Technical Difficulties

Sorry about the delay, again. Our oldest (and my favorite) laptop finally succumbed to the virus', and our newest (and the one I almost loathe) had been stepped on, so it's almost impossible to use. Luckily, I can pull some MacGyver tricks and use it. It just drives my slightly batty.

There's been a lot in the past few weeks. We took another trip to Philadelphia. It was just a follow up, to be sure all our plans for surgery are still on track. This appointment, although short, was important. We had a year break, so the doc wanted to be sure the surgery was still needed. A little refresher on the surgery. It will be to nick the tendons on top of the hip to help release those contractions, putting her in a better position to stand. The end result of the appointment was mediocre. The doc is pleased with her progress, and we will hopefully return July/August for surgery. We'll stay for a week; do some therapy and get her fitted for new braces before the surgery, have the surgery, then come home. Then return in a month to get the new braces and her casts off. All in all, it was a nice, smooth trip.

She also had a few other appointments with doctors here at our local Shriner's. Anabelle has a follow up with an ENT for her torticollis. He also is pleased with her progress, and said she should be able to avoid surgery. Which is great because I didn't even know that was in the cards! It's still very noticeable, especially when she is tired. The other appointment was a follow up with her upper extremities ortho. We talked about possibly doing dorsal carpal wedge osteotomy on one of her wrists. It's been decided after talking to wait and see how she is mobile after her legs are taken care of. It may be better for her to leave her wrists as is if she does use a wheelchair later. It'd be easier for her to transfer with flexed (bent) wrists rather than wrists stuck in extension (out straight). We plan to follow up in another 6 months. She also had a photo shoot so we could collaborate with the upper doc in Philly and see what he thinks. Luckily Ana has an amazing occupational therapist who accompanied us to this appointment. It helped to have someone there who spoke the same language as the doctor, and convey what we really wanted to. And just like the two doctors before, this one was just as pleased with Miss Bear's progress. We also got to show off Ana's WREX, although her doc didn't seemed to impressed. She didn't even ask for a demo. It's ok, Ana's still getting use to it.

Feeding therapy has also been in the picture lately. Not sure if I mentioned it before. Her therapist is happy with how in love with food this little one is. We are still under the directive to not even attempt to replace nutrition in any way with oral feeding, but with how much this girl loves her food, it's hard not to think she's getting tons of nutrition out of it. Looking back, she really has come so far with her breathing and eating. It's amazing to see.

Until the next time I feel like pretending to be McGyver...

With love,
The Polks

Philly Part 2

WE ARE HOME! 

Well, we've been home since Saturday technically...


Let me pick up from where I left off last.

On Thursday we had more therapy. It was actually very beneficial because we were able to move the time so Ana wasn't so exhausted from no naps. She was a bit tired still, but actually worked! We focused on rolling and scooting. Anabelle really liked to roll. We tried to get her into a prone position when she would roll on to her belly, she cried. Prone means she is up putting weight onto her forearms, like in an army crawl position. I think it might be to much of a stretch on the muscles in her shoulder/arm pit area since those muscles are really tight. There was also a wedge we used to help her learn to scoot. They has a smaller wedge that basically looked like a little slide, Ana sized. It has an inch lip on each side, and it was about 18 inches from top to bottom of the slide. We put Ana at the top, and at first helped her scoot down to show her how to do it. She was fine if we were doing it for her. But she got the idea, and did it solo! However... it scared her, and she cried. She's not use to moving on her own, so it was scary not to have our hands on her while she moved,  she didn't feel secure. But she is getting the idea, and I think she will progress quickly!

Friday: We had PT first. It was another good day! More of the same, but she is getting the idea, and I think it will only take a few months until she is all over the place and we will have to really baby proof again!

Saturday was our flight home. It was an early flight, especially since we had to return a car and was worried about it being spring break and the cut backs to TSA. We had a flight from Philly to Chicago, then Chicago home. With a 3 hour layover in Chicago. Unfortunately plans changed. On the flight to Chicago Anabelle's feeding tube broke. Now, she has a straight J tube. J is for Jejunum. Jejunum is the first part of your small intestine. The more popular tube is a G tube, and that goes directly into your stomach. Ana's tube bypass the stomach and goes directly to the jejunum. Her tube has to be replaced in the hospital under anesthesia. We aren't even give a replacement just in case we run into this issue. Also, because of the size she has, the part that comes out of her stomach hangs out about 6 inches or so. The tube broke in that part. I couldn't clamp it, so it just kept leaking. I had no choice but to stop her food. I dried it all up, and used some tape to try to stop it. So we finally get to Chicago. I learn that our plane is delayed by two hours. So 3 hour layover is now a 5 hour layover. This means Ana won't be eating this whole time, and it means getting her to the ER will take even longer. I tried calling doctors to get them to help expedite our process. Nope. Ana couldn't sleep well. She doesn't feel hunger, but her sugars and whatnot drop. You know that feeling when you haven't eaten for awhile, and you feel kind of sick? Yep, that's it. Then the plane was delayed another hour. At this point had been up traveling for 11 hours. Then our plane got in, and we had about a 4 1/2 hr plane ride home. Make that 11 hours 15 1/2. We land, go to get our bags, and learn because of the delays, they misplaced one bag. So I file a baggage claim. Then finally off the hospital!

We have to go to the ER, see if the department who replaces tubes will do it that night, and of course they won't. They have to admit Ana since by this point it has been over 24 hours since she's had anything, and she's dehydrated and her numbers have dropped. I usually have a really good experience with the nurses and doctors.. However this nurse rubbed me the wrong way. Maybe it was the lack of sleep and food on my end. Long story short, we finally get admitted, get her in bed, get her some sugar and electrolytes, sulfate, etc.. Which I learned the next morning they did incorrectly... And she starts to do better, but still exhausted. Get her a new tube, finally, and get out of dodge.

We got home Sunday evening. I am not sure how mom's travel solo for this trip repeatedly. I don't think I can do it again. I am still trying to recoup from this trip. Luckily Ana is able to nap:) However today (Tuesday) she is acting like her tube is in the wrong place. We can wait till morning to check, but hopefully it's fine.

Oh, but on top of this, Anabelle has been battling pink eye and a cold. She is one little trooper. Makes me feel like a big wimp sometimes :)


Hopefully that is the end to our excitement for awhile.

With love,
The Polks

The more you know

With Anabelle's first birthday just days away, I have been looking back on our lives. 

I looked back at a couple blog entries from December 2011. I knew absolutely nothing. I am still learning. However, I know mountains more now then 15 months ago. I didn't know how to correctly spell Gastroschisis, I didn't even know what exactly Arthrogryposis was. I was terrified of what was to come. 

It seemed like eternity for Anabelle to join us. I remember having such mixed emotions. I couldn't wait to hold my baby girl. But no one could tell me how long I might have with her, or what to expect at all. I knew that she was ok while still in my belly, but how would she be outside?! It was terrifying. And then the day came. March 1, 2012. Such a roller coaster day. I was so out of it because of all the lovely pain killers they gave me. I remember when I finally got to see her, and tried to ask, 'How is she doing?', I'm sure it came out as 'Keolnlsdu aslkdnfo uoasdnl'. Or at least that's how it felt by the stares I got. 

Now were just shy of a year later. If you told me we'd be here be a year ago, I'd probably laugh in your face. I didn't even want to think this far into the future. It was because the doctors didn't think that Anabelle was as amazing as she is. I couldn't imagine life without her. 

I won't lie though. It hasn't been all rainbows and unicorns. The beginning was rough. Really rough. Thankfully we have had amazing support. Not only from our family and friends, but from total strangers. We have been blessed to meet tons of other families online who have years of experience. I'm not sure we'd be as strong of a family now if we didn't have this support. It's a group of people who have already been there, done that. They have encouraged us to do what we think is best, as well as offer up some well learned tips. We have only meet a few of the families in person, but I don't feel like they are strangers. With them this road isn't so rough. It's so wonderful to have questions and have tons of people to turn to for advice. 

When I think about how far Anabelle has come, I am overcome with joy. From doctors telling us that she'd never do anything, to today, where she sat for hours and played with her sisters and laughed her head off. But that's a mix of emotions. Doctors don't know everything. And some people think what they say is stone. And to me that is terrifying. Because sometimes they are wrong. Like they were with my wonderful baby. They told me to consider my options. The genetic counselor we were working with during that time push our 'options' on us. During our most fragile time. Just hurts to think that these people can influence families to make these life changing choices and take their wonderful babies away from them. I am so thankful we didn't listen to those doctors. Don't get me wrong, they were nice during our care, but... only after we made them understand our feelings. That this is our baby, and a diagnosis, or lack thereof, doesn't change that. 

Today I tried to do a photo shot of the girls for their birthdays. Spring time in the Polk household is Birthday season! Four out of five members celebrate. Today was primarily for Anabelle's birthday. It is just wonderful to have all of them home, together, healthy and happy (mostly). 

(And yes, we are that family who does matching outfits for pictures)

She is a natural! 

Hanging out upside down! Loves it because it allows her to move her arms :)

Time for all three!

She's not sure about this pose...

And...she's done!

Not even a wardrobe change and her animals could salvage this shot

She was so tired from sitting for so long, she took a nap from about 3 to 6, and then woke up for about an hour, and slept since. I guess a photo shot is a great way to knock her out :) Good thing, because this one didn't turn out as I planned or wanted exactly. Which just means another great night of sleeping for the parents! 

Thanks to everyone for EVERYTHING. Everything has gotten us to this this point, and I am so thankful. 

More to come. 

With love, 

The Polks

Needing a traperkeeper

I always think of great topics to post here. Then I finally make myself sit here and write, and I can't think of any of them! 

Well.. we can start with what's going on, maybe they will come to me. 

Ana meet with her Rehabilitation doc last week. He says our treatment plan sounds great. And he threw out the idea of possibly doing Botox injections in Ana's neck to help relive the Torticollis. I'm still not on board 100%. I wasn't there, so I have to call and talk to him a little more. 

We're still trying to get her Bronchoscope scheduled. They are running into issues because I want to add on getting a new Jtube while she's under. You would think that I asked them to move the Earth by the way the are acting. If they go about it the way they are thinking, then Anabelle will be put under, have the scope done on the fifth floor, be transferred while under to the first floor and have the tube switched. You might ask why, if it's such a hassle, am I wanting the tubes switched. Well. Because her tube cap broke, and this is very inconvenient. Also, because if she is under, we might as well do it. She's had this tube for about 5 months or so now, and they say this tube last about 6. So why put her out in a month again if we can just do it now? Oh, and now the Rehab doctor said if we want to do the Botox, he can combine this too. That will be fun to call and try to explain and coordinate. 

Good GI news! I talked with the new dietitian  and we are starting to increase Anabelle's hourly intake while decreasing her time on. For a long time Ana has been at 25 MLs for 18 hours, plus 4 hours of Pedialyte for more fluids. There are 30 MLs in an ounce, so she was getting 15 oz of formula a day (24 hr period), plus another 3.33 oz of Pedialyte just to keep her hydrated, but not pack on too many calories. So now, each week we are increasing her by 5 ML's. This week she is at 30 ML's an hour for 15 hours. Next week she'll be at 35 MLs for 13 hours, and so on and on. She'll still be getting 15 oz of formula, just not have to be hooked up to the pump all the time. Then when we get up to 50 MLs an hour for 9 hours, we're going to call her back or meet with her to discuss bolus feeds. Then we will start on a more strict blended foods diet. My hope is to get off formula all together and have her just eat whatever we do, just through her tube. That way, when she's ready to eat orally, it won't be a shock to her intestines. 

We've also had two playdates with other AMC families. It was nice to finally meet some of the people who have been such huge helps to us since we first heard the word Arthrogryposis. And it was great to meet there wonderful kids and see how they figure stuff out on their own. It was a tad frustrating though. Amelia and Allison don't treat Anabelle any different then anyone else. However, when around kids their age with AMC, they acted as if they've never seen a brace in their life. I understand that they've never seen a kid their age with the same stuff as Ana, but I didn't expect them to be so shy about it. We deal with kids who stare at us daily. And I don't mind usually, but I never thought my kids would be those kids. I know eventually with time, and more time being inclusive, they will get it an not even think about it. I just it was just a shock to my system since they don't even see anything with their sister. But then again, it's their sister... But besides my kids shocking me, both meet ups were awesome! 


My new goal is to post a new post weekly, every Sunday. I know I've said this before. If I haven't, I've at least thought of it. I need to keep my word on this so I can hopefully post about the things I think about during the day long enough to post them here. Or at least write them down! :)

Goal for next update: To update about AMC. I defiantly don't know everything about it, but many people outside the AMC world have asked lots of questions. So AMC, maybe combined with feeding tube/Gastroschisis information. 

And please, if you have ANY questions about Miss Bear, feel free to ask. I look at is as spreading awareness, not offensive. You can do very little to offend me. 


Until Sunday!

With love, 

The Polks

Picturetastic

As promised, here are pictures! 

This is Anabelle's first helmet. They obviously sent the wrong design. 

You can see how sweaty it makes her head.             

   I mistakenly left the camera lens and she had fun kicking it while I tried to take pictures.

This is the toy Kyle made for Ana. Made out of PVC Pipe. Then wrapped in pink polka dot duct tape for a girly touch. She loves this thing. 

We call it her kick stand.

                                        

She can really kick her toys with this thing and enjoy playing independently!

                                      

We finally got the right helmet. It was a little to plain for Amelia and Allison's taste, so they decorated it with their stickers. 

Ana sitting! 

She can do it all alone now. We have to get her into the seating position, but once there, she does great! 

Occasionally she will fall forward, like so. But she can sometimes bring herself back up. Sometimes she falls to the sides. 

                                    

The girls playing with play dough. When Ana gets to touch new things, she usually makes a face like she is disgusted. It took her a while to warm up to play dough...

Ana and a silly face. 

 

My crazies. 

Alli Paige 

(wearing my first crocheted hat)

 Until next time. 

With love, 
The Polk's

Big long words

Our trip to Seattle was well worth it. Dr. Judith Hall is one of the kindest doctors I have meet. Not only does she have a wealth of knowledge to offer up, she sincerely showed that she cared. Not only for the time she was sitting with us, but for Anabelle's future. For the future of our family. She wanted to focus on Anabelle as a person, not just a diagnosis. 

I know that seems like an oxymoron because I went searching for a more definitive diagnosis. But I didn't go searching because I needed to validate anything. But I just wanted to have more information.

But to the juicy parts. 

Dr. Hall believes Anabelle is in the Amyoplasia spectrum. And on the severe side of Amyoplasia. She cannot say definitively, but believes this is correct due to the Gastroschisis along with the AMC. I'm getting ahead of myself. 

The reasons she cannot say it's Amyoplasia 100%:

 - Kids are typically presented with their arms stuck straight and legs bent,  kind of like a pretzel.  

 - Anabelle is opposite of this. Even though no two people are effected exactly the same way, Anabelle is pretty far from the typical Amyoplasia kid. 

 - Anabelle has these long dimples on her forearms and legs. Dimples in AMC are areas that didn't move much at all in utero, causing little to no muscle (and other things) to develop, so the skin basically stays to the bone, making a dimple. Ana has them on her shoulders, elbows, wrists.. All typical places. But Dr. Hall has never seen the ones on the forearms and legs quite as large as Anabelle's. Also, she was puzzled because she has seen kids with dimples on the legs, but shorter ones, and when they do have them, it was caused by the placement of the foot/feet. Meaning the toes were facing up towards the shin. Ana also does not fit that category as her feet were turned out. 

Back to why she thinks Amyoplasia in relations to Gastroschisis. She explained that in every big study anyone's done in Gastroschisis that 3-4% of the participants have Arthrogryposis, and of those with AMC, all are Amyoplasia. 

She also thinks it was all caused in relations with the vascular system. I can't remember exactly what she was meaning (I know, totally dumb of me), so I will be emailing her shortly for a refresher. 

But she cannot say exactly what caused any of it. The AMC or Gastroschisis. But she did say she is running a study of AMC and Gastroschisis/bowel adhesions soon, and will be looking for similarities. 

She also said if she finds anyone else with long dimples like Ana that she will be in touch with us. There is another genetic test they can run, more fine tooth then the two we have already ran. 

She did say that she recommends us returning to our local geneticists when Anabelle is about 16-18 years. 

AND. She said that of course she cannot guarantee anything.. however, in her observations, kids with good hip movement can walk. Anabelle has GREAT hip movement. I know that she isn't so amazing she has a crystal ball or anything... But Ana's uppers (hands/arms) don't function too great, (though she is making great strides!!) so if she can have walking in her pocket, I won't say no to it. No matter what happens she'll be fine, it'd just be nice to have the benefits of lowers.  

We also got the chance to meet other AMC families. It was really fun. There was an adorable 3 year old little boy. At first, very shy, but then he started joking around with me. Just made me miss Amelia and Allison all that more. I'm not sure how we're going to make it in March for a week when we go to Philadelphia. 

Side note: She is interested in food! We have been giving her little taste of it, and now when she sees food she yells at us if we don't give her tastes. By little tastes, I mean we dap our fingers in what we are eating and put it on her tongue. I cannot wait for the bronchoscope to be done with so we can hopefully start feeding her orally. Although, I don't think that will happen anytime soon. When we give her tastes, she is still swallowing the way she was when she was orally eating. Imagine eating air. That's the closest I can come to to describe what it sounds like. As if she is eating and breathing at once. 

Side note #2: So far this month, besides therapy, she has a total of 2 out of the home appointments. TWO! Last summer it was 20. Just shows how much she has improved in the health department. 

Promise, pictures in the next post. :D

With love, 

The Polk's