Home Again, Home Again, Jiggety Jig

The last seven days have been as busy as a barbershop on Saturday morning. They have also been bereft of any communication between myself and the Internet. I came home today to 157 e-mails, dozens of Facebook notifications, and a ream of blog posts to read through. Having caught up on those things with as much thoroughness as can be reasonably expected, I'm now ready to write my own blog post about all the happenings of the past week.

Sunday morning, we woke the twins early and left the house by 7:30am to head up north for my sister-in-law Jessica's college graduation. Jessica now has a degree in early elementary education. She is moving to our neck of the woods for the summer and looking for a teaching job down here so she can stay on through the school year. I'm hoping that she finds the perfect job to keep her in the Portland area!

Jessica and my three other sister-in-laws: Amy, Rebecca, and Nancy

After the graduation we enjoyed a wonderful celebration at the Ives' home. Since all of the Spears family was there, it was a good time to snap a family picture.

Right before we left Jessica's party, David and I shared our big news: baby number 3 is on the way! Or is it babies 3 and 4? Twins again? I should probably schedule an ultrasound.... Approximate due date is January 31, 2012.

It was almost 10pm when we got home Sunday night, with two very cranky little boys. But there was no sleeping in the next day--we got up early again and loaded up the cars to go to the beach for our annual church camp at Twin Rocks Friends Camp in Rockaway, OR.

Yes, I did say "cars," plural. Now that we are a gigantic family of four (soon to be five), we can no longer fit all of our vacation gear into one vehicle. Two cars gave us enough room to bring down the twins' Exersaucers, which made life at camp much happier for both them and us.

Oliver and Adam scrutinize a daisy - "Is it edible?"

Going to camp with children was an entirely different experience than going as just a couple. But thanks to all the help we got from family and friends, it wasn't horribly difficult. Probably the best part about our time was watching the twins enjoy new experiences in the great outdoors.

Oliver blows bubbles in the sun

Adam adores Auntie Jessica

The Pacific Ocean was one such new experience. Oliver was quite fond of wading in the frigid water. Adam, not so much.

David, Oliver, and the Twin Rocks in the background

We had a marvelous vacation, but now we're back to real life and all that entails--catching up on a week's worth of laundry, childproofing electrical outlets, painting the kitchen, and starting the manuscript for Book Two of The Chronicles of Tancred.

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Many thanks to Auntie Amy for all these great pictures. I like to think that the reason we didn't take any photos ourselves is because we were too busy taking care of our kids the whole week--but it might be more accurate to just call us lazy. Oh well....

Shelve It

Last week was spring semester finals at George Fox University, which means that this week is the first week of my husband David's summer break! After he has been studying so hard for the last several months, it might surprise you to learn that the first thing he did for his summer vacation was hit the books.

Ever since our whirlwind move (and Adam's double surgery) in January, our books have been either shelved haphazardly or piled in disorganized heaps on the basement floor. But chaos reigns no longer.

We found a great place for our favorite bookshelf in the living room and filled it up with our ancient, medieval, and early modern history titles. Coincidentally, these also happen to be our favorite books. My husband and I frequently congratulate ourselves on how well the history libraries we acquired during our single years now complement each other--an added benefit to married life.

The basement bookshelves got a complete makeover with the sections sorted out into theology, language books, reference books, poetry, fiction, political science/economics, and photo albums. Notice our handmade   Turkish rug brightening up the floor--a Craigslist find from a few months ago.

Books weren't the only thing on the agenda. A quick trip to Ikea gave us this floor length mirror. I don't know which was the harder feat--fitting it into the car or bolting it into the wall.

Another project needing attention is pictures! Our walls have been sadly bare, but that is on the mend. Above is a collection of framed art I put together by cutting the spine off a Dover book, Great Medieval Churches and Cathedrals of Europe.

This morning we made a paint run to Home Depot, so hopefully I will soon have pictures of a "cotton fluff" white kitchen (instead of one with seven different psychotically applied colors) and a green "geranium leaf" master bedroom with white trim (instead of curry yellow).

The twins have been troopers through all of our renovating and running around, enjoying their time on the front porch whenever the weather's nice enough to go outside.

Fifty-fifty

Yesterday was our two-week appointment with the surgeon to evaluate Adam's progress after the operation. Originally, he had told us the odds of the Kasai procedure solving the problem of Adam's biliary artresia were one out of three. One third of the time it works without a hitch. Another third of the time the bile starts flowing initially, but then a few months or years down the road, it stops working. Another third of the time it doesn't work at all.

Praise God, we don't have to worry about the last of those scenarios. Adam's bile is now flowing from his liver into his intestines. His color is getting better--there's just a little yellow tinge to his skin instead of the fake tan orange he was before the operation. As the surgeon put it, "We've got a fifty-fifty chance now that this will keep working and he won't have to have a liver transplant. But even if the procedure does fail eventually, at least this will give him time to grow bigger and to be a more viable candidate for the transplant should he need it."

 

This is a recent picture of Adam. Looking at the picture, you may notice several things. (1) He is wearing a "designer" onesie made by Rebecca Spears. (2) His cheeks are all puffy from the steroids he is taking. (3) He is screaming his head off. This behavior has been very typical for him over the last week. His medication has made him very, very cranky and David and I are starting to go a wee bit crazy from lack of sleep. It's kind of like the first few weeks after the twins were born, or maybe even a little bit worse.

If you would like to continue to keep us in your prayers, our short term prayer request is that Adam will sleep more and cry less. Our long term prayer request (for the rest of Adam's life) is that the Kasai procedure will continue to work.

Thanks for reading and praying! And just to give the twins equal opportunity with the pictures, here's one more photo before I sign out.

Oliver, chilling in his track suit.

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.

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.

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!

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!