Thumb Surgery

Yesterday was such an exhausting day emotionally.  Knowing we had to get up at 4am to get ready to go into Boston for Elias' surgery, I tried to go to bed before midnight to get at least a few hours of sleep. But of course, the crazy other-thinker that I am, I didn't fall asleep until 2:30. Greeeaaaat.

We checked in at 6:15, and within a half hour were in the pre-op room meeting with the doctors and nurses to go over things before surgery began. I made it especially clear to the anesthesia team that I wanted them to avoid putting an IV in his head at all costs. (During a previous surgery, they couldn't get a line in his hands, and since they were operating on his feet, their only option was his head. It was very traumatic). Last time he had surgery he was small enough that they took him from us into the operating room and we didn't see them put him to sleep or anything. This time however, since he's bigger, stronger, and knows when mommy and daddy leave, they asked if one of us wanted to be in the room while they put the mask on to put him to sleep. I said I'd do it.

Then once I got all the garb on to go into the operating room, I started to get really emotional. I told Kevin maybe he should do it, I don't know if I could handle watching them put a mask on my kids face, watching him go limp and his eyes rolling back. Kevin said "you can do it, babe" so I said fine, okay. I'll do it. Then as we were getting ready to go, and I had tears in my eyes, I told the anesthesia team I might be extra emotional because of the pregnancy hormones. Its a good thing I mentioned it. They said it wasn't the best idea for me to be around the fumes from the gas mask if I was pregnant. So Kevin had to go, which he was fine with, and I thought was probably better for Elias too, as I wouldn't be able to be calm enough to calm him down. They said it was time, and off they went. I bawled me eyes out. I don't remember it being that hard last year when we did this. Just the whole idea of putting your child into someone else's hands, entrusting them with their life, is so scary. And for a control freak like me, its terrifying. Hands down one of the hardest things I've had to do as a mom thus far. 

They give you a tracking number for your patient, which I think is hilarious but awesome, and they have a scrolling list on the TV that constantly shows the status of the surgery. So we grabbed breakfast and headed to the waiting room. Time actually went pretty fast, and in an hour and a half Dr. Cassidy came up to update us. Elias had what they call thumb-in-palm. His thumb was not in the joint correctly, causing it to be "stuck" to his palm. He was able to grasp with it, kind of like a crab-claw type grasp. So they put a pin in to put in back in place and bring it out more to point more upwards than before. He said everything went great, the pin was in place, and even showed us a picture he took of what it looked like when he was done. From what we saw, it looks amazing! It looks so much more normal than it did before. I'm so glad he took pictures, because I forgot my camera in the car and wasn't able to take a "before" before, so I'll be sure to get a copy of the pictures he took next time we see him for you all to see. 

Once he was in the recovery room, they nurse came and got us. He was still asleep when we got there...

After about 10 minutes he started waking up, and of course he wasn't very happy. His one arm is completely imobolized in a cast, and the other one is taped so much to keep the IV in that he can't move his hand. So after some apple juice, yogurt melts, and some sesame street, you wouldn't have even known he just had surgery. 

Its been difficult here at home with him adjusting to not being able to use his left arm. We had to go back to using bottles because his sippy cups were two thick around for him to hold with one hand. He got very frustrated when trying to play with some of his toys. I know in just a day or two he'll completely adapt and be fine, but in the mean time I really can't do much of anything as he needs my help with almost everything he tries to do. But he'll get used to it. We go back in 3 weeks to get the cast changed, and 6 weeks from now he'll have the pin removed right in Dr. Cassidys office. He said it should feel like stitch being removed, which boggles my mind, but as long as it isn't painful then thats great! 

Good news...and not-so-good-news...

We had our big ultrasound this morning! I was SO anxious about it that I was sick to my stomach. I just wanted to know already what the baby was! Thankfully a sweet friend was able to watch Elias so Kevin and I could relax and enjoy the ultrasound as much as possible.

After what seemed like an eternity in the waiting room, she finally called us back. Just like with Elias, as soon as she put the probe on my stomach I could see what the baby was....probably because I've been studying pictures online for the past 3 weeks so I knew what to look for...

ITS A BOY!!!!!!

Another boy for the Lances! While a girl would have been a nice change of pace, I'm very excited that its a boy! I already have everything we need. I think Elias is going to love his little brother and they're going to be really great buddies.

Thats the good news.

Then theres the not-so-good-news.

Once the tech was done the ultrasound, the doctor came in and said she wanted to take a look for herself. I knew right off the bat she must be worried about something. She started with the feet, where it looks like the left foot is definitely clubbed. Then she went to the hands. The baby had his right hand in a cupped position the whole time and wouldn't extend his fingers, and on his left hand 2 out of 5 fingers weren't extending. Basically, as far as we can see at the moment, it looks like this baby has the same problems Elias had. His foot doesn't look as severe as Elias' was, however it isn't a mild case either.

So. Here we are. Again. I never thought we'd have to go through this again. The doctor that diagnosed Elias' arthrogryposis said in his experience (which is extensive) he's never seen it in siblings. I don't think he's saying it never happens, but that its so rare that he's just never come across it. Interesting, huh?

The doctor was so sweet and gentle, and I could tell as she was explaining what she thought was wrong that she was choosing her words carefully. I told her she doesn't need to hold back, just to tell us what she thinks. We've already been around the block...we can take it. The good thing (if you can call it that...) is that if this is the same thing Elias has, there's hope. It can be corrected. It might have taken a couple extra months, but Elias is now walking all over the place and can do everything he sets his mind on doing. As long as this doesn't effect his central nervous system, we're hopeful it can be corrected.

Everything else as far as his heart, brain, spine, etc. are developing great, so that's some good news. We're scheduled to go downtown on Monday for a 3D ultrasound to get a better look at his little hands. I'm excited for that because we will get to see a better image of his little face!! We'll be having monthly ultrasounds from now on to keep an eye on things as he grows.


Here's some pictures of his sweet little profile.

Bahamas Highlights

Well, we're back. Back to reality...back to below freezing temperatures...back to snow...can we go back now?!?

We had an abolutely amazing time staying in the Bahamas with Amber and Bryce, and their "little boy" Cannon. It was about 80* every day, sunny skies, the water was perfect...everything I had hoped for. I felt the baby flutter for the first time, which was just as awesome as it was with Elias. It never gets old. We ate TONS of good food, a-la chef Amber and local restaurants. 

He thinks hes the king...

Waiting for their daquiries. 

I know...hot stuff, right? bahaha!

Cannon...sweetest puppy ever. 

World Famous Marching Flamingos

Elias' loves his Aunt Amber and Uncle Bryce!

Riding in the jeep

Daddy enjoyed some snorkeling with Uncle Bryce

We went parasailing.

Crystal clear water. Breathtaking. Worth every penny.

While we were sad to go, we have a busy couple weeks ahead of us. Next Monday we find out whether we're having a boy or a girl. Surprisingly, I think we've decided on the names for either a boy or a girl. Elias' middle name wasn't decided until I was laying in the hospital being induced, so its kinda nice just being able to relax. I'll share the first name one we find out what baby is. The middle name will be a secret until birth because it'll be a family name, and we want that person to be surprised :)

Then Tuesday the 31 is Elias' surgery on his hand. He'll be in a cast for about 6 weeks while it heals, so we'll see what he thinks about that. 

Elias practiced walking all around Aunt Amber and Uncle Bryces, but he was still pretty wobbly. But today, he walked practically the whole length of our apartment, turning corners and everything. Here's a little video of one of the many moments. 

Impromptu Ultrasound

This morning we had a monthly checkup with our OB at Tufts in Boston. I look forward to these appointments because we get to hear our baby's heartbeat and have peace of mind that everything's still going well.

I forgot that I had to give some blood today for some testing, so I panicked slightly when they told me to head up to the lab to get that done. I have terribly deep veins. I mean, SUPER deep and hard to find. So deep that one time they had to go into my foot to get blood. Yes, my freaking foot. One of the most painful things I've experienced. Anyway, I went up, explained I hadn't chugged any water (what I normally do to get my veins up) and warned them about my veins. I took a few deep breaths, anticipating lots of digging and a few sticks atleast. She poked me, and I asked if she got it, she said "yep" and 5 seconds later she was done. It was probably the best stick I've ever had in my life.

Moving on. Finally got settled into a room and the doctor comes in. She asked if I had any bleeding/cramping/ yadayada...apparently there were traces of something-or-other in my urine that were small, but still present. I told her nothing at all has been off, except the nasty post-nasal drip that wont go away. She said she wasn't concerned about it since I didn't have any other symptoms. Then we discussed the results from the sequential screening I had a few weeks ago. Basically, they combine results from the measurements taken from our last ultrasound with bloodwork done the same day. They tell you your chances of having a child with downs syndrome and trisomy 13, both of which are chromosomal abnormalities. The results were very good, so that was nice to hear. They'll do another screening at the next ultrasound, and will combine those results with the blood drawn today. Having already had one child with physical deformities, we know for us how beneficial it is to find out as much as possible before birth to be prepared. With Elias, we already knew what he was going to come out looking like. And we had a plan. We had a team of doctors lined up, ready to take action in the months to follow. So we always tell doctors when they ask how far we'd like testing to go, we say we're up for anything that can tell us whats going on with our baby, however we don't want anything that is invasive, such as an amniocentesis. The risk of miscarriage with amnio's is 1:200, which is so high!! Plus, we would never terminate a pregnancy based on findings with these tests, so there's no reason to go that far. Like I said, I want to know as much as I can to be prepared without harming the baby.

Okay. So then she went and grabbed the doppler and started listening for the heartbeat. I was shocked right away when the heartbeat wasn't getting picked up, because at the last appointment the heartbeat was right there as soon as she turned it on. She moved it all around, and at one point we both thought we heart a very faint beat, but then it went away. She finally said we'd hop over to the other room and take a look with an ultrasound. She said don't worry, the baby's are usually jumping all around. So of course when she left the room, I panicked. I thought about the traces of something in the urine she mentioned. Was I miscarrying? Is something wrong with the baby? I tried to remain as calm as possible for Elias' sake. Kevin tried to comfort me. Still freaking out.

Finally the room was ready. When the baby came on the screen, there wasn't really any movement. Then she zoomed in on the chest, and there it was. The heart beating. She measured the heart rate, and it came out to about 137/bpm. The last couple times its been higher, in the 150's/160's, so I was a little surprised. Then she asked if we were planning on finding out what the baby was. We said yes, and she said "well then lets take a look!". Totally took us off guard.

So she took a look, and then we were looking at the babys butt! She took a minute to look, moving slightly this way then that way. She said there happened to be a little shadow where she would clearly be able to see whether its a boy or girl.

She then said..."but...I don't see any obvious boy parts". You see, with Elias, it was very obvious that he was a boy. In fact, before she even told me he was a boy, I could see clear as day on the screen. Could it be a girl?!? We'll know for sure in 2 1/2 weeks!!!

New Words, New Boots

I think its time for an "Elias Update".

Elias is so close to walking now. He takes on average 6-8 steps at a time, but doesn't have quite enough control to just stop and stand still once he starts walking. However, he could stand in one spot for extended periods of time now. Its just when he gets that momentum going, he can't seem to stop. We're still a little head over heels :)

We've really been trying to get him to talk for the past few months, and he just seemed content with "Mama, Baba, and Dada". Seemingly all of the sudden over Christmas break he started trying to say some new words. In the past couple weeks his vocabulary has expanded a little more. Words he says now are:

Go
PopPop (my dad)
Mom
Buh-Bye
Sli (his word for slide)
Shhha (his way of saying shoe)

My perfect little eater has turned into a picky monster. For a while I could get him to eat PB&J, grilled cheese, mac&cheese...the typical toddler meals. Now he'll take one or two bites and be done with it. Chicken nuggets are my backup meal, and yogurt is still always a go. Thankfully he really likes fruit, so I can usually get him to eat a good bit of that in a sitting. Oh, and forget veggies. Oatmeal is hit or miss depending on the day, as well as spaghetti.  I really hope this phase doesn't last very long, because I really want him to have a balanced diet, and for sure that is not happening at the moment.

And now for a medical update:

Right before we left for Christmas I took Elias in to see his orthopedist. His braces were getting a little short, especially on his right foot (the one that had the dislocated bone). Dr. Gholve was very happy with how his feet are looking! The concern we always have is that his clubbed foot will regress and lose its range of motion.  The possibility of this happening, especially because of the type of clubbed foot he has, is very likely. So every time Dr. Gholve says its looking great, its a sigh of relief. Even with the foot doing as well as it is at the moment, we're pretty sure he'll need atleast one more surgery when hes 2 or 3 to do another tendon release. This will be necessary because while his foot hasn't gotten any worse, without the brace it still turns in some, almost like in someone thats pigeon toed. He also stands on the outside of the foot w/o the brace, so the tenotomy would release the tendon that's pulling up on the inside so that he has more of a chance of walking on a flatter foot. Did that make sense? Its hard to explain without using his foot as a visual.

Dr. Gholve also said he doesn't need the brace anymore for the right foot at all (yaaay!!!). So that foot is pretty much in the clear, praise the Lord. The doctor also recommended that to help combat the tendency of the clubbed foot wanting to turn in, we put him in a Ponsetti brace at bedtime. This is the brace most kids with clubbed feet have. Its basically shoes that have a bar the clips onto the bottom of them. Since the right foot doesn't need anymore correction, that foot is kept at a neutral position. When clipped onto the bar, the left foot is rotated outward, at a 115 degree angle. So basically we're over-rotating it in hopes it will help the foot turn out more before he needs surgery. I waited until after we got back from Christmas to put in on him simply because of how poorly he already sleeps when we're traveling. Now that we're back, its been quite the adventure getting him to wear them to sleep. Its like being strapped to a snowboard. He is so confused when we wakes up in the middle of the night and can't roll over. I've been trying to put them on a little bit before he goes to bed so he can get used to them. Its just so hard for me when he wakes up in the middle of the night screaming because hes so confused and scared. Giving him a binky and turning on his mobile doesn't calm him down like it normally would if he were to wake up. So I end up taking off the bar so that he can fall back to sleep. So bad of me, I know. But if you woke up with your feet tied together, wouldn't you freak out too???