"Hope is not blind optimism."

Says Barack Obama...

We had a great visit this week with Dr. MacLaughlin, a neurodevelopmental pediatrician at Children's Hospital. He said based on Owen's MRI, which had not been so carefully and compassionately reviewed with us, image by image, until this visit, that he "expects Owen's vision will improve." He also said that children like Owen require even more calories than "normal" babies as they are not only trying to grow, but trying to heal, to recover from an injury. He has over 35 years of experience in his field and said he's seen so many parents struggle with "the tube decision." He encouraged us to have hope - for many things.

We have decided to move forward with a G-tube (tube inserted directly into the stomach), which will be placed sometime in late March. The NG tube is a temporary solution, and is working great, but has its disadvantages. With a G-tube, Owen will hopefully take better to solid foods and will have less discomfort than that associated with the NG tube. He is fattening up and the tube has almost entirely eliminated the vomiting. He is even more adorable with healthy amounts of sweet, sweet baby fat.

We have been very sleep deprived the last three weeks... So many of you have emailed asking about Owen - I'm sorry to have dropped off the blog-o-sphere. We appreciate all of you making the effort to stay connected. After a slow process of elimination, we determined that Owen was awake and very agitated (screaming) almost every hour during the night these long three weeks due to the Zonegran that he was taking for seizure control. We now give this to him in the morning, instead of right before bed as had been prescribed. We are all now sleeping soundly.

Owen has resumed experimenting with smiling and does this repeatedly each day. It makes our heart melt each and every time. He is now also cooing and making noises, especially during the night. It makes Kelsey and I laugh with joy, even at 3:00 am. He is in his last week of the ACTH injections.

Life seems to be somewhat normal for us - something that was hard to imagine even just a couple of months ago. There are no crises. No emergencies. No seizures. We all know and understand each other and there is no longer any guessing as to what might make Owen happy or content. He enjoys the sounds of the garden and the warmth of the sunshine. And Kelsey and I enjoy cooking in the evenings - really cooking - wonderful dinners each night. We are getting out into the garden (our kale, lettuce and radishes are up), are doing some additional landscaping in our yard - moving soil, digging in one-man rocks, terracing new vegetable beds. Our garden this year will include a melon patch, a sweet corn and sunflower bed and a section of garden with trellises for sugar peas, pole beans and cucumbers. We are making plans for travel this summer and are feeling overall more settled. Owen and I spend many of our early mornings, laying in bed, snuggled up together with me appreciating the last vestiges of his babyhood, knowing that these will soon be memories, as are, already, so many of the experiences we've had with him.

The photo below was taken on a recent walk to the beach to observe the lunar ecplise. Ahhh, the beauty and the wonder.

Honestly...

I've had a number of people lately comment on how it seems as though we are so positive, and that we seem to be such a happy family - but they suggest that this situation must be so painful for us as well. It is. In fact, there are few things that I can imagine that would be more painful than what we are experiencing right now. And the pain is not just felt by the three of us. It extends to our sets of parents, our siblings and to so many family and friends. There are so many people who are affected that sometimes it is unbearable to think about all who are hurting and concerned. But I don't know of a single person in our large web who is not positive or hopeful. Kelsey and I agreed a long time ago that we would do everything in our power to make Owen's life the best we possibly could. To pity him, to pity ourselves or to give up hope would rob him of that right, the gift of life at its best. This doesn't mean we don't have bad days, that we don't get tired of going to the hospital, that somedays things don't feel incredibly overwhelming, that we don't feel angry and wonder why this is happening to our child. We are only human. But the most recent developments remind us that the balance we have right now is very, very fragile and that we must appreciate Owen and each day at hand.

We had another BIG day at Childrens on Wednesday. Owen had a lumbar puncture to obtain spinal fluid for the tests to determine whether he has any treatable metabolic disorders. One is already back and turned out negative. The rest have been sent out to Baylor and won't be back for another week or two. The doctors suspect that these will come back negative as well. Owen also had an EEG which definitively illustrated infantile spasms. We then met with Dr. Simon, the Attending doctor who has been following Owen most recently, and Tim Feyma, the Fellow who saw Owen initially in August.

We were told in our meeting that four doctors (two chief neurologists and two fellows) completed a full review of Owen's records and this, coupled with the results from the chromosomal and metabolic disorders, have led them to a final diagnosis of hypoxia during labor/delivery. They can never be 100% sure in any case, but Dr. Simon feel confident that this is a correct diagnosis. According to the line of thinking at Childrens, a steady heart rate during labor is not always indicative of a healthy baby. They have seen on several occasions where a heart rate never dropped but the baby suffered from hypoxia. Owen's heart rate was monitored continuously during labor and never changed dramatically enough in one direction or another to indicate that there was a problem. According to the doctors we've talked to at Childrens, these events happen, in both hospital births and home births, and Owen was unfortunately one of those who seemed to be just fine, but at some point, wasn't.

The team of doctors had not fully reviewed Owen's EEG and various tests from Tacoma General when they started leaning towards a metabolic issue (versus hypoxia) after the MRI results from last week. The MRI initially seemed to indicate a metabolic disorder, given how globally the brain was affected and how there didn't seem to be any focused scarring at any particular point in the brain. They now realize that what they are seeing is considerable damage throughout the entire brain which indicates a major hypoxic event. This fits with Owen's first few EEGs - almost flat lines - with the hyponatrimia at birth and with the slow growth of his head over the last four months. It also fits with the recent development of infantile spasms, which indicate a serious underlying problem. Fortunately, somehow, Owen's other major organs were spared, which certainly gives him a better chance than most babies with this type of diagnosis.

We will be back at Childrens soon, as early as next week, to begin ACTH (the steroid used to treat infantile spasms), to get Owen on a G-tube (a feeding tube inserted directly into his stomach), to get further genetics testing for all three of us (as a precautionary measure) and to get Owen seen by the neuro development team to address issues of high tone. The ACTH may or may not work - it is our best hope. Cross your fingers, toes, light a candle, pray... we really need this to work. Owen is miserable right now and has so many seizures that we've stopped counting. We will have a couple of days of training on the administration of the ACTH at Childrens and then will be sent home to give Owen his shot of this every day for 2-4 weeks. If it doesn't work in this period of time, then it won't work at all. Regardless, it is a short course and we won't have to give it to him for more than a month. The G-tube will allow us to do a continuous drip of food at night. This will get Owen the nourishment he needs, will reduce the chance of aspiration of milk into his lungs and will hopefully allow him to get better, consistent sleep at night. We held out as long as we could, and hoped that we could get him the food he needed by mouth, but with the Zonegran (appetite suppressant) and the seizures (which make him even more prone to throwing up), he's back to gaining very little weight. We just can't let this go on.

I felt ready enough recently to look back into my mother blessing book which is filled with all of the lovely words given to me by many of the women in my life shortly before Owen was born. I wanted to share a poem that my friend, Angela, sent me. As intensely painful, shocking and challenging the last four and a half months have been, this poem illustrates why it is that my experience is also a treasured gift.

She Who is A Mother

A miracle occurred when the infant was first laid in her arms.
She was transformed from a woman into a goddess known as "mother."
She thought shed known the depths of love.
She though she'd seen the heights of success.
She thought she'd experienced that which is true joy.
But nothing compared to this.
All else faded when her baby drew its first breath,
and she became a co-creator with God.

-Kukana-

I've included a few photos from Grandpa Marshall and Nai Nai's visit a few weeks ago. We are so thankful to have such wonderful parents and their visit was a cherished one.

From Indianola,

S/K/O

What in life is gained without something lost?

It is such an intense and powerful lesson to learn - perhaps one of life's hardest.

Everything was perfect and perfectly planned. My pregnancy was easy, beautiful and seemingly without complications. Kelsey and I joked... how could raising a child be any harder than bringing up the GFC baby? The garden was ready for a few week hiatus from the hands of its resident care takers. The nursery was complete - a lovely second-hand crib, local art on the wall, a driftwood and shell mobile from findings during my walks on Indianola beach. We waited...

All parents have an idea of what they think their children will be like and what their experience of parenting will be like. I've gained so much in my loss... I know Kelsey would say the same.

I have an acute awareness of what really matters. I am thankful everyday that Kelsey, Owen, our family and our friends are in my life.

I have an understanding of the tenuous balance that exists in matters of life, health and death.

I have a deeper sense of myself and my connection with all other living creatures.

I haven't written for several weeks as things changed dramatically just four days after my last posting (during Grandpa Marshall and Nai Nai's visit) and we've been trying to cope, regroup, get further testing, and figure out how to move forward.

Owen began having seizures on November 3rd, what an EEG deemed a few days later to be "pre-infantile spasms." Since then, these have progressed to full infantile spasms, as evidenced by their timing, physical manifestation, etc. An EEG tomorrow will, no doubt, confirm this diagnosis. Infantile spasms are very rare, very difficult to treat and indicate that there is a serious underlying problem. Owen currently has 6-7 episodes a day, upon wakening, with clusters of 30-40 during each episode. They have left him very, very tired. He's not eating well or sleeping well. We started him on a medication, Zonegran, for these two weeks ago. This has not helped. The next step is ACTH - a steroid with pretty intense side effects.

We decided to move forward with an MRI, which Owen had a week ago and were very surprised to learn the results. Although they aren't 100% certain, the doctors feel that the MRI has potentially ruled out a hypoxic event (lack of oxygen) either inutero or during labor and delivery. They saw little, if any, scarring (cell death) or any structural abnormalities. What they did see is that Owen's brain is not growing as it should. They've done all of the chromosomal analysis and testing for the more common metabolic disorders, and they've all come back negative. We are now exploring a small number of rare, treatable metabolic disorders and the larger number of rare, nontreatable disorders. This will include more visits to Childrens, more blood draws and a lumbar puncture (spinal tap).

The singer, songwriter, feminist, and beautiful human being, Ani DiFranco, is one of my favorites. The lyrics from Buildings and Bridges have been running through my head, especially the following...

buildings and bridges
are made to bend in the wind
to withstand the world,
that's what it takes
all that steel and stone
are no match for the air, my friend
what doesn't bend breaks
what doesn't bend breaks

I'd like to think that I've also learned to be very flexible - in my belief of what's possible, in my ability to move through each new set of challenges and in my ability to go from conversations with doctors about what might be wrong with my beautiful little boy to appreciating everything that is right about him, right now.

Remember to be truly thankful this Thanksgiving. Give your sons, daughters, wives, husbands, lovers, family and friends a hug and let them know how much they mean to you and how much you appreciate them - today. We never know what tomorrow may bring.

Happy Thanksgiving,

S/K/O