Still here…

Still in the PICU.

Judah had a couple of naps today and during each of them he had a “desat”. That’s med-speak for his blood losing it’s oxygen saturation level. I put it in quotes (and yes I’m a little bitter) because I don’t actually believe either of the occasions were a real loss of oxygen in the blood but false positives inherent to the way this is measured. I made my case to the docs but out of an abundance of caution they took him off the list to move to a normal hospital room and decided to keep him in the PICU. We’ll pester them again tomorrow.

Otherwise he had a fantastic day today. He said a bunch of words today – honey, piglet, owl, brave, stuck, rabbit, bubby, my sister and parasaurolophus. None of them are perfect but the speech therapist says that his lips seem to be functioning well but his tongue’s not all there yet. He was super active, fighting dinosaurs with me (matthew), kicking his feet, sitting up on his own and batting both arms at a balloon. The PT/OT people had him up walking though not really holding his own weight up and he actually interacted willingly with them.

The next 6 days are likely to be frustrating and hectic. Judah’s oncologist wants to start chemo as soon as possible. While his tumor is the lowest grade and slow growing, it’s location means that any growth could have potential long term complications. So chemo starts Wednesday. Monday morning he’ll have his port put in (yes, another surgery with anesthesia), Tuesday he’ll have a bevy of tests to get some baselines before he starts chemo. Wednesday he gets the first treatment, followed every Wednesday for 10 weeks, then a two week break, then 4 weeks on and 1 off for a year.

Our problem is therapy. We had hoped they would be able to work something out were he could get pretty intensive outpatient therapy at Vandy but it’s not going to be ideal. For one they don’t have speech therapy so we’d have to find some place else for that. Second they would be wedging him in wherever there are openings in whomever’s schedule had an opening so there would be no routine or chance for a therapist to build report with him. It would be a different therapist at a different time every day for weeks and probably only an hour a day. There are other therapy centers that offer all three types, O/P/S, but they don’t take insurance and while their rates are lower than places that do take insurance we’d still be paying a ton out of pocket for the amount of therapy he needs.

Judah’s becoming more like his old self everyday but still needs lots of prayer. Prayer for continued healing, prayer for him to have patience for the dozens of people poking and prodding him and making him do stuff all day, prayer for a working therapy plan (and a way to pay for it), prayer for yet another surgery, prayer that chemo has few if any side effects and that it is effective in stopping the tumor permanently, prayer to get out of the PICU, prayer to get out of the hospital, prayer that Wendi and I have patience with the docs, nurses, bureaucracy and insurance companies and prayers for a long road ahead.

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sleepy and sore

Last night was a long night. Judah has been having a lot of breakthrough pain and its keeping him awake and grouchy. It would make me the same way. He trying so hard to be brave and we are very proud of him.
He was approved to move to the hem/oc side of the floor yesterday but there weren’t any beds and as of this morning, there still aren’t any. We are so ready to get all these wires off and have more freedom.

Prayers are needed for:
-Pain management
-Moving to the hem/oc floor
-Continued healing of swallowing mechanism (we are hoping he can pass a swallow study before discharge so he doesn’t have to go home with a feeding tube)
-Continued healing of connection between what he knows and what he can say
-Healing of speech
-Bravery and strength during PT/OT

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shaved heads on cute round heads

Well the surgery went great!  Judah is on his way up from recovery now and will probably be in the PICU through the night.  Cross your fingers that all goes well and we can move to the floor tomorrow!

And on another note, Matthew went to a barber shop and got his head shaved today to match Judah.  He walked into the barber and asked him to shave his head and the barber said, “why would you do that?” So Matthew politely told him that his son was having brain surgery and his head would be shaved when he got out so he was going to match it. The barber, who felt terrible, said, “open mouth insert foot.” HAHA!

He looks so different but his head is actually really well shaped for a bald head, :)Judah thinks Daddy’s head has a funny feeling!

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CT/Shunt/Therapy plans

For the last few days, they have had Judah’s Intra Cranial Pressure (ICP) drain clamped to see if he can naturally drain/absorb it. We all thought he was because his ICP’s were reading so low and he was doing so well. At 4 am they took Judah down for a CT to ck on swelling and drainage of his spinal fluid from the brain in hopes of taking the ICP drain out. However, they found that I stead of draining it was actually just forcing its way out of the surgery wound into the area between the skin and skull. So he wasn’t managing his fluid. His fluid had just found an easier way out of the brain.
So tomorrow morning, if all goes well scheduling wise, they will put in a permanent shunt that will drain fluid from the brain to his belly internally. The surgery should only take an 1-2hrs and is minimal in risk. The Dr said it shouldn’t set him back any but instead give him the freedom to move around more and dive into PT/OT for quicker recovery.
We were at first sad about the prospect of another surgery but agreed that we need to move past this drainage issue and onto the talking/walking/treating the rest of the tumor issue. This affords us that.
We would appreciate continued prayers for Judah, surgery, recovery, us, and just being separated as a family. We miss Judah and Camilla Kate together.

Judah is going to need very intensive physical/occupational/speech therapy to fully recover and the logistics of that are complicated. Most of the Drs here think he needs inpatient therapy for 3-5 weeks but there is no inpatient therapy center in all of Tennessee that takes kids his age, the closest is Atlanta. One of the Drs thinks he can work something out here at Vanderbilt to get Judah outpatient therapy but in an intensive way – say 3 or more hours a day 6 days a week.
Being able to do therapy here would be much better for us as a family so we’re asking for specific prayers for God to open doors and make the therapy choices very clear and easy.
Thanks for all the encouraging words and prayers!

The surgery to put the shunt in will be tomorrow morning at 7:30am. Should be about an hour and a half and he’ll be intubated again but the tube will come out when the surgery is over. The process used to route the shunt to his belly will be pretty painful for Judah when he wakes up and he’ll have a total of 5 or 6 incisions (including the ones he already has) and every incision is an infection risk. So please pray for a flawless surgery, minimal pain and no infections!

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visits and progress

Judah has been working so very hard today. He sat up in bed, smiled and laughed while watching Brave, squished play-doh, sort of finger painted (he hates to have dirty hands), and then made Daddy and me feel like the funniest people in the world laughing and smiling while sitting in the rocking chair all by himself. The thing I noticed that was different about today vs yesterday is that when he was done working, he didn’t freak out. He didn’t flail and yell, he whined and then we put him in his bed and after some questions to figure out what he wanted, took a rest. Our Great God is providing comfort to our sweet frustrated little boy!
We had a ton of out of town visitors and Judah responded well to all of them. Thank you for making the drive to love on us and our boy.

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smiles and giggles make hearts full

And our God, merciful and playful has returned Judah his laugh. He is hearing our prayers and answering for His glory and our joy!
We put one of his favorite movies on and he started smiling. Then a few minutes later, laughing. Just now he sat off the bed and folded himself in half then laid back down. He’s thoroughly enjoying himself!!!

After a wonderful 3 hrs with smiling and laughing and even some words Judah crashed into an angry depression. We think he may have exhausted himself but after 2 hrs of only grunting and flailing we backed off and let him be. It is so hard to see him make such progress one minute, and then the next, backslide. He was again frustrated and cried in anger.
We prayed for Jehovah Jireh to provide patience and comfort to Judah and to us and then prayed our same prayer for supernatural healing of his vocal chords, swallowing system, tongue, mouth, and that connection between what he knows and how to say it. Please continue to pray with us and for us.
We are so grateful for the glimpse at our little boy and thank God for it. We want more!!!!

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Swallowing

Praise be to our Jehovah Rapha! We prayed for supernatural healing and He has come to our aid. Judah was, yesterday, unable to swallow or keep saliva in his mouth and today he is not only swallowing but in total control of his spot. No drooling!

Keep the prayers for supernatural healing of:
-voice box
-connection from cognitive to mouth (speaking what he knows)

Our God is mighty and has a glorious work to complete in Judah. He has carried us a giant step in the right direction. Keep praying for miraculous, quick and unexplainable healing.

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prayers (and a happy birthday wish) granted

There are a few good updates today (and a happy birthday wish for Wendi!). The oncologist came by yesterday to confirm that as they suspected it is a grade 1 pilocytic astrocytoma, which means it’s slow growing and extremely unlikely to spread anywhere else. Basically, if you’re going to have a brain tumor that’s the best type to have. Praise Jesus!
We’re seeing improvements. Judah has moved his face muscles more today, moving his lips and tongue. I even got him to snarl at me when I was being particularly aggravating. He’s been pretty agitated all day, but who can blame him. I’d be pretty angry too. More eye movements and head motion. God bless Mumzy’s hearing loss because it’s enabled her to find ways of communicating with him that no one else had found. And he’ll actually make an effort at high fives and fist bumps with Uncle Josh when everyone else just gets grunts. He let the speech therapist read to him for 30 minutes and she had him turning the pages. Started off with angry swats but by the end he was turning them gently and deliberately.
The neuro Drs also said they could try “clamping” his EVD (brain drain as we affectionately call it) which means they are seeing if he can self-regulate his spinal fluid. If he does well they could take the EVD out in the near future with no need for a shunt.
Things are getting better. He’s still got a long road ahead (as do we) and there are a lot of unknowns that we may still have to face. Keep the prayers up, they’re working!

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slow day in the picu

Today has been a slow day. There have been no real improvements or setbacks. Judah has been a little more alert but still isn’t talking other than the occasional “noooo”. He will swat at you when he’s tired of you messing with him. But really only with his right hand. His left hand seems to be less active and fidgety.
The neuro team came by today and said they want to wait awhile until they put in the shunt. The Dr said they are not in a rush to take the drain out since he’s got a ways to go on the swallowing, coughing, and talking.
We are feeling pretty down about his slow recovery. Please pray for both patience for us and a speedier recovery for Judah.

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this coming year will look, ummm, hard

We expected a relatively quiet day in which Judah would just be getting better but not much change or news would come our way, but no such luck.
First of all, we moved rooms again. No medical need for the move, just needed to shuffle some patients around for better nurse coverage.
Second we met with the oncologists about the chemo plan. We had previously discussed some of it in a hypothetical way so there weren’t any big revelations but it’s still scary. Since the tumor is low grade the chemo will be fairly low grade as well. He’ll be on it for a year, going in about once a week for treatment which takes a couple of hours. They’ll give him anti-nausea medication before the treatment to try and cut down on the side effects. He likely won’t lose all his hair but it may thin a little. He should still be able to go to pre-school in the fall. Because the medicines knock down the white and red blood cell counts he’ll be slightly more susceptible to colds and other infections and will tire out faster than he would normally. There’s an 85% chance that the year of chemo will stop the tumor from ever growing again. The scariest parts are the “possible but unlikely” side effects like liver damage, hearing loss, kidney damage, needing blood transfusions, etc. It’s also disheartening that the chemo won’t shrink or destroy the tumor that’s left in there, it only kills the parts that might still be growing. That means that any symptoms he currently has as a result of this tumor are likely permanent. We’ve yet to see him fully recovered from the surgery so we don’t know what symptoms may have been relieved by the surgery but the symptoms that could stick around are things like central sleep apnea, balance and coordination issues, troubles swallowing and managing secretions in the mouth and nose, and nystagmus/strabismus – a couple of eye related things he developed a few weeks before the diagnosis.
I (matthew) worry a lot about his spirit and his psyche through all this. He’s just gone through this major traumatic event, spent weeks tied to a hospital bed, days in pain and will soon start a treatment that will make him feel sick and tired for a solid year and there’s just no way he can understand all that. No way to help him grasp that things would have been much worse if we didn’t do all this. It’s just hard to feel like a parent at all when you’re powerless to protect your child or to help him understand things. Mentally I’ve always known that my job as a Christian parent was just to keep my kids alive and do my best to show them Jesus in my life. That at some point no matter what we did right or wrong the sin nature in them would break them like it does all of us and that brokenness would lead to (or, Lord forbid, away from) the Cross of Christ. I knew, in my head but maybe not completely in my heart, that ultimately my role in Judah’s life would have to be yielded up to the business God had with him. I just didn’t expect to so soon come to the point where I had to completely yield it. Where I’d be powerless to affect the direction, the quality or even the duration of Judah’s life.
The best I can do for Judah at this point is to keep praying that God be very close, very real, and very obviously present with Judah (and us) through this. That He keep protecting his mind and spirit, keep healing his body, keep showing the strength of His Mighty Hand through our family. And I can keep asking, begging even, all of you to pray likewise. And I’ll keep doing those things for the next year at least.
The last update is that the neuro docs are leaning towards putting in a vp shunt. That is essentially a permanent drain in his head that syphons off the excess spinal fluid when the pressure builds up and dumps it into his stomach. It sounds scarier that it is. It will be basically invisible, running under the skin of his scalp down the neck and into the body. It’s still another surgery and more recovery but it’d get him out of the ICU and ensure that he never has hydrocephalus problems down the road. So please pray for a clear direction on that.
Thank you all for your continued prayers. Judah is getting better. It’s just going to take a little time.

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