How many PhDs can I fit into one post?

I didn't mention it before, but my braces were removed about a month ago. It's amazing the difference.

Before (September 2012)

After (April 2014) I have to say, all in all I'm pretty happy with the result. Besides having straight teeth, I can actually fit dental floss between my teeth, which is a huge improvement. My dentist is really excited about how well my teeth straightened up and now we're going to begin work on some minor cosmetic dentistry, mostly involving evening out my bite and whitening my teeth, particularly one that has yellowed after a root canal many years ago.

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In other news, my heart is broken.

No, really. It’s true. Literally.

I have mitral valve prolapse, which is a fancy way of saying one of my heart valves is deformed and doesn’t do its job. It regurgitates blood in the wrong direction, so my heart has to work twice as hard to pump my blood in the right direction, so that it can flow where I need it to. You know, like my lungs and my arms and legs.

I’ve known about this condition for 3 1/2 years, but it’s likely I was born with my heart this way and never knew it. In fact, it appears to be a hereditary anomaly. I went to the emergency room one night with a ruptured ovarian cyst and the P.A. on duty noticed a murmur. I thought, “I have a murmur? What does that even mean?”

I told my doc about it at my next regular appointment a few months later and she decided to run a bunch of tests, bloodwork and an echocardiogram. That’s another fancy word that means ‘ultrasound for looking at your heart.’ The results came back and suddenly I was a heart patient.

It was easy at first. I was told everything was fine and I could do everything as I normally do. I was told I’d need to have an echocardiogram once a year so that it could be monitored, but that it was unlikely to get any worse.

But a couple of months ago, after my last echocardiogram, I found out it had become worse.

Now I have a cardiologist and I have to travel 1,000 miles to see him. Distances are big in Alaska and my doc is in Anchorage. I met my cardiologist for the first time last month and he ran more tests. He took more blood, ordered another echocardiogram, and ran an EKG. He listened to my heart and told me it was “moderately severe.” I thought, “‘Moderately severe?’ What does that even mean?”

He told me I needed to come back for a transesophageal echocardiogram, which is a really fancy way of saying he wants to get an ultrasound of my heart from inside my esophagus. Stephen and I just came back from Anchorage yesterday. The doc said I’m going to need surgery within the next five years, but it would most likely happen within the next 6 months. He told me that I’m a really good candidate for my valve to be repaired. This is good, because replacement valves don’t last very long and may require blood thinners for the rest of my life.

He's referring me to one of the best heart surgeons in the country, who happens to be in Spokane, WA. He said this surgeon is a specialist in robotic heart surgeries and that I won’t need my whole chest cut open, just three to five small scars, where portals will be made under my arm. Recovery time should be under 2 weeks.

I googled this surgeon and read everything I could find. He seems like a good surgeon. He has a whole list of degrees and certifications. He graduated from Harvard. He gets good reviews on the internet.

Then I found this video:

I think I’m going to be ok. I think I’m in good hands and that I’m a relatively low risk patient, regarding overall health. Sometimes I get palpitations or pressure in my chest and I worry, but mostly, I think I'm going to be just fine. I have good doctors and good support. Best of all, I have Stephen, and he's going to do his best to make sure I'm ok no matter what. ❤

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All's well that ends well

Seren had her final post-surgery check up with her ophthalmologist today. This is really less of an event as it is a formality, since Seren pulled the tube out of her eye by herself little more than two weeks after we returned from Anchorage. However, it is nice to hear that the procedure was, indeed, successful from the professional who performed it. He was pleased to see that in addition to her eyesight being normal, she has not had even a single instance of gooping, crusting, swelling, or redness since he saw her last. The only concession he made on that report was the possibility that she may experience a similar tear duct blockage in the future, but we don't have any reason to worry about that, even if it does happen. It has been so nice not having to think about Seren's eye all the time, but should it happen again, we'll just take it in stride, just as we always have.

The actual silicon tube Seren removed from her eye on August 25, 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.

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.

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.

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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.