Thursday, January 14, 2010
The gospel according to Ella...
Our friend's cat had been sick for a week and along with praying for her uncle, Ella has been praying for the health of the cat. I told her yesterday that our prayers were being heard because uncle CJ is getting better, and she wanted to know if Summer, the cat, was getting better too. It was one of those mom moments, where you know you have to proceed even though you are not sure if where you step will fall out from beneath you. I was prepared for questions of why God answered one prayer but not the other, I was prepared for sadness that the only cat consistently in her world was gone, I was even prepared for questions about what they did with her little kitty body when she died. What I was not prepared for was Ella's explanation of Kitty resurrection. sn.
The post I had hoped to NEVER write...
This is my beautiful Ella and her BEAUTIFUL hair. She is almost four and we have discussed who is allowed to cut her hair since she was two.
It was such a simple understanding. We dialoged this exact conversation at least once a week for the last year and a half. I thought we had it down. Ella was so proud of her hair, almost vain really. I would have to coach her on being humble because she got so many complements on how long and pretty her hair...WAS. She came home from my aunt's house and my mom sheepishly told me that Ella had cut her hair. My stomach dropped and I think I even vomited in my mouth a little. She didn't just cut it a little. She took scissors and lopped off a large chunk of hair from each side of her head. When I composed myself enough to ask her "why did you cut your hair" in a normal voice, not scream it at her like a banshee, she replied simply, "it was bugging me" and when she saw that my eyes were twitching like one of those cartoons whose heads where about to explode, she said, "don't worry mommy, I'll fix it tomorrow." 
As the days went on, my daughter, who was sporting quite a mullet, realized that a lot of tomorrows would have to pass before she got her hair back. I wanted to cry every time I looked at her. I would like to say that this is an over exaggeration but seeing her truly caused an ache in my heart. I decided that it was time to take her to the beauty salon to see if they could make something out of the "weed wacker got to my head" look. As you can see, Ella was not happy about having to get her hair. She kept saying, "I want long hair like a princess, not short hair like a brother". 
The stylist and I told her how adorable she looked and that this would be a great hair cut until her hair grew out and after a while she kind of liked her new do. WE LIED. It still looks like a weed wacker went crazy on her head, but whatcha gonna do? I want her to feel pretty even though my heart still catches in my throat when I do her hair in the morning. The moral of the story is to explain to your child that if they cut their hair it will take as long as they've been alive to grow back.
Me: Ella, who is allowed to cut your hair?
Her: Mommy and Monica.
Me: Do you cut your hair?
Ella: No mommy.
Me: Do your friends cut your hair?
Ella: No mommy.
It was such a simple understanding. We dialoged this exact conversation at least once a week for the last year and a half. I thought we had it down. Ella was so proud of her hair, almost vain really. I would have to coach her on being humble because she got so many complements on how long and pretty her hair...WAS. She came home from my aunt's house and my mom sheepishly told me that Ella had cut her hair. My stomach dropped and I think I even vomited in my mouth a little. She didn't just cut it a little. She took scissors and lopped off a large chunk of hair from each side of her head. When I composed myself enough to ask her "why did you cut your hair" in a normal voice, not scream it at her like a banshee, she replied simply, "it was bugging me" and when she saw that my eyes were twitching like one of those cartoons whose heads where about to explode, she said, "don't worry mommy, I'll fix it tomorrow." 
As the days went on, my daughter, who was sporting quite a mullet, realized that a lot of tomorrows would have to pass before she got her hair back. I wanted to cry every time I looked at her. I would like to say that this is an over exaggeration but seeing her truly caused an ache in my heart. I decided that it was time to take her to the beauty salon to see if they could make something out of the "weed wacker got to my head" look. As you can see, Ella was not happy about having to get her hair. She kept saying, "I want long hair like a princess, not short hair like a brother". 
The stylist and I told her how adorable she looked and that this would be a great hair cut until her hair grew out and after a while she kind of liked her new do. WE LIED. It still looks like a weed wacker went crazy on her head, but whatcha gonna do? I want her to feel pretty even though my heart still catches in my throat when I do her hair in the morning. The moral of the story is to explain to your child that if they cut their hair it will take as long as they've been alive to grow back. This is Ella's current hair style.
And for good measure, tell them that if they EVER cut their hair, you will make them scalp every Barbie, every My Little Pony, every baby doll in your home. That is the threat in our house. I don't really think I need one, looking in the mirror is punishment enough, but it is there just in case her cutting fingers ever get itchy again (I am so glad that Ella can't read at this moment!). By the way, I find myself so traumatized that I accost perfect strangers and warn them to talk to their daughters about not cutting their hair. A women was shopping next to me at Target the other day with her daughter who had the most lovely long blonde locks and I grabbed her arm (literally) and told her, "please, tell your daughter not to cut her hair!!". She whipped around to her daughter looking, I'm sure, for scissors getting ready to snip years of growth away, the way a mother would whip around if a fellow shopper grabbed her arm and said, "your child is about to fall out of the cart!!". When she saw the her child was benignly sitting in the cart she kind said, "um, okay" and walked away from the crazy lady with the bugged out cartoon eyes.
Tuesday, January 12, 2010
CJ update...
This is CJ getting ready for his cat scan this morning. He is feeling rough and very nervous for the upcoming procedure.
This is Wes, our favorite radiology technician
This is the radiologist looking over his cat scan. Notice all the white areas of his lungs. Those areas should be black. The cloudy white stuff is fluid and infection. You can see that there is A LOT of it. 
After reviewing the films they decide that he definitely needs intervention today. He REALLY didn't want surgery so the specialist opted for a less invasive procedure. They put a small tube through his back and into the space around his lungs and drain the plural effusions (pockets of infection). The hope is that this will get rid of enough infection that the antibiotics will do the rest.
I got to stay in the room with him while they inserted the drainage tube. They make a small incision on his back and insert a long skewer type needle through his scapula, between his ribs, and into the area just out side his lungs. They used ultra sound to make sure they didn't hit a rib or puncture a lung. He has a lot of muscle so they had to be pretty aggressive with poking the skewer through. That was the only point that I felt faint. He wasn't feeling anything because they had him all doped up but it was still unsettling to watch the 12" very thick needle being crammed into him. 
He is feeling better because there is some relief from the pressure out side his lungs, but they are disappointed with the amount of fluid being drained. His white cell count is still on the rise and the fluid outtake is falling. They think that there are loculations (thick pockets of infected goop) in the space around his lungs that can't be drained from the tube they placed today. He has another cat scan scheduled for 1st thing tomorrow morning to see if he really has loculations and how advanced they are. That will determine how invasive a surgery they have to do. The danger with pleuritic effusions is that the fluid gets thicker and thicker and the loculations attach themselves to his lungs. If that happens they will have to open up his chest and scrap away the infection, potentially damaging his lungs and putting him at a higher risk for respiratory failure.
This is Wes, our favorite radiology technician
This is the radiologist looking over his cat scan. Notice all the white areas of his lungs. Those areas should be black. The cloudy white stuff is fluid and infection. You can see that there is A LOT of it. After reviewing the films they decide that he definitely needs intervention today. He REALLY didn't want surgery so the specialist opted for a less invasive procedure. They put a small tube through his back and into the space around his lungs and drain the plural effusions (pockets of infection). The hope is that this will get rid of enough infection that the antibiotics will do the rest.
I got to stay in the room with him while they inserted the drainage tube. They make a small incision on his back and insert a long skewer type needle through his scapula, between his ribs, and into the area just out side his lungs. They used ultra sound to make sure they didn't hit a rib or puncture a lung. He has a lot of muscle so they had to be pretty aggressive with poking the skewer through. That was the only point that I felt faint. He wasn't feeling anything because they had him all doped up but it was still unsettling to watch the 12" very thick needle being crammed into him. He is feeling better because there is some relief from the pressure out side his lungs, but they are disappointed with the amount of fluid being drained. His white cell count is still on the rise and the fluid outtake is falling. They think that there are loculations (thick pockets of infected goop) in the space around his lungs that can't be drained from the tube they placed today. He has another cat scan scheduled for 1st thing tomorrow morning to see if he really has loculations and how advanced they are. That will determine how invasive a surgery they have to do. The danger with pleuritic effusions is that the fluid gets thicker and thicker and the loculations attach themselves to his lungs. If that happens they will have to open up his chest and scrap away the infection, potentially damaging his lungs and putting him at a higher risk for respiratory failure. The pulmonary specialist currently caring for him is very competent and aggressive in his approach. He said that this is just bad luck. It started out as pneumonia and only 5% of people with pneumonia get pleural effusions and an even smaller percentage of those patients get the loculations. CJ is always the exception to the rule.
Sunday, January 10, 2010
The life and times....
After doing a scan on CJ's lungs they saw that they were filled with fluid and infection making it hard for him to breathe correctly. They ordered a procedure called a thoracentisis. Basically a needle is inserted in his back and a tube is passed through to his lungs and the fluid is drained away. They explained that it was all very routine and although there could potentially be complications they expected it to go smoothly, we should have known that smoothly, and CJ don't really go hand in hand. 
"....we will be inserting a little needle and removing some fluid to send off for culturing...." 
"...and then drain a little fluid..."
"...this is all very routine, let us know if you are having any pain or breathing problems..." 
CJ was talking and doing fine and the next thing we know he is slumped over the table and gasping for breath. I would have noticed sooner that he was nearly unconscious, but I was too busy taking pictures. 
His heart rate dropped and he had no color in his face and was sweating profusely. They immediately stopped the procedure even though there was A LOT more junk in his lungs (even after fulling a 1000ml jug, just off right lobe) and called a code team "just in case". I refrained from asking, " 'just in case' WHAT" because I thought I already knew the answer. 
A small crew of people got him stabilized and they called for a portable chest x-ray to see if there was a pneumothorax (I heard the word but haven't been to web MD it to see what it really means, something having to do with air being in the plural sac around the lung, I think. Either way, it was bad). His blood pressure went from 65/33 when he was almost passing out, to 198/104 with a pulse of 120. He kept begging them to take the needle out of his back and I kept telling him that they already had. He said that he felt like he was being stabbed through his lung and he couldn't breathe. 
It was SCARY. For him and for me, and from the expression on the technician's face, for her as well. We are still not exactly sure what went wrong, but the working theory is that as they took the fluid from the lung it wanted oxygen, which is transported through the body via blood. So the there was this sudden demand for blood and his heart just couldn't keep up so he started crashing until his body could compensate. That was the only theory I remembered, although they talked about other things. I really didn't care. I was trembling from the inside out and trying to reassure CJ that all is well. In the end, he was nearly fine 30 mins later. His heart rate and blood pressure returned to normal (his sick normal) and his breathing was slightly better. We got back to his room and some of his buddies were there to visit so I got him settled in and took my leave. I found the nearest exit (which was marked "authorized personal only" - It was this little outdoor oasis which I thought was such a nice Zen place to create for the hospital staff, until I realized that it was where they went to smoke) and collapsed in to a sobbing heap. It was just SO MUCH. He really was fine, telling the staff a story in great CJ fashion, and the next second he was inches away from heart and respiratory failure. It was so fast and unexpected. Realizing how precariously life is balanced is terrifying. Not just his life, but all of us just seemed so fragile and temporary. I have to say that the only thing that pulls me back from the edge is the knowledge that this life is suppose to be temporary. We are eternal soul inhabiting these very mortal and breakable bodies. I don't like it, but that is the plan. 
"This may sting a little...."
"....we will be inserting a little needle and removing some fluid to send off for culturing...." "...and then drain a little fluid...""...this is all very routine, let us know if you are having any pain or breathing problems..." 
CJ was talking and doing fine and the next thing we know he is slumped over the table and gasping for breath. I would have noticed sooner that he was nearly unconscious, but I was too busy taking pictures. 
His heart rate dropped and he had no color in his face and was sweating profusely. They immediately stopped the procedure even though there was A LOT more junk in his lungs (even after fulling a 1000ml jug, just off right lobe) and called a code team "just in case". I refrained from asking, " 'just in case' WHAT" because I thought I already knew the answer. 
A small crew of people got him stabilized and they called for a portable chest x-ray to see if there was a pneumothorax (I heard the word but haven't been to web MD it to see what it really means, something having to do with air being in the plural sac around the lung, I think. Either way, it was bad). His blood pressure went from 65/33 when he was almost passing out, to 198/104 with a pulse of 120. He kept begging them to take the needle out of his back and I kept telling him that they already had. He said that he felt like he was being stabbed through his lung and he couldn't breathe. It was SCARY. For him and for me, and from the expression on the technician's face, for her as well. We are still not exactly sure what went wrong, but the working theory is that as they took the fluid from the lung it wanted oxygen, which is transported through the body via blood. So the there was this sudden demand for blood and his heart just couldn't keep up so he started crashing until his body could compensate. That was the only theory I remembered, although they talked about other things. I really didn't care. I was trembling from the inside out and trying to reassure CJ that all is well. In the end, he was nearly fine 30 mins later. His heart rate and blood pressure returned to normal (his sick normal) and his breathing was slightly better. We got back to his room and some of his buddies were there to visit so I got him settled in and took my leave. I found the nearest exit (which was marked "authorized personal only" - It was this little outdoor oasis which I thought was such a nice Zen place to create for the hospital staff, until I realized that it was where they went to smoke) and collapsed in to a sobbing heap. It was just SO MUCH. He really was fine, telling the staff a story in great CJ fashion, and the next second he was inches away from heart and respiratory failure. It was so fast and unexpected. Realizing how precariously life is balanced is terrifying. Not just his life, but all of us just seemed so fragile and temporary. I have to say that the only thing that pulls me back from the edge is the knowledge that this life is suppose to be temporary. We are eternal soul inhabiting these very mortal and breakable bodies. I don't like it, but that is the plan. He has another chest x-ray tomorrow so we will see if his right lung is any more clear. We are thinking that they will want to go in and drain more off the right and start draining the left because his white cell count is still on the rise (indicating that the infection is still running rampant in his body). We are on day 8. I am so ready for this to all be over.
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