Saturday, January 30, 2010

The Update!

Here it is!  The official update on everything we can think of to update you on!  We will answer your questions in order of popularity – and then update you on things that you didn’t even know to ask…

The most popular question is “how’s Mike”?  And the answer is Mike’s GREAT! 

And then there are other questions that follow from that one.  Such as “how is he doing with daycare”?  And the answer is Mike REALLY enjoys going to daycare.  And we’ve decided that calling it daycare really isn’t fair to the Nanny’s.  They call it an “Edu-Care” center.  And I think that we will start calling it “pre-school”.

“Pre-school for 9 week old babies” you say?  And we say - “Yep”.  The entire center, from the infants to the 5-year-olds, is set up like a school.  And each age group, even the infants, have a curriculum that they follow every day.  This didn’t come as a surprise to us – we knew all about it and this was one of the primary reason we selected the Nannies.  But they still continue to impress us with how much the really do with the infants.  For example,  this past Friday Mike had his first art project!  We won’t comment on it too much just yet.  It’s still hanging up at the Nannies right now – and once we get a picture of it, we will post it here!

Another popular “Mike” question (usually ask with some obvious concern).  The quick answer is that we (and Mike!) couldn’t be happier with the way things are going.  The orthopedic surgeon was extremely pleased with the tenotomy procedure.  He is still in his casts, but we simply cannot explain the drastic change in his happiness.  Before the procedure, he was in one of two states of existence – sleeping, or screaming.  And by screaming, we do NOT mean that he was crying, or crying loudly.  We mean that he was looking up at us with panic, pleading eyes and screaming at full volume which, without a doubt, meant “why aren’t you helping me!!!!!!”.  It was an absolute heart breaker.

And now?  He doesn’t care one single bit about wearing his casts.  Especially since we put a little moleskin around the top to stop the chafing!  He enjoys clicking his heals together when he is happy and he’s been known to bring them crashing down in a loud “bang” when he is mad or has some gas!  He has so much fun playing on his mat (which is what he is doing right this very second!) or swinging in his swing.  And the best part?  As much as it broke our hearts to have him looking up at us with the pleading scream – he now looks up at us and that big toothless grin spreads across his face, melts our hearts, and turns us into blubbering parental goo!

DSC_0097 Here I am playing on my mat!

 

DSC_0111

Look at that smile!

And there have been other things happen too.  For the two weeks that Mike was out of the casts, he got to enjoy a “real” bath!  He was a little unsure about the first one (“Are you guys sure that I should be sitting in the water?  We never did it this way before…”) – but by the second one, he realized that this was the equivalent of a baby spa treatment.  He would start out just sitting in the tub of warm water and relaxing.  And if you didn’t watch him, he would relax so much that he would just fall asleep!

DSC_0081 Hey – I think I like this bath thing!

 

 

DSC_0079

This is fun AND relaxing!

 

 

DSC_0087 …maybe a little TOO relaxing…

 

 DSC_0084 Hey!  Was I asleep?

And we have one more surprise to share with you all.  Mike made a big transition yesterday and he’s really excited about it.  Unfortunately, we don’t have pictures of it yet so you will have to wait!  Hopefully in the next day or two, we will be able to write a quick post about it.  Until then, here is one more picture of our beautiful smiling baby boy…

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Hi everybody!

Saturday, January 23, 2010

First day at DAY CARE!

This past Friday was an interesting day.  It was Mike’s first day at daycare! 

The whole daycare adventure actually began about 6 months before Mike was born.  We started with a map that had every licensed daycare facility in Knoxville.  We checked websites, checked state licensing boards, check complaint records, and checked for facilities with the highest state ratings.  We cut the list down down from nearly 100 to a couple of dozen.

Next came the phone calls, who would have openings, checking the curriculum, asked a handful of basic questions and got the list down to 6.

Next came the visits, talking to the directors, meeting with teachers, asking a LOT of questions about everything you can think of, toured the facilities, observed the teachers, observed the students, made surprise visits, and ended up getting the list down to 3.

Then we ranked the three (just in case something fell through at the last minute!).  We made the required $25 deposit at our preferred location (called the Nannies in case you are in the Knoxville area).  And then Mike was born.

After he was born, we confirmed that The Nannies would still have a place available.  We attended their “new parent orientation”.  We filled at all kinds of paperwork (a media release form?  Yep – we filled it out…).  We met with Mike’s teacher (several times), showed her the casts and his brace to make sure they were ok with it all.  Everything was good to go!

Now it’s time for Mike’s first day.  You can imagine that we were a little anxious about the whole thing.  But everyone at The Nannies has gone out of there way over the last several weeks to make us feel a part of the family.  And once Mike got back to his room, you could tell that he was going to be just fine simply by the way he was looking around the room.  So sure – we were anxious.  But we were also pretty certain that it was all going to work out just fine. 

And when we went to pick Mike up, he was just as happy as when we left.  All of that work so that we would select the best daycare was all worth it.  Here’s hoping that the next 5 years will be just as happy and that they will have him prepared to be the smartest kid in his kindergarten class!

Tuesday, January 19, 2010

Surgery and surprises…

Today was the day for Mike’s surgery to relieve the strain on his Achilles tendon.  It was a day of surprises – and they actually began yesterday afternoon.

We got a call from East Tennessee Children’s Hospital yesterday afternoon.  They wanted us to be at the hospital patient registration at 6am.  “6am?” we asked.  “For a 9:30 surgery”?  Indeed – but because the surgery had been moved up to 7:30.

Of course, that was actually a good thing.  The earlier we get in, the earlier we get out.  That’s the moto for outpatient surgery!  And the earlier we get out, the earlier we get home where Mike can get some rest in his own bed.

So out the door we go at 5:30 this morning.  We (remarkably, for the Lee family), arrive at the registration desk early.  The collect all of our personal information and send us up to our room.  Nurses arrive to take his weight, length, head circumference, O2, blood pressure, pulse, and I’m sure there were other things that I missed.  They asked about allergies, medical conditions (is being born a medical condition???), medicines, respiratory issues – including sleep apnea (in an 8 week old?  I guess anything is possible…), blood issues, and other things that I can no longer remember.

The next step was the anesthesiologist.  She came in and asked a bunch of additional questions.  The one question that is important to the story is, “what is Mike’s gestational age?”  And the answer is 38 weeks.  The anesthesiologist flip through her chart and said, “so you’ll be staying the night, right?”

What?  Staying the night???  What part of outpatient surgery requires an overnight stay?  Turns out that when you add his gestational age (38 weeks) to his birth age (8 weeks) you get “46”.  if the number is less than 50 then they want to keep you overnight.  Apparently, if you are below the magical “50” number then you are at a slightly increased risk for “bronchial spasms”. 

While we were in no way prepared for an overnight stay (dogs to care for, classes to teach, jobs to work – only the clothes on our backs, no toothpaste, no deodorant, no baby milk, no breast pump), we were actually a little relieved. 

“Why relieved” you ask?  While we understand that the procedure that Mike had done is the medical equivalent of getting his finger nails trimmed – we simply can’t explain the feeling when the wheel your little baby off behind the big red doors marked “SURGERY”.  Having 24 hours of constant medical attention is more reassuring than having 3 or 4.

How did the surgery go?  A short 40 minutes after they rolled him through those big, scary, red doors, Doctor Crawford popped in to the waiting room to tell us that the surgery went remarkably well.  Not only that, but he was able to complete all of the regression with this first cast.  He will need to leave this cast on for 3 weeks for his tendon to heal, but there should not be an follow-up serial casting.  And when he goes back to his brace, there shouldn’t be any pain from the tendon strain.

So – all things considered – we are happy with the outlook.  And we will be sure to keep you posted with the progress!

 

IMG00037-20100119-0652 I’m being brave on my way into the operating room!

 

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Boy – I sure was tired when it was all over!

Saturday, January 16, 2010

The decision has been made…

Here’s the official update on Mike’s brace saga.

Last Thursday, we went to the orthopedic doctor.  He looked at his foot and said (obviously enough), yep – there’s a pressure spot with an open blister!  He then went on to explain what was actually causing our problem…

Mike’s Achilles tendon hasn’t “stretched” enough and is pulling his foot sideways in his shoe.  It doesn’t help that his feet are so small and we already have the smallest sized shoe (which is still a little big).  Our options were becoming limited.

We could continue modifying the brace (remember that we had it modified a last Tuesday but it hadn’t been on his feet yet), or we could cut the heel cord.

Being leery of surgery, especially on an 8-week-old baby, we thought it would be prudent to at least give this “untried modification” (and possibly one or two more) before we jump in to cutting heal cords.

But in an effort to do our due diligence and educate ourselves more, we asked the orthopedic doctor about this “cutting the heal cord”.  After all, it sound like something fairly horrible (perhaps more horrible than the brace). 

The procedure itself is called a “subcutaneous tenotomy”.  The procedure does indeed involve “cutting the heel cord”, but as it turns out, it’s not nearly as horrible as it sounds.  The surgeon merely “nicks” the tendon in order to relieve a little of the tension and allow it to stretch easier.  Then they put the legs and back in a cast for three weeks while the tendon heals.  Then it’s back in the brace.  That is the 10 cent explanation – if you are curious, you can google clubfoot tenotomy and read about it in much greater detail…

In the end, we left the doctors office Thursday morning with the idea of trying the latest modification to the shoes and brace.  We also thought that if we were still having problems, we could go back to the orthotics place on Friday to see if there was anything further they could do.  By Monday, the situation would either improve and we would stick with the brace – or it would not improve and we would go the tenotomy route.

By Thursday afternoon, Mike had been screaming for 5 hours straight – ever since the moment we put the brace back on.  I’m not talking about crying – or even crying very hard.  I’m talking about an all out, ear piercing scream.  And any parent that has heard their child scream like that KNOWS that SOMETHING has to be done RIGHT NOW.

As luck would have it, we got an email from a fellow clubfoot parent.  She told us about her son who had gone through a nearly identical situation with the Dennis Brown Brace.  And while she didn’t know that we had just seen the orthopedic doctor – and she didn’t know that Mike was smack in the middle of hysterics – and she certainly didn’t know how well timed her email would be. 

She told us of her son Mathew.  She had thought that he was a “colicky” baby and they had struggled with pressure sores from his brace.  Everybody was exhausted and at wits end.  Then Mathew had the tenotomy procedure.  After three weeks in a cast it was time to go back to the brace – and Mathew went back in without any more complaints OR pressure points!

So we called the orthopedic doctor Thursday and scheduled the procedure for Mike.  And the doctor is confident that the tenotomy will significantly reduce our brace issues.  And after hearing Mathew’s story, we are certainly more comfortable (and even cautiously optimistic!) that things are going to get better.

In the meantime, Mike is asleep on his grandma’s lap.  No matter what – life is good…

Wednesday, January 13, 2010

The “Club Foot Brace Saga” and “Going out to eat”…

It’s not often that we combine topics.  Especially when the topics are not directly related.  However,  we wanted to fill everybody in on where we are with Mike’s brace but also tell everyone about our dining out adventure!

First the brace story.  We’ve been keeping an eye on the dark pressure point on the back of his left foot (it was a small purple/black dot about the size of a bb).  We started off by taking the brace off and checking it every so often – every couple of hours in the beginning then gradually tapering of to twice a day.  It was looking like the dark spot was getting smaller and we were happy about that.  However, the red spot which surrounded the dark pressure point looked like it might be getting bigger and more red.

Then, yesterday evening while we were getting Mike ready for his bath, we noticed that some skin had begun to peel away.  We call the on-call orthopedic physician assistant who instructed us to leave the brace off until we could see the orthopedic doctor.  We voiced our concerns (once again) about leaving the brace off for such an extended period of time.  However, the PA told us that at this point, losing the skin was a more serious issue than trying to correct his feet.

So today, we made yet another trip to the orthotics place.  And once again, the fine folks at Hanger made some modifications to his shoes.  At this point, his shoes have more modifications than your average custom Harley.  The guys at Hanger really have been great – especially Allen who has great patience with our "every-other-day” visits.  Today we asked him if this was a common occurrence.  He said that the pressure points were common, but that it was unusual for it to continue this long.  Usually, it’s one simple adjustment to eliminate the cause of the pressure and that’s it.  However, everyone is absolutely stumped as to what the actual cause is…

We also made a trip to the pediatrician today.  She saw the back of his heal and was fairly concerned.  She told us that the affected area was through multiple layers of skin and that it needed to be treated like a burn.  Now we get to apply Silvadene cream and a band-aid to his heal twice a day for two weeks.  She also confirmed that we should leave the brace off until we see the orthopedic doctor…

…and that appointment is tomorrow morning.  So we will know more tomorrow!

In the meantime, Mike has been sans brace since last night.  And today he has been in the best mood all day long.  No crying.  No fussing.  The perfect little angel.  We absolutely HAD to take advantage of the situation.  After all – the doc may instruct us to put the brace back on tomorrow!  We were deciding what to do when the stomach growl gave us the perfect idea – we’ll go out to eat!  We haven’t been to a restaurant for over 3 months.  And we know of this little “hole-in-the-wall” Cuban / Mexican place down the street that is one of our favorites!  So we packed everything up and headed out.  And I have to say, it never tasted so good!  Mike continued his angelic performance and had every waitress in the place making googlie eyes at him and he just smiled right back!

We came back home and it was time to feed Mike.  We are pretty sure that he liked the  chips and salsa too – even if it was somewhat processed by mom!

Monday, January 11, 2010

For the first time this decade…

Something happened in Knoxville today that hasn’t happened this decade.  For the first time – that right – the first time THIS DECADE, the temperature rose above the freezing mark!  Even if it was by a mere 1 degree.

OK – sure.  The current decade is only 11 days old.  But still, the all time record for Knoxville is 12 days – so it is still a monumental mark!  Especially considering that our average high for this time of year is 46 degrees…

And as with all monumental occasions – you have to celebrate in some way.  How did we choose to celebrate?  By taking a nap in the big boy recliner!

 

DSC_0085 Mike and dad taking a nap in the recliner!

Sunday, January 10, 2010

Did you hear?

I’m not the type of person to “rub it in”, but sometimes something happens and I feel compelled to let as many people know as I can…

Anyone who follows college basketball has heard about the arrest of 4 UT players (who combined for more than 30 points per game) who were arrested on alcohol, drugs, and weapons charges on New Years Day.  And you might have heard that one of them has officially been dismissed from the team while the others are still serving an “indefinite suspension” while the police finish their investigation.

…and you may have heard that the remaining 9 players (6 scholarship players and 3 walk-ons) had to play number one ranked Kansas…

Now that is a mountain of adversity to climb!

At one point, Bruce (who is used to having a very deep bench to pull from) had 2 freshmen and 3 walk-ons on the floor playing against the number one team.  Two of the seniors on the team were in foul trouble all game and played precious few minutes.  That adversity mountain seems taller and taller…

…and did I mention that Tennessee has never beaten a number one team an Thompson Boling?  In fact, the last time they beat a number one team at home was in the 60’s at the old field house.  And now that adversity mountain makes Everest seem like a little hill…

But they took the court and played hard.  They were absolutely NOT intimidated by Kansas.  Hard defense and good offense all night long.  It was an exciting game to watch (and even more exciting to actually be there!).  The crowd spent most of the night out of their seats cheering on the team.  Forty minutes of “never give up”.

And how did it end?  Well – remember it was a very tall mountain to climb.  And it was the number one team.  And the did beat us by 34 points last year in Kansas.  A tall, tall, rugged, mountain.

How did it turn out.  Ummmmm – we beat ‘em!  And it wasn’t a “Holy Cow” type game where Kansas dominated and Tennessee made a last minute comeback – no sir!  Tennessee took the lead about 3/4 of the way through the first half – and (other than a single in the second half) they never looked back.  In the end, the score was 76 to 68.

Suddenly, our own little personal mountain of adversity seems a little more manageable…

Saturday, January 9, 2010

What’s going on?

We have had a lot of people who have been asking “what’s going on?”  And we understand that many of you are curious about Mike and his progress with the club foot treatment.

Our last post (way back on New Year’s Eve!) we told everyone how we were excited about the transition from the casts to the brace.  And indeed, we were excited!  Certainly the brace could not be any more difficult than the casts – right?  The brace might even be easier than the casts – right?

Ahhhh – the naive notions of new parents.  So – let’s go back and add some more observations about the casts.  They certainly were not an absolute pleasure.  They rubbed and pinched and chaffed the top of his thigh.  It was impossible to keep the poop off of them.  And each time we got a new cast, Mike insisted on peeing on it at some point within the next four hours regardless of our best efforts!  And the sponge baths were starting to get pretty old too…

However, they were pretty much “get it and forget it”.  We would go to the orthopedic doctor on Thursday’s and he would cut off the old cast and put on a new one.  For the rest of the week, there was nothing to do other than wipe them off occasionally. 

And the braces sound so NICE!  We can take them off every once in a while.  We could give him REAL baths.  They would be considerably harder to pee on (and virtually impossible to get poop on!).  The chaffed spots on Mike’s thigh could finally heal.  And they were so SIMPLE – two baby shoes with a bar between them holding the feet in position.

But oh how quickly we learned.  First thing, the casting moves the feet to the proper position, but the tendons have not yet had a chance to stretch.  The biggest problem is the Achilles tendon – it wants to pull the heel up and point the toes down (which is just the opposite of the position we are shooting for).  So the single most important rule of the brace (other than actually wearing it) is to make sure that the heel is ALL THE WAY DOWN in the shoe.  Of course, you can’t see through the shoe (it looks just like a normal, open-toed baby shoe with a solid heel) so it is very hard to tell if you are doing it correctly.  And you simply obsess over it after you hear the doctor say, “it’s imperative that you get the heal all the way down – you MUST get it down – the foot will revert back if you don’t get it down – you MUST get it down”.

So now we are obsessed.  Is it down?  Are his toes curled?  Did we get the strap tight enough?  Are the laces tight enough?  And on and on and on.  And the other things that we didn’t think of until we got home – how are the outfits with feet in them going to work?  How are we going to get pants off to change his diaper when there is a bar connecting his feet?  And on and on and on…

And Mike certainly wasn’t shy about voicing his dislike of his new situation.  And while his cries certainly were tugging on the heartstrings – we knew that in a couple of days he would become accustomed to his new brace and be happy again.

Then this past Tuesday night, we took his brace off and noticed a small (bb sized) dark purple pressure point on the back of his left heel.  So we went back to the Hangers (the orthotics place) on Wednesday and they added some additional padding to the shoe.  Thursday morning, the spot was still there – so we went to the orthopedic doctor Thursday.  He believes that the pressure point is a result of not have the heel down all the way (GREAT!  We were trying so hard!).  Friday morning, the spot was STILL there, so we went back back to Hangers and they gave us a new pair of shoes. 

Today, the spot is still there and we are trying a multitude of “heel padding techniques” to help (after several calls to the on call orthopedic P.A.) and we believe that the pressure point is improving.  And as we are getting ready to go to bed – we are really hoping that the padding is making Mike more comfortable.  He is already asleep, and that is a good sign.  He didn’t go to sleep until 4am last night!

So – we promise to keep you posted!  And here is hoping that we get some sleep tonight…