Monday, February 2, 2015

Valium & Viagra

These are two things I didn’t think we’d ever have in our medicine cabinet.  At least not for a very, very long time – ha!  I surely didn’t think they were things we’d be giving our baby.  But, as it turns out, these two drugs have applications that are very different from what the public perceives as their only uses. 

First, let me tell you that I’m not one of those people who prefers to medicate – ever!  We’re those crazy people who try everything BUT medicine to solve our ailments before we go to the medicine cabinet or pharmacy… that’s just how we roll.  Ellie has flipped our holistic/alternative medicine world upside down, though.  Being perfectly aligned with a belly full of organic, grass-fed yum yum and skin slathered in homemade, raw, organic butters/creams, scented with essential oils is fabulous… but it won’t repair the holes in her heart.  It won’t make up for the fact that the right side of her heart can’t function like it should or make up for some of the physiological things that come along with Down syndrome.  I just want to clarify that we’ve never been big advocates of traditional medicine… but traditional medicine is exactly what is healing our child, so we can’t hate on it, right?  I don’t want anyone to think that medicating Ellie is fun for anyone… but it’s what has to happen to keep her safe and to get her on the road to getting better.  Heck, I’ve never been a fan of surgery, either… but that’s the road we’re on here.  If this journey has taught us anything, it’s that each child and situation is unique and it’s best not to judge how other people approach feeding, diapering, medicine or treatment… every parent (okay, 99.9% of parents) is/are doing everything in their power to do what is right for their child.  Even if the means are different from what you would do, it doesn’t mean they aren’t trying their best.  The road we’re traveling with Ellie is so much different than the one we traveled with the boys, but we have been trying our best since day one with Lance, even as our methods morph from day to day.

That being said, Ellie has had a few good weeks lately.  She is still storming… in fact, she’s been storming every day since the reemergence of her storms on January 6th.  The thing that’s frustrating at times is that when we transfer to a different unit within the hospital; we have to explain everything again and again to staff members until they get to know Ellie.  When we’ve been inpatient for 68 days already, and we have 2 to 3 different nurses every 24 hours (plus new docs, nurse practitioners, PCAs and nursing students), you can see where this can get tedious.  Fortunately, in the TCC, they have a “Primary Nursing” program.  So, we now have a primary daytime nurse who knows Ellie very well and is always on top of things – finally, some continuity of care.  We do, occasionally, get a nurse or doctor who thinks we’re crazy or who doesn’t believe the diagnosis of autonomic storming.  Ehhh… think what you will… I’m not the type to make up complications for my child… this poor kiddo has plenty of mountains to climb without me being a hypochondriac.  But I kind of want to punch people in the throat when they question the diagnosis and ask things, like, “Does she just have a dirty diaper?” or “Do you think maybe her skirt is irritating her?”.  Yep – I’ve left her in a poopy diaper and an itchy skirt for the past 4 months… how did I just now realize that?  Ha. 

Whoops – tangent… my bad.  Back to our sweet bug:  Ellie was switched from Ativan to Valium as the rescue drug for her storming episodes.  I didn’t know that Valium was used for anything other than anxiety.  Valium doesn’t work as quickly, but it’s an oral (errr… G Tube) medicine that can be easily administered at home.  The thing I like about it is that Ellie doesn’t go out with Valium.  She is still alert, but more comfortable.  Ativan was heartbreaking at times because it would often “snow” her and she’d be out for hours.  So on days when she had Ativan (which was every day), we wouldn’t be able to do as much therapy and such.  Valium is a slower acting, but better option for Ellie.  When they finally charted a pattern for her storming times (always in the morning), they started scheduling a dose of Valium to hopefully prevent the storming episodes.  Ellie, however, just decided to start storming earlier and earlier in the day so that it wasn’t yet time for Valium when she kicked off her shenanigans.  We’ve been putting her on ice to slow the storming episodes.  Valium plus ice works beautifully.  And Viagra?  Well – Ellie’s actually been on Viagra for a while now.  The generic name for Viagra is sildenafil and it’s actually a medicine used to treat pulmonary hypertension.  It’s working beautifully on Ellie right now and may be a long term medication once she’s past her next surgery.  Who knew, right?  Well – other than my nursing and pharmacy friends.  She is still on propranolol (a beta blocker used in her case to treat her storming) and clonidine (a BP med that blocks some of the neuro impulses associated with her storming) and Lasix (her original heart medication… a diuretic to treat her pulmonary over circulation).  And if you’re noticing a pattern here, you’re not crazy.  Almost all of the meds that Ellie is on are used to treat other conditions.  Yes, maybe this med is for blood pressure or this one for anxiety, but they also work to block certain neuro transmitters to calm her storms.  Oh, and this one for erectile dysfunction, yeah – it’ll help with the pressure in her pulmonary arteries.  And THIS is why prescription medications kind of freak me out.  We’re using them for their side effects, essentially.  We’re still weaning clonidine, but very, very slowly now.  I do NOT want her on this at home.  I do not want to have to worry about her starting withdrawal if we miss a dose for whatever reason.  I don’t plan on missing doses of medicine, but we all know that sometimes things happen where you forget one of the million things that you are supposed to do in a day – and I don’t want big repercussions for missing a dose of that nasty stuff.

On a very positive note, Ellie is getting stronger by the day.  She’s been working on this head control business for months now and for her, it’s a very big task.  A head is a heavy thing to control when you have low muscle tone (every time we’re working on it in PT and OT I think of the line from Jerry Maguire, “the human head weighs eight pounds”) – literally, EVERY TIME.  In the past 2 weeks, Ellie has shown remarkable improvements in head control.  This is a big step for her.  She is still not taking any food by mouth – the bottle business is just not working – but once she can sit up and support her head, we’ll be allowed to try some purees.  I can’t even begin to tell you how excited I am to try those.    I’m a little bummed that she’s forgotten how to eat by mouth, but by the way she sucks her thumb, I know she hasn’t actually lost the ability to suck, she just doesn’t have interest in bottle feeding.  Little turkey! 

And she smiles – oh, how she smiles.  She’s been able to smile for a while now, but in the past two weeks, she’s really decided to share her smiles with us more.  Last Monday (Jan. 26th) was probably the best day that Ellie’s ever had.  She was smiling all day long.  She was pleasant and very alert.  She did well for PT and OT that day and was so happy, I almost think she’s starting to laugh a bit (but we can’t hear it, of course, because of the trach).  It was just a remarkable day for her.  She had been sick the week before and she was getting sick, storming more severely, and had a ton of secretions in her trach.  Antibiotics (again… something I really try to stay away from) worked wonders on her little body.  She was still sick for 4 or 5 days, but recovered quite well. 
Other than sneaking in snuggles and such, we’ve been swamped with work and training.  For me, January was a killer month at work.  I was so happy to log off work last Friday and put January to bed this year.  When Brandon gets here, we’re focused on training.  We spend our weekends (trying to entertain the boys) and trying to squeeze in as much trach training as possible.  We knocked out a ton of training this weekend.  The next few weekends will be packed as well, but this is what we need to do to get this sweet girl home. 

We should get to go home in another 4-5 weeks or so (hopefully sooner if we can get the home health care set up and training in sooner).  Hopefully, we can go home by the end of February (as long as we can get rolling on home health care).  Ellie is slated to have her next heart cath in mid-March.  So if things get pushed back here, we may be staying through the heart cath.  And if our prayers are answered in the manner we’d like them to be, Ellie’s next cath will show that she’s ready for her next heart surgery.  Sooooo, that would extend our stay by a week or two.  I guess what I’m saying is maybe we’ll be home this month… maybe next month… maybe April.  We really have no way of knowing.  We’ll try to get out this month so that we can come back for the cath, but there are a lot of factors that play into that planning.  When we go home, we’ll have a minimum of 8 hours of nursing care, 7 days a week.  We’ll likely have more like 12 or 16 hours a day.  As you can imagine, this will take some serious coordination to get back into a routine at home.  If we end up hanging out here until the first week of March or so, I may see if we can move up the heart cath so that we aren’t going home for 4 days and trying to coordinate nursing care and then coming right back.  But hey… it’s Ellie’s world, I’m just living in it.  We’ll do whatever is best for her.  At this point, home seems kind of scary, really… even though we can’t wait to be back.

I have so much to say about our past weekend, but I’ll devote a blog post to it – hopefully tomorrow.  For now, I’ll let you catch up on our past 2.5 weeks in pictures… did I mention that Ellie will be 5 months old tomorrow?


 Ellie in a gown awaiting her heart cath on 1/16

Not yet awake after the cath... but had GREAT results!

 My sisters (Emily, Tracy & Karen) abducted me on Friday, 1/16 
so we could do a wine and canvas night in Newport

Karen & I hard at work 

 Mom & Dad stopped by on Saturday 1/17 to drop off the boys and see Ellie in the TCC

 Big eyes for Aunt Tracy

Grandma & Grandpa Maier came down to snuggle with Ellie & celebrate Lance's bday

 Out to dinner for Lance's 4th bday

He's not happy at all, is he?

 Ellie likes to flirt with her new PT, Sam.

 Who is that beautiful girl in the mirror?

 The boys back home

 When they came down to the RMH on 1/23, we had their tent set up on the bed... 
they got to go "camping" all weekend

 And on Saturday, 1/24, it was beautiful out - perfect day for the zoo

Selfie w/ Mommy - 1/28 (another nose trial window) 

 Face painting at the RMH - he's supposed to be Capt. America... rough, I know

 Ellie gave smiles to Andrew Beech when he came to visit

Lovin' the mirror again

Kaleb's face paint... quite impressed with this Raphael

Now that Ellie is allowed to lay on her belly (sternal precautions are almost up), she loves sleeping this way... and it's perfectly safe because her airway is always open.

My favorite picture - the boys giving Ellie a check-up on 2/1

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