Saturday, July 26, 2008

Saturday, July 26, 2008 in the Evening

Hello all. Sorry for the delay in writing, but it has been a restful, lazy Saturday here on the mountain.
Houston has returned from MFuge in Charleston, SC with the Youth Group. He had a great time, but he is exhausted. After picking him up from the church, we all went to see the Zman at the hospital. Zander enjoyed seeing his big brothers and he continues to rest well.
The nurses told us that he has had a good day. Earlier in the day he was smiling and looking around, so this is our positive note for the day. Jackson and Houston enjoyed visiting with Zander and the Zman continues to rest well. He is still on pain meds and sedatives, but the nurse indicated that these will likely be decreased in the coming days. Zander is still taking 15 ml of milk every 3 hours and he has not had any rejections.
Tomorrow, he will have more xrays done to see what is going on. We are praying that his espohagus is showing signs of stretching. We are also praying that the drainage from his chest tube remains zero as there has not been any fluid from the chest tube in about 24 hours.
I hope that each of you have a restful Sunday. I will write again tomorrow afternoon after seeing Zander. Christie and I thank each of you for your continued prayers and comments. We definitely feel the strength of the church and others through this journey. May God bless each of you!
May your dreams be endless Zander...with all our love.

Friday, July 25, 2008

Friday, July 25, 2008 in the Early Evening

TGIF everyone. It has been a good day for Zander. Christie and I spent the afternoon with him today and it would be an understatement to say that he is resting much better. He literally is a different baby. Before, he was struggling as if he were having a seizure just to be able to breath. Now, he rests comfortably and only uses the muscles in his chest and abdomen that we use when we breath. It definitely makes you appreciate how much we take breathing for granted.
Dallas, one of his nurses said that he had a great morning and that he was alert at times, but that he was sleeping much deeper. While we were with him, one of the many machines that he is hooked to was removed because his respiration has so greatly improved. We brought his frog blanket to him last night and Dallas indicated that he has been sleeping with it. In fact, as the pictures show above, he clutches to it like Christie and I would like to be clutching to him. At one point this afternoon, Christie and I contemplated picking him up and running, but I told her that my days as a football player were long ago. As such, we decided just to touch and kiss him as much as possible while he slept.
On a positive note, Zander's plumbing below the stomach is working well. While present he made a deposit that I would have had a hard time getting out. They have increased his feeding to 15 ml every 3 hours; however, it appears that he may be going up later tonight.
Although it is difficult to imagine what this sweet boy is going through, Christie and I are grateful for the care he is getting and the fact that he is much more comfortable with the trachea tube.
I will post again tomorrow afternoon or early evening after we have seen the Zman. In the meantime, I hope that each of you enjoy your Friday evenings.
Sweet dreams and rest easy Zander. We love you.

Friday, July 25, 2008 in the Morning

Good morning all. Zander's surgery went well. It lasted about 45 minutes to 1 hour. He is now on a trach and he is breathing much better. Unfortunately, he will like be on the trach when he comes home, but we are still praying for complete recovery before we bring him home. His stomach has enlarged and he is now on 15 ml of milk every 3 hours. Thank God he is resting better. He seems to be be more comfortable. Thank you to everyone for the prayers to get the Zman through surgery. Dr. Kelley is considering going back in next Wednesday and tightening the traction sutures. I will write later in the day. We are helping Christie move her stuff into the school today. Several of her teacher friends are helping, but I am just the strong back for the morning. I will post again later today with pictures of the little guy. Thanks again for the prayers and comments. They really get us through. See you soon sweet well. Clancy

Thursday, July 24, 2008

Thursday, July 24, 2008 at about 2:00 p.m.

Hello all. The Zman is not having a good day. Chrisite and I received a call from Dr. Kelley about 12:30 p.m. Dr. Kelley said that the current breathing configuration (C-PAP) is making the little guy work way to hard. He had 2 or 3 episodes throughout the night. Dr. Kelley said that Zander's trachea now has some malasia (sp?) (softness/floppiness) in it. It should be more rigid. Dr. Kelley said that due to the softness in the trachea Zander is basically breathing through a straw (his trachea) that is flexible on the end. Each breath he takes, is like trying to breath through a straw that had flaps on the end of it. This causes build up of mucous and other secretions down around the trachea and into the lungs. He is not aspirating on the mucous, but it does cause him to work much harder to breath. As a result, Zander is now back on the ventilator for the next few hours. Around 4:00 p.m. he will be taken to surgery and a tracheotomy will be performed. By doing so, Zander's trachea, his throat and the accompanying membranes will be allowed to rest and grow stronger. Dr. Kelley said it would be a temporary thing until the cartilage in the trachea becomes stronger along with the supporting membranes. Dr. Kelley will also inject contrast into his stomach to see how it is growing. We should know more later tonight. Sorry there are no pictures, but I will post some later. Zander is resting much better at present. As parents we are worried about his little body being able to handle the surgery, but we understand why this has to take place. The care he is getting is wonderful and we thank God for all the nurses, practitioners, therapists and doctors everyday. If you get a chance on your drive home today....ask God to look over Zander during surgery. I will write later this evening. God bless each of you. We love you son!

Wednesday, July 23, 2008

July 23, 2008 in the Evening

Good evening all. Christie, Grandpa Paul (my grandfather) and I just got home from seeing Zander. The little guy was doing well and we were thankful to have talked with the Nurse Practitioner on duty, Melissa.
Melissa told us that Zander had a pretty rough go of things earlier in the day (before lunch) when he had 3 pretty hairy episodes. We found out that his oxygen level fell to about 11 out of a possible 100, but they were able to give him oxygen and he recovered. These episodes also occurred at 2:15 p.m. and about 7:30 tonight. They have increased his oxygen intake and he seems to be tolerating it well. Melissa said that he was doing much better than earlier in the day. She also told us that although he appears to be working really hard to breath she said he is not working as hard as others in the same situation that she has seen. He is using muscles that you and I do not use when we breath, but that it is okay.
Zander is resting more now. When we were there to see him, we still could not touch or talk to him, but I broke the rules when he had his eyes open and he looked around at Grandpa Paul, which I am pretty sure my grandfather enjoyed. He does seem to be resting better and he was not startled into an episode when he looked at us while we were there.
He is beautiful and we are so thankful for him. We just pray and hope that he is not in too much pain. Please keep praying that his breathing gets better and that he is not in too much pain. The comments and prayers give us strength each day. Please also pray for a safe trip for Grandpa Paul to Florida as he will be braving the Atlanta traffic.
I will write again tomorrow afternoon after we see Zander (in the afternoon). Christie and I are spending some time together in the morning just the two of us. I apologize in advance to everyone for this delay (Mom), but the next post will be a good one.
Sweet dreams son.......Mommy and Dad

July 23, 2008 in the Afternoon

Hello all. We just returned from seeing Zander. He is still on the C-PAP machine and continues to struggle with breathing. His nurse said that he had 3 episodes since 7 a.m. this morning which required intervention (oxygen mask) in order to get his oxygen levels up and his respiration stabilized. She also indicated that Dr. Kelley was in to see Zander before lunch. Dr. Kelley has increased his feedings from 6 ml to 10 ml per feeding. He has not rejected any of his mother's milk.
At this point in time, they are continuing to monitor his breathing. Christie and I were there for about 2.5 hours and he did not have an episode. We are unable to touch him and we really cannot even talk because it startles Zander and sends his breathing into an erratic downward spiral. It does appear that the little guy is really still working very hard at breathing so everyone is somewhat concerned that the ventilator may be the way to go at this point especially if his episodes continue. Dr. Kelley also examined Zander and removed the suction catheter from his nose and placed it into his mouth. By doing so, Zander now has no obstruction in his right nostril to breath through; however, as noted last night, his left nostril is very tiny.
On a positive note, Zander's jaundice levels are dropping and they do not think that he will need to be under the light for this issue.
Christie and I are planning on going back this evening. My grandfather (Paul Covert) is permanently migrating from Columbus, Ohio to Florida and he will be staying with us this evening. He too is excited to see the Zman.
I will write again later tonight if anything has changed. I think that Dr. Kelley was going to look in on Zander before he left for the day. Your prayers and comments are appreciated more than you know and they give us strength each day. God bless!
Rest well Zander....we will be to see you in a few hours.

Wednesday, July 23, 2008 in the Morning

Sorry to all that I did not post earlier this morning. We are getting ready to go down and see Zander. We have been cleaning up around the house this morning. It needed it.
We spoke to Alisha, Zander's nurse about 9:00 a.m. this morning and she told us that he was still fighting on occasion. He is still able to calm himself and hopefully the time will increase between his spats so that the little guy can get some sleep. Alisha also told us that he has lost a little weight, but that is expected.
That is all we know at the point. We remain prayerful for Zander and that his breathing continues to progress with less difficulties. Thanks, as always for the prayers, comments and concerns.
I will write again tonight after we spend some time with Zman today. See you soon little man...

Tuesday, July 22, 2008

Tuesday, July 22, 2008 in the Evening

What a day! God is still in the business of miracles and we received good news today on two fronts. First, Zander underwent an echocardiogram and the cardiologist said that he had a VSD, which is a fancy way of saying that he was not concerned with the pinhole murmur in Zander's heart. He just wanted to run another echocardiogram before Zander was discharged. Whew, one less doctor is a good thing right?
The bigger issue today was the procedure by the pulmonologist. He was unable to go through Zander's right nostril because of the suction catheter and we learned that Zander's left nostril is very narrow and will likely need surgery to open it by an ENT. Oh well, lose one doctor and gain another. However, Dr. Ledbetter (the pulmonologist) inserted the camera into his trachea and lungs through the mouth. He told us that the membranes in the throat are inflamed and the two flaps covering the trachea overlap due to the swelling. He looked at the trachea and told us that there was no stenosis (narrowing) in any part of the trachea and that the voice box and vocal cords are fine. He also told us that he looked at Zander's lungs and the left lung was fine, but he was unable to see the bronchials in the upper right lobe; however, from a practical standpoint this would not hamper Zander down the road. LONG STORY SHORT THE ZMAN IS OFF THE VENTILATOR!
Christie and I spent quite some time with Zander after the ventilator was removed. He does struggle with it since he cannot breathe easily through his right nostril due to the suction catheter or through his left nostril since it is a very small and tight passage. As a result, he is on a C-PAP machine inserted into his nostrils to help him with breathing.
It is hard to watch him breath because every few minutes he begins to cry; however, he does calm himself. He also has an increased amount of blood coming from his chest tube presumably as the result of the test. As we spent time with him, he was able to breath longer before he became frustrated and began crying. When he cried his respiration rate and oxygen would drop and his heart rate would climb. To further compound problems we were encouraged not to touch or talk to him so he could recover on his own and we could actually hear faint cries coming from his sweet little mouth.
We just arrived home from the hospital and Christie, Jackson and I are winding down from a tumultuous, but good day. We will check on the Zman before going to bed. All of the prayers for Zander are working and he told me to tell you thanks. In all seriousness, words cannot adequately describe our heartfelt appreciation for the love we have felt from everyone. Friends, family, hospital staff and people we have not even met have shared comments on the blog and they greatly uplift our spirits and give us strength.
Until tomorrow, sweet dreams and God bless each and everyone one of you. Goodnight Zman, Mommy and Daddy (and hundreds of others) love you and wish you sweet dreams.

Tuesday, July 22, 2008 in the Morning

Good morning! Everyone appears to have slept well in the Covert household last night. Christie and I just called the NICU and they said Zander is sleeping well at this point. His nurse advised us that he had a big bathroom session (1&2) during the night, so we are happy that his bowels and bladder are working well. Zander is now having feedings of 6 ml 4 times per day. Dr. Kelley increased his intake and Zman has not had any residuals (the milk coming back out the tube) as far as the milk being put into his stomach via the gastrotube.
Dr. Hayes, Zander's cardiologist is coming in at some point this morning and running another EKG on the little guy. Zander does have a murmur and it also appears that he has a pinhole in the heart structure. Dr. Hayes said he wanted to run another EKG today to get a better look at the heart no that Zander is less swollen following surgery. We are praying that the little guy's heart is okay.
We will be at the hospital by 1:00 p.m. today for the procedure to be performed by Dr. Ledbetter (pulmonologist) where he will look into Zander's lungs. I am sure Zander will not like be poked and prodded to the extent that he will be today so we also remain prayerful for his comfort through today.
I will post again later today, but for now, Zander is sleeping soundly and liking his mother's milk. We know that each of you have busy lives, but we are so thankful for your prayers, thoughts and comments. We are literally getting prayers and comments from around the world and it is amazing how great God is!
Rest easy precious son...we will see you soon. God bless!
Mommy and Daddy

Monday, July 21, 2008

Monday, July 21, 2008 in the Evening

Good evening all! I hope everyone got off to a good start to the week. since my earlier post Christie and I have met with Dr. Kelley and Dr. Ledbetter at Zander's bedside.
First, Dr. Kelley came in today on his rounds to look at Zander. He removed Zander's bandages around the chest tube and the incision site. After doing so, he removed a few of the staples from Zander's surgical incision site and replaced the staples with steri-strips. He did indicate that a small amount of infection had set in at the site (which is not uncommon) so Dr. Kelley ordered a stronger round of antibiotics for the Z man. He also examined the chest tube and indicated that everything was in order. Dr. Kelley also increased the amount of tension on the traction sutures so that additional pressure would be applied to the proximal (throat portion) esophagus. For obvious reasons, Zander strenuously objected to Dr. Kelley doing everything that he did, but the little guy soon settled down. Although it was hard to watch, I am glad I did so I now better understand how everything works.
After performing the clean up, Dr. Kelley sat down and advise me that he receives daily x-rays of Zander's chest and abdomen. He indicated that it did not appear that the esophagus (throat portion) had moved that much. He said that it was going to be a long road but that Zander was progressing better than he expected. He did not give me any time frames, but he said that Zander was doing better than most of the babies in similar situations. Christie and I are so thankful that Dr. Kelley is so easily approachable and able to answer our questions.
We also met with Dr. Ledbetter, Zander's pulmonologist. He is going to be performing a procedure on Zander tomorrow about 1:00 p.m. Since Zander has now twice rejected being taken off the ventilator (last time was Saturday), Dr. Ledbetter is going to put a camera into Zander's trachea and look at the lungs to see if there are any problems. We are praying that it is just swelling from the trauma to his little body, but Dr. Ledbetter said he will be looking at the lung structures for possible abnormalities as well as to see if there may be any signs of infection.
As a result, the little guy does need prayers and a good outcome on the test tomorrow.
The pictures above are of Zander when Dr. Kelley examined him. These clearly show the traction suture device (orange rods), his surgical incision site and the chest tube. The last picture is a picture of Zander after Dr. Kelley fixed him up and after he received his pain medicine. He is obviously happy to have received the pain meds.
I will write again tomorrow after our visits with Zander and after his procedure...if not sooner. Hugs and kisses to all and many thanks for your encouraging comments, prayers and love.
Sweet dreams are loved by many. We pray for your comfort. God bless.

Monday, July 21, 2008 in the Morning

Good morning everyone. Christie and I, along with Houston were up bright and early this morning. Houston is on his way to Charleston, SC with the youth group for MFuge, a week long summer mission trip. We are sad to see him go, but happy that he is going to serve the Lord. I dropped him off this morning at 5:30 a.m. and he was excited to be with his friends.
After dropping Houston off, I went to the NICU to see Zander. He was waking up and expecting his next feeding of milk. The nurse allowed me to change his diaper. This was the first time that I have been allowed to change his diaper. That boosted my spirits. Zaner is doing well at this point. He is a little jaundiced still, but they are monitoring him. Hopefully his numbers have peaked concerning the jaundice, but they will keep us posted. Dr. Kelley will be in later this morning to look him over and possibly remove his chest tube and make another attempt at removing the ventilator. Zander has a small incision on his belly (made by Dr. Kelley) and the nurse indicated that she has pulled out certain tools for him to use when he comes to see Zander.
Zander is still taking the milk without rejecting it and his digestive system appears, at this point to be working fine. He is going number 1 and number 2 at this point. Like his big brother Jackson he drinks alot.
Christie is at home resting (hopefully). It both really hit us hard after getting home last night, but both of us are constantly uplifted by the encouraging words, comments and prayers from everyone. It truly has been a blessing! Christie will be down to see Zander in a little while. We try to plan to come see him just before feeding time/medication time because that is when he is the most responsive to us.
Jackson was sound asleep this morning when Houston and I left but he has been a big boy over the past few days with his little brother and he has been a great help with his Mommie. Christie is still moving slowly, but she says that she is not hurting to the extent that she did following her pregnancies with Houston and Jackson.
I am off to save the world from any and all legal troubles for the day, but I am planning to take most of the week off to spend time with Christie, Jackson and Zander.
I will write tonight. I hope all is well with everyone this morning. The sun is shining, the sky is blue and it is another beautiful day in Chattanooga. God is good!

Sunday, July 20, 2008

Sunday Night July 20, 2008

Leaving Zander was the hardest thing I have ever done. Although he is in good hands, Christie and I had a hard time leaving the hospital knowing that he was not coming home with us. Prior to leaving though, we had a great morning and early afternoon with him.
When the Houston and Jackson came to the hospital to visit today, I went down to meet them at the entrance. For whatever reason, I turned down the wrong hall and ended up in an outside area for hospital employees. As I walk by, Dr. Kelley, Zander's surgeon recognized me and we talked about Zander for about 10 minutes. This was the first time we talked with Dr. Kelley since the surgery as he has had several surgeries in the past 72 hours. In any event, he proceeded to tell me that Zander's esophagus is about 3 inches from being able to connect. His largest concern at this point is that he does not want to stretch the portion of the esophagus coming from the stomach as it would likely pull the stomach up and out of the abdominal cavity. That brings us to the stomach issue. I have yet to comment about Zander's stomach because I wanted to talk with Dr. Kelley first. Now that I have done so, Zander's stomach is only about the size of a dime. A normal baby's stomach is about the size of a half-dollar. This is a significant concern for Dr. Kelley's plan of attack in that he can really only stretch the throat portion of the esophagus at this point.
To counteract the stomach issue, Dr. Kelley is now allowing Zander to have breast milk. The milk is being pumped directly into his stomach every 3 hours. Since the portion of the esophagus that is connected to the stomach has been closed off for now, Dr. Kelley believes that feeding Zander at this point will expand his stomach. Essentially, the stomach will expand over the next few weeks as they incrementally increase the amount of the breast milk he takes in alot like expanding a balloon.
Dr. Kelley did say that Zander was a tough kid and that over the next two weeks additional tension would be applied to the traction sutures attached to his upper esophagus which will in turn continue to stretch the esophagus southward towards the stomach. He did tell me that Zander was going to be in the NICU for "a while", but alot of Zander's time in the NICU is dependent on the expansion of his stomach and getting the tubes closer together. Dr. Kelley said he did not want to connect the espohagus to the stomach until the stomach was expanded. Doing so too early, based upon his expert opinion would only cause Zander to have significant stomach troubles including acid reflux on a large scale. Basically, Zander will be taking baby steps. Hurry up and wait is now the mantra by which we live.
We are now at home. Although we are close (about 15 minutes away), it is not close enough. It is good to have Houston and Jackson with us as we have missed them dearly over the past few days, but we are thankful that they had a great time in Florida. We are praying that Zander has a good night. We spoke with the NICU and they said that he is not rejecting the breast milk that he is receiving through the gastro-tube. Thank God for small miracles. It will be hard to sleep without him close, but we have pictures at our bedside.
We love you all and hope that each of you has a great start to the week. I will post again tomorrow (or maybe later tonight depending on if I can sleep). As always, thanks for the thoughts, prayers and support.
Sweet dreams Zander. Good night all.......

Zander, Sunday, July 20, 2008

Well, it has been a great 12 hours with Zander. Christie was able to hold him and change him late last night. What a blessing for her. She was overjoyed to be able to hold him for the first time. She and I have been with him for most of the morning and he has been awake and looking at us.
Christie's sutures have been removed and we are cleared to leave at anytime today. I am trying to negotiate a trade for a permanent room in exchange for legal services so we do not have to leave our precious baby boy, but it does not look like it is going to work. We are going to stay for a few more hours and then try to get home. Grandma Judi (my mom) is in with Zander and she will be returning to Knoxville later today. Grandma Pat is picking the boys up from Mark here in a little while and bringing them to the hospital to see Zander before we all head home.
I will write again from home tonight. Again, many thanks and return blessings to everyone for the prayers, comments and love.