Saturday, May 2, 2015

Testing and surgery

Dear Eleanor,

A lot has happened in the past two months since you were born. I told you a little about your diagnosis of Micropthalmia in your right eye. About a week and a half after your were born, a hemangioma birth mark appeared on your face. It was light and small and first but quickly grew and darkened. Your Pediatrician, Dr. Sorensen, said if it started spreading, that could be cause for concern. Once it started spreading, I took you back in and Dr. Sorensen referred you to a Pediatric Dermatologist at Phoenix Children's Hospital, Dr. Gildenstern. Dr. Gildenstern said you likely have PHACE Syndrome (which is an acronym:)
  • Posterior fossa abnormalities and other structural brain abnormalities
  • Hemangioma(s) of the cervical facial region
  • Arterial cerebrovascular anomalies
  • Cardiac defects, aortic coarctation and other aortic abnormalities
  • Eye anomalies
PHACE Syndrome basically means a child presents with a hemangioma bigger than 5cm and has at least one abnormality, although there are usually several unexplained abnormalities. Since they usually come in clusters, Dr. Gildenstern ordered an MRI, EKG, Echo and abdominal ultra sound for you. She was also concerned about the hemangioma spreading on your neck because if there was something going on internally in that spot, it could affect your breathing.

Of course your dad and I googled PHACE Syndrome and read about all of the worst-case scenarios that are posted online. Brain damage, the two sides of the brain not forming together, heart problems...we read that brain and heart abnormalities are the most common with PHACE and that really scared us. We were very worried but tried to remain positive. We had a family fast, where many of your family members fasted for you (including your grandparents, aunts, uncles, cousins and even one of my cousins, Emily Richardson, and my good friend, Heidi Robinson), as well as individual fasts. So many prayers were offered on your behalf. Your dad and I felt a lot of peace after fasting. We felt that everything would be okay with the results and if there was anything abnormal, it was part of the plan for your life and we would get through it together. We were still nervous about the testing, though, since you had to be put under anesthesia for the MRI.

You had all of your tests this past Tuesday, April 28th. After we got to the hospital and checked in, we had a few minutes to wait. Your dad and I found a quiet corner in the cafeteria, where your dad administered a Priesthood Blessing. He blessed you that your body would be able to withstand the anesthesia (etc). It was a beautiful blessing and we were both in tears. After being admitted and talking with the anesthesiologist about the procedure and risks, we waited for the doctor to come get you in a little room. I held you in my arms and paced back and forth, worried sick but trying to be brave. It was difficult for me to hand you to the nurse when the time came. As we waited in the cafeteria during your testing, I looked around at other parents waiting. One mom was leaning over with her head in her hands. I saw worry and concern on their faces. I thought of the parents who come to PCH over and over for surgeries and tests, the children who are sick all the time or battle chronic illnesses. It was humbling. We were relieved when we were able to see you. You were on a patient bed in recovery, being monitored by a nurse. I was able to feed you Pedialite and then formula, which you happily ate (you couldn't eat formula for hours prior and were hungry). We had to wait two days for the test results, which we received at your follow up appointment with Dr. Gildenstern. Every test came back with negative/normal results. Hearing that was such a huge relief! We felt so grateful and continue to thank our Heavenly Father.

The next hurdle was your eye surgery, which was only a few days later, on Friday, May 1st. Your dad bought a 3-D model eye and showed Oliver the different parts of the eye and explained what the doctor would be doing. We did this for Family Night the Monday night prior to your surgery. We had to go over it a few times because Oliver thought the doctor was going to take out your whole eye. It was fun to see him learning about it.

For as nervous as I was for your MRI and other tests, I was much more nervous for your surgery. I jotted down a few thoughts on a Facebook post the night before:

"This mama is feeling a little nervous tonight. Our sweet little girl is having eye surgery in the morning. For those who don't know, Eleanor was born with an abnormality in her right eye called Microphthalmia (which is fairly rare; it occurs in 1 in 10,000 babies and the cause is unknown). Basically, her right eye stopped growing at 20 weeks in utero and is smaller than her left eye. We don't yet know if she will have vision in her right eye but she does have cataracts on her lens, which will cloud any vision she may have. Her surgery tomorrow is a lensectomy to remove the lens. The thought of my little two-month-old going into surgery has my stomach in knots but we're trying to remain positive. On a very positive note, we thought she may have other internal abnormalities, so she had to have an MRI, EKG, Echo and an abdominal ultra sound earlier this week and all tests came back with normal results. We are so grateful and relieved. This is one special little girl. We love her so much."

So many people commented and offered their support through prayer and positive thoughts. It was helpful to have that support cheering us and you along. I'm copying those comments here so you can read them:

Vilma Estrada Praying for your loved little one, she is so blessed having such great loving parents.

I was pretty emotional on the day of your surgery, especially when they started prepping your for surgery (having us get your gown and socks on, taking your vitals, having us sign consents). I was really trying to be brave but it was difficult. I felt much better after talking with Dr. Bryan (your eye specialist whom you see regularly and performed your surgery) and the anesthesiologist. I trusted they knew what they were doing. I was okay during the procedure as we waited. I really felt okay about it. 

You were crying because you were hungry and couldn't eat before surgery. 
It was such a relief to see you after your surgery. I got tears in my eyes as I saw the nurse feeding you Pedialite. Everything went smoothly. Dr. Bryan said there were not only cataracts on your lens but other things clouding your vision, which he removed. He drained some of the fluid from your eye and was able to get a good look at your retina, which he said is still in tact. He believes you will have vision in your right eye; it will just be a matter of training your brain to use it. We will need to put a patch over your left eye to help with that process. He also thinks you will likely need to wear a contact in your right eye. When you are older, you will have a prothetic lens put in your right eye.

Feeding you after your surgery. I felt such love and gratitude as I looked at you here. 
Some more comments after I posted that things went well:


You are one loved little girl. At only two months old, you have already been through a lot. You're going to be a strong person. I have no doubt you will see adversity and go through difficult things but these things will make you stronger. I hope you never doubt your worth. Your dad and brothers and I love you so much! We are so grateful you're in our family. 

Love, Mom


Monday, March 16, 2015

One-Week Photo Shoot

I love this happy little milk smile.

You are absolutely beautiful. We love you, sweet girl. Love, Mom

Sunday, March 8, 2015

The story of your birth



Dear Eleanor,

You are finally here (and finally have a name)! You were born one week ago from today: Monday, February 16th at 6:53pm. We are so happy you're here. You have filled our home with your sweet spirit and disposition. We absolutely adore you.
Six days old. 
We arrived at Banner Desert Hospital in Mesa a little after 7:00am for my scheduled induction. After filling out the paperwork, our nurse, Liz, escorted us to our "new home" (as she called it). I put on a gown and got "comfortable" in the hospital bed. 


Since I'm positive for Group B Strep (I was with your brothers as well), I had to have four hours of penicillin, then wait a couple of hours and have more penicillin. My doctor started the induction process with a balloon catheter, which took me from 3cm to 5cm while I was receiving the penicillin. Like with Josh, the penicillin was the worst part for me because it felt like my left arm was on fire for hours as the penicillin traveled through the IV. Liz would turn the dosage down, which felt so much better, but would have to turn it up again after a short time so we could complete the dosage before starting the induction. At 3:45pm, I was 6cm and 80% effaced. The contractions weren't too bad; I really tried to focus my breathing through them and it helped. A little after 4:00pm, I started feeling cold and shaking, which I knew meant I was getting closer. I felt I was at a 4 or 5 on a 1-10 pain scale. I knew I wanted an epidural (unexpectedly not having one with Oliver was a bit traumatic for me) so I got the epidural before starting the Pitocin, even though the pain wasn't too intense yet. The epidural made me a little nervous this time because I felt a bit of cramping in my back when it was administered but I was told this was normal (I just don't remember it from my epidural with Josh). I was told the anesthesiologist was the best and could do this with her eyes closed. That made me feel a little better. After getting the epidural, I felt so much better. So warm and relaxed, I almost fell asleep during the Pitocin (I had only had 3.5 hours of sleep the night before; I just couldn't sleep, which was so frustrating.). By 5:40pm, I was at 8cm and 90% effaced. Dr. Labesky came a short time later to break my water. Not long after that, I started pushing. I only pushed for 12 minutes and then heard your sweet little cries at 6:53pm. 
Left: Alex (Dr. Labesky's intern), Dr. Labesky, and our nurse, Kristal. They were all amazing. I love my doctor! We were sad Liz's shift ended and she had to leave (the nurses refer to leaving before the baby is born a "Labor Looser") but Kristal was also an amazing nurse. We loved all of the staff. 

They laid you on my chest and my eyes filled up with tears. It's such an amazing feeling to hear those little cries for the first time and to see you for the first time. It almost felt surreal. I felt gratitude and love wash over me. My first thought when I saw you was that you look like Oliver did when he was a newborn (your dad told me he thought this when he first saw you, too). 




(More pictures - being weighed, Wendel putting diaper on, etc.) 

We wanted Grandma, Oliver and Josh to be able to see you that night but we had to stay in the L&D Room for two hours before being moved to the Recovery Room (where visitors are allowed), so they had to wait until the next morning. Oliver was so excited to see you the next morning. Josh was a little apprehensive but also very curious. 


I love these pictures. Your brothers love you so much. It was so sweet to see them meeting you for the first time.
First picture as a family of five.
Choosing your name wasn't easy for us. We had a difficult time choosing your brothers' names, too. Your dad likes to wait until after he sees you to decide on your name. I love older, classic names and really wanted to name you Kate, which has been on my name list since 2008. I liked the name Genevieve for your middle name because it's a family name (my maternal great grandmother's name and my paternal great grandmother's middle name. Both women were wonderful, charitable women. I was reading recently about my PGG. She met a man on a bus who needed dental work done so she took him to a dentist and paid for the work to be done. She also saw a little boy who needed a coat so she bought him one. What a great example to look up to!) Your dad liked the name Genevieve for your middle name but didn't like Kate for your first name at all. He felt it was too popular and just didn't really like it for your first name. But there weren't any other names he felt strongly about. And he wouldn't discuss names until after your birth, which was stressful for me. 

The day after your birth, one of the nurses told me she was a little concerned about your right eye because you weren't opening it. She said it looked like it was fused shut and she had called a specialist to come look at it. She told me he would likely have to cut it open or you might possibly need surgery to open it. 

So we were sitting in the hospital room, you asleep in the bassinet between us, discussing names the day after you were born. The eye doctor, Dr. Underdall, would be coming soon, and we had a little time to ourselves before he arrived. Your dad was looking up names online and said, "What do you think of Eleanor?" We had friends back in WA who named their daughter Eleanor years ago and at the time, we had both said we really liked the name. I still liked it but wasn't sure if I wanted to use it. You dad read the meaning: "A light that shines in darkness." Right then Dr. Underdall walked in. The nurse had already put numbing drops in your eyes. He used a metal clamp to open your right eyelid so he could examine your eye. The nurse assisted him, which they did in a far part of the room, so we couldn't see. It hurt my heart to hear you scream the way you did. We expected him to tell us he would need to cut your eyelid open or something along those lines. Instead, he told us you were born with Microphthalmia, which means your right eye is about half the size of your left eye. He said your right eye stopped developing in utero, around 20 weeks. He said he could see cataracts on your eye and that you would likely need surgery to remove them. He said you may not have vision in that eye. He referred us to some specialists in the valley and then left. 

Two days later, still in shock and feeling uncertainty, we were sitting in the waiting room at the Retina Specialist's Office in Phoenix. Your dad again brought up the name Eleanor. I needed to let it sink in a little more. I liked the name and liked the meaning a lot. I just didn't like making such a big decision under pressure (we had to let the hospital know by Friday and it was Thursday). 

At your appointment, Dr. Bryan did an ultra sound of your eye and found cataracts and a thin rod, connecting from the back of your eye to the front. He said usually this rod goes away in utero but didn't in your right eye. He said surgery would be necessary to remove the rod and the cataracts, to give you the best chance for vision in that eye. He also said it looked like the retina was attached but surgery would let us know for sure. He wanted the surgery scheduled when you were one month old. The thought of my little one month old baby having surgery made me nervous. It was a lot to take in in only a few days. He said considering the spectrum of Microphthalmia, you are on the better end of it. You have an iris and a pupil. Your retina appears to be attached. You may have vision in that eye. 

Your dad and I talked on the way home about what a special girl you are. We talked about the strengths you will be blessed with to help you in this life and how you are blessed with wonderful older brothers to look out for you and be an example to you. We talked about how we hope we can be what we need to be for you. We let our tears freely fall as we talked about these things. We then decided Eleanor is the perfect name for you. You may not have vision in one eye but you will always be a light shining in darkness. I requested Kate as your middle name. I still liked Genevieve but I liked how Kate sounded with Eleanor. It took your dad a few minutes to think it over but he agreed. We think we'll call you Norah for short. We have always loved Norah Jones' music (The Long Way Home was our wedding song) and considered Norah for you as an option for your first name, so it seems to be a fitting nick name. 

We love you, sweet girl. You have already blessed our family with your sweet, amazing spirit. I look into your eyes and mine fill up with tears because I can feel the Spirit. We can't wait to see the great things your Father in Heaven has in store for you here on earth. We're so glad you're here.