Wednesday, December 30, 2009

Wednesday, December 23, 2009

Advent Prayer by Henri Nouwen

Someone sent this to Rusty and Lynette, and seeing as Henri Nouwen is one of my all time favorites.... I just had to share it here too. Merry Christmas friends. May you find joy this season in His presence.

Lord Jesus, Master of both the light and the darkness
send your Holy Spirit upon us this season.

We who have much to do
seek quiet spaces to hear
Your voice each day.

We who are anxious over many things
look forward to Your coming among us.

We who are blessed in so many ways
long for the complete joy of Your kingdom.

We whose hearts are heavy
seek the joy of Your presence.

We are your people
walking in darkness, yet seeking the light.

To You we say, Come Lord Jesus.

Sunday, December 13, 2009

a different Christmas

We're doing Christmas a little differently around the Davis house this year. We have purchased three modest gifts. Only three. And they aren't for anyone that lives in the Davis house. You'd think our tree would look awfully bare, with no shiny, fancy packages under it. A little useless, right? Empty stockings? Was someone bad in the Davis house? No, we're just doing it all differently this time around.

Did you know that Americans spend an estimated $474.5 BILLION on Christmas each year? And that the average American will spend $935 on Christmas this year? Here's a breakdown that will (should) turn your stomach. The average American will spend, this year:
  • $550 on gifts for family & friends (that's just ONE american!)
  • $120 on themselves (HAVE to have that new Christmas outfit!)
  • $70 on co-workers and miscellaneous others
  • $41.50 on a Christmas tree
  • $32.48 on Christmas cards & postage
  • $22.61 on flowers
  • $95.04 on food & candy
  • $51.43 on decorations
  • $960.50 on holiday travel for those who don't live near family
Jason and I decided to change up our Christmas many weeks ago. We've had many conversations about spending less to be able to give more. Giving to individuals who we know that are in need, yes, but also giving relationally, to one another, and to certain people in our lives. You see, the very first Christmas was a moment that broke the silence of 400 years... God's people had not heard him speak for ages. They were living in darkness. They were in need of a voice. They were in need of hope. And then, from Bethlehem, a baby cried out into the darkness. God was with them. When they needed a savior most, on their worst day, on their darkest night, God came, broke the silence, met their need, and dwelled among them.

We know families, not only in this community, but all across the world, who are living in silence this Christmas. They have had their worst day, and it replays each day after. They are living in darkness, and it is time for their silence to be broken.

Christmas was meant, from the very beginning, to be voice in the darkness, and an experience that makes us more like Christ. May yours be just that. It's more than enough.

Merry Christmas,

Wednesday, December 9, 2009

life keeps moving on...

Things are continuing to progress with Olive. You can check out the latest update over at Lynette & Rusty's blog:

Little Olive is a fighter! Let's keep fighting with her in prayer.

Olive Updates...

More updates from Lynette over the last week on little Olive...

Get us out of here!
Rough and frustrating day.

This morning after we arrived to the hospital we were told we needed to leave the NICU while the neurosurgeon tapped Olive's head. Midway through the procedure the neonatologist came out to tell us that the neurosurgeon had changed his mind and decided to put in a temporary drain that would stay in for seven days. She told us the procedure was almost finished, and we started asking many questions. For one, WHY was he doing a different procedure than he had discussed with us yesterday without talking to us first? Especially because we had talked with him yesterday about our concerns with placing a temporary drain when Olive still has lingering signs of her infection (her WBC count and protein aren't yet back to normal since her meningitis). We were told by a neonatologist we trust from the States that this is not an ideal procedure given her current labs.

After he finished the procedure he came and talked to us. He said that the research shows the same rate of infection between intermittent tapping and a temporary drain...not what we have heard from other sources.

Throughout the day Olive's oxygen level wasn't as well as normal so they decided to increase her oxygen. She also had an increased heart rate with no signs of infection so they thought she was having pain from the procedure...things that didn't happen with the drain the last three times.

The doctors and nurses told me they would like to keep her in the incubator for the afternoon so that she could rest. I was feeling pretty frustrated as to why she couldn't rest in my arms so I asked the head doctor again and she said it would be ok to hold her. After holding her her oxygen saturation went up on its own and we could take her off of the oxygen they were giving her.

They had put tape all over her head to keep this drain in place and some of it was coming off and I could see the catheter from the drain was starting to come out. The neurosurgeon had tried to secure it with the nipple off a bottle and that was filled with moisture from Olive sweating. Warm and moist...a perfect breeding ground for bacteria. great.

So I showed the doctor that the catheter was coming out and pointed out the moisture. All the residents came over to look (7 of them) and after calling the neurosurgeon they decided to remove the drain later tonight to prevent infection. They decided to take out an additional 20 ml before removing it. In the morning they had only removed 5 ml...which I am still confused at why they would remove such a little amount.

The resident came to remove the drain, and Olive screamed through the whole thing as her hair was being pulled out by the crazy amount of tape they had put on her head. After the resident started draining the fluid, we noticed the tape on her head getting wet...not a good sign. By the time everything was finished and we were cleaning up the tech came to test the CSF fluid and pointed out that there were 53 ml of fluid in the container. That means that instead of draining the 20 ml of fluid as planned, somehow she didn't notice it continuing to drain and she ended up draining about 48 ml of fluid in a two minute period.

Earlier today they told me the max they can drain is 10 ml/kg every four hours. That would mean 17 ml of fluid every four hours. Clearly you can see this wasn't ideal. The doctor tried to play it cool and I was nervously looking at Olive. Her fontanel was EXTREMELY sunk in after everything was over. The resident then told the neonatologist what had happened and the neurosurgeon. They said the biggest things they worry about it dehydration, low blood pressure, and electrolyte imbalances. I have also been told before that they cannot remove the fluid too quickly or it can have serious implications on the brain.

I didn't want to put Olive back in her isolette tonight. The doctors went home and lots of new residents came on shift...who are usually confused and learning things for the first time. The nurses that were on tonight were also not the best ones of the group. Both things leaving me nervous.

Then one of the younger nurses came over and said in Thai, "Mother, you can hold her for ten more minutes and then you need to go home so that we nurses can work." So the nurses can work? Am I really bothering you that much by sitting here and holding Olive as she sleeps in my arms? Ten minutes later she returned to give me a lecture about visiting Olive too much and getting in the nurses way. I told her that I didn't understand, because the head nurse gave us the ok to visit her anytime we wanted. I said that it didn't seem to bother anyone but her. She said it would be better if we came less like the other parents and that our daughter's situation is better than the other babies in the room.

I wanted to tell her that I didn't want to be here. That Olive was supposed to go back to the States last week, but she got meningitis from her drain and couldn't leave. I wanted to tell her that in the NICU in America that the parents can visit anytime and research proves the benefits of it.

Let's just say that by the end of our conversation I was in tears and walking home. It took everything in me not to tell her what I really thought of her. Probably for the best.

Who knows what tomorrow will bring...but I am praying lots of prayers that Olive will be o.k. tonight despite the circumstances of today.

another day...
Olive did well overnight last night. Today after arriving at the hospital the head nurse asked us to talk to her in her office. She said she that last night she heard about last night's incidence with the nurse being rude and wanted to apologize. Apparently this isn't the first time this nurse has been aggressive with parents in the NICU, as well as other nurses on staff. She told me that she communicated with all the nurses that we are able to visit from 8 am to 8 pm, and that the nurse will be written up for her impolite behavior.

Around noon our doctor from the private hospital came to visit along with the two nurses who were going to travel back to the States with us last week. They asked how things were going and when they found out about all of the issues we have had with trying to remove fluid from Olive's head they were unpleasantly surprised. They suggested we talk directly with the head neurosurgeon about these issues.

We originally moved Olive to this hospital because the doctors at the private hospital spoke very highly of the neurosurgeon here. However, he has been either out of the country for the last month or too busy to be involved in Olive's case and sends his team instead of coming himself. We are not willing for Olive to continue to be an experiment for the residents to learn on, especially with procedures that will may affect her brain and long-term outcome. Since arriving here we have had her first drain cause meningitis, two poorly done lumbar punctures where only 6 ml of fluid was removed, and another poorly placed drain with major mistakes made when removing it. Something MUST change if we are going to stay here.

All this to say, tomorrow we have a meeting set up with the head neurosurgeon to talk about what the plan will be to continue removing fluid from Olive's head, and to request him to be the one to do these procedures rather than passing them off to his students. If this meeting doesn't go well, we will consider moving her back to a private hospital, even though the cost is 10 times greater.

This evening after visiting hours ended, we went with one of the NICU nurses to see Christmas lights downtown Bangkok in celebration of the king of Thailand. We had a really nice evening out together.

Sleep is beckoning me...

Hoping for a change.
Yesterday we met with the neurosurgeon and his team. We shared all of our frustrations with Olives' care so far, and our concern with her remaining here without a better plan in place.

Before leaving after the meeting he tapped Olive's head and removed 20 ml of fluid.

Apparently our neonatologist had training in the States before, and she has agreed to do tapping every two days to remove fluid. This seems to be a good option, better than having residents without much experience doing it, or waiting for the neurosurgeons to come who are extremely busy.

Tomorrow the neonatologist is going to do another tap. Rusty and I have agreed to give this hospital another 3-4 days and see how things go after having our meeting with the neurosurgeon and see if things improve. They are saying that if the protein continues to decrease in her CSF (cerebral spinal fluid), and she reaches 2 kg (4.4 lbs) then they would go ahead with the VP shunt surgery.

If after a few days we are still not feeling comfortable with the care we will most likely move her back to the private hospital.

over and out.

Wednesday, December 2, 2009

Olive and the teddy graham

Sorry for the delay in updates on Olive... This little teddy graham has kept me pretty knocked out lately.

Here are updates on Olive from Lynette over the last few days:

No more infection!
Thursday, November 26, 2009 at 10:50am
Olive had another lumbar puncture today and the results were very good. No more bacteria found in the sample, and the white blood cell count, protein, and sugar were all back to normal. She has been much more active and breathing on room air again without the help of any machines, so we are feeling very encouraged about this.

Rusty spent the morning holding her, and at lunch we swapped and I spent the afternoon holding her. Tonight after I put her back in her isolette she was crying, irritated and flinging her limbs in all directions. I took her back out and thought maybe she needed to be burped, but that didn't seem to help all too much. She probably cried for a good 15 minutes without calming down. Then I noticed her trying to shove her hand in her mouth, so I stuck my finger in her mouth and she started sucking away. We gave her a pacifier and she was suddenly comforted and fell asleep. This is the first day she has had a strong sucking reflex, so we are excited. We may be able to start trying to breast feed later in the week if she continues to stay strong and breath well on her own.

CT Scan
Saturday, November 28, 2009 at 7:23am

Today Olive's neurosurgeon came to look at her recent CT Scan (done yesterday) and explain the results to us. Her brain tissue continues to expand (!!!), and the clot from the previous hemorrhage continues to liquify. We are excited for every good news we get about her brain tissue continuing to expand, even if it is little by little. Olive also still has communicating hydrocephalus which means they can continue doing lumbar punctures every few days to relieve the pressure in her head.

As far as the results of her lumbar puncture, the CSF fluid contains no more bacteria or organisms so that is good news. The glucose level in her CSF fluid is also back to baseline. However, her protein and WBC count are still not back at the normal level. He said that this increase in protein causes her CSF fluid to be more viscous, which is why we need to wait to put in the VP shunt. If we did it now, the increased protein level could cause the shunt to clot and not work properly.

SOOOOO...the neurosurgeon is saying that we will wait on the WBC count to level out as well as the protein. Once those two lab values are in place we will consider putting in the VP shunt...maybe in another two weeks or so. And hoping that her weight is closer to 2 kg (4.4 lbs) by then.

If an opportunity to return to the States would arise before the surgery we would jump on it. Otherwise we will plan on being here for the surgery and recovery.

Last night I tried breast-feeding Olive with the help of the nurses and she was starting to get the hang of it. However, this morning when the neonatologist found out he wasn't too impressed. He says that it is very important for us to know her intake and output at this point, and he would like to wait on that. there was no more of that.

Today I was looking at photos of Olive in her first days of life and couldn't believe how much she has changed in two months. She has been through so much in her short little life, especially to think that my due date isn't even until December 15th. We are so grateful for each day we've had with her and for the days ahead.

Olive - 2 days old

Olive - 2 months old

Livin it up in Bangkok
Mon at 9:05am

Olive had another lumbar puncture done today, and only 6 ml was removed because she was being squirmy and the resident couldn't keep the needle in. She only had 6 ml removed a few days ago too. From what I hear from the States, normally you release around 15 ml or above at a time, so I'm hoping they know what they are doing by releasing such a small amount.


Her protein level and WBC count in her CSF decreased more today (this is good news). Tonight she is getting a blood transfusion of packed red blood cells cause she was a little anemic. She was sucking away on her little pacifier when I left her tonight.

Rusty left for Chiang Rai this morning and will be there until Wednesday night taking care of some business with the sponsorship program and visiting friends.

So, I figure now that I'm all alone in Bangkok its time to live it up!

"Living it up" will most likely consist of visiting Olive at the hospital everyday, going out for a cappuccino with whip cream, and if I'm feeling real wild and crazy I might even start writing thank-you notes.

the word on the street.
Tuesday at 10:13am

I spent the day at the hospital with Olive today. Today she was pretty drowsy and not acting much like herself. This evening her oxygen saturation was on the low side of being o.k. so the residents decided to do another lumbar puncture. I was feeling anxious about having another resident do the procedure since the last two times they didn't do the best job and only removed 6 ml of CSF fluid.

I'm trying to find the balance of protecting Olive from being a resident's case to practice on, and being a patient's mother who isn't super annoying. I realize I am at a teaching hospital, but I am not a fan of Olive being someone's case to practice on...(insert nervous sigh here).

Olive cried through the whole thing. They removed 15 cc of fluid this time. After the procedure she seemed more like herself and spent a good 20 minutes alert and flinging her little limbs around. I held her for another hour before walking back to the apartment.

Tomorrow the neurosurgeons are planning on placing another temporary ventricular drain to remove more fluid.

The head neonatologist said it would be o.k. for me to begin trying to breast-feed Olive tomorrow, so I'm hoping things go o.k.

Rusty was able to be home for the rice harvesting at the AYDC in Chiang Rai today. All the parents of the kids came to participate so he was able to connect with a lot of them and share in eating some dog for lunch. : >)

The weather in the north is much colder than here in Bangkok. He is sleeping in a sleeping bag and comforter in Chiang Rai, and I am sweating down here in Bangkok as I listen to Christmas music.

Still no word on another flight being available to go back to the States anytime soon.



P.S. We have five breast pumps donated for the NICU in Chiang Rai, so we are set!

The little champ.
Today at 10:56am

Had a really good day with Olive today. This morning the opthamologist came and looked at her again and said he is still very pleased with the results and doesn't think she will be needing any further treatment. They will keep doing weekly checks to make sure things continue to stay on track with her vision.

This afternoon we started breast-feeding. Olive latched on like a little champ, and once she was on her eyes got huge and she looked really excited and unsure what to do about the milk coming out into her mouth. I was laughing at her little expression and trying not to scare her with my shaking. Her vitals stayed good, and she had no issues with her oxygen level dropping so the neonatologist gave us the go ahead to continue trying a little each day.

Today I also met with both the neurologist and neurosurgeon. Starting tomorrow morning they will do daily tapping to remove fluid from her head. From what I understand they just use a syringe and will remove between 10-30 ml of fluid each time.

Rusty will return tonight from Chiang Rai. He had a really good time connecting with friends there.




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