Sunday, April 30, 2017

Evanna is [T H R E E]

I’m generally good at keeping my emotions in check and remain level headed.... but then something will trigger and I become this big blubbering mess unable to stop the tears from flowing. Sometimes it tears of happiness… but other times it tears of sadness too. Despite the small level of fear Nick and I live with in regards to Evanna and her health, I'm happy to say that -- 

Evanna – you are officially T H R E E years old!

Another absolutely amazing milestone… and I’m almost having a hard time wrapping my head around it! You have such a personality right now, and it I could sum it up in just a few words -- they would be: calm… yet feisty, content… yet strong-willed, and easygoing… yet determined. It’s crazy that you can be one thing and then another, but allow me to explain:

CALM – Despite hospital admissions becoming shorter and further in-between (such an amazing accomplishment in its own accord), we continue to get tons of compliments on your overall “calm demeanor” and medical staff are always so surprised at well-behaved you remain while getting accessed or going through a procedure. Blood draws are starting to get a bit harder as you get older, but you still take it like a champ!

FEISTY – let’s just say that you would not be here today if it weren’t for this quality. You are one fierce little fighter, who continues to knock one curve ball after the next out of the park and almost make it look a little easy. There's a reason I often use the phrase #EvannaStrong in my updates. 

CONTENT – whether it’s playing for hours and hours by yourself or simply satisfied to sit and watch movies on your tablet… you my dear, are just a dream. While you've started to realize there's a world outside our 4 walls, you're the happiest at home playing with your favorite familiar toys with just mommy or daddy (or one of the nurses) within arms reach.

STRONG-WILLED – while this is a great quality, it sometimes makes certain tasks harder than it needs to be. We definitely see this come out the most during occupational therapy (but if we're going to be honest -- feeding therpay, physical and speech). We are trying so hard to expand your world, but no matter how hard we try, you almost shut down and not entertain new exercises and toys. You know what you like, and nothing else matters! While I hope you never loose this quality, I do hope that as you start to understand the benefit of these activities and be a little more open-minded to try new things. xo

EASYGOING – it’s amazing that despite everything you go through, how practically unphased by it all you remain. I do sometimes wonder if this will be something that will change as you get older, but I still feel like as you begin to comprehend more and more, you’ll still remain somewhat easygoing and continue to go with the flow as we’ve always done so in the past. You've been handed a rough set of cards, but continue to take it all in stride -- I couldn't be more prouder to be your mom than I already am!

DETERMINED – when there's something you want, you won't stop til you get it. Whether it's trying to gain our attention, play with a certain toy, watch a movie, or dictate how a medical task is completed. While you're very good at getting your nightly trach care done, lying perfectly still for ECHO's or receive breathing treatments (ie. that we did to treat that horrible cold that landed us in PICU last October) -- it's still done on your terms. You'll behave wonderfully for not so pleasant medical procedures, but only when it's done under favorable conditions... ie. you get to watch a move on the tablet. But hey, we'll take what we can get, and are happy to do whatever it takes to keep you happy. You endure more than most 3 year olds do, but take all those expectations that have thrusted upon you with so much grace and dignity -- and couldn't be more proud and honored to call you ours.  

 ////// things I want to remember ---
˔ you always wake up so incredibly happy and excited, it's infectious - wish I was that excited to wake up in the morning lol.
˔ despite your current lack of speech, you definitely know how to tell us what you want or express when you're either happy or upset.
˔ you do this cute little happy bounce when we've figured out what you want and we comply.
˔ brushing our hands aside is generally how you tell us no - but it's so adorable nonetheless.
˔ you get so excited when we pack up and are getting ready to take you out, and when we pull into the garage arriving home.
˔ your favorite movies currently consist of Frozen (still!), Monsters Inc (probably your #1 right now), Lilo & Stitch, Finding Nemo, Tangled, and Lion King if you're in the mood. It's really hard to "get you onto new movies", but I keep trying in an effort to save our sanity.
˔ while you're becoming less reliant on soothers, you always have "a favorite", and it always seems to change monthly lol.
˔ the "if you're happy and you know it" game is your favorite thing to do with your dad.
˔ I always gets asked if you tug or pull on your vent tubing, but the most you ever do is pick up and move the tubing if it gets in the way of your playing. It's kind of funny to witness.
˔ still doesn't happen very often, but once in awhile, you'll finally give in and give me a quick cuddle. Just a few days ago, your dad figured out that if he uses a blanket as a pillow (as he doesn't have boobs), you'll cuddle with him for a few minutes too.
˔ you absolutely love getting up on my lap and insist we play "peek-a-boo". you've even begun to dictate when I should cover my eyes, or uncover them to say "peek-a-boo".

Right now, things are GOOD. Close to perfect that we haven’t experienced in quite some time (which I would pin point to the summer after you were born). We’re essentially able to live “season to season” right now, and it’s a marvelous feeling to say the least! We’re very busy, but enjoying a lot of normalcy lately – and the future is starting to look very bright. We’re gaining some real momentum, and the flow of good news about your health right now has us feeling “cautiously optimistic”. I still have moments where I grow afraid of when this "period" will end, but I try my best to quickly shake those feelings away and enjoy the here and now while we can.

You continue to be our greatest blessing and life lesson… all rolled into one really cute package, and we love you so very much! 

[More pictures of Evanna's "Strawberry Shortcake" themed birthday party will be posted when I do my next update in a week or two]

Sunday, April 23, 2017

|| on c l o u d n i n e + Easter ||

April is off to a fantastic start – and I really hope this is the beginning of a positive trend! I'm over the whole “when it rains – it pours” bit that we’ve been enduring for quite some time, and so I'm really looking forward to how the rest of this year will continue unfold.

Of course I’m currently referring to our mini ICU admission and fantastic bronchoscopy results that took place a few weeks ago – but I can’t emphasize enough how this procedure, and the results that followed were such a huge deal! Because my social media updates on Instagram and  Facebook were pretty detailed and thorough, I’m going to save myself a little bit of time and just copy + paste them here – –


April 5, 2017

BRONCHOSCOPY RESULTS || so the bronchoscopy results are even better than I had anticipated (partially because I was too afraid to get my hopes up). We had the same Respirologist that did it last year – which was great for consistency purposes.

For the longest time, Evanna was on ventilator settings of “27/12”. The number “12” representing the level on PEEP (pressure) Evanna requires to help “stent open” her VERY floppy trachea. When someone undergoes a procedure and needs to be intubated – you can generally extubate a person successfully off the ventilator around a PEEP of 4-5.... so yes, Evanna required more than DOUBLE the amount of pressure to support her breaths (I can't emphasize enough how high that number is). In the OR, the Respirologist was able to go all the way down to a PEEP of 2 🎉🎉 I’m seriously in shock right now!! While there are still are a several steps to take before we start taking Evanna off the vent – this means we’re definitely headed in the right direction, and weaning off the ventilator and decannulating (taking the trach out) may be much closer than we thought!

At the moment Evanna is back in the ICU on her home ventilator with settings decreased to 20/8 (so the PEEP has been decreased from 12 to 8). Evanna's being monitored for 24 hrs... but we're not quite sure what the plan will be after that. They may discharge us tomorrow and have us hang around these settings for a few months before trying to wean again, or do another decrease or two in the morning. Due to the fact that this is the first massive decrease we've ever done since Evanna's trachoestomy, they may be reluctant to push much further right now, but we'll know more in tomorrow.
Thank you SO much for all the prayers today -- they were definitely heard, and I'm one super happy mama right now.

April 6, 2017

AND WE'RE DISCHARGED || by far our happiest ICU admission to date, and I'm seriously on  c l o u d  n i n e  right now. While the medical team was busy rounding on other patients this morning, the nurse practitioner came in after talking to the Respirologist on the phone and stated that everything seemed to be in order and we could immediately take Evanna home.

We actually ended up running into the Respirologist out in the parkade (it's actually the second time this has happened lol), and he reiterated how happy he was with Evanna's bronchoscopy results + revealed that he had actually sprinted her off the ventilator for an extended amount of time while in the OR and she handled it just beautifully. We'll now be seen back in clinic in about 4 wks and look at making additional decreases (though I'm not sure whether it'll be in the form of vent settings decreases or play with the idea of sprints off the vent). My head is spinning at how fast this is all of a sudden going – but we've been​ warned in the past that once Evanna was "ready", the process would gain momentum and changes will start to happen on a more consistent basis.

Again -- a PEEP of 8 😍 (I may have sung that as we were walking out of ICU lol).

Since our discharge, things have actually been quite low key and don't have much more update on. The Stollery has called and confirmed that we're slated for an early June Cath date (*cue sigh*), and I will confirm that everything is in order at our next cardiology appointment that we have later this week.

Our next Complex Airway Clinic appointment has been scheduled for May 10th (which is just a few weeks away)! Unlike past CAC appointments that are generally for monitoring and check-up purposes only-- this will essentially be an "all day" thing (which I'm already mentally preparing for), as the respirology team plans to do more ventilator decreases! Hello #ventfreesummer (if I say enough, then it just has to happen, right?)!! At the moment, I don't know what those decreases will entail (ie. additional PEEP decreases or experimenting with some actual sprints off the ventilator), but I'm still excited nonetheless.... and based on how well she handled the first big decrease -- I'm confident she will do well and handle it just fine. We also plan to ask about a passy muir valve (aka "speaking valve")... which will help direct air through Evanna's vocal cords and hopefully help enhance the noises she's already making and have a chatty toddler in no time! We weren't able to entertain the idea before, as this valve actually adds PEEP, and due to how high her PEEP was before, were told we had to wait until some decreases we made before experimenting with one. Some kids don't like pussy muirs -- but we're still keen to try one and see what Evanna will do when we put it on her trach *fingers crossed*.

Evanna with her cousins Alexa, Dax and Xoey
Easter has recently become an important time of year for me. It usually involves our anniversary and signals that Evanna's birthday is just around the corner. My sister and her husband recently moved to High River, and so because she wanted us to come see their new place, had asked if she could host Easter this year. So we drove out to High River on Saturday and had dinner with my family -- including my grandparents who drove up from Fort Macloed to join us. Before dinner, we quickly took some photos of the kids in their "Easter attire", and though it required a lot of patience and creativity to keep them all content and happy (especially Mr. Dax....), it was definitely a bit easier than the Christmas photos just a few months ago... so I'm going to call it a win lol.

/////// other little updates --
I've recently been able to encourage Evanna to walk along the couch ("furniture walking") if she wants to gain my attention. She's recently become a huge "mommy's girl" (Nick may be a little heartbroken over this new development lol), and so it's become a motivator for her to walk along the couch to get to me. Last Monday, nurse Carmen accidentally discovered that if you now hold Evanna under her armpits, she will take steps towards certain toys or her tablet. It's something Nick and I have tried to get her to do in the past, but I guess it wasn't something she was interested in doing until now.

These last two weeks of April have proven very busy which entailed a night out with friends this past Friday, another "trach mom night out" yesterday for me (we have a little local group of "trach moms" that try to get together about once a month for brunch or dinner), and Xoey's (our niece) baby blessing today! Evanna's 3rd birthday is next weekend, and my dad's 55th birthday the first weekend of May!

......AND before I forget, I was featured on another podcast (first podcast from 2016 is available here) back in February, and I've been meaning to link to it here on the blog for those who haven't had a chance to listen to it yet. CLICK HERE to hear our episode on Extraordinary Moms that I did in honor of CHD Awareness week where I talk about Evanna's journey and try my best to explain a "day in the life" of what it's like to be a "Trach and Vent" family!

xo The Irvine Family

Tuesday, April 4, 2017

|| Evanna's new ride + an early anniversary ||

"Trachieosaurus" shirt from StomaStoma // Hair bows c/o  AB Bows Handmade

On the surface things have been relatively calm and even “serene”, but it has remained quite busy and somewhat “go-go-go” behind the scenes. Most of it involves getting some things in place for Evanna as we leave the first quarter of this year behind and make some plans for the rest of summer leading into fall.

In respect to Nick and I, we are currently just putting the “finishing touches” on our legal basement suite and will hopefully have an ad posted and the suite rented out before the end of April. This project has eaten up most of our free time over the past few months (especially for Nick, I can’t emphasize enough how hard he’s been working to complete this project), so it’ll be nice to finally have to time to focus on more personal projects such as building the rest of our fence and do some landscaping in May, and even tackle some interior design ideas that I’ve been dreaming up since the day we moved in.

In regards to Evanna, we’ve been able to make a few small positive changes such as discontinue a few more medications in March and work on transitioning her from her standing frame to the walker. With medications, she’s on just iron, aspirin + Vitamin D – essentially all supplements and just quite an amazing feat in my opinion. The transition to the walker has been going okay, but I don’t think she quite understands the freedom it gives her and hasn’t realized the walker’s full potential…. but I’m confident in time that will come.
We also had an intake assessment with an organization here in Calgary called GRIT to send in Evanna’s application for PUF funding from the province that will provide early intervention services to help integrate Evanna into the school system over the next 3 years.

“Alberta Education provides Program Unit Funding (PUF) to support the educational needs of children with a severe developmental disability or delay. Children who are at least 2 ½ years of age and less than 6 years of age on September 1 are eligible. The funding is used to support children’s participation and learning in early childhood programs.”

Evanna qualifies for the full 3 years (the first year or two will definitely be home-based), and due to her age, will start this fall! I was a little apprehensive about the whole process and feel like Evanna is too young/not ready – but we’ve been reassured that Evanna is definitely ready and will benefit so much from this program. We chose to go with GRIT (as there are a few several organizations to choose from) based on all the favorable recommendations from fellow medical families that I am acquainted with and our primary trach nurse from the Complex Airway Clinic who noted that GRIT  was the most experience with medically complex kids – especially those with trachs. So based on that, I didn’t really bother (nor waste precious time) looking into other organizations and immediately set up an intake assessment with GRIT at the end of February. The two ladies that came to perform the intake assessment fell head-over-heels for Evanna and just thought she was the most precious thing ever. They were ecstatic about our potential acceptance into their program and made several comments about how well she’s going to do over the next 3 years and all the progress they’re anticipating she’ll to make. Once the PUFF funding is in place, GRIT will hire someone to work with Evanna around June, and the program will officially begin in September -- as it follows the regular CBE (Calgary Board of Education) school schedule (essentially it’s “early intervention preschool”). At the moment it’s been eluded that we will start out with 4 days per week, and because Evanna’s a “morning person”, has been signed up for a morning program.

---------------------------- in other news ----------------------------

For the 4th year in a row, Evanna’s medical needs is somewhat trumping our anniversary once again – 

[April 2014] 37+ weeks pregnant and moved into the Ronald McDonald House up in Edmonton
[April 2015] Evanna hitting 184 days in the ICU and yet, not at the halfway point when all said and done
[April 2016] Evanna’s emergency debridement sternotomy surgery
[April 2017] bronchoscopy procedure

…. so we decided to celebrate our 5th anniversary a little early this year and keep it simple (per Nick’s request) since we just went away to Lake Louise back in February and have another small trip planned for this June. It’s our 5th wedding anniversary this year, and we had always talked about going to Las Vegas to mark this particular milestone (it’s where we had gotten engaged), but such is life and unfortunately that trip will have to wait until a more appropriate time. While this is something I would have been upset about several years ago, I’ve learned there are more important things in life and “it is what it is”.
So last Thursday we booked one of our nurses for a day shift to watch Evanna, and Nick and I went and got brunch from a place that I had been wanting to try out for quite some time (I consider myself a “wannabe foodie”  lol) at a place called The Bro'kin Yolk on the North side of Calgary. We took the time to talk about everything we’ve accomplished over the past 5 years and how far we’ve come as a couple. We’ve crushed almost all the goals we set for ourselves and were able to take a moment to marvel at all our hard work. We tried to talk about what the next 5 years will look like, and while there were a few things we see happening, there are currently a lot of balls in the air (…. and yes, most of that has to do with Evanna lol), so while we continue to move forward – it’ll be in some state of limbo (which is becoming normal for us).
After brunch, we headed to Kensington (downtown Calgary) see the Peace Bridge off Memorial Drive before walking over to try an extravagant milk shake from Burger 320. We then went to see a movie before heading home and spending the rest of the afternoon + evening with Evanna. Overall, it was a nice little moment to enjoy some quality time between all the hustle and bustle of life.

Granting a PICU bed remains available (as it’s generally the main reason our surgeries and procedures get bumped), Evanna’s bronchoscopy will take place on tomorrow morning. At the moment we’ve made the decision that I will still go to work that day (this shift was scheduled weeks prior to getting the procedure date), and Nick will take Evanna to the hospital that morning for the routine procedure (because they have to be at the hospital extremely early, I will help Nick get Evanna admitted and then head off to work). I’ve made Nick promise to call me the moment he finishes speaking to the Respirologist and share the results with me (so all the details will be fresh), and will then join him back at the hospital the moment I get off work. I’m super nervous for what they will find and just *crossing my fingers* that Evanna’s trachea will show that it’s finally starting to strengthen, and we can lower some of her vent settings and work towards sprinting off the vent.
We went into last year’s bronchoscopy with very high hopes, and were discharged a few days later completely devastated that not a single change was made to her very high ventilator settings. Despite improvements in certain areas of Evanna’s health -- we’ve been at this plateau for what I consider the “big stuff” for quite some time (I’m taking years here…), and would honestly like to see some momentum happen. I just wanna see the light (even if it’s small) at the end of this tunnel in regards to our trach/vent journey and know we’re headed in the right direction. We’ve seen the power of prayer work in the past, so if you can, keep Evanna in your thoughts and prayers tomorrow morning that the bronchoscopy will go well and that we’ll receive some positive results.

Last Thursday I called our Cardiology clinic to see if they could inquire to our Cath date, as we STILL hadn’t heard from the Stollery about a timeline for this procedure. One of the cardiac nurses retuned my call and stated that she called Edmonton and at the moment we’re currently slated for June date (….. and yes, by jaw hit the floor when she said that). The nurse stated that it was obvious that I wasn’t happy about this timeline and completely understands that while Nick and I are reasonable people (we’re not newbies to our healthcare system, so we know how to “wait our turn”), but there is a lot riding on this procedure and we’ve been waiting long enough. The nurse said at the moment, there was nothing she could do, but would email our primary cardiac nurse and cardiologist, as our cardiologist is the only one who can advocate for quicker date. Unfortunately our cardiologist is away for another week, but thankfully this bronchoscopy is providing enough distraction in the meantime. The referral paperwork that was submitted asked for the Cath to be done “within the next 3 months”, and it should have gone in at the beginning of February, but due to some communication limbo, it didn’t go in until mid-March … so my hope is that our cardiologist can try and work some magic and have it moved up to sometime between the end of April or beginning of May.

Thanks again for your all your love, prayers and support,

xo The Irvine Family