Thursday, 11 December 2014

Medical Update: Jadon

During the past week, Jadon has had more than his fair share of doctor visits.  Last Thursday I took him to the pediatrician because he had a five day history of cold and flu symptoms.  Some of his other siblings were experiencing the same symptoms so we knew he had picked up a flu virus. He had been choking on his mucus throughout the night so we were sleeping with one eye open and giving him steamy bathroom humidity treatments, running a cool humidifier in the room and spraying nasal mist up his nose to try to loosen the sludge.  The doc gave him an antibiotic and an oral prednisone prescription assuming he now had a pneumonia.

Unfortunately, Thursday night was not much better.  In fact, his secretions were not really an issue but he kept dropping his body temperature and having cold sweats.  His forehead was constantly coated with a bead of cold water and no matter how much we attempted to warm him his temp was very low.  I knew this was not a good thing so in the morning my mother-in-law joined me in the trek down to the Hospital for Sick Children.  As I expected, after triage, we were quickly whisked into a room and Jadon was put on a monitor.  His oxygen saturation dropped to 63% so the nurse put him on a little flow-by oxygen.  He was listless and lethargic much of the time.

Very shortly after our ER arrival a doctor arrived to assess him.  He had a chest x-ray, blood work, ECGs, ventolin treatments, and multiple doctor visits.  He was taken on and off oxygen but in the end the ER staff wanted it left on.  His saturations were dropping frequently to the high 60s and once into the low 50s.  At first the physicians thought he had a respiratory infection but they then decided that, yes, he had a flu, but it was his heart that was causing the low oxygen.  He was having TET spells due to the flu stressing his heart.  This is something that is not uncommon to babies with unrepaired Tetrology of Fallot.  He was admitted to the cardiac floor for observation then discharged in the morning after his oxygen levels and energy level normal returned to near normal.  Although I wasn't thrilled about having to be at Sick kids in the first place, there was an upside to it all.  The ER docs arranged for a cardiology work up Wed. Dec 10th (yesterday).  I had already had an appt booked with a local pediatric cardiologist, but the team felt if he were already linked up with Sick kids, things might move along quicker. They were also keen on having all of his tests on file in the event of a subsequent ER visit.

Tuesday we headed to our regular pediatrician for a weigh in, and check-up as well as a vaccination program start.  Unfortunately Dr. B. did not feel Jadon was well enough to start his vaccinations. (He has no vaccinations as the orphanage doctor said he wasn't well enough to get them) His weight was back to nearly where we started :(.  But, he was better clinically than the week before.  Likely his weight dropped due to his illness.  Dr. B was able to access the results of all the bloodwork and swabs and he told me Jadon tested positive for RSV.  This is a respiratory virus that is particularly tough on kids under 2 years of age.  It sends many babies into hospital every year.  I was almost relieved he had it because it was the one respiratory condition I was afraid of him getting.  I did not think he would fight it well at all.  So far he is doing not too badly.  I had figured on a week in hospital if he got RSV.   Hopefully he will get fully over it soon.

Now, that brings us to yesterday...Wednesday.  The morning started out with 45 min cardiac ECHO. (ultrasound of the heart and its surrounding structures)  Jadon was a trooper.  Since he will not lay on a stretcher without me, I laid on it with him laying on top of me.  He lay so still during the test that he actually fell asleep.  That's right. No sedation.  Just a lot of friends and family praying :)  After that was completed we headed for an ECG.  Immediately after that, we were called in for a oxygen saturation check and medical history session by our cardiologist's nurse.  I was in the midst of telling her Jadon's medical history when I noticed she kept readjusting his sat probe.  It was reading in the mid to high 70s.  I quickly informed her this was baseline and she shut the machine off. In the course of conversation I told her he had RSV and that I was trying to keep him away from all the other cardiac babies.  She agreed it was a good idea and took me to a room to wait for the doctor.  "It will be a bit of a wait as the doctor is seeing another patient, but this way you will not have to sit in the waiting room with all the others," she said.

I was led to a small dietician's consult room to wait as the examining rooms were all in use.  I fed Jadon, played with him, played with him some more,  and slowly started to get very tired.  I had not had time to grab breakfast and it was 12:45pm at this point.  My lone source of sustenance, apple juice, was not cutting it anymore.  I dug around in the diaper bag and found a Mars bar.  I felt like a little rebel chomping down on a chocolate bar in the dietician's consult room.  The room had posters of the Canada food guide, articles about healthy cholesterol and plant sterols, and a pictorial of what a healthy plate of food looks like.  It may have been the only time a chocolate bar has or ever will be eaten for lunch in that room...hee hee :)

We waited well over an hour for the physician.  At which point Jadon became sleepy and dozed off in my arms.  Finally, the cardiologist's fellow showed up, asked some questions, then told me the results of the ECHO.  He said they can see the tetrology of fallot, the shunt is working well, and the pulmonary artery is a decent size.  Say what?  I was told he had a really small, underdeveloped pulmonary artery.  The fellow explained to me that sometimes with increased blood flow the artery will grow. It appears that is what has happened!  This is very good news!  I was also told that he is not "shunt dependant".  In plain English this means:  If he develops a clot on the shunt he will go very blue, but he will not likely die if he is brought to the hospital urgently.  His body will use other vessels to get to the lungs.  This was music to my ears!

Once the attending doctor came in, he introduced himself and said he will be Jadon's Sick Kids doctor from now on.  He explained Jadon's heart condition in detail, and said they would be presenting his case to the cardiovascular surgical team at either next week's meeting or the first one in January.  Once that has happened, we will be called in to meet the surgical team in the preceding weeks.  He also offered to arrange consults for the other needed specialties: ENT, Gen surgery, and genetics.  ENT for his ear, Gen surg for his swallowing/feeding issues, and genetics to rule out a chromosomal issue.  Hopefully things get arranged soon.  I  hate don't enjoy waiting. I was told that since Jadon is reasonably healthy and his shunt is functioning well to expect his surgery in 3-6 months.

While typing this blog post, my cell just rang.  It was Sick Kids.  The cardiology fellow was on the line... he called to say the list of patients was too long for Monday's meeting, and that Jadon would be presented at the first meeting in January.  After that, I would receive a call.  He then said, "Are you ok with that?"
"Yes."  ...what else could I say?
I was a bit deflated but I also realize that nothing will be done during the two weeks following next Monday's meeting anyway.  Christmas holidays are coming.  Even the pediatric cardiologists and pediatric cardiovascular surgeons need a vacation. 

Just don't be gone too long...Jadon needs you.

Saturday, 22 November 2014

Not your typical diet...

When most people think of the D-word they think of a conscious effort to eat healthier and in turn drop a few pounds.  Jadon is not in need of that.  He needs to gain weight.  Just as losing is hard for most of us, gaining seems equally hard for him.

Jadon is small. Like, less than the 3rd percentile.  We feel it would be great for him to be a little bigger before he undergoes cardiac surgery so we are trying to fatten him up a bit. 

Part of the problem is he is unable to swallow anything with chunks.  He chokes on anything that is not the consistency of pureed pumpkin soup.  No lumps whatsoever.  We are guessing this is related to his esophageal atresia that was fixed at two days old.  It is possible that he may need his esophagus dilated or stented.  Hopefully this will be addressed sooner than later.  But in reality, I am guessing it will take a number of months before there is anything done to address this issue.

So... we have resorted to trying to feed him as often as we can during his waking hours.  If we give him a lot at a time, he vomits.  So we continue with frequent, small portions, of infant cereals, yogurt and baby food jars made for babies that are the 4-6 months old.  At this point, we do not blend up our own food as our economy job blender does not puree small quantities to a fine enough consistency. 

Yesterday, Steph came home pleased.  He had found some high fat yogurt.  6% fat!  Maybe this will help!

Another thing that we think might help with weight gain is the good, old, Canadian winter!  In Vietnam, Jadon would sweat profusely with each feeding of his warm bottle.  The temperatures outdoors were humid and often above 30C.   Indoors, the temp was around 25C.   When we kept the indoor temp lower, the room felt chilly :)  In Canada, winter has arrived early.  Snow is scattered along the grass like a loosely woven blanket.  The house is heated, but only to temps around 21C.  This big drop in temp allows Jadon to drink his bottle without his hair and back completely soaking in sweat.  It was as if every bottle was a work-out while we were in Vietnam.  Now, Jadon has a few beads of perspiration on his forehead occasionally, but rarely soaks his hair or clothing with feedings.
Maybe, just maybe his weight will start to increase.

I might be just hopeful, but as I look at this pic taken on night one with Jadon, I think maybe he has gotten a teeny bit fuller in the cheeks.

Monday, 17 November 2014

Finally Home! My wife is AWESOME!

Home at last!  We landed shortly after 9:00, were picked up at the airport by our good friends Yu and Carolyn Chen and got home around 11:00.  It was great to walk in the door with all of us here together!  Mom had prepared a nice snack, as well as picked up fruits and milk, and had baked muffins and prepared a Shepherd's pie for supper tomorrow.  Very little for us to do in the food prep area which is great!

We chatted and hung around for a bit then all the kids went to bed eventually.   Of course, the last one to do so was Jadon.  He is not so sure about things and is trying to figure things out.  He didn't like the winter coat nor the car seat... but being in Canada he will have to put up with them for a long long time!  Once Jadon was looking a little tired Sara was able to lie down with him.  They are sleeping soundly now... hopefully for a long time!

Have I ever mentioned how amazing Jadon's mother is?  How remarkable a woman my wife is?  In an adoption, the primary goal is typically to help create bonding and attachment to the primary caregiver, which in many cases is the mother.  This helps to quickly create a 'safe spot' for the newest, overwhelmed member of the family.  We did the same.  Sara did the majority of the hands-on care giving while I did more of the support work (like prepare and then wash the bottles that Sara would feed to Jadon).  While this is really nice for Sara because she is the one that Jadon opens his arms to the most, and the one the he wants to be held by, and the one he smiles his best for etc... it can also be very tiring.  Because often, she is the ONLY one that he wants, specifically when he is not feeling great - sick or tired.

The last few days have been exhausting for Sara.  Saturday evening we went to the hospital and Jadon was admitted.  The two of them stayed there from then until Monday morning around 8:15 when we picked them up on the way to the airport.  I have been fighting this crazy long fever/cough that first Logan and then Rykauna got.  In between fever spells with enough Advil, I feel fine to do some things.  However, we did not want Jadon to get whatever bug this is so.... we have even more limited my direct dealings with him, and even my bottle preparing, feeding etc... were stopped.  I couldn't go to the hospital to stay and help Sara out with Jadon.  Logan went in for about 6 hours to help out as much as he could.  Overnight, it was mommy, mommy and more mommy.  On our two flights today, a total of about 17 hours flying time, Sara had Jadon for the majority of that time.  While the rest of us were sleeping or chilling, she was comforting, entertaining, feeding.  It really bugged me to see Sara working so hard when I was just across the aisle really not able to do very much.  But Sara was an absolute trooper.  No complaints(ok maybe a couple little ones), a smile on her face (with occasional tears), Sara went through this all.  She got likely about 5 or 6 total sleep hours over the last 3 days.

I am so proud of her.  I am blessed to have her as my wife.  Rykauna, Logan, Hudson and Li Lin are blessed to have her as a mother.  And now Jadon will also come to know how blessed he is to also call her mom!

An excellent wife who can find? She is far more precious than jewels.
Her children rise up and call her blessed;  her husband also, and he praises her:

Proverbs 31:10, 28  

Sunday, 16 November 2014

On our way!

Just a short post to get you all know that Jadon just got discharged.   He is fit for travel.   Who knows about the rest of us!  We are heading to the airport in about 10 and hopefully all goes well.   We will be landing in Toronto about 8:45 pm Toronto time.   Thanks so much for all your prayers.   Please continue.   On the home stretch now!

Saturday, 15 November 2014

Update on Jadon

I just got back from the hospital.  Jadon spent an ok night but the good news is this morning he coughed up a piece of meat which was what had become caught in his throat.  The bad news is that he developed a fever.  It turns out the he once again has bronchitis!  So, the plan is to keep him in the hospital until tomorrow morning and the kids and I will stop by on the way to the airport to pick Sara and Jadon up.  Talk about last minute!  The doctor would like to keep Jadon hydrated and will give him IV antibiotics to combat his bronchitis.  She wants to make him as healthy as possible for the flight.

Meanwhile, I am fighting the fever that Logan at the beginning of the trip, and Rykauna more recently were fighting.  Because of this I can't stay at the hospital with Sara.  Logan is there right now for a few hours to help Sara with Jadon and to keep her company.  I will take a couple hours sleep to try and get rid of this fever and then we need to get all packed up.

This trip has been quite the challenge in a variety of ways.  Please continue to pray that all would work out and that we will not have any more hiccups before we get our little guy home!

Please Pray Again... Another Night in the Hospital

This post was supposed to be about the fusion between East and West that you find so many places throughout Vietnam... the food, the architecture etc...  however, Jadon is once again in the hospital.

We figured that with three visits to the Family Medical Practice, one overnight there, as well as a cardiologist consult at Tam Duc Hospital (where Jadon had his heart surgery done) was enough of a insight into the medical care in Vietnam.  However, apparently not.  Today at lunch, Jadon aspirated some food.  Due to his esophageal atresia, though repaired, this is a fairly common occurrence.  However today, he didn't seem to be able to clear out his lungs properly, and his breathing was rattly for the rest of the afternoon.  When he wouldn't take more than a couple ounces of his milk bottle, and immediately spit up when we fed him his baby food and cereal, we thought we should bring him in.  Sara and I went with Jadon to FV Hospital, a French Private hospital.  The doctor was concerned that he could not/would not eat and drink.  This is a concern for most children, but with Jadon's small size and his heart shunt - the pediatrician is concerned that if he does not have enough fluid, his blood will thicken and cause issues with his shunt.

So, she has admitted Jadon overnight for observation.  The plan is to have him fast overnight but give him IV fluids to keep him hydrated.  Then attempt to get him to drink tomorrow afternoon and hope all goes well.  When something like this happens, we don't know whether to laugh or cry... so we have done some of both!  We would really appreciate prayers that all would be settled so that we can make our flight on Monday.  We can't wait to be home with Jadon and all the kids!

Friday, 14 November 2014

Passports and Lunch with Emmy

Today (Thursday) Rykauna and Hudson are still sick.  Hudson thankfully seems to be getting better.... Rykauna is still running a temp and has developed a nasty cough.  Since today was the day we had prearranged to pick up Jadon's passports and meet Emmy for lunch it goes without saying that some of the family had to stay at the condo.  Since Jadon was really fussy in the morning, and Logan did not really feel like traipsing around doing the passport business, it was decided that just Li Lin and I  would go.  She of course, loved having mom all to herself.

We went first to the Canadian consulate and picked up Jadon's temporary Canadian passport. Next, we cabbed it over to the Vietnamese passport office and waited for Loan to meet us there so we could pick up his Vietnamese passport.  Once that was done, all of our official duties and paperwork were completed.

I headed out to meet Emmy my co-worker for lunch.  Nothing like meeting a co-worker for lunch halfway across the world!  Emmy was here in Vietnam for a family wedding and travel so it was nice to get together.  I had the BEST beef noodle soup I have eaten since here in Vietnam.  Emmy is the "foodie" in our department at work so I knew the restaurant she chose would not disappoint.  It was a nice little break from the constant low-level chaos we have been going through!

Today (Friday) we sort of lay low.  Rykauna is still going through the stages of her fever/cough and we are hoping tomorrow is a better day.  Hudson was up and about and though not his normal perky self, he did eat more and talk more, which are both indicators that he is well on his road to recovery.  He even joined Steph, Logan and Li Lin for a short swim before supper.  We then went shopping to pick up a few things for Jadon... feels weird buying formula and baby food for a 26 month old, but that is what we do!  He is eating a better variety of food and we are trying to decrease his formula intake so he will eat more of other foods but that will be a gradual process.

Just the weekend left in Vietnam, and then we fly home on Monday.  The trip has not gone exactly as planned, what with the illnesses and we haven't seen as much as we would have liked, but the important thing is, Jadon is in our arms and we are bringing him home.