We're HOME!!!!

Rebekah was more than a little exited to hear the words "go bye-bye!"

She made some great friends with the doctors and nurses

in the last two days (when she was feeling better)

but she was eager to get in the car and go!

We had a very uneventful trip home.

And made it home just before dark.

Rebekah slept the entire way.

I drove...and drove.

Thank you all so much for your prayers.

We felt each and every one.

We love you all!

Drew and Nancy

Zachary and Justin

Aaron and Caleb

Rebekah Grace

The next post.....

.....will be from somewhere other than our hospital room!!!  We are packing up and getting ready to move out!  :)

Please pray for safety for Rebekah and I as we head to Greenville.  I am thankful that it looks like we will be leaving soon enough to get there before dark, or shortly after.  If you remember from our trip down here, I do NOT like driving in the dark.  So if you would pray that the remainder of the discharge paperwork and things that need to be completed will be done quickly, I would appreciate it!

Rebekah has spent the entire morning hanging out at the nurse's desk.  She loves her new friends as long as they don't have gloves or a medicine syringe in their hands!!  :)

See you later from our happy abode (I refuse to say the word, for fear that something will crop up at the last minute!!!  :)

Nancy

Prayer Request

I just spent a few minutes with Brian, Jude's dad, and they received some disappointing news this morning.  Jude had been doing well, and there was a possibility that he would come off the bypass today.  Instead, he needs to have more invasive procedures, all with their own set of risks and potential complications.  If you are interested in more details, you can read Brian's explanation here.

I know Brian and Rose would certainly appreciate your prayers, both for Jude and for them.  There is nothing in the world like the emotional roller coaster of watching your child fight for his/her life.  Please uphold our friends in prayer today.

Nancy


P.S.  Bekah is doing well this morning!  We are waiting on the doctors to round and just maybe, we will get a discharge date!! :)

Feeling Better!

I can tell Rebekah is certainly beginning to feel better!  She wants to be out of the bed and socializing with everyone!  Since Rebekah is not plugged in to oxygen right now, she loved the freedom of following the nurses around the unit.  She spent the better part of an hour hanging out at the nurses station tonight charming all of the nurses. :)  The unit has a new telemetry system (monitors heart rate and oxygen saturations) that is wireless, so the kids just have a small white box with the leads attached to it, instead of being confined to a bed with a monitor beside them.  It's great for the kids!!  Rebekah picks up her box and away she goes! :)

The theme of the day was giraffe.  :)  Yes, it totally all matches, and yes, I have a blast dressing Rebekah!  I'm already mourning the fact that by the time Rebekah has another surgery, she will be too big to wear the cute onsies and leg warmers. So sad!

Rebekah is totally in love with Mickey Mouse right now.  Do you know how many stores do NOT carry Mickey Mouse??!!  I searched through Walmart, Target and an entire mall (with no Disney store) before I finally found this Mickey at KMart.  Rebekah has been best buddies with him ever since. :)  I figured if a girl goes through open heart surgery, the least she can have is a Mickey Mouse!

We had a nice surprise today - MAIL!!  Rebekah received two cards and a package today, and she was delighted!  She very meticulously studied the cards and looked at all the pictures on them.  It was really sweet.  She also very much enjoyed the new book she received, and spent a lot of time looking at the pictures after we read it.  Thank you for the enjoyable surprise!

Tomorrow morning Rebekah will be having another chest x-ray.  I'm really hoping to see some good results from this one!  As of this morning's x-ray (at 6:30 in the morning!!), there was still a large area of fluid on Rebekah's right lung and a small collapsed area in Rebekah's left lung.  Both are no worse than they were before, but they don't seem to be much improved from two days ago.  The good news is that Rebekah is handling it well since she was able to go without oxygen all day and keep her sats up!

Rebekah finally settled down and went to sleep.  :)  I told you she was feeling better!  She's starting to play her "stay-up-till-midnight-and-sleep-all-day" hospital routine.  Better get out of here fast, or she's going to have a serious adjustment when we get back home.  :)

As you pray for Rebekah, please continue praying for baby Jackson.  He had his best day ever on Sunday, and I know his parents needed that bit of encouragement.  His battle is far from over, so please remember him in prayer.  And we have another little heart buddy named Jude who also needs prayer.  He has a big test tomorrow to see if he can make it off of the heart/lung bypass machine.  If he is strong enough, then he will be scheduled for his first open heart surgery a day or two later.  His parents would also appreciate your prayers.

Nancy

Passed!!

Rebekah PASSED her swallow study this morning!!! The time for it actually got changed twice before we got down there, so she didn't have her study until after 11:30.

They mixed some barium with some flavored koolaid, and at first Rebekah was eager to gulp it down.  Then she really tasted it and didn't want to have any more.  Can't blame her!  :)  But she was super cooperative, and she drank four different times for them to get plenty of video of her.  It's actually a super-quick series of x-rays that run together to make a short video.  So you can see exactly when the liquid enters Rebekah's mouth, as it goes to the back of the throat, and finally when she swallows.  It's pretty cool to watch!

The radiologist did see two abnormalities in the swallow study.  First, sometimes the liquid in Rebekah's mouth goes up (into her nasal passages) and not down into her throat.  We know all about this one!  It's a part of the DiGeorge syndrome since the back of her throat/vocal cords/nasal passages aren't quite "normal."  The second thing they noted is that Rebekah has a delayed swallow.  This means that the liquid goes into her mouth, to the back of the throat and then kind of hangs out there for a few seconds before it is swallowed down.  The concerning part is that during this time Rebekah's airways are wide open, setting up a perfect opportunity for aspiration.  However, this is NOT something caused by the vocal cord paralysis.  It is likely that Rebekah has always been this way, and probably will always be this way.  It is obvious that her body has learned to compensate and protect her airways.  I could tell the speech pathologist was a little hesitant to say that Rebekah was cleared for thin liquids because of the delayed swallow, but it is obviously something that Rebekah has had all her life, and she has never had an aspiration problem before.  In fact, if she hadn't had a vocal cord issue, we wouldn't even know about the delayed swallow.  So, the speech path. agreed to let Rebekah resume her normal diet, liquids and all!!  :)

So, in light of that news, we are beginning to hear the H-O-M-E word whispered around the unit.  Not sure of exactly when it will be, but things are definitely progressing in that direction.

Nancy

Sunday

Today really was a day of rest!  Other than a chest x-ray this morning, Rebekah's day was very low-key.  Dr. Bradley came by this morning, and said that last night's x-ray showed some improvement, so at least we are on the right track!  Rebekah will have another x-ray sometime tomorrow, and we are hoping that it will be much improved.  Rebekah was up a lot today.  In fact, she was really in her bed only for naps today.  She wasn't walking around as much today, but she was sitting up in a chair, or on our laps, or on the floor playing and coloring a good bit of today.

Pain control continues to be an issue for Rebekah.  She is fine and wants to get up and play as long as she has good pain coverage.  But, when the pain meds start to wear off, she has cries and whimpers, even in her sleep.  We are trying very hard to keep her pain under control without medicating her so much that she sleeps all day.

We really struggled with Rebekah wanting something to drink today.  She just doesn't understand why she can't have a sip of water, or juice, or milk.  It is so hard to try to distract her or get her to accept another choice.  I had Rebekah's nurse call the speech pathologist this afternoon to check with her to see if Rebekah could have a milkshake.  My reasoning is that it is as thick as the yogurt/pudding/applesauce/ice cream consistency that has been approved for Rebekah to eat.  Thankfully the speech path. agreed and we were able to get a milkshake for Rebekah to drink.  I think it just made her feel better to have something wet in her mouth.  Rebekah actually ate very well today.  She had an entire serving of mandarin oranges for lunch along with a few green peas and the milkshake.  For dinner she ate a large (for her) portion of my salad.

After the discouraging news yesterday about Rebekah's vocal cords, we had some really, really good news today.  Rebekah has been OFF her oxygen for about five hours today, and has kept her sats above 90%!!!  We hadn't really let ourselves hope that Rebekah would go home without oxygen, but it looks like that might be a very real possibility!  Before surgery, Rebekah had absolutely perfect sats (between 98-100%) without oxygen.  After surgery, she has been from about 85-100%.  Some of the lower sats could be attributed to the fluid still remaining on her lungs.  However, Dr. Bradley thinks that possibly the re-routing of the blood flow through her lungs may have lowered her sats just a bit.  He is fine with her sats being above 90%, and she has kept them up so far today since the oxygen was turned off.  We'll continue to monitor the sats in the hospital, and then occasionally for a few weeks after we get home to make sure things are still where they need to be.

So tomorrow morning, sometime around 9:00, Rebekah will have her swallow study.  They will be giving her different consistencies of food and beverages to see if she aspirates any of them into her lungs.  The food should not be a problem, but there is some concern that she is aspirating thin liquids.  We would certainly appreciate your prayers for the swallow study tomorrow!

Nancy

Saturday!

I am happy to say that Rebekah seems to be feeling better today!  :)  Or at the very least she is tired of laying in her bed and wants to be up and doing things.  She was wide awake shortly before 7:00 this morning, and we started the day with a bath and beauty treatment.  :)  Bekah wasn't crazy about taking some of the stickies off in the bath, but she seemed to relax and enjoyed having her hair washed. 

Some of you may remember from one of my posts a few days ago that Rebekah's voice has been very soft and whispery since surgery.  The first couple of days, we just assumed that it was a hoarse throat from having the breathing tube in.  After several days passed, though, we became concerned that something more might be wrong.  We talked to Dr. Bradley about it Thursday night, and he referred Rebekah for an ENT consult.  The consult didn't happen until late last evening.  We really liked the ENT that we met with last night, and he listened to our concerns about Rebekah and then decided to do a scope of Rebekah's airways to see if there was anything going on.

As it turns out, Rebekah's left vocal cord was paralyzed at some point during surgery.  It possibly has been stretched, or it could have been severed.  The nerves around the voice box go down into the chest on one side and go back up on the other side.  Time will tell whether or not the paralysis is permanent, but Dr. Bradley told us that is one of the areas that he was working in.  As careful as he is, one of the risks of open heart/open chest surgery is damage to the vocal cords.  For now we watch and wait to see what happen.  Her voice could come back in a matter of a few weeks to a few months.  If not, then the damage is permanent and we will discuss options for restoring her voice at that point.

One of the struggles we are already having with Rebekah's vocal cord loss is communication.  She can and does speak, but it is very, very soft and some sounds are just lost.  It has been a source of some frustration here in the hospital in a relatively quite room.  I think our whole family is going to have to work extra hard to make a point to listen to Rebekah.

Another complication of Rebekah's vocal cord is her swallow.  Because the nerves control the vocal cords and swallowing, there is a serious risk of aspiration.  Rebekah has been given the "okay" to have purees and solids, but nothing thinner until she has a swallow study on Monday.  So, no liquids at all for the weekend for sure.  On Monday we will find out if Rebekah can have normal liquids, or if she can have thickened liquids, or if she will not be able to have liquids at all.  It has been a rough day already since Rebekah wants to have a drink with her meals or during the day.  To make up for the lack of fluids, we are giving Rebekah three bolus feeds of Pedialyte during the day.  We will find out on Monday if we need to continue that at home, or if Rebekah will be cleared for liquids.

Rebekah has still been in a fair amount of pain today, despite the fact that we have continued her pain medications.  She is also scratching her incision relentlessly.  She has been getting Benadryl as often as she can have it, but she still managed to scratch off the top half of her steri-strips covering her incision.  Bek's nurse had to come in and re-bandage Rebekah's incision.  We can't keep up with what that girl will think of next!

Look at who is up and walking!!  :)  Rebekah has wanted to "go bye-bye" off and on today.  So, a couple of times today we took walks up and down the hall.  Understandably Rebekah is still a little unsteady on her feet, but we are thrilled that she is doing this well!

Rebekah has another chest x-ray ordered for tomorrow morning.  The x-ray she had early this afternoon still looked "wet," so there is some fluid that she still needs to get off her lungs.  Sitting up, moving around, walking, all of these things will help Rebekah get the extra fluid off.  Also, she is still on an increased dose of Lasix three times a day.

So today has been a little rougher as we've had to deal with some of these little complications, but overall Rebekah is still doing so well.  We are so thankful that God has given Rebekah to our family!  I haven't heard any updates on baby Jackson today, but please continue to pray for Jackson and his family.

Nancy

Friday Update

The good news is that I finally got some pictures uploaded and posted.  The bad news is that Blogger put them in this post in random order, and I haven't been able to figure out how to rearrange them.  I know it's supposed to be all click-and-drag friendly, but right now Blogger isn't playing nice.  So enjoy the pictures and I'll try to give some explanations so they all make sense.  :)

Rebekah had a very special gift delivered to her on Tuesday from the Butcher family!  If you don't know them, Annabelle was a very special little girl who spent much of her time in the PCICU at MUSC.  She lived for only a few short months with a very broken heart.  As a way of remembering their sweet Annabelle, her parents began a program called Annabelle Baskets.  The baskets are given to babies who require open heart surgery to repair their heart defects.  Rebekah has been the recipient of two Annabelle Baskets, and this time she received a specially chosen package from Annabelle's family.  Rebecca, thank you so much for the thoughtful gifts you put together for Rebekah.  I know she doesn't look too happy in the picture, but you really found a lot of her favorites!  (The Hello Kitty pencils brought the first smile we'd seen since surgery!)  And the little bear sings "Jesus Loves Me."  It's Rebekah's favorite song!!  :)  So thank you again, Rebecca.  What a special surprise!

Let's see....I think this picture was Thursday night.  It was the first night Rebekah wanted me to hold her.  She still seems to be in a good deal of pain, and I feel like we spend our time chasing her pain instead of staying ahead of it.  We requested doses of Oxycodone, Tylenol and Benadryl (Rebekah has really been itchy around her incision.) before bed tonight, and Rebekah finally seems to be sleeping peacefully.  I asked her nurse to please give the pain meds when they are scheduled through the night instead of as-needed, so hopefully Rebekah will sleep all night!

This afternoon Rebekah felt well enough to go to the playroom.  Here it is called the Atrium.  She had a good time playing with some toys, then she asked to color.  We stayed for about an hour, and she did really well.  She was sitting on her own and playing with some toys, and she even stood and took a couple of steps with Drew's help.

I think this picture was Thursday morning. I love the legwarmers, and so does Rebekah!  She looks so cute in pink and gray!  :)  All of the lines you see in the picture are now out.  Rebekah was moved to the floor this morning, and she still had an IV in her left foot.  (The one in her right foot wouldn't flush last night, so they removed it.)  All day Rebekah has cried any time a nurse has used the IV in her foot.  This evening she got her nausea meds through that IV and just cried and cried and cried.  I asked the nurse if we could just take it out, since Rebekah was getting all of her other meds through her g-tube.  She called the on-call doctor, and he gave the green light.  It was a good think we took it out because it had infiltrated and left the top of her foot swollen!  No wonder the poor girl was in so much pain when anyone messed with it!  The swelling should ease overnight, and by morning she should be able to walk without any pain.

Bekah loves to play with Daddy's hats!  :)  Even though she isn't smiling a lot, we have had periods of play time today.  Rebekah and I play this silly game where we blink at each other and try to copy the blinks.  I know, it's a silly little game, but it entertains her.  :)  Anyway, she started it tonight on her own right before she fell asleep.  I love that she's starting to feel well enough to play a little!

This afternoon after Rebekah played in the atrium, she was taken downstairs for an echo and a chest x-ray.  We're assuming they both were fine since "no news is good news" when it comes to tests and labwork.  Rebekah was such a good girl for her echo, in spite of the fact that she was really tired after playing in the atrium and would rather have gone back to her room for a nap!

We borrowed a small stroller from the unit to take Rebekah to the atrium.  She isn't up to walking yet, and holding her for long periods of time is still uncomfortable for her.  The stroller was the perfect thing!  She enjoyed getting out for a little while.

Mommy and Bekah in the PCICU on Thursday night.  We stayed a little later than we normally do since we had to leave earlier in the evening when Jackson came back from the OR.  I saw Jackson's grandparents in the atrium this afternoon, and they said he is not doing well.  Please, please continue to pray for little Jackson and his family.

Rebekah loved playing with the Weeble Wobbles in the playroom.  She spent a good deal of time putting them on the little ferris wheel, sliding them down the slide, and just having fun.  She reluctantly shared some of them with another little heart friend who was also playing in the atrium.  :)

Mmmmm....strawberry ice cream!  So far it's the only thing Rebekah has eaten since surgery.  I can't say that I blame her! :)   She has also enjoyed some apple juice, but that's about all she has had orally.  We're not pushing her since she is getting her overnight feeds.

Rebekah is settled for the night, and I'm about to get some sleep while I can.  Thank you all for praying for our heart babies.  They are special little people!!

Nancy

Friday Morning Update

Rebekah had a great night last night resting and working on her overnight feeds. She was bright eyed and energetic when I came in this morning to see her. Shortly after I arrived, after hugs and saying hello. I found out that all had been cleared for Rebekah upstairs. So a little bit of packing and we were off for a morning trip.

We are now settled in on the floor of the step down unit. Home away from home. Rebekah has been pretty restless since we got up here. I think she was in a bit of pain so we asked for some pain meds and she is feeling better.

After sometime on Skype to say hi and play with her brothers and grandparents it is now time to settle in for long lazy afternoon nap.

We hope to have a quiet afternoon and evening. We will update again later this evening.

-D

Still in the PCICU

Rebekah was all set and ready to move up to the floor today, but she is going to spend one more night in the PCICU tonight.  She is doing very well and could have easily moved, but they are out of space!  :)  There was another patient on the floor that should have been discharged, but it didn't happen tonight.  Rebekah will move up as soon as the other patient is discharged in the morning.

I believe there was another reason that Rebekah was kept in the PCICU tonight, and it doesn't have anything to do with her.  Because of staying in the PC, I was able to meet another family whose baby had surgery today.  He was brought back to the bed space right beside Rebekah.  We sort of had a mutual friend-of-a-friend circumstance that led me to start talking with them.  Anyway, I would love for you all to remember baby Jackson in your prayers tonight.  He had a long day of surgery today, and I know the family would appreciate your prayers.  His caring bridge site is http://www.caringbridge.org/visit/jacksonwyatt/journal.

Thank you all for praying!  We appreciate all of your prayers and encouragement!

Nancy

Post-OP Day 3

It's amazing how much a little (or a lot!) sleep can help!! Rebekah looked totally different this morning when we came in to see her.  She was alert, responding to our questions, and looked much, much more comfortable this morning.  Her nurse said that she had slept comfortably all night and had not woken up until around 9:00 this morning.  Rebekah was awake for about 2 hours before she fell asleep for a little nap.  Sleep makes such a big difference!

Rebekah's chest x-ray this morning was definitely showing improvement from yesterday.  She still has pockets of atelectasis, but overall her lungs are much better.  Her oxygen sats confirm that because she is at her baseline normal sats today.  Yesterday her sats were hovering in the upper 80's/low 90's.

With the good echo Rebekah had last night, and the improving chest x-ray from this morning, Dr. Zyblewski gave the okay to remove Rebekah's IJ (intra-jugular) and arterial lines.  Those came out around 1:00 this afternoon, with only minimal bleeding.  So Rebekah is not on any more IV medications!! :)  She does have an IV in each foot just in case she needs some IV meds for some reason, but they are not being used right now.

Rebekah's feeds went much better overnight as well.  It looks like her belly is starting to wake up from the anesthesia, and the nurses were able to work Rebekah up to 15ml's/hour of Pedialyte overnight.  Tonight we are going to try running Pediasure (Rebekah's regular formula) beginning at 15ml's/hour and see how she does.  Hopefully her belly will tolerate the feeds with no nausea.

She is really doing so much better today.  She is actually playing peek-a-boo and smiling with Drew.  Yesterday she could barely move or open her eyes without whimpering.  The change is just amazing.

And the best news of the day is that Rebekah is moving to the floor!!!!  She has met all of the requirements to be kicked out of PCICU, and as soon as her room is ready she will be moving to 8D.  We are excited!! :)

Nancy

Wednesday Night

Well, better late than never!  :)  Rebekah had a fairly good afternoon once we got some medications switched around and a little more pain medicine on board.  She was finally able to get some sleep, which would make anyone happier!  :)

I'll see if I can recap everything that happened today, partly because all of you are interested, and partly because I want to remember what the doctors said today.  Yes, I freely admit that if I don't write something down, I won't remember it!!

Before we saw Rebekah this morning, she had an echo in the PCICU.  This is perfectly routine, and all PC kids have an echo and a chest x-ray pretty much daily.  On Rebekah's echo this morning, there were three things that the doctors noted.  One, the function in Rebekah's right ventricle was diminished from yesterday's echo.  Two, there appeared to be a small area at the edge of the new conduit (the one that connects her collateral artery to her pulmonary conduit) that could have been the beginnings of a blood clot.  That is serious because this new conduit is only 6mm in diameter.  It would take only a very small clot to block that conduit completely, and that would be very, very bad; potentially fatal, even.  Third, Rebekah's pulmonary pressures appeared to be higher than what they were when she came out of surgery.  Also, during Rebekah's chest x-ray this morning, as I mentioned in my earlier post, she had several areas of atelectasis (collapse) throughout her lungs.

Also today Rebekah's potassium was on the low side, so she did have to receive a bolus (one single dose) of replacement potassium.  As of this evening's lab, her potassium was at a low-normal level.

So, as I said in my earlier post, Rebekah began CPT (chest physical therapy) today to try to open up the collapsed areas of her lungs.  She is having CPT every six hours around the clock until her lungs clear.  Tonight's x-ray did show some improvement, although the right lung is still quite hazy.  It's hard to get a really good look at her left lung because her heart is so large!  :)  Another thing that is helping with Rebekah's lungs is that she had negative fluid output today, which is great!!  That means that she expelled more fluid today than she took in.  Normally that's not a great thing, but it is terrific right after surgery! She needs to get rid of the extra fluid that has accumulated over the last couple of days.  The negative output is a direct result of the two diuretics (Lasix and Diurel) that Rebekah has been getting regularly for the last 24+ hours.

If you have followed Rebekah's blog since her last surgery, you may remember that Rebekah has taken Sildenafil (more commonly known as Viagra) for about a year.  It was discontinued right after surgery, but with the higher pressures in this morning's echo, the doctors decided to resume Rebekah's Sildenafil.  They also increased the dosage to 4mL's three times a day, which is a significant increase from her previous dose.  It would seem that the Sildenafil is already beginning to work since this evening's echo showed the pressures down to the level that they were when Rebekah first came out of surgery.

As for the small area that might potentially be the beginnings of a clot.....Rebekah is now a member of the Aspirin club!  Many, many heart kiddos take aspirin, and I have truly been surprised that Rebekah has avoided it this long.  However, she will be on a small dose of aspirin from now on, probably for life.  It is vital that her conduit not clot off, as it truly would be a life-threatening condition.  The only change that the aspirin means is that we will have to be a little more careful about any cuts, scrapes or bumps that Rebekah might get as she will certainly bleed more easily.

The thought for the decrease in right ventricle function is that the heart is simply bruised and hurt from Monday's surgery.  It will take a little time for it to heal and be completely back to Rebekah's "normal" function.  As of this evening's function, the right ventricle was already showing some improvement from this morning.

Rebekah continued to gag and retch for a good bit of today, even with little to nothing in her stomach.  I asked (begged, pleaded, pretty much demanded) for the doctors to switch her nausea medication from Zofran to Phenergan.  The Zofran is a more mild medication, and it just was not helping Rebekah at all!  After Rebekah received her first dose of Phenergan (around 2:00), she really seemed to relax and rest more easily. She still had periods of retching and gagging, but far fewer incidents than before. We were so thankful that the Phenergan worked to bring her some relief!

Dr. Bradley came by to check on Rebekah around 5:30 this evening, and he is still very pleased with her progress.  In fact, Rebekah is doing so well, that he decided to remove her pacing wires and chest tubes.  The pacing wires are actually leads he puts into her heart during surgery and leaves the ends exposed on the outside of her body in order to hook them up to an external pacemaker if necessary.  Thankfully, Rebekah's heart rhythm has remained normal and she has never needed to be "paced."  The chest tubes drain fluid that accumulates in the chest cavity following surgery, and Rebekah had a surprisingly small amount of fluid over the last 48 hours.  In fact, she had less than 20mls of fluid output from her chest tubes all day!  The lack of fluid is definitely a huge answer to prayer, as this was one of the more troublesome complications that we were warned could be a problem this time around.  Thank you all for praying!!!

Before Dr. Bradley took the chest tubes out, Rebekah got some IV morphine and some Versed so that she would be more relaxed and not feel too much pain from getting the tubes out.  She was great!! She cried just a tiny bit, but for the most part she lay very still and let Dr. Bradley do his job.  Rebekah has been scratching at her incision often today, so she got some Benadryl a few minutes after Dr. Bradley was done.  We were joking that she had quite the cocktail of drugs tonight!  Hopefully it means that she will sleep well!

And speaking of sleep, I think I finally have everything documented from our day.  Now it's time for me to sleep!  :)  Sorry this was a very technical post, but I didn't want to forget anything.  I never know when some obscure detail will be important later on!  I will make sure I get some more pictures up tomorrow.

Thank you all again for so faithfully praying for Rebekah.  We are forever in your debt!

Nancy

Wednesday Update

 Sorry this post is a bit later than usual today.  We've been busy taking care of Rebekah and talking to her nurse and doctors since we came in the room!  It's surprisingly busy to simply sit around at your child's bedside in the hospital.  :)

Rebekah found her fingers yesterday afternoon, but just briefly.  She does have an IV in that wrist, so it makes getting her fingers into her mouth a little challenging.  Plus, she doesn't have too much coordination back yet, so keeping her fingers in her mouth has also been a bit of a challenge.

We came in this morning just as the doctors were rounding, so it was nice to get the quick rundown of today's plan from them.  Basically, the plan is to get Rebekah moving a bit more - not necessarily walking, but at least sitting up straighter.  The head of her bed is elevated, so she's sleeping in a semi-sitting up position, but she tends to slide downward into a little ball.  Rebekah has several pockets of atelectasis (collapsing) throughout both lungs, so the doctors are working on getting her lungs to expand more and open up.  The best ways to do that are movement, not lying down flat, and coughing.  If Rebekah knew how to blow, she would also be blowing bubbles to help.  :)

As you can see from the above picture, Rebekah was less than pleased to be up and out of the bed.  After about five minutes, she was asking to get back in the bed.  I think she lasted on Drew's lap about 15 or 20 minutes total, which is a good start.  She is resting in bed right now and we will probably get her up again after lunch.

Rebekah tried her best to sleep in Daddy's lap, but she was very restless.  It seems to be hard for her to find any type of comfortable position right now.  She says "no" if we ask if she hurts, but she is whimpering some and just overall feels yucky.  The nurses are keeping up with her pain protocol, but recovery from open heart surgery is just plain miserable even with pain meds.

Bek finally decided that sleeping across Daddy's arm was the best she was going to get, so that's how she finally settled down.  But only for a few minutes and then we let her get back into her bed.  The doctors did order chest PT to be started today, so that should help open her lungs up as well.  Rebekah loves the vibration of the percussor, and she actually dozed off while the respiratory therapist was working on her.  :)

Rebekah's throat seems to be very sore still (and I'm sure it is!!).  Her cry sounds like a small kitten meowing, and her voice is very soft and high-pitched.  It will improve over time, but for now it is very pitiful sounding.

It seems like Rebekah's stomach has begun to wake up just a little bit.  She tolerated the Pedialyte last night pretty well.  It ran it at just a dribble, really, so there was not much in her stomach at once.  This morning she did have some apple juice and Pedialyte left in her stomach, so we're kind of watching to see how that progresses during the day.

I think that's about all the updates for now.  We will certainly update again if anything changes, or this evening if all remains quiet today.  Oh, and as of this morning Rebekah's temp was just slightly elevated, so it is coming down much closer to normal!  :)

Nancy

Tuesday Night

Well, what's a recovery without a few bumps in the road?  :)  Honestly, Rebekah is doing so, so well for having been out of surgery for only 30+ hours.  She is having a few little "bumps," but all of them are totally normal, and we really expected them.

First, Rebekah has been running a fever off and on throughout the day.  It is pretty normal for a fever to follow anesthesia, and so far it has not been a high fever.  Next, Rebekah's digestive system still hasn't woken up from the anesthesia.  We were very excited that Rebekah was drinking apple juice today, and it is a good thing.  BUT, the juice went to her stomach and stayed there.  Rebekah had trouble all day with retching and gagging, so  around 4:00 this afternoon I asked Rebekah's nurse to check her stomach contents.  She pulled out (through Rebekah's g-tube) all of the apple juice that Rebekah had during the day.  We realized that Rebekah's poor stomach was so full that it was causing her to be very nauseated.

Soooo, Rebekah is on a restricted diet at the moment.  They are going to let her have small sips of water or juice, but only very, very small sips mainly just to coat her sore throat.  They are also going to run feeds overnight, but it will be Pedialyte at 5mls/hour.  The nurses will be checking stomach contents every few hours to make sure that Rebekah's belly is not filling up and causing her discomfort.

Also, Rebekah is retaining fluids a little bit, so she was started on a second diuretic this afternoon.  She usually takes Lasix on a daily basis, but they have added Diurel to the Lasix to try to get her to output some fluid.  Because of the fluid retention, Rebekah's lungs are having to work a bit harder.  This afternoon her sats were dipping a little below her normal.  We are hoping that will resolve once she loses some fluid.

All in all, we are still very, very pleased with where Rebekah is right now.  These little bumps are completely expected and are very mild in terms of what she could be facing right now.  Thank you again for your prayers for our baby girl!

Nancy

Sleeping Beauty

We came into the PCICU this morning to find a nice surprise - Rebekah had been extubated during the night and was back on her home level of oxygen!!  This is terrific news!  We are thrilled that she is doing so well!

Naturally, Rebekah is still very heavily medicated, so she is mostly sleeping.  Every once in a while she kind of flutters her eyes open and stares at us, and then goes right back to sleep.  Can't blame her!  I would be sleeping, too!!  :)

Rebekah did surprise us by briefly sitting up all on her own.  She didn't have any idea what she was doing, and I really think it was more reflexive than anything.  But it send us all scrambling to catch IV's and tubing before she unintentionally pulled lines out herself.  She always has to do something to keep us on our toes!  :)

Rebekah has also been alert enough to drink some apple juice.  She's had about a carton and a half over the course of the last few hours.  She takes it a few sips at a time, but it's a great start!

Her throat and voice are very rough from the ventilator, so she hasn't really started to talk yet.  She sort of half-whispered "juice" to Drew once, but other than that she is sticking to sign language or nodding her head.  She has answered a few yes/no questions for us by shaking her head appropriately.

Rebekah does know that Mommy and Daddy are here.  Her nurse said that she woke up this morning (before we got here) and was very calm - no crying or anxiety.  It doesn't surprise me.  This is her home away from home!  :)

This is Rebekah's one and only "awake" picture since surgery.  Even though she had her eyes somewhat open in the other pictures, you can tell she's still really medicated.  She is really medicated in this picture, too, but she was a little more awake.  She let me wash her face a little bit and she took a few sips of juice before she went back to sleep.

That's about all the news right now.  We're enjoying Rebekah's smooth recovery so far and praying it continues!!

Nancy


P.S.  Just as I "published" this post, Dr. Bradley came by.  He said he is very pleased with Rebekah's progress at this point and that she is doing as well as he could have imagined post-surgery.  We asked about meds and oxygen after going home, and Dr. Bradley was cautious about his answer.  He said his leaning would be to get Rebekah off anything and everything that they can't prove has very specific benefits.  But, he did say that the other doctors, and especially Dr. Lucas, would weigh in on their thoughts and opinions before any final decision would be made.

Update #7

This should be the final surgery update for this surgery!!!  Yippeee!!!  Dr. Bradley surprised us by coming into the waiting area before we got the text that he was finished.  It was a very nice surprise to see him!  :)

The first good news we had was that Dr. Bradley was smiling!  Those of you who know him in real life know what a good sign that is!  :)  He said he was very, very pleased with how things went, and that Rebekah tolerated everything well.  They did put her on the heart/lung bypass (ECMO) as we suspected, and they did replace her original conduit.  Dr. Bradley was able to put a little bit bigger conduit in than what she had before.  I believe she had a 10 or 12mm conduit before, and he replaced it with a 14mm.  So, not a big change, but one that he felt was necessary.

One surprise we had was that in the sedated echo right before surgery, the doctors noticed an area of enlarged muscle just under her conduit.  It could be that this area was also a contributing factor to the high pressure in her heart/lungs.  Anyway, Dr. Bradley was able to cut away some of that muscle to allow better blood flow and he removed some scar tissue around it.  The new conduit that Dr. Bradley put in actually has a human donor valve in it this time around.  Rebekah's previous conduit had a bovine valve.  He said there should not be any noticeable or medical difference to Rebekah with one valve versus the other.  I get the feeling that it is more of a decision of what they have on hand to use.

SO....the big question....YES!  Dr. Bradley was able to attach Rebekah's collateral artery to her pulmonary conduit.  He had to use an additional conduit (tube) to make the collateral stretch far enough to attach it.  Drew asked Dr. Bradley if that smaller tube/conduit would need to be replaced sooner than Rebekah would have otherwise needed her larger pulmonary conduit replaced.  Dr. Bradley just smiled and nodded a little bit and said, "It's likely."  We'll cross that bridge when we get to it.  For now we're thrilled that she will be able to have some use of her right lung!!!

So, all total Rebekah was in the OR about 10 hours, with somewhere between 8 and 9 hours of actual surgical time.  We know that she is back in the PCICU because all the other parents got kicked out when she started rolling.  (For those of you not familiar with PCICU procedures, when a case comes back from the OR, or when a new case comes into the PCICU for the first time, it is called "rolling."  As in the bed is "rolling" into the PCICU.  It is the only time that parents/visitors are not allowed in the PCICU.)  We were told that we could go in to see her around 5:00, so we have about 20 minutes or so until we can kiss her little cheeks.  :)

The plan is to take recovery very slow.  The doctors are going to monitor Rebekah's pain, breathing and heart rhythms for a few hours.  When they are sure she is stable, they will slowly allow her to start waking up.  From there it will just depend on how fast her body wakes up and recovers from surgery.  Dr. Bradley did do a lot during surgery today, so it will take a little while for her body to adjust.

Thank you all for praying for us and Rebekah today.  We are just so, so thankful that God worked through Dr. Bradley to help our little girl.  We are certainly blessed beyond all that we could ask or hope.

Nancy

Update #6

Update #6:  "Rebekah just got off the heart/lung bypass machine.  They are working on getting some bleeding stopped and closing her up.  May be an hour or so more."

Yay!!  It sounds like they are going to finish up sooner than they thought in update #5!  That's good news!  We think, from talking to the surgeon on Friday, that being on the heart/lung bypass machine means that she had to have her original conduit replaced and that he wasn't able to just patch into it with the new conduit.  Of course, this is just an educated guess, since we haven't specifically heard that from the surgeon or medical staff.  Will be anxious to hear directly from the surgeon what he was able to do.  Definitely will mean a little extra recovery in the PCICU after having been on the heart/lung bypass (also known as ECMO).

We are off to grab some lunch quick, so our next update may be a bit later.  Will keep you all posted!!

Nancy

Update #5

As of about 1:15, "They are still working away, about halfway done maybe.  All is going well. Will send another update in an hour."

Wow.  We are more than six hours into surgery, and about halfway done.  It's going to be a very long day!  We knew that surgery could be 10+ hours, and it certainly looks as if that will be the case.  By far, her longest surgery to date (the longest previous surgery was about 7 hours).  Please pray for wisdom, strength and endurance for Dr. Bradley.  I cannot imagine working on something so tiny for as long and tediously as he is working on our daughter's heart.

Nancy

Update #4

"Still working away.  Rebekah is very stable. Will update again in an hour."

Very, very thankful that Rebekah is doing so well!  One of the surgeon's concerns was the pulmonary hypertension that Rebekah battles in her left lung, so it is good to know that so far it seems that she has been unaffected by this.

There is really no way to guess how much longer the surgery will last.  Since we have gotten very vague updates, there is no way to predict exactly how far Dr. Bradley has gotten and how much he has left to do.  We'll continue updating each time we hear something new!  Thank you all for checking in and praying for Rebekah!!

Nancy

Update #3

"They are working away.  All is going well.  Will call back in an hour with another update."

Sounds like things are progressing well.  Mommy would like a little more detail, but I am happy to know that things are going well so far.  I'm working my way through photo editing to hopefully have some pictures to post in a little while.  It's keeping me busy, anyway!  :)

Nancy

Update #2

Things are still going well.  Two and a half hours into the surgery and Dr. Bradley is still working his way through the scar tissue to get to the "real" surgery part.  Scar tissue is completely normal and comes from Rebekah's previous surgeries.  We anticipated some of this, but usually it only takes an hour or so to work through it.  Dr. Bradley also cleans it up so that the next time he has to go in for surgery it will not be built up any more than it has to be.  Thankful to have such a great team of doctors, nurses, technicians, and anesthesiologists working with Dr. Bradley today!

We should have another update in roughly an hour.  We will post again with any new information as we get it!

Nancy

Update #1

We got our first update about 9:15 this morning.  It says “Started on time, all is going well.  Working on cutting through the scar tissue.” 
 

It will take Dr. Bradley quite a bit of time to cut through the existing scar tissue and clean up the incision area (from the previous surgery) before he moves into the lung/artery area.  As Mr. Pat, Rebekah's anesthesiologist, said this morning, "We're expecting a long day in there."  

We anticipate our next update coming around 10:30 or so unless there are problems between now and then.  Keep praying for our precious girl!

Nancy

For the Boys

Of course, the rest of you can watch the videos also, but I promised to put videos from our time at the South Carolina Aquarium on the blog for the boys.  :)

This first video is when I fed the sting rays.  There were pieces of shrimp to put on the end of the long pole-thingy and when I put it in the water the rays would come grab the food.  Literally.  I thought the one ray was going to jump out of the water to get to me.  They have pretty decent-sized teeth, too, so I'm sure they could really bite hard if you got your finger in the wrong place!

Again, this video clip is mostly for the boys' benefit.  This is the big ocean tank where we watched all the fish swimming around.  It was so much fun, and Rebekah loved it!  There were two divers in the tank while we were there (I didn't get them in the video), and one of the divers came to the side of the glass and gave Rebekah a "high-five."  She was so excited about that!  She even told the anesthesiologist this morning about "high-fiving" the diver that was in the tank!

Hope you enjoy the videos, boys!  Have a great day in school today, and we will Skype later.  I love you!!!

Mommy

Quick Picture

Back Row: Justin (8) and Aaron (almost 6)

Front Row: Rebekah (2), Zachary (9) and Caleb (3)

Wonderful Day

I have so much to post about our day and weekend, including pictures, but not tonight!  :)  Tonight I will be trying to cat nap in between giving meds, changing feeds and getting up to be at the hospital by 5:30am.  Rebekah will be taken back to the OR around 6:30 in order for the team to get the prep-work started.  She will be given Versed (an anti-anxiety drug) before she leaves us, so that she will be relaxed and won't feel any fear or anxiety.  The anesthesiologist, Pat, will be taking good care of Rebekah tomorrow.  He has been with Rebekah for several surgeries and catheterizations, and he takes care of her like she is one of his own grandchildren.  We just love the way he loves Rebekah!  Once Rebekah is in the OR, she will be given an anesthesia and then the team will begin placing IV's, arterial lines, a catheter, multiple  monitors and probes, and bringing her body down to a lower temperature so that surgery can begin.  The plan is for surgery to begin around 7:30; actually we have been told that Dr. Bradley likes to begin his surgeries at 7:30 sharp!  We will be updating both Facebook and the blog throughout the day tomorrow as we get updates from the OR.  I would expect that our first update will probably be close to 9:00.  Thank you all so much for your comments, encouragement, help (both for our expenses in Charleston, and help at home with the boys and grandparents), and most importantly your prayers.  Please continue to pray for Rebekah tomorrow and as she recovers.

Nancy

Long Day!

We made it!!  Thank you all for praying for Rebekah today.  The schedule ran as smoothly as I have ever seen on a pre-op day.  There was a bit of a snag in the admissions office this morning since Rebekah was a last-minute change to the surgery schedule.  They did not have her updated surgery date and paperwork ready, so it took a little longer than usual to get through the admissions process.

Once that was done, though, we sailed right through the morning.  As soon as we got to the pre-op room, the nurses were waiting on us.  They got her height (33 and 1/2"), weight (23 lbs.), oxygen sats (97-100%) and blood pressure (86/43).  The nurses had hardly finished that when the EKG technician came in to do Rebekah's EKG.  Rebekah was as good as gold, and they got a perfect reading the first time!  As soon as she was done, we headed straight down to x-ray where we waited for a total of TWO minutes before we were called back to have Rebekah's chest x-rays done.  Back up to the pre-op room just in time to walk back out to echo.  Rebekah did beautifully for both her x-ray and echo.  No sedation needed!!

We were back to the pre-op room, and that's when things took a big stall.  We were waiting for the doctors, surgeon, and surgeon's assistant to come in and look over all of the tests and x-rays and talk to us about surgery and sign consent forms.  We waited and waited and waited and waited and...you get the picture.  :)  Hospital time is like no other time in the world!  So finally about 4:00 all of the doctors had made their rounds, talked about the surgery, recovery, possible risks, complications, and legalese!

There really were no big surprises today from a surgery standpoint.  Dr. Bradley still has the same plan that we discussed several weeks ago in our phone conversation.  He told me today that at least he has a plan to start with and that he would be "making it up as he goes" once he actually gets into Rebekah's chest.  He is a little concerned about having to tie this new artery into Rebekah's pulmonary conduit because the conduit is working so well.  Dr. Bradley said that he really doesn't want to mess with that conduit, but we don't really have any other options.  So please pray for no complications!

I think Rebekah (finally!!) just went to sleep, so I'm going to sign off and join her.  Please pray that she (and I!) will be able to sleep tonight.  She was very tired and grumpy at dinner tonight, but when we got back to the hotel and I put her in bed, she was wide awake and bouncing (literally!).  She does not need to go into a major surgery sleep-deprived!

Thank you all for your prayers and comments both on the blog and facebook.  We are so blessed by so many of you praying and caring for our family!

Nancy

We Made It!

Very short post to let you all know that Rebekah and I made it safely to Charleston around 10:30 tonight.  We are settled into our room and I am (still!!) waiting for that little stinker to fall asleep.  She had just enough sleep in the car to not want to fall asleep again now.  :)

We will be up bright and early for Rebekah's 9:00 pre-op schedule tomorrow.  It will be a long day, and I will not have my computer with me.  So the next chance I get to update will probably be tomorrow evening.  Please pray everything goes smoothly tomorrow!

Nancy

Bumped

Well, we all know it can happen, and sure enough it did!  Drew answered the phone call from MUSC around 8:00 this morning, and we were given two options:  give up Rebekah's surgery date on Wednesday (and get put back into the schedule for another 60 or so days from now), or scramble and be in Charleston this evening for pre-op tomorrow and surgery on Monday.  We were left with the distinct impression that we had a choice to make, but they were really hoping we would make it down there tonight.

So after scrambling through 20 minutes of phone calls, we called MUSC back and told them to put Rebekah on Monday's schedule (December 12).  This involves no small effort as plans for the boys, packing, school (both for the boys and for Drew), and last minute details all have to be rearranged in a matter of a few hours.  Things that we had four or five days to finish up now have to be done in four or five hours.  In all honesty, I can't believe I'm as calm as I am right now.  Either the panic hasn't set in yet, or I'm in complete denial! :)

We have a lot of things that need to happen today just to make this work, so I'm going to list a few specific prayer requests for today.  First, pray for Drew's parents.  They, too, are rearranging their schedules since they keeping the boys for us and we are using their car to go to Charleston.  Drew's mom is on her way here, and soon after she gets here, Rebekah and I will leave.  That brings me to my next point.  I really don't like driving at night, and it looks like a good portion of my trip this time will be at night.  Please pray for safety for Rebekah and I as we travel.  Also, Drew had already rescheduled some of his exams for today (technically his exam week begins on Monday 12/12), but he was planning on taking the remaining two exams on Monday morning, so those will also need to be rescheduled for tomorrow or Saturday.  As soon as those exams are done and he gets things wrapped up at home, he will join us in Charleston.  Please also be in prayer for our boys.  For weeks they have known that Rebekah will have surgery, and we had gone over the plan with them.  We had also planned to do a few special things this weekend that are obviously not going to happen now.  They are in a bit of shock that I will be leaving in just a few hours.

Once Rebekah and I get to Charleston, things will slow down.  She needs to be at the hospital at 9:00 tomorrow morning for pre-op, and we will probably be there till 4 or 5 in the afternoon.  Rebekah will have x-rays, bloodwork, an echo, possibly a sedated echo, possibly a CT scan or angiogram, and I can't remember what else.  Pray that all goes well tomorrow.  Saturday and Sunday we are just going to hang out in Charleston and rest.  I should find out tomorrow what time we have to be at the hospital on Monday, but I'm sure it will be early.

That's all I can think of for now.  I will try to update later tonight when Rebekah and I get to Charleston.  Thank you for praying for Rebekah and our family!

Nancy

Two Weeks

Two weeks is....

a long time yet

such a short time 

to get ready to

place my baby

in the hands of 

an incredibly skilled surgeon

his "A Team"

and most importantly

the Hands of God.

One Month

Well, as much as I have tried to not think about it, I have to admit to myself that Rebekah's surgery is really right around the corner.  One month from today, to be exact.  I've tried hard not to think "next month at this time we will be driving to Charleston," or "next month on this day we will be at MUSC for pre-op all day."  We both know that Rebekah needs to have this surgery, but knowing and doing are two completely different things.  It is never easy to take your child to the hospital for any type of surgery, but knowing that the outcome of this particular surgery is so questionable is difficult this time around.

Drew was finally able to catch Rebekah singing "Jesus Loves Me."

Then she promptly follows the song with an important announcement.  :)

Dr. Bradley warned me that his will be a longer and more complicated surgery than Rebekah has had before. They will have to cut through a large amount of scar tissue to get to the collateral that connects Rebekah's right sub-clavian artery to her right lung.  Dr. Bradley said it would be similar to chiseling a vein out of concrete - very long and very tedious.  The scariest part in the procedure is that they will have to partially or completely collapse Rebekah's right lung in order to reach the collateral.  Dr. Bradley is concerned about what effect that might have on the already high pressures in Rebekah's left lung.  If the pressures go to high, they will have to start Rebekah on nitric oxide to relax her heart and left lung.  There would be an increase in recovery time if she continued to need the nitric oxide.  We are really praying that she responds well to the collapse of her right lung so we don't need to face this option.

Dr. Bradley also said that Rebekah has "hundreds, if not thousands" of collaterals branching from her aortic system and leading to her right lung.  According to Dr. Bradley and Dr. L (our Greenville cardiologist), these collaterals range in size from microscopic to medium-size. The "medium-size" is the one that Dr. Bradley is going to try to connect to Rebekah's pulmonary artery.  Each of these little collaterals by themselves is no big deal, but the effect is staggering on Rebekah's heart.  Her heart is pumping blood through all of those little collaterals to her right lung, when it should be pumping that blood out to her body.  Dr. Bradley believes this is the main reason that Rebekah's left ventricle showed some enlargement on the last echo.  The plan is to coil off (block) the biggest handful (dozen or so) of these collaterals each time Rebekah has a heart catheterization, but we were told that, in effect, it will be like being covered in fire ants and picking them off one at a time with a pair of tweezers.  One fire ant is no big deal, but hundreds of them can be deadly.  We are really hopeful that this medium-sized collateral will provide some relief to Rebekah's tired heart, but in reality, it just may not be enough.  Please pray with us that this surgery will be successful and that this collateral will continue to grow and take on more and more pulmonary blood flow.

Rebekah and Mommy went to a friend's baby shower. 

It was fun to dress up and do something "girly!"

We truly, truly appreciate each one of you who has lifted Rebekah up in prayer. Your encouragement and love for our family has been such a blessing to us.  Please continue to pray with us.

Nancy

Princess Boo

Our kiddos dressed up for our church's annual 

Fall Festival two weekends ago.

The boys totally came up with their dress-up "theme" weeks ago. 

 It was all their idea.

They had a great time designing and painting their "armor!"

Introducing Princess Boo and her Knights in Shining Armor.

 Back: Justin and Zachary

Middle: Aaron

Front: Princess Boo and Caleb

 What? You aren't supposed to push the
 beanbags through the holes??!

 Even a princess needs to wear a ball cap once in a while!  :)

 I love the expression on Rebekah's face as she's peeking out from behind the scarecrow.  So cute!!

Oh, and she's sucking on her coveted Dum-dum lollipop.
Just try to take that away! :)

And a good time was had by all.  :)

Ride for Mike 2011

It is with a little tinge of sadness and a whole lot of thankfulness that I can say the 2011 Ride for Mike is officially over.  A little sadness because it's a bit like the day after Christmas - you have looked forward to it for so long that it's going to be a little disappointing not to look forward to it until next year.  And so much thankfulness and gratefulness to all those who made today possible.

I know I will probably forget someone, but I'm going to try to mention those that I know had a part in today and in the weeks leading up to today.  First, Jonathan and Annette, thank you so much!  Your love and encouragement have touched our lives in ways we will not forget.  And Emma, Jonathan, and Josiah, thanks for putting up with all the hours your dad spent training and riding for this event!  :)  Mike and Janet McCaskill, thank you so much for all you do behind the scenes to support Ride for Mike.  Even though I never met your son, I know he must have been a wonderful person for so many people to have loved him so much.  David McQuaid, thank you for taking your time today to support and ride part of the way with Jonathan.  You not only encouraged Jonathan, but you blessed us as well.  Eddie Helton, thank you for your support and riding a part of today's ride with Jonathan as well.  I'm looking forward to seeing the pictures!  :)

And for everyone who prayed for today's ride, participated in the Ride for Mike Family Fun Ride and picnic, or donated to Ride for Mike, thank you!!!  From the bottoms of our hearts we thank you.  May God bless each of you for blessing our family.

Nancy