17 August 2012

Home again and other good news

After a long morning of travel and a completely uneventful flight, Seren and I are home and in our own beds. Porter and Stephen were very happy to see us, but since Stephen is working today (in-service before school starts), we weren't able to spend much time together. Good thing there's an entire weekend ahead of us!

Seren's eye looks great. There's no bruising or redness of any kind. She's unhappy about having to use antibiotic drops for the next 5 days, but it's better than getting an infection. When it's all over, she'll be grateful we put in the extra effort to do everything correctly.


I didn't mention it before, because I didn't want the news to be overshadowed by Seren's surgery, but while we were in Anchorage, I received a pretty important phone call. Right after we all returned from our cross-country excursion, Porter and I both had our annual doctor visits scheduled. Porter had some blood work done and the results are in...

You may recall that Porter has had a struggle with some food allergies during the last year. At one point, we had removed milk, soy, wheat, eggs, and peanuts from his diet entirely. To make matters worse, he would break out in head-to-toe eczema when exposed to these foods, in addition to the gastro-intestinal problems they caused. We did our best to make sure he was able to eat "real" food that tasted good, despite all of those missing ingredients from his diet.

Well, the call I received was from our family doctor. She said that his allergy screen came back 100% negative! That's right, he can eat ANYTHING he wants again... with one concession: although he is no longer allergic to these foods, he may still have a sensitive stomach when exposed to them. So, we have to watch for signs of discomfort, but aside from that, he is entirely in the clear! We are very happy about this and extremely proud of Porter for doing so well in situations when foods he was not allowed to have were present. In fact, when he was given his first egg this week, he had to be convinced it was okay to eat it!

Thank you all (again) for the love and support while we dealt with this. This last year was a struggle, but we're on the other side now and truly grateful for all of the tips and advice that were sent our way. We wouldn't have been able to find some of the wonderful foods we discovered on this journey or cope with the dramatic change to our dinner table without your help.

16 August 2012

Anchorage: Day 3

The alarm went off at 4:45am this morning, so that I would be able to get myself showered and ready and still have plenty of time to rouse Seren, get her dressed, and meet the cab at the front door by 5:45am. Poor Seren didn't want to wake up--she even told me she'd rather sleep than get her eye fixed, but minutes later, we were brushing our teeth together and she was slowly preparing herself for the long day ahead. The cab was 5 minutes early, but so were we, and we arrived at ANMC just before 6am. We waited at main registration for the morning shift to arrive, attached her admittance bracelet to her ankle (it was way too big for her wrist), and headed upstairs to the Day Surgery clinic at around 20 minutes after the hour. We had about a 15-minute wait before we were taken back to the surgery prep area, which was plenty of time for Seren to get silly with excitement about her procedure. She was given a child-size hospital gown with sleepy tigers on it, a pair of disposable slipper socks, and a mesh head covering.

Seren being silly in the waiting room

More silliness

Taking vitals before the big show
...And then the bomb was dropped.

As I mentioned previously, Seren has a bad case of trypanophobia. So bad, the mere mention of an IV to administer anti-nausea medications to counter the side-effects of the general anesthesia turned that bright and happy little girl you see above into this:
This is not the face of a happy little girl.
 She was crying hysterically and completely inconsolable before we had even been given the definitive word on the IV situation. Finally, I did the only thing a good parent can do in these situations: I lied. I hated it. It made my stomach turn to be that deceptive, but it was the only way I could get her to calm down. I said, "Let's try this. How about if the nice nurse right here [wink, wink to the nurse beside me] gets you a Band-Aid to put on your hand, right here? That way, when you wake up, if the Band-Aid is gone, you know they poked you, but if it's still there when you wake up, you know you're alright. They can't put the needle in your hand through a Band-Aid, right?" The nurse caught my drift and had a Band-Aid waiting before I even finished my talk with Seren. Seren accepted the conditions, although hesitantly, but it was enough headway to get her to take a dose of Versed to calm her down enough to take her into surgery. Another 20 minutes went by and she was singing nonsensical songs to the stuffed animals the nurse gave her to hold. And then she was wheeled away.

My next stop was the cafeteria. I certainly wasn't sitting around in that waiting room on an empty stomach.
Egg-A-Mooby-Bagel, yogurt + granola, and a Mocha Frappucchino
After breakfast, I headed back upstairs to the waiting room and well, I waited. I made a good advancement on the book I brought, while checking the flat-screen monitor with patient updates regularly between paragraphs. At nearly 10am, her doctor appeared before me.

"She's all done," he said, then went into an account of the details of the procedure. Apparently, she did very well while on the table and everything went swimmingly until the doc lost sight of the end of the tube. He explained that this wouldn't have been a problem, except that the tube could not be recovered while in the tear duct, so it had to be removed and he had to start over with an endoscope. Again, this wouldn't have been a problem, except that the doc rarely uses the endoscope and so he is relatively unpracticed at directing it through such small areas. So the on-duty otorhinolaryngologist was called in to supervise this part of the procedure. It is not known where the end of the tube mysteriously disappeared to, but it is known for certain that no damage was done. However, the meticulous use of the endoscope lengthened the estimated time of the procedure significantly. A small price to pay for a job well done, in my opinion.

A few minutes later, I was called into recovery to see Seren. But she wasn't there yet. So I sat and waited, camera in hand, so you could see this picture:
Also not the face of a happy little girl
It was explained to me that Seren's needle phobia continued into her unconscious, anesthetized state and she, apparently, woke up in a screaming panic. The nurses said they had never seen a child with that severe of a phobia. They told me they were stunned by her reaction and heartbroken that there was nothing they could do to calm "such a sweet girl," so they called me in early, so that she could cuddle up with me as soon as she came out of the operating room. She was only awake enough to curl up into my lap after the nurses handed her to me, but immediately passed out cold for another hour.

While she was sleeping, one of the nurses helped me take the IV catheter out of her hand and place a fresh Band-Aid over the place where the first one was taken off.

When she woke up on her own, she did it far more peacefully than when under the anesthesia. She slowly regained her motor skills and got her feet underneath her, before we carefully made our way to the cafeteria for her to eat the first food she'd had since pizza last night, a banana. By the time the banana had been reduced to a slippery husk, she was wide awake, chipper, and talkative. She had also discovered the needle mark under the Band-Aid on her hand.
"Those tricky people!" she said. "They poked me through the Band-Aid!"
"Are you okay? Does it hurt?"
"No, I'm fine. But that was very tricky."

I packed up some extra food and some Jell-o from the cafeteria to take back to the hotel with us and we took the first shuttle back. Seren immediately took a shower, changed into her pajamas, and finished a container of Jell-o. Then we just relaxed and watched tv for the rest of the evening.

I did get an important call this afternoon, though. Since Seren's surgery went so well, her post-op appointment was cancelled for tomorrow and we will be flying back home first thing in the morning! Since we have to be up early for our 8am flight, we will be going to bed soon. But first...

Thank you for all of the love and support we have received this week. Seren was so happy to read the comments, emails, and text messages from all of you. It meant the world to both of us.

15 August 2012

Anchorage: Day 2

Today was far less busy and exciting than yesterday, but it was a good day nonetheless.

We woke up at 6:00 this morning, in order to get ready and eat breakfast before boarding our shuttle to ANMC at 7:30am and arrive at Seren's pre-op appointment at 8:15am. After breakfast, we had about 20 minutes to kill while waiting for the shuttle, so we milled about outside the hotel and Seren made friends with a very nice family from Nebraska, who was vacationing in celebration of the elder patriarch's 80th birthday. Many remarks were made about how clever and bright Seren is and Seren ate up as much attention as she could glean by showing off everything she knew about electricity, lightning, the solar system, and a dozen other topics. You'd think this scenario would get old, but it doesn't. I love how much she enjoys sharing her knowledge of the world around her with people that she meets. Teaching is truly in her blood.

After the family left on their tour bus, we spent some time looking at the potted flowers in the parking lot of the hotel. I introduced Seren to the clever design of the snapdragon flowers and taught her how to open and close the "mouth." She found this highly amusing and it proved a good way to pass the time.

We arrived at the hospital in plenty of time and checked in at the ophthalmology clinic. Seren was restless with all of the waiting before entering the doctor's office, which did not help her already built-up anxiety due to a life-long case of trypanophobia. When we were taken into the office by the nurses, she sat down and described her dread. To her great relief, the nurses explained to her that they "don't do needles in this clinic" and that there would neither be any blood tests today, nor any iv medications tomorrow (assuming there are no out-of-the-ordinary circumstances while she is anesthetized). In fact, the anesthesiologist will be using a general anesthesia administered by a gas mask. Seren was so excited by this idea, instead of the iv catheter, she was literally bouncing up and down in her seat.

Dr. David Chamberlain, M.D. is a practicing family doctor, who specializes in ophthalmology. He flies down to Sitka once a year to address patients with specialized opthalmological needs and refers them to ANMC for further treatment or prescribes a local treatment that may not need advanced care. He saw Seren about 9 months ago during of these visits and will be the doctor presiding over her procedure tomorrow. He is a very nice man with a kind, upbeat manner. Seren is very comfortable with him and was excited when he explained what would happen after she falls asleep tomorrow morning. He talked to us about the procedure, made sure everyone was on the same page, swabbed her eye to see how much goop was backed up in the tear duct, set the appointment, and signed all the paperwork. And that, as they say, was that.

So the upshot is that Seren's surgery is scheduled (first!) at 6:30am tomorrow morning and there will be no cutting, needles, or otherwise intrusive equipment used. The procedure itself will take about 15 minutes, but because general anesthesia has to be used, we expect to be there anywhere between 1 to 2 hours. She is not to eat or drink anything after midnight tonight, until after the procedure is done. There will be no need for any analgesics to be prescribed, however, an optic antibiotic steroid has already been prescribed, just in case it is needed.

After we wrapped up everything there, I had to scope out our transportation options for the morning, since the regular shuttle does not run before 7am. It was a good thing I checked, because the hospital issued a voucher for us to take a taxi. Again, this saves me out-of-pocket costs and Seren is very excited to get to ride in a taxi.

We had an early lunch, there at ANMC, before taking the shuttle back to the hotel to watch some tv and take a nap.

Since Seren doesn't get to ingest anything after dinner tonight, I treated her by taking her to the mall behind our hotel and doing some window shopping. She ended up with a new swimsuit, a bag of jelly beans, and a couple of gifts for Daddy & Porter. After killing about an hour or so at the mall, we walked back to the hotel and ordered a pizza and a bottle of root beer, which we have just thoroughly enjoyed in front of the tv in our room.

It's still only 6:15pm here, but we will be heading off to bed soon. Our taxi will be here at 5:45am and it's going to be a long day. But before I sign off for today, here is one of the very last pictures you'll ever see of Seren with a goopy eye.

14 August 2012

Anchorage: Day 1

All four of us woke up at 4am this morning in order to load up the bags I finished packing last night and run to the Sitka airport, where Seren and I would depart on our 6am flight to Anchorage. Since this was both Seren's and my first flight off the island since we moved out here, I'd like to share my observations of this experience

 Inter-Alaskan air travel is a whole lot like taking a Greyhound bus anywhere else in the country. TSA rules aren't relaxed, but they are streamlined in such a way that showing up half an hour before your flight is a normal habit Sitkans have developed. The line moves quickly and amiably. The TSA staff are courteous and professional. Once you are ushered past the screening area and into the gate area, the process moves very quickly. Boarding starts almost immediately and the line shuffles at a rates of about 2 seconds per passenger. What would normally appear to be a long queue is cleared out and loaded onto the plane in less than 20 minutes. Flight staff are competent and friendly. There is no time for confusion to set in or disagreement to take place about space or seating. It's almost exactly as practiced as walking in a straight line back to the classroom after recess. Our flight did, however, take 20 additional minutes to take off, due to a technical error regarding a fuse, but the Captain announced the delay well in advance and did not keep us wondering what was going on, as we continued to receive updates every 5 or so minutes until it was resolved.

The first leg of our flight was 22 minutes or 65 miles, depending on how you like to look at it. Either way, it was only long enough to get into the air before our descent was announced. Our flight stopped briefly at Juneau to pick up and drop off more passengers, which is normal for Northbound flights from Sitka. We did not get off of the plane, but were back in the air less than half an hour after we touched down.

Oh, and the landing! Stephen has described Alaskan landings to me many times, but it's an entirely different matter to experience one first-hand. Because the runways are shorter (and frequently surrounded by water) Alaskan pilots have become deft in using the landing itself as a means of slowing the entire aircraft quickly and efficiently. There is none of that gentle gliding onto the runway you've all become so used to in the lower 48. It's down, and brake, and that's it. The entire plane feels it when the tires hit pavement. A good landing is a fast landing.

The second leg of the flight was significantly longer than the first. Anchorage is more than 600 miles Northwest of Juneau. The Captain explained that we were both flying higher (about 18,000 ft) and faster than normal in an attempt to make up for the delay in Sitka. When the primary means of transportation between cities is the flight you're on, the flight must run on time (or as near to it as is safely and reasonably possible). Near the middle of the flight, the Captain pointed out Mt. Logan in the Yukon, the second largest peak in North America (second to Denali, which is in Alaska). So, I took out the camera and took some snapshots of the beautiful scenery we were flying over.

Mt. Logan, Yukon

Clouds and sky

Seren did very well during the entire flight. She sat next to the window and did not even attempt to sleep. Most of her time was occupied looking out the window or reading a Calvin & Hobbes book she chose to take with her. She actually read about 80% of the 176-page book during this flight, which is quite a bit of dedication for a sleep-deprived 5-year-old on an airplane. She didn't complain. Not once. She was happy, excited, and inquisitive the entire way there.

We landed in Anchorage at about 9:10am and had claimed our baggage and were waiting for our shuttle to the hospital to check in by 9:40am. We had a 50-minute wait for the next shuttle to arrive, so she and I sat outside at the shuttle stop and amused ourselves with flowers and leaves, buildings, and people. A very nice couple vacationing from the United Kingdom struck up a conversation with Seren and she willingly took advantage of the opportunity to share with the foreigners all she knew about Alaska and its wildlife.
Seren hamming it up for the camera, outside Ted Stevens International Airport

Note the "badge" sticker given to her by the TSA agents in Sitka.

We were the only people on the shuttle to the hospital and the driver was listening and laughing with me about Seren's many questions on the way there. The driver was very nice and helped us with our luggage both into and out of the van, even refused to allow me to help him load. More notably, he did his job with a sort of genuine pleasure, the kind I hope I never learn to take for granted from Alaskans.

Inside the hospital, we were quickly directed to the housing department, which has an entire wing to itself. It was explained to us that we would not be staying on the hospital campus, but instead at a Quality Suites in downtown Anchorage. There was only one problem: It was just after 11am and check-in at the hotel wasn't until after 3pm. The good news was that I was given a pair of allowance cards that will be supplied with $25 per day for each of us to use for food at the hospital cafeteria AND the cafeteria has prepped hot food on par with a mall food court (Stephen would compare it to the cafeteria offerings at a major university). So Seren and I spent an hour or so getting food, eating, and calling family members to check in, then we found the playground (which amounts to a couple of slides in a gravel pit) and played for an hour or so, then we went to the gift shop where Seren graciously accepted candy from an on-site artist, then we went outside so she could run in the grass, then we went back to the cafeteria to eat some ice cream before FINALLY finding our place at the shuttle stop to head to the hotel.
Cafeteria lunch

Seren chasing a group of boys at the playground

A seal gut parka on display at the hospital

Mind you, neither of us had slept since 4am and Seren had still been very well-behaved throughout the whole day. She even drew positive remarks from passersby and people she interacted with along the way. I'm very proud of the attitude and stamina she showed on a day like this.

The shuttle to the hotel was full. We ended up in the furthest back row, next to a woman (maybe in her 70s) and her 6-year-old granddaughter. Seren immediately made friends and they laughed and played the whole ride away. The grandmother and I had conversation about our reasons for being at the hospital, the length of our stay, the beauty of Sitka, the weather, family, and on and on. She's a graduate of MEHS and was very pleased to hear that Stephen has a full-time music program going there. She's had 3 daughters graduate from there. She has at least 2 nieces who are going to go there. She expects several of her 15 grandchildren to go there. It's a kind of legacy that we have encountered over and over again with Mt. Edgecumbe students and I'm still surprised every time I hear the stories of lineage and history that pass through that institution's doors. They are staying at the same hotel we are and she was eager to tell me about all the best places to take Seren to walk, play, hang out, and eat. Her granddaughter tried to arrange an impromptu play date for this evening, but I had to decline. We were just too tired from the long day of travel. I could see that the grandmother was eager to see us again, to spend time with us and let the children play together, and I genuinely hope we run into them again before we leave.

It's 10:15pm now. Seren and I laid down for a nap at around 4:30pm and I have only been awake for a few hours. Seren is still sleeping soundly. She needs it. We have an 8:15am pre-op appointment to keep in the morning.

11 August 2012

A little fun and a little prep

This weekend is the 3rd Annual Sitka Seafood Festival. We've posted about SSF before, but it's so neat to see how this community event continues to gain momentum and support from all of SE Alaska. There was a parade this morning, followed by merchants of every variety and food ranging from fry bread to Filipino. There were event competitions, including a cake contest, a "Sitka Signature Dish" contest, fish head toss, fish head bobbing, tote races, and more. After checking out all the wonderful vendors and activities, we took a tour of the USCGC Maple, the largest buoy tender in the Coast Guard, which is stationed here in Sitka.  This year a Highland Games event was added to the festivities, so Stephen & Porter went in style. (I apologize for the poor picture quality, I didn't think to bring a better camera than my iPhone.)
Stephen says this is the first time he was out-shined at a Highland event--Porter definitely turned some heads.
Men's caber toss

The Pub was among the food vendors. Here you can see them cooking up whole fresh-off-the-boat dungeoness crab, corn on the cob, and potatoes right on the lawn for $15/meal.

Live local musicians kept the party going. (To the right, out of this shot, was the BIBCO beer tent.)

Sheaf toss

Highland dancers

City of Juneau Pipe Band (How cool is their logo)

Porter was completely enthralled with the bass drum.

Women's stone throw
All of the athletic events were held on the lawn of the former Sheldon Jackson campus (now the Sitka Fine Arts Camp), which is currently undergoing massive remodeling and restoration. This being the first year we've had Highland events in Sitka, most of the athletes were first-timers as well. The community was very supportive, though, and we expect this event to grow in future years.


In other news, Seren and I will be flying to Anchorage this week for a minor surgical procedure on her eye.

Seren, like me, was born with clogged tear ducts, a condition which doesn't affect eyesight or ability in any way, it just gets a little messy from time to time. Because of the blockage, the lacrimal sac produces more fluid in an attempt to push the blockage out and her eyes tend to look runny or mucusy most of the time. In my case, the blockages naturally cleared from both eyes when I was about 4 years old. However, Seren was not so lucky. The blockage in her left eye cleared naturally, but her right tear ducts still have a blockage somewhere between the lacrimal sac and the nasal passage.

This image borrowed from the Children's Hospital Colorado website

In the image above, you can see that you have two tear ducts, one on the upper part of the eyelid and one on the lower part of the eyelid, in the corner of each eye. These ducts run down the side of your nose, where they connect with the sinus cavity beneath the cheek bone and (eventually) the nostrils.

Seren's procedure will require full anesthesia because of the delicate work that has to be done, but it's actually a very simple and straightforward solution. First, her tear ducts will be flushed with saline. Then, a very thin tube will be placed in both tear ducts in her right eye. The middle of the tube will only barely be visible in the corner of her eye and will be completely painless. Both ends of the tube will run down the nasolacrimal duct and be stitched together with one dissolving stitch to the inside of her nostril. Even though this is considered a surgical procedure, there will be no cutting involved. The tube simply keeps the ducts open enough that they can heal properly after the blockage is removed by the fluid flush. After about a month or so, the stitch inside her nostril will dissolve and the tube can then be pulled out painlessly.

Our normal healthcare is provided by SEARHC, here in Sitka, but they do not have specialist facilities that handle this type of procedure, so we will be flown to Anchorage on August 14th, where she will be seen and treated at Alaska Native Medical Center on the 15th (pre-op), 16th (surgery), & 17th (post-op), and we will fly home on the 18th. We have housing arranged for us on the medical campus, which will make everything much easier to deal with. I am so very grateful that all of this - flights, procedure, & housing - are being paid for by the Oklahoma Cherokee tribe. Without them, we surely would not be able to afford the cost on our own.

I don't want any of you to think that we are worried about any of this at all. In fact, it's quite the opposite. Stephen & I are excited for Seren to have this cleared up and Seren is excited to be able to do all the things she loves without having to worry so much about keeping her eye dry and clean. We consider this event to be just another part of our adventures together as a family and, as such, I will be taking pictures whenever the opportunity presents throughout this trip and updating you guys from here, in the blog. So stay tuned and leave your words of encouragement and support in the comments. I know Seren will love reading them.