Monday, January 31, 2011

This Trailer's not Trash

In the last year or two, book trailers have emerged as a novel way of promoting books. I remember watching the trailer for Sense and Sensibility and Sea Monsters and getting a good laugh out of it.

Today I saw a well done trailer for a new historical fiction book, Pale Rose of England, by Sandra Worth.




I have no idea how this book will read, but this trailer makes me want to get it and to learn more about the company that produced the trailer itself. Last spring, my husband put together a low budget (or should I say, no budget?) trailer for I Serve. As an amateur effort, it pleased us both immensely, but it would be fun to see what a professional company could do to produce a trailer for my next book, Road from the West.

Thursday, January 27, 2011

The Waiting Game

Many of you have asked for updates on Adam's condition. "Did the surgery work?" The reason I have been silent for a week is because we just don't know yet. The surgeon told us it might take a couple weeks after the surgery to see improvement in his skin coloring and bilirubin levels. I have two doctor's appointments next week, one with the surgeon and one with Adam's pediatrician. Hopefully those appointments will give us some answers, and Lord willing, they will be answers that we want to hear.

In the meantime, Adam has been recuperating well from the surgery. He is definitely fussier than normal, but he is still sleeping solidly at night, usually four hours at a stretch (a huge blessing for me!).

In the picture above you can see the gamut of medications he is on: oxycodone and ibuprofen for pain management; simethicone to help with gas distention; prednisone (the big bottle), a steroid to prevent inflammation; omeprazole, to reduce the heartburn created by the steroid; an antibiotic, the proper name of which I am not even going to try to spell; and last but not least, a multivitamin to make up for deficiencies caused by the jaundice.  

As you can imagine, getting him to take all those meds is no picnic either for him or for me. The only one that he seems to actually like ingesting is the oxycodone--which is also the only one that he'll stop taking in the near future. Our mornings are spent with lots of crying, pinched cheeks, forced swallowing, and attempts to avoid vomiting everything that made it from the syringe into the stomach.

In the midst of this severe trial, it's still a joy to watch both the boys growing older. Oliver just moved up to 3-6 month clothing this week and Adam will be soon to follow. They've both been enjoying their new dangling toys, courtesy of cousin Phinehas, and David's MacGyver mobile made of foil has also been a big hit.

We've also been completely overwhelmed by the kindness of our church family with all the visits, meals, love, and prayers. Thank you, thank you, thank you from the bottom of our hearts. Please continue to pray for Adam, and I will be sure to give an update next week when we find out more information.

Adam placidly plays with the new toys.

Oliver attacks the new toys.


Thursday, January 20, 2011

Hospital Happenings

It's day four at the hospital for Adam (or day eight if you count last week's stay at Doernbecher). Things are looking up, and we are looking at the possibility of going home tomorrow. Maybe. You never can say for sure with these things.

Yesterday Adam had the tube taken out of his nose. Today he got his epidural taken out and his urine catheter. He started drinking clear liquids again last night and has had four feedings of formula today. Our nurse said that he's healing up much faster than the previous two Kasai patients she attended.

The big topic of conversation after a surgery like this is--of course--poop. Adam pooped. Several times. It was green and dark brown. This is good. It means that the bile is starting to flow from his liver into his small intestine. Our surgeon took a picture of it as a teaching tool for the residents. I did not take a picture of it, so you will just have to imagine what it looks like.

It's much too soon to say if the operation has been successful but the early signs are good. When Adam goes home he'll be on steroids and antibiotics for a long time, a year or more. His condition needs to be monitored regularly, and we will have dozens of follow-up appointments with different specialists. I'm pretty sure that "going to the doctor" will be a large part of Adam's life for the next several years, but scads of medical appointments are a small price to pay for the gift of being alive.

Praise God from whom all blessings flow!

Adam, a lot happier now than he was after the operation on Monday.

Adam, enjoying his dose of morphine.

Meanwhile, Oliver enjoys his vacation at the Hayes home...

...and successfully convinces Aunt Amy to let him pose for some pictures.

Monday, January 17, 2011

Doernbecher Take Two

Today was Adam's second surgery at Doernbecher Children's Hospital. This time the surgeon did the full Kasai procedure to correct his biliary artresia. The surgery went well, but we won't know for a couple weeks whether Adam's liver will cooperate and start draining bile into the loop of small intestine that is now directly attached to his liver. In the meantime, we will probably be in the hospital for about a week. Adam is still on an epidural to handle his pain and on antibiotics and steroids to keep down the inflammation and to help the liver accept the new state of affairs. They say that the steroids will make him swell up like a balloon, so now our twins might start looking more identical.

On the way to the hospital this morning we saw a vivid rainbow above the city of Portland. It was a beautiful reminder of God's covenant with us and how He fulfills his promises to His people. "All things work together for good for those who love God, for those who are the called according to His purpose." (Romans 8:28)

Oliver and Adam play on their blankets while we pack our bags for the hospital.

Aunties take care of the boys in the surgery waiting room.

Adam getting a last minute hug before going down the hall to the operating room.

Oliver conks out on Auntie Jessica as we wait.

The Lortz family likes to play games, even in hospital waiting rooms.

Our little boy fresh out of the operating room, with breathing tube, heart monitor, and a wicked new scar.

At least he's too doped up to feel much right now.

Still cute, even after five hours on the operating table.

 Sleep tight!

Saturday, January 15, 2011

Vicissitudes

The latest news on Adam is that we checked out of the hospital last night and will be checking back into it on Monday.

Yesterday afternoon I spoke with the surgeon. He has been working on Adam's case all week. When he did the cholangiogram during Adam's surgery on Tuesday (inserting contrast to show where the bile ducts are in the liver), he said that he thought he maybe saw some small ducts connecting the liver and the intestines. He also saw very few bile ducts inside the liver (typical of the Alagille Syndrome). This led him to doubt whether Adam had biliary artresia and so he decided not to proceed with the Kasai (connecting a loop of the intestine directly to the liver).

The GI doctor agreed that perhaps Adam's jaundice is a result of the Alagille Syndrome instead of biliary artresia. Over the last few days they have been running scads of tests to determine whether this is the case: liver tests, heart tests, eye tests, skeletal tests. The surgeon got the pathologist to speed up his examination of the liver biopsy, and yesterday the results were in. It is most probably NOT the Alagille Syndrome and it most probably IS biliary artresia, the original diagnosis.

Although the biliary artresia diagnosis is not 100% positive, the surgeon has decided that he now needs to do the Kasai procedure since the only other option is a liver transplant. This procedure has a much greater chance of succeeding in patients who are less than three months old, so time is of the essence. We are scheduled to check in for surgery at Doernbecher at noon on Monday and the surgery is supposed to start at 1:30pm.

It is more than a little disheartening to be back to square one. Please pray for Adam to stay healthy for the surgery and not suffer too much when he has to go back on his clear liquid diet for 24 hours before the surgery. Please pray for me to be able to take care of both twins and handle the emotional stress well. Please pray for David to be able to juggle work, school, and family during this difficult time. And most of all, pray that the surgery would be successful!
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