. We lose sleep over feeding EVERY SINGLE NIGHT. We should take pride in everything we do to feed our little ones because FED is best. It is also beautiful.

So here is to my tubie family for helping me see the positive, and understanding me. Thank you for sharing your stories and your photos. Thank you for giving me your time and support.

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Lyra being fed at night back when she still had an NG tube

How to Survive Your Child’s Hospital Stay

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As many of you know, Lyra was in the hospital again for a few days last week. She had an infection and became dehydrated. Because she is a complex case, it required closer monitoring than an average child. She was home two days later and it doing great. During my stay I ran into a mom in the elevator. I have no idea why she was there. It really doesn’t matter. It’s never a good thing. She was obviously stressed, upset, and worn down. She mentioned that it was the first time her son was in the hospital and I could tell she felt overwhelmed. While I wasn’t able to say much to make that mother feel better, I figured I would pass along what I have learned.

How to Survive Your Child’s Hospital Stay:

  • Take a deep breath: Panicking will only make the situation harder/scarier for your child. I used to view hospitals as scary horrible places. Going into one nearly gave me a panic attack every time (even though it was never because I was sick). Oh how my views have changed. When my baby is hurt or sick, I now view the hospital as a safe place where we find solutions.
  • GO HOME!!!!!: This may sound CRAZY to many people, but trust me. If you are going to have a child in the hospital for any length of time, you need to take breaks and GO HOME. When Lyra was in the NICU at Children’s National, nurses used to “yell” at me all the time to go home and get some sleep. I get it now. By going home you are NOT neglecting your child. You are recharging. Since Lyra is older, Mark and I trade nights there. No one really sleeps in the hospital (Lyra included), so this allows us to always have one adult who is fully functional taking care of her. And, if you can’t have someone else stay there, let the nurse know. Night nurses will make sure to keep a special eye on your child if you can’t be there. I know that Lyra has been passed around and held when we couldn’t be there.
  • Get to know your nurses: Nurses are amazing people and your biggest ally in the hospital. They are your teammates and they care about your child. If your kid has a rough day, they take it home. Trust me, I have been told by nurses. Nurses will help you take care of your child beyond administering meds. For example, Lyra is a terrible sleeper, especially in the hospital. At night, the nurses will frequently rotate with whomever is staying with her. They will rock her and hold her and try to put her back to sleep so we can get a small amount of rest. Now, if you happen to not like your nurse, it is totally okay to request a new one. Not everyone clicks. It’s okay.
  • Ask questions: No one is going to think you are stupid for not understanding something. Sometimes the medical professionals get so wrapped up in their conversation they forget there is someone in the room who is not familiar with the terms. It is okay to remind them that you need an explanation in normal people terms. Many doctors are happy to explain and even draw pictures. While their picture of often about as legible as their signatures, it’s the effort that counts.
  • Know where the refreshments are: I am not talking about the cafes and cafeterias. Every wing that I have been in has an area with a fridge, water cooler, and coffee (at the very least). Make sure you are keeping hydrated and for the love of god eat something. I can’t tell you how many times I have heard a code go over the speaker system because a parent fainted. If you are on the floor, you can’t take care of your child.
  • Accept the help that is offered: You would be amazed who comes out of the woodwork. Don’t be too proud to accept food, a change of cloths, or the offer to take your dog until your child is home. I am still humbled by the outpouring of support.
  • Ask for help: If you need something, ask for it. I have had to ask for food in ERs, asked friends for help with my dog, and a number of other things. People often don’t know what to do or how they can help. You would be surprised at how willing they are to give support.
  • Speak up: If you think something isn’t right, say something. While they may be the medical professionals, you are the specialist in your child. Especially if they are non verbal, you know when your child is in pain or just not doing well.  You know how they normally act and how they communicate things. It’s okay to be “that parent”.

I am sure many of the other parents who read my blog have their own words of advice. Please feel free to add them in the comments section. While I hope no one ever has to have their child in the hospital for any length of time, know that it happens and you can survive it.