Technical Surgery Details

If you are anything like me and you want detailed answers to all the questions… this post is for you. So just hang with me because I’m going to do a little review for all the newbies joining us. But I’ll include pictures with lots of detail to bring everyone up to speed.

So let’s start with What is Chiari Malformation? Info Source

Chiari malformation (kee-AH-ree mal-for-MAY-shun) is a structural abnormality at the back of the brain and skull. Normally, a large hole in the base of the skull accommodates the connection between the brain and spinal cord. This connection point is surrounded by fluid that can move freely between the head and spine. In someone with a Chiari malformation, the back of the brain (the cerebellum), is pushed down through this opening, creating pressure on the spinal cord and restricting that fluid movement between the head and spine. That pressure leads to a wide variety of symptoms.

Those symptoms may include:

  • Headache that gets worse with exertion, including exercise, coughing, sneezing, or laughing. The pain may also be experienced with certain movements, such as bending forward. (Henley was having these symptoms a lot before her second surgery)

  • Neck pain, specifically at the base of the neck or between the shoulder blades.

  • Dizziness (Henley had a lot of this around age 7 before her second surgery)

  • Tingling or numbness, usually in the hands (At age 7 Henley had this in hands and in her feet)

  • Unsteady gait (unbalanced, clumsy, she basically looked drunk while walking a straight line. Henley is also currently having trouble with some motor planning things like walking down stairs, getting on escalators and overall coordination)

  • Loss of fine motor skills (handwriting, using scissors etc: Current issue)

  • Choking on liquids (Henley struggled with this at Age 2 & again at age 7)

  • Spine deformity (scoliosis)

  • Speech Issues (Current Symptom)

  • Difficulty swallowing (Henley had increased swallowing issues before her second surgery, she would chew on food and eventually just spit it out because it was hard to swallow)

  • Gagging or vomiting (Just about every single feeding from 18mths until her surgery involved gagging or vomiting)

  • Developmental delays

  • Failure to gain weight (Henley was considered “Failure to thrive” when she was a baby because she couldn’t gain weight no matter how much we fed her)

Other symptoms that Henley had that were not official documented “Chiari Symptoms” were:

  • Seizures (we believe this was due to the amount of compression on her brain stem. This completely resolved after her second surgery and we have not seen one since

  • Cognitive “cloudiness” After Henley’s second surgery it was like a curtain was pulled back and she was able to mentally process things so much faster. She had more words to say, spoke clearer and faster and seemed to have a lot more energy.

What does the Cerebellum Control in the Brain? Info Source

The cerebellum has several functions relating to movement and coordination, including:

  • Maintaining balance: The cerebellum has special sensors that detect shifts in balance and movement. It sends signals for the body to adjust and move.

  • Coordinating movement: Most body movements require the coordination of multiple muscle groups. The cerebellum times muscle actions so that the body can move smoothly.

  • Vision: The cerebellum coordinates eye movements.

  • Motor learning: The cerebellum helps the body to learn movements that require practice and fine-tuning. For example, the cerebellum plays a role in learning to ride a bicycle or play a musical instrument.

  • Other functions: Researchers believe the cerebellum has some role in thinking, including processing language and mood. However, findings on these functions are yet to receive full exploration.

What does your brainstem do? Info Source

Your brainstem sends messages between your brain and other parts of your body. Your brainstem helps coordinate the messages that regulate:

So now you know why those things are super important, the rest of this will make more sense. This first picture is a NORMAL brain. Source: Science Photo Library

Okay so let me get into some imaging to show you what Henley’s brain actually looks like. Below are pictures of Henley’s brain AFTER her first surgery in 2012 when she was 2 years old. Each year I went in to our local neurosurgeon telling him that while yes, she had stopped vomiting every single day and a few things had certainly improved, we still felt like there were some issues but weren’t sure what to attribute to. We went year after year with basically the same response. “These things aren’t Chiari related”. It made me feel defeated and like I was crazy.

In 2016, I knew in my gut that something was not right. So I set out for a second opinion and wanted to find the most knowledgable person I could in the world of Chiari to talk to. We met with tons of professionals, had sleep studies, swallow studies, speech and occupational therapy evaluations, MRIs, CT scans, X Rays and ended up in New York sitting in front of Dr. Greenfield in December of 2016. All of our speculations of this actually being “Chiari related” were validated and surgery was scheduled for a few months later. Here is a before and after video of what Henley’s brain looked like pre-and post op in March 2017.

Here is one of Dr. G’s PA’s showing the before and after images of Henley’s brain from March 2017 - June 2018

Here is Dr. G explaining what he sees on her MRI from Oct 2022

So what is the surgery going to look like this time? Basically if you watch those two videos back to back you can see how great everything looked in Henley’s brain in June of 2018 (1 year post op) so the plan is to repeat the same surgery and get things back to the way they were then and hopefully they should stay this way for the long haul.

Why was there a change from June 2018 to October 2022? Well the simplest answer is that she has doubled in size since she was 7 years old and with that comes brain and skull growth. With Chiari, that is the issue, the brain needs more room sometimes than the skull will allow, therefore it causes compression of the brain up against the brainstem which causes all kinds of symptoms and that is what we are dealing with currently.

He talked about ossification of the dura tissue in the video, what does that mean? Simply: The definition of ossification, or osteogenesis, is the process of bone formation.

What is the pericranium? The membrane (or periosteum) which covers the outer surface of the skull. This is where they harvest tissue from Henley’s own head to create a “patch” that will be used to help create a larger space for her brain. Sometimes they use cadaver or bovine tissue, but being able to use your own tissue (analogous tissue) is ideal because you have less risk of rejection. They will be using this tissue again but Dr Greengfield feels much more certain that because of her age that hopefully the tissue is less osteogenic (full of stem cells that are set on creating bone).

Just because I have an actual picture of this, here is a picture of Henley’s skull in 3d. Kind of wild, I know. But if you look, you can see the half moon shape taken out of the bone at the base of her skull. This is where they have removed bone and will remove a little more bone this go round to allow more space back there. This hole and the fact that Henley is missing part of her C1 vertebrae is the reason she can’t do things like trampolines and jerky rollercoasters. Not a great idea if you are missing skull bone in that area that provides protection around your brain. Keep in mind, you have a layer of muscle over this area and then she has the “patch” that will be sewn into the covering around her brain. So it’s not like her brain is just fully exposed here.

All of these things to say, they will be repeating the same surgery as last time and going in to help relieve the pressure being put on her brain stem by her cramped cerebellum. It is possible that once he is in there he may choose to cauterize some of the cerebellum tissue if it does not look healthy but we won’t know that until Wednesday once they are in there.

Update, Surgery Date & another Brave Day!

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I can not even begin to unpack all that has happened over the past 15 days. I feel like my life shifted into hyper drive the minute we were told Henley needed another surgery. The logistical circus of planning a major out of state surgery is mind boggling. I spent an entire week making phone calls to teachers, administrators, extracurricular instructors and therapist in effort to come up with a plan and a time frame for all the things. The plane tickets, lodging challenges in Manhattan, insurance hurdles.... its a lot. In addition to that, the girls competed in a horse show. More on that later.

Since posting my last post, I have heard from literally hundreds of you. It's overwhelming in the best way and I know that the Lord is using you to remind me that He is right here with us in the mess. So thank you. Thank you for reading all of my words and going down this path again with us. More than anything, thank you for praying.

Several of you remember that 6 years ago, this very month, we decided to do a fundraiser for our trip because of the enormous cost involved in a surgery like this and all of the things that insurance does not cover. A friend of ours gave us the idea of selling t-shirts to raise money and to ask people to wear the shirts on the day of Henley’s surgery in support. Adam and I sat in the waiting room in New York while Henley was in surgery and were reminded over and over again that even though we were a thousand miles away from our family, our support system and our home, our community was back at home standing with us. The Lord used you that day, in ways you may never even know this side of Heaven. Thank you.

As the Lord does, He often shows us just how small our faith is and orchestrates things we could never make happen on our own. During that time, we raised more than enough money through your personal donations, church matching gifts and buying of Brave merchandise, that we took the leftover money and started an official 501c3 non-profit to be able to pay it forward and help other families who were in a similar situation. Since then, we have been able to provide financial support and assistance for several families in need and community support for countless more. I think, there is no time like the present to do it again! So we are going to order another batch of Brave Shirts NEXT WEEK. If you don't already have one, or need a new size because your child (like ours) has doubled in size since they wore one, you can go right now to www.bravecampaign.com and purchase a Brave shirt to wear alongside of us on Feb 22nd in support of Henley.  The proceeds from the sale of your shirt (or donation if you don't want a shirt) will go to Brave Campaign and the funds will be used to support families in need. And as the Lord does in His perfect timing, just this past week we have learned of two families whose children will also be having brain surgery in the next 6 weeks and are in need of support. Would you help us knock it out of the park and do some big things for these families?

SOME IMPORTANT DETAILS:

1. If you would like to get a Brave Shirt in time to wear it with us on Feb 22nd, your order HAS to be in the system by midnight on Jan 26th. That is ONE WEEK from today. We have to have our order placed with them by January 27th to guarantee that we can get them out to everyone before we leave for New York. (If you would like to help us distribute shirts, we will have some pickup locations that need a person to handle those)

2. We have had the question before in the past if we can run a custom color for an organization to wear (aka, baseball team colors, business logo colors etc). We can make this happen, but there is a minimum order for colors outside of our usual purple and white. Please email us at bravecampaign@gmail.com to discuss.

3rd Time is the charm....right???

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We got a call from Dr. Greenfield today....

How do you tell your 13 year old they need a 3rd brain surgery? I'm at a loss. This time it's different. It seems harder than before. 

Let me back up....

September 19:  I took Henley in for a well check visit with her new pediatrician (old one retired). We haven't been to a well check in a while because, well, my kids are so rarely sick and in need of a doctor that we just don't go there anymore like we used to. Except when we need things like physical therapy papers signed...which is why we went. 

During that appt, her pediatrician did the standard check up things and became a bit concerned when she was checking her reflexes and could not get any response. I observed the doctor, knowing what she was looking for, continue to carry on a casual conversation with me while she tried more and more tactics to get the reflex response she was looking for. She even excused herself briefly to retrieve another tool so she could check again. She came back, more focused on getting the result she was looking for to no avail. No reflex response in either leg. She looked at me and said "Mom, when was the last time you saw Henley's neurosurgeon?" My response without skipping a beat was "I suppose it's time, you think?" she agreed and said it was probably time for some updated imaging...specifically of her spine.

She continued with her examination and began looking at her eyes. I watched as she was examining and I noticed something that I had not seen before. Her eyes were twitching. How have I never noticed this? Is this new? The Dr says to her nurse to make a note of a Nystagmus....I knew I had heard that before in Chiari literature, but this was a new one for Henley. 

I asked the doctor if she could refer us to someone who could test Henley for POTS (Postural Orthostatic Tachycardia Syndrome) because it was something I had read about being connected to Ehlers Danlos Syndrome and I wanted to rule it out. The doctor said that she could test her in the office, so she did. Within 10 minutes, Henley had another new diagnosis. POTS....add that to the list I suppose. Send a referral for cardiology, send lab orders for bloodwork. Sigh. 

As we wrapped up the appointment, the doctor checked in on several other things. 

Physical therapy? Yes, twice a week. 

Speech therapy? Yes, 3 times a week. 

Any other concerns? 

I don't think I want to talk about any more concerns, this is enough for one day. 

I checked out and called Henley's neurosurgeon's office on the way home. I told them we had some new neurological concerns and that we needed orders from Dr. G for updated imaging. 

September 20: Took Henley with me to the chiropractor and was telling him about our appt the day before. He pulls out his Reflex Hammer to check her himself. He tries, and tries and tries....no reflex response. Then he does some other muscle and neurological testing and says "yeah, probably a good idea for you to follow up with Neuro" and then would not adjust her. 

End of Sept: MRI scheduled for soonest available date- check. 

It felt like maybe that same week Henley's speech therapist asked to talk to me after one of her sessions and said "It seems like Henley's speech seems to be a bit slushy sounding? Have you noticed that?" My answer was yes. But as a mom sometimes it's hard. Listening to your kids speak day in and day out, you just hear what they mean and aren't always listening to the mechanics of their actual speech. A week later Henley's physical therapist said in passing "She seems a bit weaker on her left side today." This is when my mommy brain kicks into high gear and I start paying super close attention to everything. 

September 26: We took a little RV trip to meet some friends in Tennessee that we hadn't seen since February. While we were on the trip the other mom (who also happens to be a nurse) asked me if I felt like Henley's speech was any different because it sounded like things were a bit different since they saw her in February....more red flags.

October 14th: Speech Re-Evaluation test to see where Henley is vs 6 months ago. This result shows about a 50% regression since April. Keep in mind, she has been doing speech 3 times a week for the past 2 years at this point with the same therapist. 

October 31st: Halloween was the earliest we could get in to do Henley's full spine MRI so we did that (in costume) instead of trick or treating and then went out to one of her favorite restaurants. I came home and popped the CD in the computer and immediately knew that things weren't great.... but where was the brain MRI? Why wasn't that on the order? :::insert angry mom face:::

November 1: VERY frustrating conversation with a nurse in Dr. G's office that caused me to end up in tears and using all of my intense momma bear words to get another order sent over for a BRAIN MRI

November 9: Brain MRI, Flex & Extension X-Ray Check

Then we wait...and wait....and wait....

November 15: Henley is working on a project for school and is putting together a poster board where she has to cut things out and glue it on a board. I am not even sure how to explain this, but all I know is that my 13 year old has been using scissors her whole life and when she was cutting paper out for this project it looked like she had never used scissors before. 

Late November: One day I was unpacking a box of Christmas ornaments in the living room and Henley was in the kitchen. She asked me a question and I didn't understand her so I stopped what I was doing, but didn't turn around to look at her because I wanted to just use my ears to see what I could hear. I asked her to repeat what she said and she did.... I COULD NOT understand a single word. Without saying another thing, I looked up at her and she was holding up a plate. It took me 15 seconds to try to decode in my head what she could have been asking me and then based off of my assumptions I answered what I thought was her question. This scared me. Have I been looking at her every time I hear her talk in order to understand her? Have I been using context clues to decode what she is saying? When other people hear her talk, do they hear what I couldn't understand when I wasn't looking at her????

December 1st: Henley and I were in the car together driving to the horse stables and we were stopped at a stop light. I looked over at her and asked "Henley, you have been doing speech therapy for YEARS (like at least 8 years y'all), I feel like you know how to make these sounds correctly, right?" She immediately said "I know in my head the right sounds and I think they are coming out right but then y'all correct me and say it isn't right" ::Insert dagger in my heart here:: to clarify, her speech therapist was very clear in her request with Henley and with me that when we heard the wrong sounds, we were supposed to correct it on the spot so she could make a mental note and re-try it immediately. 

I told Henley then, that this is why we were doing all this testing, because I had a hunch that there was something standing in her way from making the right sounds and that I felt like she KNEW how to do it, she just had a physical barrier that was making it harder. 

December 9th: Phone call with Dr. Greenfield in NY. We told him everything that had happened up to this point and expressed our concerns, but were asking for his professional opinion based off the images. He said that her images showed that their was still a bit of compression on her brain stem and that while it wasn't significant like it was when he operated in 2017,  it still wasn't "nothing". He told us about another patient that seemed like a clone case of Henley that he had just operated on the week prior whose only issue was swallowing. He said that when this patient was 7 she had surgery and now she is 13 and started having those original symptoms creeping back in. He was happy to report that 4 days post op, she was back to normal and the surgery fixed the problem. This sounded eerily familiar. Dr. G said that he wanted one more image to gather one more piece of information before making any decisions on what to do next. He wanted a CT scan of her brain. MRI's are great at looking at tissue and organs. CT scans are really great at looking at bone and calcium. He wanted to look and see if it was possible that there was an abundance of calcified scar tissue on Henley's brain where her previous surgery was and if that was causing extra pressure on her brain. We agreed to not make any decisions until we had that information and we would circle back after the images were done. He said that, when a 2 year old has surgery for Chiari, they almost always have to go back in and do a second surgery at some point, just purely because of their growth and development being so drastic between that age and when they are finished growing. He said at 7 years old, a child is still fairly early on in development and there is still a lot of growing left to do which can make the brain like a moving target of sorts. I would say that Henley doubled in size from age 2 to 7 (between 1st and 2nd surgery) and now we are 5 years past surgery 2 and she has doubled in size again. Henley is now 5'1" and catching up to me fast! So it makes logical sense that this might be part of the equation here. 

December 16th: CT Scan. I immediately sent the images off to Dr. G when we got home and we waited. We messaged each other back and forth a bit before we could connect on the phone.

January 3rd: We were finally able to connect with Dr. Greenfield and his PA on the phone. He started out the call reviewing what he understood to be the situation at hand based off of our correspondence and said that based off the images from the CT scan, it gave validity to the things we are seeing on our end. He said that the CT scan did show a considerable amount of calcification on the scar tissue and this could be the reason for her symptoms. Her brain stem is compressed, and Dr. G feels like Henley could benefit from another surgery. 

So here we are, sitting in this decision. We've had lots of conversations, talked with Henley and ultimately scheduled surgery for Feb 22nd in New York. 

There are more details to come, I have lots more to say, but that is all for now. Please keep checking back here for updates if you want to follow along. More than anything we beg of you, your prayers. Prayers that this is the LAST surgery she will ever need. Prayers for Dr. Greenfield, that his hands will be steady and do JUST ENOUGH and no more. Pray that her speech is restored and she is able to function like everyone else her age. Pray that all the complications she is experiencing fall away like scales from her body. Pray that she experiences The Lords presence like never before and that she feels safe and secure, knowing that He is her ultimate protector. Pray for us as a family, that we stay healthy, mentally, emotionally and physically through this process.

If you are reading this, we consider you a part of our tribe. We love you and are so thankful for you. 

Leslie

Puzzle Pieces

I work really hard to make sure that Henley feels like she is informed. I am always trying to stop down and be sure she is part of the conversation and that she in on this journey WITH me and not just in the car of her life that I happen to be driving at the moment. Most days are running at top speed and I’m mentally managing what feels like to be a million things at once. When I slow down and look at my children I am met with their simplistic life. They aren’t in a hurry. They aren’t anxious about deadlines or all the to-do’s. They are right here in this moment right in front of them.

Tonight as I was putting Henley to bed I said “okay, so tomorrow…..” and she interuppted and said “eye appointment”.

She knows.

She’s paying attention.

She’s taking it all in.

Did I even tell her about this appointment? Oh my goodness! this is a big one. I need to prepare her for it. So I stop. Slow down, sit beside her bed and we start talking.

“So tomorrow we are going to go have a CT scan of your eyes to see if we can get some more information about why the left one is having some trouble.”

“Okay”

“It’s not long like the MRI’s, this one should be pretty quick, but it’s going to give us a picture that we need to help us figure out the problem. Kind of like a piece of a puzzle that we need to get the puzzle figured out. Does that make sense?”

“Not really”

“Well, think of our health like a great big puzzle with lots of pieces. You know how when you put together a great big puzzle, it helps when you have a few people helping to put it all together. Some people organize the pieces by color or shape, some people look at the puzzle from one direction and some look at it from another direction. We all bring out problem solving skills to the table when we do a puzzle. So in this instance, you are holding the box of the puzzle pieces and the people who are helping mommy to make sense of the puzzle are some doctors. It’s going to be your job to put your pieces to the puzzle on the table and we will figure out where they go and how they fit to make the picture make sense. So every time you tell mommy or a doctor what you feel or what is going on inside of your body, just think of it like you are handing us a puzzle piece we’ve been looking for. Then we will all work together to get this puzzle figured out.”

This made sense to her. She smiled and I know that it’s because she feels like she has a role in her own life, she is not just a spectator. She knows her voice matters to me. She knows she is going to be heard because I am going to silence the world to hear what she has to say. I know without a shadow of a doubt that God equipped me with a strong personality because he knew this girl was going to need a fighter for a mom.
My goal is to empower all of my kids to have confidence in themselves so they will speak up when they have something to say. I want them to know how to advocate for themselves and make educated decisions. I want Henley to know that there is more to life than a diagnosis and that her differences are not limitations but a platform.

Infection

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Well, I was almost positive we were in the clear with Henley. Judging by the pictures everyone would have thought so too until last Thursday. I noticed things were looking a little more red than usual and a tiny spot in the incision looked like it was trying to split. I called Dr. Greenfield's office immediately and sent them a picture. They said if she was not running fever, or any puss was coming out of it and there was no enlarged area on the back of her head that looked like fluid collection then we just needed to keep it really clean, dry and watch it very closely. 

We followed all of those steps and its looked worse and worse day by day. Yesterday we hit a breaking point quite literally. The incision opened up and began bleeding yesterday. Henley came home with blood on the back of her shirt and several times the blood would clot and then open up and start bleeding again. We sent more pictures yesterday and asked them what to do. Dr. Greenfield called me personally and we talked for a little bit on the phone. He said that after seeing the pictures, it was clear that it looked as if it had almost healed completely and something has happened to "make it angry". He was concerned at the level of redness on the lower of the two incisions and said that it looks infected and we need to treat her with antibiotics to try to quickly get this under control. He said we did not need to go to the hospital, but to just get on the meds 4 times a day for 7-10 days and he wants me to send him photo updates daily so he can watch it with us. 

So that is where we are at as of now. We had planned to leave town this weekend but have cancelled all of our plans to stay close to home and near a hospital should anything change beyond this. Please keep Henley in your prayers and pray that she does not start running fever or anything else decides to leak out of the incision. I have seen people get flown back to NYC for things like this and so it makes me a little bit nervous. 

Reflection.

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Isaiah 43:1-3 “Do not fear, for I have redeemed you; I have called you by name, you are mine. When you pass through the waters, I will be with you; and through the rivers, they shall not overwhelm you; when you walk through fire you shall not be burned, and the flame shall not consume you. For I am the Lord you God, the Holy One of Israel, your Savior.”

This verse pretty much sums up the promises we have relied on for the last 6 months. I feel like it’s important to be reminded that the Lord NEVER promised us that our lives will be easy and free of trouble. However, He does promise that we won’t ever be left “alone”. Our faith WILL be tested. The Bible tells us to “rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope!” Romans 5:3-5

So much of what we have gone through has been a relentless testing of our faith. It’s hard to really even grasp what faith truly looks like until it’s put on trial. For me, it has looked like saying over and over “Lord, I don’t have this, but I trust that YOU are 10 steps ahead of me and will provide a way through this firestorm that I can’t even make sense of.”

This has been the hardest lesson for me to learn. Having almost no choice but to TRULY surrender my life and the lives of my children, placing them back into the Lord’s capable hands and stand to the side and release control. To truly trust at my core that HE has got this and doesn’t need my help, rather just needs me to put one foot in front of the other and just. keep. walking. down the path He put me on.

I have said many times “Lord, I DO NOT have the strength, I need you to give me whatever its going to take to get me through this season.” and He has. HE has made us Brave. HE has given us supernatural peace. HE has allowed us to have the perspective we have on life. HE has given us comfort when we don’t understand why things happen the way they do. HE has orchestrated schedules and conversations and and doctors and people to happen right on time. The Lord has NEVER left us alone in this. He has ALWAYS been way ahead of us and provided for our EVERY need. I would be foolish not to be shouting about His goodness from the rooftops.
Someone told me once “God rarely shows up early, but He is NEVER late. He is always right on time.” So true.

A friend shared this song with me about 6 weeks ago and its been our anthem. I pray that you will seek the Lord in whatever you are dealing with and let HIM show you what it truly means to Be Brave.

www.bravecampaign.com

Update: First week home.

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We have been home now almost a week. This past week has been a complete blur for me. Most days I couldn't have even told you what day it was, what the weather was like outside, where my children were or what time it was. 

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We arrived back in Texas Monday evening. It was about all I could do to make the trip home from the airport. Henley did great. She had no problems on the plane with the pressure and she has been off pain meds completely for almost two weeks. She is seriously making brain surgery look like it was a piece of cake after that first week. They always say children bounce back like you wouldn't believe, but seriously, It's pretty remarkable. The minute we got in the car at the airport I had to take all of my pain meds just to be able to endure sitting one more hour in the car ride home from Love Field. 

We got to the house decked out in our winter gear and it was about 90 degrees outside. In addition to the strangeness of the drastic weather change, walking into our house felt strange. We've never been away from our home for such a long period of time. It was perfectly clean and smelled like home but it took some mental re-adjusting to the space. We dropped our things and Henley wanted to go straight to her room. Her room had been completely re-decorated while we were gone by some of my very sweet friends. The whole room is just precious and I can't wait to share pictures soon. Henley is in love with her new space! I held it together long enough to be super excited with her about her room and then quickly headed downstairs, went straight to my room, put my pjs on and collapsed. I was OUT...for days. I mean literally, I did not wake up again until Wednesday. 

I felt like falling into my bed was like collapsing across the finish line of the longest marathon I'd ever run. I just laid there staring up at the sky....for an entire week. My mom spent the days here with us to help with everything. Laundry, meals, cleaning the kitchen, taking care of kids and me. You name it. She is a rockstar. Adam went to bed Monday night with a fever and spent most of Tuesday in bed nursing a cold. We were both down for the count. Our physical bodies and emotions just completely and utterly spent. 

Wednesday I woke up in a LOT of pain. Adam had been talking to Dr. McClure in New York almost daily. When Dr. McClure called to check in on me on Wednesday, he suggested we go back to the ER to get some more imaging to make sure there was no internal bleeding or new findings. Not wanting to go to the hospital and truly wanting to be able to get the pain under control myself {stubborn}, I spent the day trying everything I knew to get on top of the pain. I finally ended up throwing in the towel that afternoon around 3:00pm and told Adam to just take me to the Emergency Room. I could not understand why I was still in SO much pain and it had been an entire week. I was taking a LOT of very strong pain meds and I still felt like dying might be easier. I took my last two Percocet pain pills and Adam drove me downtown to the hospital. We walked in the door and the minute we told them the story of the past week, they went into high gear. I have never seen an Emergency department move so efficiently {I knew it was possible!}. From the time I walked in the door of the hospital until I was being wheeled into the CT scanner for a CT angiogram was about 15 minutes. It was truly impressive. They ruled out internal bleeding which was our main concern. They checked my kidney function, urinalysis and bloodwork. All came back within normal range {Praise the Lord!}. With those concerns at ease, then came down to pure pain management. The nurses came in and gave me a 25mcg of fentanyl. 15 minutes later I had ZERO relief. They gave me toradol next since it had worked last week...15 minutes later NO RELIEF. They finally came back in 15 minutes after that and gave me 100 mcg of fentanyl and that finally kicked the pain. The doctors concluded that the pain is because of what is called "Infarction" which is tissue death due to inadequate blood supply to the affected area. Most people have heard of Myocardial infarction which is the partial death of heart tissue aka: a heart attack. So basically, it feels like my kidney is having a heart attack. ALL. THE. TIME. Imagine every part of your abdomen from your belly button on your right side all the way around to your spine cramps up so intensely that you feel like you might explode from the pressure. That's about how I have felt for the past 11 days. Well, the good news is... It's just part of my kidney dying. Everything else looks Fantastic! {insert sarcasm here}

If you know me well, you know how much I can't stand medications. I lean towards all things natural and so having to rely on these medications so heavily and be subject to their unruly side effects has been a very hard pill to swallow {see what I did there?}. However, I was thankful to have them and I was thankful they were working. We were able to go home much more relieved Wednesday night and I was put on a very strict schedule of taking my pain meds in exactly 4-6 hour increments {alarm included}. I spent the next two days pretty out of it as you might imagine. Throwing up because of the meds, but needing them to keep the pain under control. Saturday morning, 11 days post-op was the first time the pain wasn't the reason I woke up. I decided to take advil instead and see if that work keep the pain at bay....it did. I went another 6 hours and took another round of advil and so on and so forth. I made it through an entire day without the hard core meds.

Sunday, I finally felt like the fog was lifting. Like I could see clearly for the first time in a week. Slowly but surely I was able to get up and take a shower and get ready to go to church. I was so ready to get out of the house. I expended way too much energy getting ready, but I made it. After church I came home and went right back to bed for a couple hours. I am really hopeful that the major pain has finally subsided and I can move forward without the drugs. Tomorrow I see a specialist at UT Southwestern who is a personal referral from the Doctors in New York. This doctor will be the one following my case from Texas. 

First of all, thank you for praying. We know that we have been on the front lines of a serious spiritual battle this year and we KNOW the power of prayer. Thank you for linking arms with us and praying fervently for our family. We have felt the prayers and there is no other explanation for the way we have been able to walk through this other than the fact the The Lord has provided for our every need. "but those who hope in the LORD will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint." Isaiah 40:31 

We are so thankful to everyone who has signed up to bring meals, sent cards and gifts, who have donated to the go fund me site, and have bought t-shirts and necklaces at www.bravecampaign.com you guys are seriously amazing!! You have orchestrated and declared Brave Days at school and on the baseball field. You have overwhelmed us with love and support and shown thousands of people what it looks like to be a part of the body of Christ. You have encouraged our family and carried us through in ways you may never know. Our plan is to take what The Lord has done through our story and turn Brave Campaign into a non-profit and keep paying it forward for other families like ours who need help traveling for treatments and who are facing times where they have to step up and Be Brave. We hope that you will continue to help us by shopping for a purpose at the site (we still have lots of t-shirts, necklaces and bracelets!), knowing that the money from your gifts and purchases will be stewarded well. 

Peace out PICU!

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We are so excited to have been released from the PICU. Henley is actually OUT OF THE HOSPITAL. We are kinda shocked, but she is doing remarkably well and although she is still on some pretty major drugs, we are able to manage the pain without IV meds. We have moved her back to our little hotel across the street from the hospital and are planning to have a peaceful and uneventful recovery for her here over the next week. Our main concern is keeping germs off of the back of her head so we are doing a lot to keep hands clean and use the topical medications we have on her incision site. We also have to work with her on moving her neck and head because her neck is very stiff after the surgery. We are encouraging her to look SLOWLY from side to side frequently. Henley has a follow up appointment with Dr. Greenfield at the end of this next week and then we should be released to come home over the weekend. 

New York is expecting a Blizzard on Tuesday & Wednesday so we are excited to see this place covered in snow! 

We have changed out plans a little bit and decided to stay put in this one hotel until we come home. So our address for the rest of our time here is: The Helmsley Medical Tower 1320 York Ave # L, New York, NY 10021

Top 3 Questions I get asked about Henley:

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I realize some of you want more details than just the "cliff notes" version and it just dawned on me that I hadn't written anything about the actual surgery that took place and the details of that. I also tend to get the same 3 questions about Henley over and over so I figured, it might be easiest to just address all of those questions in this post. 

1. What did they actually do in the surgery? Well, they first shaved the back of her head. Then they made an incision down the midline of the back of her head. They had to cut through the neck muscles first before getting to the skull, then they were able to access her brain through the area they had removed at the base of her occipital bone in her previous surgery 5 years ago (yes, that means she has been missing bone on the back of her head all this time). Once through the muscle and occipital boney area, they reach the dura (the covering of your brain). They cut through that and were able to get a good look at everything from there. Once they were inside, they determined that her herniated cerebellar tonsils were still healthy tissue and so they choose not to resect those (i.e. cauterize that part of her brain that is falling below her foramen magnum). He felt that he was going to be able to give Henley's brain the space that it needed by sewing in a patch to give her brain some more room to breathe and for spinal fluid to flow freely. There are many approaches to this and where the "patch" tissue comes from. Some surgeons use bovine tissue or other animal tissues. Dr. Greenfield was able to use Henley's own tissue by harvesting tissue from another area on her brain and then placing it over where they had cut the dura. 

So think about it like this, when you get a new pair of jeans and the knees are really tight, then over time you wear out the knees of your jeans and they fit looser or sometimes you rip them and have to sew in a patch. It's the same concept. Henley's brain is just too big for her skull and so in order to keep spinal fluid flowing, they needed to free up some space so that she doesn't have a fluid collection on her brain or in her spinal column. In the first surgery when she was two, they thinned out the lining of the brain (the dura) in hopes of giving her brain casing more elasticity so it wasn't so tight in there. That worked for her for a good 5 years but things change as children grow and so it's a moving target. This time we had to sew in a patch to give more space.

2. What kinds of symptoms was Henley having that caused you to start investigating? Man, if I had a dollar for all the times this question was asked! Here is a list:

* Speech Difficulties. As in, it became physically difficult for her to get words out of her mouth. She would sometimes mix up letters in words that she had been saying for years or not be able to say things clearly that she had always said before like "foot". By the end of the day she was so exhausted from a day of talking she just wanted to be quiet. Over the summer, we noticed ourselves asking Henley to repeat herself over and over because we truly could not understand what she was trying to communicate. 

* Trouble walking. Henley has always gotten overly tired and had trouble walking long distances, but she began tripping and falling a lot. One of her teachers noticed her trip over her feet about 4 times one day while she was walking with assistance from one room to another. She described this as if Henley's brain wasn't telling her feet to move as fast as her body was trying to walk. It became pretty apparent that this was happening more and more frequently and she seemed to just get more clumsy and would be bruised up all the time from one thing or another. When we tested her for physical therapy and occupational therapy, it was even more obvious that she was really overcompensating for basic tasks she couldn't do. For instance, walking a straight line or balancing. This girl would fail any and all sobriety test just walking "normal". We learned that she appeared to the average person that she was just like other kids because she would speed up the activity to make it look like she was able to complete something, but when we slowed her down, she could. not. do. it. She would get so frustrated and cry because it was like her body just wasn't cooperating.

* Difficulty Crossing Midline. This comes into play when you are trying to do things like driving, writing or basically anything that forces you to cross one part of your body over to the other side. Like moving your arm across your body to the other side to grab something. Henley would just overcompensate and do everything in her power to avoid crossing midline. This is a sign that your right brain is not communicating with the left side of the brain. This also can affect the top of your body not talking to the bottom part. For example, jumping jacks? hilarious. (sorry that was terrible) 

* Daily Pain. At school, you would have zero idea because Henley hides it so well. She doesn't want the attention and she really doesn't know what "no pain" feels like. Every. single. night. for months and months she would need an ice pack at bedtime and complain of a headache, leg pain, back pain etc. By the time she had finished holding it together for a day of school, she would just let it all go when she came home. Some days even though she really wanted to go outside and play, she would just lay on the couch while everyone else would go play in the backyard. 

* Trouble Swallowing. We started noticing that she was physically having trouble swallowing certain foods and sometimes would chew and chew on something that she had eaten forever (i.e. grilled cheese sandwiches) and just end up crying because she couldn't seem to swallow it and would have to spit it out. It was heartbreaking. She would chew on simple things like bread and then it was like watching her try to swallow rocks. During a swallow study, we learned that she was overcompensating by drinking out of straws and when we took the straws away and tried to have her drink from an open cup, she would choke. 

* Tiring Easily. Henley just started getting less and less able to handle walking any distance. She would ask to be carried or to ride in a cart constantly. At Target, the grocery store, pretty much everywhere we go, someone was needing to carry her. She is 7...not a toddler. 

3. What about that "other situation" you talked about? You said there were potentially two problems and this surgery was addressing the most pressing issue. So here is the story on that. It's hard to explain in words but I'll do my best. If you look at Henley's MRI from right to left you will see her cerebellum and the herniated cerebellar tonsils that travel down next to her brainstem. Then you see her brainstem in the middle and then her odontoid on the other side of her brainstem (looks like it's at a 45 degree angle). This angle changes when you move your head up and down. It's basically a joint. Henley has Ehlers-Danlos Syndome (EDS) which is a genetic connective tissue disorder that is caused by a defect in the structure, production, or processing of collagen or proteins that interact with collagen. Collagen is kind of like your body’s glue -it is what holds your skin, joints, blood vessels, and other major organs in place. It typically presents itself in childhood or young adulthood with hypermobile joints prone to misalignment, stretchy skin that tears easily, and fragile blood vessels prone to cardiovascular complications (such as aneurysms). Loose ligaments can misalign the proper angle of the odontoid bone causing it to push backwards, compressing the brainstem. Chiari Malformation is a downward displacement of the cerebellar tonsils (part of the brain) that puts pressure on the cerebellum and brainstem from the other side, progressively damaging them over time, and blocking the flow of cerebral spinal fluid (CSF). So, if you understand what I just wrote then you understand that we basically have two potential problems that cause compression of the brainstem. One is on one side and one is on the other. The reason for her surgery this past week was for the Chiari and what it is doing to the spinal fluid flow and the compression from the back of her head to the brainstem. Often times when you do the Chiari surgery to remove the pressure on the back side, it causes even more instability on the other side. SO, all that said, you have to have a surgeon who understands both of those issues and how one effects the other so that they can take all of that into consideration. There is a very real possibility that one day down the road Henley might have to have a Craniocervical fusion. It's an awful procedure and we want to pray against this for her. So please, every time you think of Henley or our family, pray against any instability in her spine and head. 

So, there you are. Those are the most commonly asked questions I get and there are your answers. 

Update on Henley from Adam

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The situation in the ICU is such that there is really only room for one parent to sleep in the "room", which is really just an area sectioned off by a curtain, so I went back to our hotel to sleep for the night. As expected, neither Henley nor Leslie got very restful sleep last night. Today, Henley has improved some. She was able to eat a blueberry muffin and drink a little water without any issues, which is a big step in her goal of getting to eat a cupcake. The physical therapist came in and we were able to get her out of bed and walk for a little bit, which went really well. She was then able to sit up in a chair for about hour before climbing back in bed. She also got a visit from her little buddy, Darby, which livened her up immediately. 

As you can imagine, she got pretty worn out from all of the activity and the pain started getting the best of her. We got her some meds and she is resting comfortably now. Continue to pray that she is able to keep food and water down, which is key for her strength, and that the pain is kept at a tolerable level. 

Again, thank you guys for all of the prayers and support. We are truly humbled.

In the PICU

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In the PICU. Henley is stable and in and out because of all the drugs. Even with Dilauded her pain is still at a "5". They did mess with her neck muscles quite a bit so that is to be expected. And for those of you who have been holding out hope, they did have to shave the back of her head this time

I am certain I have never seen so many teams of Doctors and Nurses all rounding on one patient. It's rather impressive how many people are constantly coming by to check on her. There is a critical care team, the neurosurgery team, the pain management team and possibly one other group. Each group of people seems to have about 4 people.  

Surgery is OVER in record time

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Wow! I mean WOW. Dr. Greenfield just came out and said he is DONE! Like an hour earlier than expected!!

The best way to tell you what happened is to give you the response to the specific prayer requests we asked for yesterday. 

SPECIFIC PRAYER REQUEST:For all of our Prayer Warriors, here is what you can be praying for specifically.

1. Dr. Greenfield. Pray that he has the best nights sleep of his life. That he wakes up peaceful and has unbelievable clarity tomorrow. Pray that Henley's surgery is the best surgery he has ever performed and the results are PERFECT. Dr. Greenfield said that once he opened her up it was very clear what he needed to do in her specific situation. His exact words were "It was not ambiguous at all, there was no question what needed to happen here." Prayers for absolute clarity were answered. I specifically asked how he slept last night and he said he actually slept great. ;-) 

2. Pray that the LORD'S hands are performing the surgery in the place of his hands. I had a friend message me this this morning: "The Lord woke me up in the night and told me to pray for you.  He gave me a vision of himself hovering over Henley during her surgery.  He was a bright light of presence.  He also had a fully armed angel standing guard at the door of the operating room.  I know today and right at this moment he is with you all. I pray that you feel His presence overwhelming you as He sings his songs of peace and love over you.  We love you and are interceding in prayer." We have felt peace in this moment for sure. It's an unbelievable feeling. 

3. Pray that there are NO complications, NO Infection (meningitis is a big risk with this surgery), NO spinal fluid leaks, NO spinal fluid collection or any need for extra blood, and that the time she is under anesthesia is minimal. Dr. Greenfield said that when he got in there that he did not feel like he needed to remove the part of the brain that was hanging down because the tissue all looked healthy. He said that the arachnoid space was all very much intact and therefore she had almost no risk of a spinal fluid leak! There was no need for extra blood and she was only under anesthesia for about 3 hours as opposed to the 4-5 hours we were expecting. There were no complications and everything was very clear cut.  

4. Pray for her heart to be strong, her lungs to be clear, and her brain to function properly. She is healthy and stable. Praise the Lord. 

5. Pray that this surgery is THE LAST surgery she will ever have to have and that THIS surgery will alleviate the need for any future surgeries. (Because this is one of two potential problems she has regarding compression on her brainstem and we are addressing the most important of the two issues tomorrow) This is to be determined, but we will keep claiming that this is all that will need to be done. 

6. Pray for the nursing staff to be EXCEPTIONAL. For them to be sweet and caring, kind, compassionate and that they will go above and beyond to make sure this is a good experience for Henley. So far so good. We are about to head to the PICU and so we are about to really experience the nursing staff now. 

7. Finally, pray for PEACE for us, and for Henley. She is so nervous. She is worried about the pain she knows she is going to be in and we are anxious at the thought of not being able to do anything to make it better. It's unbelievably hard to know that you are willingly walking your child into a situation that is going to cause her a lot of pain. Even when you know it's the right thing to do and that it's the doorway to a much better life. It still doesn't make this any easier. We have had peace. LOTS of peace. God is so good and has surrounded us with exactly what we needed in this moment and on this day. Our good friends from Texas are here with us who have a daughter (Darby) who also has Chiari and sees Dr. Greenfield. They "just happen" to have an appointment tomorrow with him and so were scheduled to be here at the same time. God is in ALL the details!

THANK YOU FOR PRAYING. Keep praying! Now comes the REALLY hard part which is the pain she will be in and all of the IVs and uncomfortable-ness that comes with recovery. We will post more in a little bit after we see her and can get a handle on the situation. 

Love you all. 

Letting Go.

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We were able to suit up and go into the O.R. with Henley. They gave her versed i.e. "Giggle juice" to help to make her relaxed before going back. Apparently that is not standard procedure around here, but we requested it because her emotional state is of HUGE importance to us. After all, we are the ones who will deal with the emotional aftermath in all of this and they will get to walk away. 

Going under anesthesia is terrifying for Henley. It is for most people to be honest. However, there is one memory that neither one of us can seem to shake and that is the memory she had when she came out of surgery the first time when she was two. Immediately upon waking Adam and I were right there with her. I leaned down to hug and kiss her and the first words out of her mouth were "I'm so sorry mommy." As if she had done something to deserve all of this. To deserve this pain. I have never been the same. 

We have spent years talking through this, trying to make it okay. It's not. I don't know that it ever can be okay. Those memories run deep and she remembers them even 5 years later. She remembers waking up crying and she remembers being sad. 

I can't even talk about it all without crying. 

Yes, I'm sure I need therapy....we probably all do. 

So, we were able to go into the O.R. and meet a few of the people who are with Henley this morning. We told them that there were thousands of people praying over them today. Henley was really silly thanks to the drugs. They began putting all of the monitors on her, stickers all over her chest etc. Henley started making comments about payback and putting stickers on all these guys when she was done! When it came to the mask and the anesthesia it was again....traumatic. You can see it in her eyes. You can see trauma happening. There are no words for this. I prayed over her and and begged the Lord one last time to stand in our place and keep her safe. We kissed her and were escorted out of the O.R. I lost it when I walked out of the room. The child life specialist was there with us and Dr. Greenfield followed us out of the O.R. He reassured us that she was going to be okay. 

There is nothing that makes this easier. Walking away and handing over the life of your child is excruciating. My only hope is knowing the I left the Lord in there with her and HE is watching over his baby.

The Plan

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We just met with Dr. Greenfield and spent about 30 minutes with him discussing everything regarding the surgery in the morning. 


THE DETAILS:

1. We will arrive at 6:00am (5:00am Texas time) 

2. Surgery is scheduled to start at 7:15am

3. Surgery should take around 4 hours

4. Henley should stay in the ICU for the duration of her time here at Cornell. We are thinking she will get released probably on Sunday, give or take a day, depending on how everything goes. 

5. Dr. Greenfield feels like he would like to give Henley a big enough window between being released from the hospital and her post op appointment just to make absolutely certain she is safe to get on a plane and head home. At this point there is talk of that either happening on Friday afternoon (the 17th) at the VERY earliest which would have us flying home Saturday or Sunday, but more likely seeing Dr. G on Monday or Tuesday (March 20 or 21st) to be cleared to come home after that appointment. We don't have return flights home yet so we are just playing all of this by ear.

SPECIFIC PRAYER REQUEST:

For all of our Prayer Warriors, here is what you can be praying for specifically.

1. Dr. Greenfield. Pray that he has the best nights sleep of his life. That he wakes up peaceful and has unbelievable clarity tomorrow. Pray that Henley's surgery is the best surgery he has ever performed and the results are PERFECT. 

2. Pray that the LORD'S hands are performing the surgery in the place of his hands.

3. Pray that there are NO complications, NO Infection (meningitis is a big risk with this surgery), NO spinal fluid leaks, NO spinal fluid collection or any need for extra blood, and that the time she is under anesthesia is minimal. 

4. Pray for her heart to be strong, her lungs to be clear, and her brain to function properly.

5. Pray that this surgery is THE LAST surgery she will ever have to have and that THIS surgery will alleviate the need for any future surgeries. (Because this is one of two potential problems she has regarding compression on her brainstem and we are addressing the most important of the two issues tomorrow)

6. Pray for the nursing staff to be EXCEPTIONAL. For them to be sweet and caring, kind, compassionate and that they will go above and beyond to make sure this is a good experience for Henley. 

7. Finally, pray for PEACE for us, and for Henley. She is so nervous. She is worried about the pain she knows she is going to be in and we are anxious at the thought of not being able to do anything to make it better. It's unbelievably hard to know that you are willingly walking your child into a situation that is going to cause her a lot of pain. Even when you know it's the right thing to do and that it's the doorway to a much better life. It still doesn't make this any easier.

We will have a LOT of time to sit tomorrow and I will be updating this site regularly as we get updates from the Operating Room. Tomorrow I will detail out exactly what they are doing during the surgery. As of this moment it's kind of like a "we need to get in there and see what we are dealing with first" type of thing. Thank you all so much for praying. We love you. 

P.S. Tomorrow is "Brave Day" If you have purchased T-Shirts or anything else from www.bravecampaign.com make sure you wear it tomorrow and any other time over the next several weeks. Post on Facebook and tag us in your post. We are showing Henley all of the pictures and she LOVES seeing all of the photos. If you have not checked out the fundraising site for Henley's Brave Campaign, check it out and grab a shirt, necklace, or bracelet to show your support.

Quick Details

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We have arrived in New York and are settled in our little place for this first week. We will be staying at The Helmsley Medical Tower this first week while Henley is in the ICU. This location is literally across the street from the Specialty Surgery building and so it will make it very easy to take turns getting showers and naps etc since there is little of that happening in the ICU. After Henley gets out of the ICU (approx 5 days), we will move to a cheaper hotel down the road a bit to save money and to be with those in our family who are traveling up here to be with us. If you have anything you would like to send to us over the next couple weeks, please send it to the hotel. Address is: Leslie Thomas C/O The Helmsley Medical Tower 1320 York Ave # L, New York, NY 10021 We will be in this location until Sunday March 12th. Then we will move to The Bentley Hotel 500 E 62nd St, New York, NY 10065 for the next week. Food is VERY expensive here and we are using our Amazon Prime to get some groceries and things we need delivered to our hotel (food, bottled waters and several other items we didn't even know we needed until arriving) There is also an app people use here called Seamless where you can order meals from local restaurants and they deliver directly to the lobby of the hospital or hotel. We are hoping to utilize that a bunch too. 

We have Henley's Pre-Op appointment tomorrow at 1:00pm and will have a lot more details after that appointment and I plan to write a post tomorrow explaining more in detail about the surgery itself and specific prayer requests. Surgery is Wednesday morning and since she is the youngest, that means she gets to go first. I will know a "time" tomorrow. Thank you all for praying. We know we are being carried through all of this because the Lord is answering your prayers and giving us exactly what we need in each moment. Thank you. 

Countdown to Surgery... 5 days

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It's sobering to think that one week from today we will be in NYC recovering from Henley's surgery. 

It has been so hard to write over the last couple of months. There have been so many things I felt like I needed to write and process. Things I needed to document for Henley, but I have not felt like I had the mental space to be able to go there quite yet. 

Coming home from New York I felt a mix of emotions. Mostly, I felt peace and validation. I knew that I needed to sit face to face with what is believed to be one of the best pediatric chiari specialist in the world and lay out all of the information we had and see what he could make of it. During that appointment I asked him point blank "Are you the best surgeon to be doing this surgery?" I needed to hear him validate everything my gut was telling me. I needed him to be kind and conservative and compassionate. I needed someone to take the time to explain everything in words we could understand and not give us a plan steeped in fear and uncertainty. The Lord knew what I needed and as always, he provided just that. Since the appointment, I have gone back and listened to the audio recording a handful of times just to be certain I heard what I thought I heard. Are we making the right choice? It's a constant question in need of the Lord's reassurance. 

I have spent hours in prayer over this question. I've ask the Lord to stop everything if this is not the path we are supposed to be on, and all along we've gotten green lights and clear paths. Planning this kind of a cross country trip and operation is no small feat. I've prayed that the Lord give us direction and boldly prayed that He provide ALL of the finances we would need for this trip, and He is showing us that He is doing just that. During one of my prayer times the Lord has reminded me of this verse Eph 3:20-21. "Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us, to him be glory in the church and in Christ Jesus throughout all generations, for ever and ever! Amen." HE IS doing more than I could have even thought to ask, and it's pretty cool to watch Him show up in every little detail.

The Lord knows how hard it has been to think about our entire support system being back here in Texas while we are in NYC, but distance is no match for our God. As it turns out, There are several people who will "just happen" to be in NYC the EXACT DATES we are there for surgery for either their work or for a last minute vacation decision. 

Other than the details of actually getting to NY to do this surgery and figuring out all of the things involved in that, there has been a LOT to process emotionally. Several things are new and then a few things that are resurfacing from 5 years ago. This time around we have a 9, 7 and 6 year old to help them process all of this too. There have been many nights I have stayed up late answering questions that Haven had about everything. Her main fear is that Henley will be scared and in pain. Zane is fairly clueless about it all. I am pretty certain he is just confused why Henley is getting so much attention. When I told him his sister was having brain surgery he responded with "What's your brain?" and "What does that do?" Uhm....just controls everything, no big deal. 

Henley on the other hand is having a really hard time. Yesterday was especially hard for both of us. I had taken her to a chiropractor appt that morning and went to take her back to school. While walking with her through the halls she started saying her tummy was hurting and she was nervous. We stoped and sat down to talk about it but she couldn't put her feelings into words except to say she was nervous. Tears started to run down her face and she tried her hardest to pull herself together before sitting down in the lunchroom with her friends. We have told her all along that it's totally okay for her to cry and to ask questions and to talk about it. She has asked some hard questions like "what are they going to actually do to my brain?" and "How do they make the "zipper" (scar on the back of her head)?" 

Sunday morning we sat and talked a little bit about it all and I felt like this was the first time she maybe understood WHY this was all happening. I forget that sometimes when she is being tested for things and we are investigating a specific issue we ask a lot of placebo questions to mask the real questions we need answers to. For instance, instead of asking questions that may lead her into an answer like "Does your head hurt?" We will look at a pain scale and say things like "can you tell me how you arm feels?, your eyes? your head? your elbows? etc" This way she doesn't really know why we are asking and she won't mask her true answer. Because of this she maybe doesn't know the RESULTS of what we found out and what has led us from one step to another. News Flash: She doesn't read the CaringBridge. All she knows is whatever she said and we found out is now the reason she is having this super scary operation. I figured that maybe sharing this info with her is the info she needs to be able to process through what is about to happen. It's also very important to me that she knows that we are doing this FOR her and not TO her and that Adam and I are her warriors and we are fighting with her on the same team, with the same goal. I pulled out her MRI images from the last 5 years and showed her the comparison. I explained the images to her as best I could and told her that her brain was having a hard time "breathing" {translation: Very little spinal fluid is able to get through} and that her brain was so tight in there and this part of her brain needed a little more space so that it didn't feel so squished by its neighbors {translation: Her brain stem is being compressed by the cerebellum and anterior craniocervical junction (CCJ) and needs more room to function properly} So Dr. Greenfield is going to go in and give the brain some more space so that it's happy and no one is squishing each other. 

The rest of our conversation went a little like this: "Henley, so you know how you say your head hurts a lot and sometimes you say that you can't feel your feet or your hands? Do you know that those things are all connected to this part of your brain back here? You know when have trouble understanding you and ask you to repeat things all the time? and how you get really tired when we go to the grocery store and have a hard time walking? Did you know that those things are all controlled by this part of your brain too? You know when you tend to fall and trip some days more than others, you have a hard time eating certain foods or sometimes you say that your eyes are blurry in one eye or another? Those things are all symptoms of your Chiari!" The look on her face was one of enlightenment. Of course! Why didn't I think of this before? She has NO IDEA that all of these "random" things are connected, its just how she goes through life. She doesn't know what it would look like to not feel all of those things. You could see the wheels turning. I said that when Dr. Greenfield goes in and makes some more space for her brain that its possible that those things will all go away. She smiled for just a second at the thought, but then immediately went back into anxiousness. She wanted to change the subject and move on so I let her. I told her we could talk about it anytime she wanted and I would always try to answer her questions. 

I would ask that you please pray so specifically for Henley's fear and anxiety. Pray that the Lord shows up big time for her and helps her work through emotions that I have no authority over in her little mind. Pray that the Lord gives Adam and I discernment to say the right things and to are able to give Henley exactly what she needs to be able to process the things she needs to process at this age. Pray for Dr. Greenfield. Pray that he gets the best night sleep of his life Tuesday night and wakes up feeling amazing on Wednesday morning before he goes in for Henley's surgery. Pray for his family, for his kids to be well and for this to be a peaceful week in his home too. We know that behind every surgeon is person with a life and a family and drama and chaos too. But our God is bigger than all of the things we bring the table and He has control of every single detail. Pray for anesthesiologist, the nursing staff in the operating room, and all of the people who will touch our child in this process. Pray that they are gentle with her and care for her like the angel she is. Pray that she has NO infection and recovers quicker than anyone has ever seen. Pray that she doesn't cry when she wakes up from surgery. {There is a story here, but just please pray that crying is not part of the memory she has when waking up from anesthesia} Pray for Haven & Zane. Pray that they are safe and watched over carefully while we are away. Pray that they have all of their emotional needs met too. Pray for them as they process all of the questions they have and see and experience things they have never experienced before. Pray for them to be well while we are gone, because nothing is worse for a mother than knowing her babies are sick and you can't get to them to make it all better. 

And for us. Please pray for Adam and I to be able to process what we both need to process emotionally over the next few weeks. Pray for us to be able to sleep soundly and for our stress levels. I am personally SO tired and feel like I have been running a marathon since August with no water break. I am so desperate for a break, a moment without drama and total chaos. I am daily fighting the urge to want to run in another direction. I want a beach and a massage and to rest in the sun and float in peaceful waters. I want to read a book for enjoyment and not because I am researching something. I want to be able to turn my brain off and think of nothing, and quite honestly, I am finding it very hard to get there. There has been so much going on in our lives other than just what is just going on with Henley, and I will be having surgery myself when we come home from New York on my kidney. Pray that we can finish this race strong and have a LONG season of rest and peacefulness. Thank you all for praying and for your support. We COULD NOT be doing all of this without the love and support the Lord has blessed us with. I say it all the time, but I do not know how people make it through this life without a church community. It takes a village. Thank you for being apart of our village. 

Field Trip to the hospital

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Well, this was just about the best idea ever. It made a HUGE difference for Henley. We have learned that when we can put Henley in a leadership role, it helps her to overcome some of her fear. So we told Henley that since Haven & Zane had never seen an MRI machine or she was going to need to "show them the ropes" and give them a tour. Honestly, she has never "seen" an MRI machine either since she has always been asleep, but she has way more experience in hospitals than the other two and so she took on the role confidently. 

Haven and Zane were more willing to jump up on the table and try it out. Zane was especially excited about the "movie goggles" they had. We told them they could all get a turn, hoping that Henley would actually get on the table and we could get her to have a non-fearful experience with the MRI machine. She did great and we all felt much better after this was all over. 

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Tips for other parents: If this is something your child ever has to do, I would HIGHLY recommend #1 doing it at a children's hospital if you can, and #2. Ask them about taking a tour beforehand. I have learned from several child life specialist that if you can help them walk through the experience with a stuffed animal or themselves it helps because they know what to expect and they can go into a procedure knowing that they will come out okay. We also use a lot of simple terms with Henley when we talk about procedures. For MRI's we tell her that it's time to take her "special pictures" of her head instead of using the word MRI since that means nothing to children. We are very honest with her when something is going to hurt or she is going to have to have blood taken. I will prep her beforehand and say. Remember we are going to see Dr. R. Remember, he is just a "talking doctor" (which means we just talk about stuff, no ouchies happen in their office).  I tell her too, "Hey, we have to go get some blood taken because the doctors need some information and your blood has the answers they need. Yes, its going to hurt, and that TOTALLY stinks big time, but afterward we can go do something fun. Would you like to stop for Ice Cream or Cupcakes?" This way she knows she can trust me and I am always going to be truthful with her. She also knows that I am her warrior mama bear and that I wouldn't let anyone do anything to her that was not for a really good reason. She knows that I am on HER side and that, she and I are working WITH the doctors to make her healthy. Lots of kids who deal with medical stuff feel left out of the decision, they often feel blindsided when adults don't tell them things because they think kids don't understand. I am here to tell you that THEY DO! Henley remembers things from when she was two years old, and how we handled things and set the stage for her then has made a difference in her perception when she is seven.

During our MRI Field trip, we made sure to praise all of the small things she freely chose to participate in. She certainly held back and was more than willing to let her siblings go first, and they obliged because they didn't have any previous fear of the situation like she does. Once the other two had gone we asked her if she wanted a turn. We asked her every step "Would you like to put the movie goggles on so you can see the movie?" She shook her head. "okay, well you have to lay down like Zane did so that they work." She laid down and we let her sit there for a minute knowing that we were all right there and that there was zero pressure for her to do any more than that. Then we said, while you are watching a movie is it okay if you ride in and out of the machine like Zane did?" She was reluctant but agreed. The operator slowly moved the bed in, waited a minute and then moved her slowly out of the machine. We asked her if she was ready to get up and she said "yes" so we took the googles off and let her hop off. With each step we call this "collecting positive experiences". We don't ever push her, but just do what she is willing to do and if she gets stuck on a step, we stop and talk through it. I will ask her "Would you like to see mommy do it first?" or "How about we let Draff (stuffed animal) try first" Generally kids don't even know what they are afraid of, they are just afraid, so we have learned that if we can take very small steps and collect positive experience along the way then she feels so much less anxious about the situation the next time. For Henley this works, I realize all kids are not like her, but we have certainly had to learn a lot about helping her to overcome fearful experiences.