Princess Cloey: Day 4-change of plans

Thursday, July 22, 2010

Day 4-change of plans

Cloey's sleep study was moved to today, so we didn't make it to the zoo : (

The good news is we will probably go tomorrow, and be coming home Monday.

The not so good news is that we have decided to sign a modified DNR for Cloey, allowing respitory and pain control support only.

This trip, our last Mayo trip and her symptoms have concluded that there is irreversible damage to her brain, causing her autonomic nervous system (basically everything you're body does automatically: breathing drive, heart rhythm, pupil dilation, bladder/bowel control, etc.) to not function properly.

When she was born her skull was abnormal causing pressure on the lower part of her brain stem & spinal cord. This was discovered on our first trip to Mayo when she was 2 1/2. we did a decompression surgery (removing bone in her skull & spine) to relieve some pressure. It wasn't enough & subsequently fused her entire cervical spine to prevent damage to her brain or spinal cord. after the first surgery she showed some "signal changes", a black line on her MRI. she lost her pincher grasp in her left hand and had some overall left sided weakness, Hardly noticeable though. The spinal cord can usually grow around damage like that and she would probably recover. Since then her breathing etc. has deteriorated but there has always been another possible explanation. She has a spine x-ray every year and they have been perfect, no new growth or anything. It wasn't until this trip that all the pieces started to fit together and point to her brain & spine.

There is no way to tell if the damage was there when she was born or was caused during the surgeries, and it doesn't matter, she would be paralyzed from the neck down if we had not done it.

There is no "fixing" the brain. we have the choice to try to stay one step ahead of her symptoms (eventual 24hr vent dependence, colostomy bag, pacemaker, repeat spine surgeries, etc. etc) we could probably manage her for another 10 years, but it would be quantity not quality.

Cloey does not want that. she tells me she wants to take her g-tube and trach out. She wants to play with other kids. Today when we showed up to the hospital for a sleep study she wouldn't talk to me. She was kicking me and saying she wanted to go home.

As Ty and I talked about what to do, we remembered that all we have ever wanted was for her to be a kid. all the fighting has been to give her some kind of life. If we wanted her to just stick around and be on machines we could have stoped trying in the NICU. We could have put her in a group home.

What all of this means is that Cloey will still be on the vent, but minimal hours and rate, just enough to keep her comfortable. If she needs CPR they will do breaths only and not chest compressions. We might continue to do minor surgeries like ear tubes, just to keep her out of pain, but we will not be "fixing" anything. We will manage her care primarily at home, with a possible scheduled maintenance trip to Mayo once a year, should Cloey decide to fight the system like usual and stay with us for a few years. basically we will only be doing supportive care and allowing God and Cloey to decide when her work here is done

Are hearts have been heavy all week. we really hoped they would find something fixable. We truly appreciate every one's support & wish we could say "Thanks to you, Cloey will be fine" but instead it's "Thanks to you we were able to confidently make the hardest decision of our lives"

We will get the results from the sleep study in the morning but are not expecting any changes. Ty will be flying out here on Sunday to help me get Cloey home safely on Monday. Then we will start the process of signing the DNR and giving it to all of her nurses, care providers, etc.

While I am extremely sad and get physically sick when I think of losing her, I watch her and realize how much of her life she has spent being "handled" by doctors, nurses, therapists, caregivers, us~

It's time to let Cloey be a kid, even if it's only for a short while.

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Some issues Cloey has faced

POTS
Von Willebrand
Ventilator dependant (12 hours)
bone anomalies
numerous infections
hypoglycemic, anemia, malnutrition
excema
at risk melonoma "abnormal birthmark removed"
intestinal deformity
tracheostomy
sleep apnea
sub mucus cleft pallette
esophegial reflux
VSD (hole in her heart) & arythmia
gross & fine motor skills delay
"lazy" eye/ glasses
spinal stenosis/fusion
bladder surgeries
sensory integration disorder
speech/motor planning delay
tonsils and adnoids removed
10 sets of ear tubes
mental retardation
siezures
Failure to thrive

The birth of a miracle

A Mother’s Story
A tiny purple foot. That’s all I could see. There was no, “it’s a girl,” or no “oohs and aahs.” I wasn’t holding her. The room was too quiet. No baby crying – just fast, technical talk between the doctors and nurses. This was the first time I had given birth, maybe this was normal. I just wanted to hold her, but all I could see was a tiny purple foot – shaking. I remember thinking that she must be cold.
Finally a nurse was bringing her over to me – wrapped in a blanket. I thought she was going to hand her to me, but instead she just said, “Kiss her forehead. She has to go upstairs.” I looked at her new daddy and said, “Go with her.” I think he was relieved not to have to make the decision between wife and daughter himself.
As he left the room I realized the prompting I had received months before to be sealed in the LDS temple (married not only for time, but also for eternity, so that we and our children can be together forever) was in preparation for this moment. I found comfort in knowing that if she didn’t make it, I would have the opportunity to raise her after this life.
Eventually, I was taken upstairs to see her. Her dad was with her. He put his arm around me and I reached into the clear little box and touched her hand. She was covered in tape and wires. Her eyes were shut and she wasn’t moving. Ten seconds passed – maybe – and a helicopter team came rushing in, with all the technical talk again. I asked what was going on. Someone held a paper in front of me with a diagram of a heart on it and started to explain what was wrong with hers. They said she was being taken to Phoenix Children’s Hospital.
I wasn’t listening. I just watched them as they lifted her tiny body into another box and took off running. Her protective daddy asked if he could go with her and they said no, he would have to follow by car. He kissed me and off he went, along with his dad, to be with our new baby girl.
At Phoenix Children’s Hospital Neonatal Intensive Care Unit (NICU), her concerned father was told Cloey had a coarctation of the aorta. She was on a breathing machine and was scheduled to have a surgery the next morning. The doctors showed him the x-ray that showed a hole in her heart. Acting on faith, Cloey was given a blessing by her dad and his grandfather. He had never given a blessing before, and had only been ordained an Elder (received the power and authority to give such a blessing) a few months before. I was not there, but was later told by a nurse it was a very powerful experience. She said several nurses paused during the blessing – unheard of in the NICU. The words of the blessing were more than an new dad with a heavy heart could have uttered on his own. They had to have come from a loving Father in Heaven who was mindful of the new challenges our family was facing.
Cloey was born on March 25, 2001 at 3:13 p.m. at Desert Samaritan Hospital in Mesa, Arizona. Within hours, both she and her daddy had left the hospital. Very early that next morning – before the sun came up, I called my husband. I was crying – lonely, and unsure of what was happening with my new baby – so he came back to be with me for a short time. By 10:30 a.m. on March 26, I had checked out of Desert Samaritan Hospital and was on my way to Phoenix Children’s Hospital to see Cloey. When I arrived, she was the biggest baby there and was right by the window. For that I was thankful.
Sometime that day, they ran another echocardiogram of her heart before taking her to surgery. The hole that was there the day before was gone. Cloey would not need the surgery! It was a real life miracle. The only thing that had been done to Cloey between the x-ray with the hole and the one without, was the blessing she had been gien. I knew then that the Lord truly does answer prayers, and that the power of the priesthood is real.
Cloey spent the next 14 days in the NICU. We were right by her side every day, and would stay until 1 or 2 a.m. We would go home briefly, eat and sleep, and return by 7 a.m. each morning. We read to her, played musical toys for her, talked to her and dressed her in her own clothes.
At one point, when they were trying to wean her off the breathing machine, she crashed. Alarms went off and they told us to step back. We thought we were going to lose her. Three days later when she was successfully breathing on her own, one of the doctors told us, “She is the master of her own destiny.”
Around this time, the geneticist pulled us into a room off of the NICU to give us the results of some blood tests they had taken. We thought this was just procedure. We later learned the blood tests were ordered because of her “dysmorphic features”.
The geneticist asked us to sit down. We held hands. He told us Cloey had an unbalanced translocation duplication 16q22 monosomy 14q32, to be exact. He wasn’t sure what to classify it as because he had never seen it before. But he was sure she would be severely physically and mentally delayed. He told us that it would be significant. She may never walk or talk or even know who we were. We both cried.
Until that moment we thought that this NICU stay would be our trial. As soon as she was better we would go home and this would all become a distant memory. We really had no idea something was “wrong” with her. All our hopes and dreams were gone for her at that second. Then he said, “You can take your baby home, and I will see you in six months.”
We went out into the hall and told my grandmother what the doctor had told us, and we all cried again. Then we went back into the NICU. As soon as I saw her again I stopped grieving for what she wasn’t and started loving what she was. She was so beautiful and was fighting so hard. She had no idea what we had just heard or that she had limits. She was just trying to be a baby. So we took her home and knew we would do all we could for her.