Q&A with Evan

First, I want to say how fun it was to hear questions from you all! I am excited to answer them for you so you can get a better look into Evan’s wonderful little life! I think after this post, I would love to just add on to every post from here on out with answers to anything y’all ask in between! That way, you don’t have to wait over a week for an answer when I choose sleep and snuggles over writing.

What illness does Evan suffer from?

Well, the short answer is “I don’t know.” The long(ish) answer is we’ve done some genetic testing so far, and it has all come back normal. However, we’ve learned that genetic testing is so much more complex than we could have imagined, so it may take a while before we can truly figure it out. There is one test that is newer called an Xome study, but we would need more clinical information (concrete diagnoses) before we can do it or we could get a false negative. We are also scheduled to go to John’s Hopkins this summer to see a genetic specialist to determine if he has a rare form of skeletal dysplasia (there are over 400 different kinds). So for now, we don’t know. And honestly, we may never know. And that’s okay. I will just keep calling it Evan Norton Syndrome where the biggest symptom is being the cutest and most precious child in the world.

Will Evan outgrow all of his medical needs?

Yes. And no. And I don’t know. Yes, he will very likely outgrow is breathing issues. Yes, he will very likely eat by mouth one day for all of his nutrition and hydration. No, he will not outgrow whatever his genetic condition is; you can’t outgrow genetics. And a whole lot of I don’t know. His hypotonia is pretty severe seeing as he is almost ten months old, and this week I witnessed a three week old kicking his butt in tummy time. But to be fair, I think that baby is just super advanced. So as far as his motor skills, I would say he’s a giant question mark. But we believe he will walk and play and be the awesome person he was made to be just in his own time! We run on Evan’s time for everything here!

Have you had a chance to meet/talk with other families with needs like Evan’s?

Yes! And we are so grateful! There are so many online communities available to parents of medically complex kids. We also have made good friends with one of Evan’s NICU nurses, Martha, whose kids have similar needs to Evan’s. She has been one of our best resources and supports. We also have a group where we live that meets once a month. I can’t wait to go when we’re off isolation and maybe (hopefully) a little better rested.

What are some things you are looking forward to seeing Evan do and experience in the next year?

Oh, so many things! What a loaded question! I am looking forward to him gaining more motor skills so he can better experience the world around him. I am looking forward to his first birthday which feels so close. I am looking forward to him meeting his little friends he talks to through Facetime, Marco Polo, and videos in texts. I really want to take him to the aquarium when we go to John’s Hopkins, but I am also super nervous about being in a crowd like that with him. But, its far away still, so plenty of time to get used to the idea! We’re also excited, and nervous, to take Evan to church for the first time this spring. It’s a big crowd, and it will be loud, so I don’t know how it will go, but we will sneak in the back and probably sneak out too. I am also excited for a day when I can run errands with him! I am very tired of this isolation gig, and I think the fact that I can see the light at the end of the tunnel is making it worse. Oh well! I know I’ll miss these days of snuggles and playing at home one day, so I shouldn’t wish it away. I am also very, very, very excited for life with no MRSA eyeball.

What do you need for Evan (in terms of items that can help with his development)?

We have a lot, but I am sure there’s always something! Several people have asked for specifics on this one, so Alex and I are working on what would be our “wish list” for little E. Sometimes we don’t know what we need until we need it.

Do you feel like you have community?

Yes! Our NICU/PEDS family has been amazing for us. We’ve kept in contact with pretty much everyone from the NICU, and Evan’s primaries have become my best friends. It’s been such a sweet blessing that came out of such a hard time in our lives. We’re really excited to be able to truly dive into a new church community this summer too. We’ve had so much support from family, friends, and even strangers throughout our journey. It’s so amazing to see how the Lord moves and shows us His provision when we need it most. Now, I will say that sometimes I do get lonely and feel forgotten or misunderstood as a mom. But I know that most of that is my own insecurities and lies I let myself believe. Overall, in most hours of most days, I feel incredibly blessed and loved. There’s nothing sweeter than watching other people love your kid.

Before Evan, did you or Alex have any medical experience or training?

Yes and no. Alex is a certified EMT, so he has had a lot of experience running calls on the ambulance. I, however, have no training other than what Grey’s Anatomy has offered me. That show seriously misrepresents premature babies and their appropriate care, by the way. Alex has a lot more confidence than I did at the beginning when we were still in the NICU. I was always so afraid I would hurt Evan. Learning Evan’s stuff has actually been super easy though. We had amazing nurses in the NICU too who really made sure we were prepared for everything long before it would happen. I also really like to fully understand what is going on with him, so I ask a lot of questions and do my own reading (within reason). Side Note: Do not Google your kids’ symptoms or random diagnoses without specifics in mind, mamas! You will always come to the conclusion that your kid is dying. Information being so readily available is definitely a blessing and a curse. But, it is nice to get a deeper understanding when you have specifics to research. I get asked often in doctor’s offices if I was a nurse or they assume I worked in the medical field before staying home with Evan. My answer is always, “Nope! I am just Evan’s mama.” My fellow special needs moms out there can definitely relate, I’m sure! Oh, and I used to be so queasy around blood and needles, but after watching your kid, who is a bleeder, get stuck about a thousand times, you get over it.

What kinds of therapies does Evan do?

Evan sees a speech therapist and a physical therapist each twice a month. They come to our house which is so nice because I don’t have to get out of my pajamas…seriously, I look like a dumpster fire every time they come. Speech therapy is focused on getting Evan to eat by mouth. We started with pacifier work, and we have moved up to spoon feeding! Evan has a very weak swallow reflex, so that has made it difficult to do liquids from a bottle. His suck pattern is also inefficient. Since he is almost ten months now, our plan is to bypass bottle feeding and move on to baby foods then hopefully work towards taking liquid from a sippy cup! He has been doing surprisingly well with the baby food. Today, he ate 1.5 teaspoons of apple at one of his feeds! He takes very small bites, so a goal is to get him comfortable accepting and handling more in his mouth at one time without getting overwhelmed and choking. With physical therapy our goals are mostly centered around reaching milestones and working on his poor flat head since the helmet hasn’t worked out for us yet. We do stretching to move his head to the right. We lay him on his right side to get him more aware of that side of his body. We assist him in rolling over from back to belly and back again. We do a lot of tummy time to work on his head control. At one point early on, and even still now, we do massage and light joint compression to get him to accept touch and not get overwhelmed by it. It also helps him be more aware of his body. Essentially, he has to learn that he has hands, feet, arms, and legs that can do things if he wants them to. Since Evan has pretty severe hypotonia, he will need to work a lot harder than other kids to reach even the simplest milestones which makes it so much sweeter when he makes any progress. We don’t take any of it for granted. Also, I feel like it is important to mention just how much we LOVE our therapists. Every single one we have worked with in-patient and out has been amazing.

What’s your Starbucks order?

This one makes me laugh. Y’all know I love (and need) my coffee! It all depends on my mood! My go-to’s include: iced coffee with cream and vanilla, a pumpkin spice latte (because I am a basic white girl), a vanilla latte (hot or iced depending on the weather), a latte with two pumps of vanilla and two pumps of cinnamon dolce (it tastes like a snickerdoodle), a hot white chocolate mocha, or an iced caramel macchiato. When I was dairy free when I was still pumping for Evan, I would get a cold brew with one pump of vanilla and a splash of almond milk. I also get bacon, egg, and gouda breakfast sandwiches, bacon sous vide egg bites, and chocolate croissants. Wow, seeing that all typed out makes me feel kind of gross but also kind of thirsty/hungry.

What color are Evan’s eyes/hair?

Both are light brown! He’s very handsome.

Why does him being upright (like in a carseat) cause him to have a hard time breathing?

A lot of preemie babies are very positional with their breathing, meaning they can breathe more easily when their necks (airways) are straight. When a baby is in a car seat, especially before head control is in play, his/her chin comes down to the chest. This causes the airway to become more narrow (I think?), so it it harder to breathe. Evan’s airway is so temperamental. In the NICU, we would have to change the way we were holding him often or some days not hold him because his breathing couldn’t take it. He breathes best when he is on his belly since his neck is extended, but he also hates being on his belly. Luckily, he is getting better! We are actually going to try to car seat test soon to get him into a regular seat again! Goodbye, giant cooler!

This is Evan’s car bed up close! This was from when we learned how to use it, so were in a hospital room not a car.

Do you see your family staying in Roanoke for a while?

Yes. 100% yes. Just the thought of changing his care team if we were to move makes me queasy. Right now, he has a team of about 20 doctors and therapists who see him. We love them, and we trust them. We do not want to leave them…ever.

What is he allergic to?

Milk protein and his old helmet! The verdict is still out on his new helmet. We got it yesterday.

What size clothes is he in right now? And is getting him dressed harder with all of his tubes and wires?

He wears 6 month clothes currently, but I think he might be in 9 month by the end of March or early in April! He is due for a growth spurt. Getting him dressed is just different. Not harder. We have to feed his feeding tube and pulse ox wire through his onesie, and we always have to go feet first with them because of his cannula. We are very thankful for the way onesies are made! With sleepers, he can’t do ones that zip up unless we were to cut holes in them for his feeding tube and pulse ox. In the NICU we could get away with his cords coming out the top for two reasons: he was almost completely immobile and he was monitored 24/7 by machines and nurses. Oh, and he needs mittens always now because he won’t leave his cannula alone! We found some that have velcro so we can tighten them to stay on! Goumikids is the brand–highly recommend! I really just want every product they sell in Evan’s size.

How has your faith grown since becoming a mom, and what scripture have you found you’ve been clinging to?

In the NICU, Psalm 61: 1-3 was my constant prayer and even now, I go back to it so often. “Here my cry, O God, listen to my prayer; from the end of the earth I call to you when my heart is faint. Lead me to the rock that is higher than I, for you have been my refuge, a strong tower against the enemy.” Being Evan’s mom has made me lean on Jesus more than I have in my entire life. I think of Job too; he experienced so much suffering and loss, and at the end of it, he was grateful. He said “My ears had heard of you, but now my eyes have seen you.” (Job 42:5). I remember talking about this verse in a campaigners lesson I gave when I was a Young Life leader. It still stands so true. In the pit of despair, that is when we are most aware of our need for God. That is why we can be grateful in suffering. We are given a unique chance to have an intimacy with the Father we never would have found in different circumstances. We are given the opportunity to truly trust Him fully and surrender to His will. I love my God for who He was yesterday, who He is today, and who He will remain to be tomorrow. He is GOOD. Always. I could probably talk about this question for days.

How do you care for yourself in this season of constantly caring for Evan?

I just chuckled at this one. I am still figuring it out. And, I think, depending on the day, “self-care” looks different. Some days its giving myself the grace to look like a human piece of garbage in public and not care. Some days it’s drinking a lot of coffee (okay, most days). Some days it’s taking five more minutes to just stand in the hot water in the shower. Some days it’s actually taking a shower. Some days it’s taking a nap when Alex gets home from work or sleeping in on the weekend. I’ve gotten two pedicures since Evan was born too. My feet wish that number was higher. And some amazing friends and family have gotten me gift certificates to my favorite place for facials and massages! I also think caring for myself is in making time for Jesus every day which is my Lenten goal! I can so easily find excuses to not make time for scripture and truth and prayer in my days. But this Lenten season, I am going to call myself out on my crap and not make excuses. When I lean into the Father, I am a better mom, wife, sister, daughter, friend. I owe it to the ones I love to be in tune with the Spirit.

How has parenthood affected your marriage?

Honestly, it has made me love him so much more. Obviously, there are times when we get frustrated with the other–usually due to lack of sleep, caffeine, or proper nutrition (usually all the above). But that’s normal marriage I would say. No relationship is perfect. Entering into parenthood is stressful. Entering into it under the circumstances we did was, well, I don’t think there’s a word that would suffice. I would equate it to expecting a light breeze and stepping outside right into a tornado. It’s been hard, but it’s been good. Watching Alex love Evan is probably my favorite thing in the world. Watching him fight for and advocate for him is incredible. I am so lucky to have him as my parenting partner. When one of us is having a particularly hard day, the other (usually) just picks up the slack without even being asked. We always say, “We are a team.” Sometimes we say it just to reassure the other person that they are doing a good job, and it’s okay to have an off day or be tired or frustrated or need a break. Parenting has forced us to be more honest with each other about where we are emotionally too. We know we can’t be our best for Evan when we are spent, so we need to rely each other more in those moments.

Has Evan’s personality started to come out?

I would say it’s always been evident that he is dramatic and stubborn. In the NICU, he would hold his breath to get attention or make someone go away if they were trying to get him to do anything that required work (we’re sorry, Sam!). When Evan says no, he says it loudly. But I do think he is getting more aware of the world, so he’s just more fun! He laughs when we tickle him. He flirts (always!) with his girlfriends when they come to see him. He looks so pleased with himself when he does certain things (mainly pooping). He loves music, and now that we have confirmed that he can hear in at least one ear, I know I’m not making that up. He hates napping and usually only does it for his daddy. He doesn’t like to be alone. He hates his helmet (old and new). When he wakes up in the morning, he demands attention. His newest love is this little blue elephant stuffed animal with a bell in it that jingles. He thinks that thing is hilarious. So yes, he has a big personality, and it’s amazing. It just keeps getting better.

What’s in your diaper bag?

This one requires pictures. I love that this was asked. I wouldn’t have ever thought to share about our diaper bag on here. Our diaper bag isn’t actually a diaper bag; its an EMS medical bag. It is large and heavy and not at all like the cutesy ones we got from our registry.

Excuse my toes.
Evan wanted to be in the picture. This is what it looks like on…big haha. Typically his oxygen tubing would be going into the bag, but this was just me wearing it for show not actually using it.
A slot for everything we need including an oxygen tank! Top mesh pocket: diapers, wipes, and butt cream. Bottom mesh pouch: extra outfits, burp cloths, and washcloths.
The front bottom pocket: emergency button kit if we need to change out his G-tube.
Front top pocket: emergency essentials (gloves, a syringe for g tube venting, tegaderm, and the bulb syringe lives in the cup holder of the stroller) and my wallet.
Red pouch: G tube care and emergency essentials.
Orange pouch: mom and dad essentials for unexpected hospital stays.
Yellow pouch: airway supplies and emergency essentials.
Blue pouch: oral care and back up pacifier.
Not in the diaper bag, but an essential part of traveling with Ev: our suction machine. Evan’s got some grown man boogies and spit that he can’t handle, so this thing has (literally) saved our lives.
Also not IN the bag, but so important to take with us: his monitor! This is a picture of it on the floor of my car because the sun was making it impossible to read in my passenger seat. Also pictured: a full back up oxygen tank. That bad boy lives in my car and for good reason! As you read the other week, it has come in handy!

So our “diaper bag” isn’t really a diaper bag and doesn’t all fit in one bag. But, we’ve got a good system that works for us. Just realizing I completely forgot to add in his little backpack for his feeding pump! Duh, that’s so important. The kid’s gotta eat. Whoops.

What upcoming surgeries does Evan have?

Well, I’m glad you asked! He has surgery TOMORROW! Or today, depending on when you read this. March 8 at 7:15AM he undergoes surgery to correct his clogged lacrimal duct which is the reason for our chronic MRSA. They will also do a sedated eye exam to get a better idea of his vision and internal structures. Last week, ENT was able to piggy back onto our surgery, so they will do a sedated ear exam and most likely place tubes in at least one of his ears if not both! I am so thankful they were able to coordinate and make this happen. Please pray for peace for Evan’s mama and daddy as surgery is never fun. For energy for us (mostly me) since it’s 10:40 and Evan still has yet to go to sleep, and we have to be up at midnight and 3AM then leave the house at 4:30AM. Pray Evan goes to sleep soon if your reading this right after I post it. Pray for his doctors and nurses. Pray for no issues with intubation. For easily managed pain after surgery. For a clear call on whether or not we need to get admitted for a night. For easy recovery and success in all the things!

THANK YOU!

I really liked getting to hear from you guys for this blog post. Thank you for sharing in our story and our adventure with Evan. In the future, I’d love to just tack on questions and answers to the bottom of posts. So send them my way whenever you think of them! Also–If I missed your question in the midst of my sleep deprived mom brain trying to relocate them all this evening, please send it again! I’m sorry!

Our Life in the NICU: Part Two

We were blessed. Blessed to know ahead of time that we would be spending time in the NICU. I always told people that, and I believe it. Knowing something hard is coming gives you time to prepare for it. By June, we had truly accepted that NICU life was our normal. This was how we would experience the newborn stage. This is where we would navigate the uncharted waters of parenthood.

Sweet boy with his daddy.

Alex was lucky enough to be able to take six weeks of FMLA when Evan was born, so for six weeks, we spent every moment together. We had never done that in our whole married life. I don’t actually know any married couple, aside from those retired perhaps, who can say that. It was a dream. I fell more in love with my husband in the months we spent in the NICU than I knew possible. We were a team in all things. Alex showed me Christ’s love in ways I had never really experienced from another person before. He sacrificed for me and for Evan daily. He always put our needs above his. He was the quiet strength I needed on my darkest days. Our marriage was strengthened by crisis. This is one of the many gifts the NICU gave us.

My whole heart outside of my chest.

As I said in my last post, June threw us curveballs. Evan was throwing up roughly 30-40 times a day, and honestly, that may be a conservative number. Through all the extensive testing his doctors did to establish a cause, all we could find was acid reflux. “The worst case of reflux” one of his doctors “had ever seen in any NICU patient.” This doctor has been practicing for decades. I told you. Evan is special. He has to do everything in a dramatic, over-the-top manner. We got to the point where we just didn’t put clothes on him anymore because changing his outfit at every single caretime just to change it again five seconds later was irritating him so much that he would throw up even more. To this day, I cannot hear another parent say their child throws up “a lot” or has “really bad reflux” without rudely thinking “you have no idea what acid reflux is.” (I know that each child is different and everyone’s experience is their own. But comparison, that nasty thief of joy, comes at me and leads my mind to these sinful and inconsiderate thoughts. I am human, and I am sorry.) Evan did not gain any weight at all in the first two weeks of June. Our team decided we would place a G-tube, a more permanent way to tube feed that goes directly into his stomach, in hopes that this could relieve some of his reflux since he wouldn’t have a tube going down his esophagus. He was put on the surgery schedule for June 13, a day when, thank God, Maegan would be with us.

In the midst of all of this vomiting, I should mention that we were also working with speech therapy to teach Evan how to suck-swallow-breathe, a combination necessary for eventual PO (by mouth) feeding. He did not have much of a swallow reflex when he was born, so if he had food, vomit, or even spit in his mouth/throat, he would choke, hence all of his desaturations. When Sam, our wonderful speech therapist who we still work with today, would come to work with him he often said “no, thank you” by dropping his sats and turning blue. How rude of him. Thankfully, Sam didn’t take too much offense and stuck with us even though Evan was pretty mean to her during our time in the NICU.

“No pictures, Mom. I don’t feel well.”

Even though Evan was throwing up constantly, dropping his sats often, and turning blue so frequently it seemed like it was for kicks and giggles, we started to get comfortable. Good NICU nurses are ones who teach you how to be calm in chaos, because life with a preemie will be chaos at least for a while even if you go home. We had great ones. Maegan knocked in the cardinal rule of the NICU: If we don’t freak out, you don’t freak out. It took some time for it to sink in, but it did. Martha taught us a second one: It’s okay that it’s not okay. I don’t even know if she knows she did this for us. But it was one of the most impactful lessons I learned.

We now knew what beeps mattered and which ones we could ignore. We knew when to ask for help. We knew Evan well enough to know something was wrong even before the monitors told us. We knew to breathe and stand aside when nurses needed to rush to his aid. We knew that when his blood oxygen was reading 9% and his HR was 31, his God would save him through the hands of his guardian angels. We knew that this would be temporary. We knew that our God is a faithful God who redeems all things.

Waiting for the surgeons to come get him.

June 13, surgery day, finally arrived. Evan wasn’t allowed to get any food until his surgery so he was just getting IV fluids. That was the happiest and calmest day he had had his entire life. No food. No vomit. We were worried he would scream in hunger all day, but he was so sweet and content. Our hearts were equally broken and joyful. Our sweet boy was made happy in hunger. But maybe this is a lesson…our time with a sick child has been a time of intense hunger and need for Jesus, and because of that it has been one of the most joyful. Wow, I am still learning.

We said a prayer as they wheeled Evan away and decided to go for a walk outside to keep our heads clear. We barely made it 20 yards from the hospital doors before we got a call from the surgeon. “There’s been a complication…” I honestly cannot remember everything he said to me on the phone because we were sprinting back towards the hospital. I remember “CPR,” “epinephrine,” “we got him back,” and “we will meet you in B pod.” Our boy was NOT okay. This was NOT the way this was supposed to go. We rushed back into the NICU, and a group of nurses and CNAs were getting all of our things from D pod to move to his new carespace in B pod. You don’t bump back up in the alphabet. That’s not how the NICU timeline is supposed to go.

We stood and watched as they rushed Evan in. He looked lifeless to me. He was pale. He was limp from medications. He had a breathing tube keeping him alive. I remember his temperature was way too low, so they had a heating pack underneath him. I think there were at least six people in his carespace frantically working on him. “They are freaking out,” I thought. “What am I supposed to do?” They drew blood and called out numbers. They ordered blood for a transfusion.

So swollen.

All of this was happening while the surgeon explained what happened to us again in person. You know those risks they tell you about before any surgical procedure no matter how small? How there are things that happen in less than 1% of people, but they still need to mention it? Well, Evan is that less than 1%. His airway spasmed when they tried placing the breathing tube when putting him under. It completely closed. No air could get in. They had to give him epinephrine and do chest compressions to keep him alive and get his airway open again. Once they could place the breathing tube and get his vitals up, they couldn’t risk proceeding with surgery or extubate with him being so unstable. I don’t know if I was stepping up and being the “strong one” or if I was just in too much shock to react, but I just stood there and said “okay” while Alex reacted the way I think I was supposed to. Once things settled, the respiratory therapist pulled a chair up beside Evan’s bed and told me to go hold his hand. He didn’t look like himself. He looked like he had lived a thousand lives since I last saw him just an hour before. Where was my sweet tiny baby? Why did this happen? Where do we go from here?

We stayed late that night. It felt even more wrong than usual to leave him behind as we went home to get some “rest” (you never truly rest when your baby is in the NICU). Maegan had picked a nurse for him that night since he was supposed to be post-op. Her name was Brittany; she would later become our night primary and a dear friend. When we got home, I came undone. Alex held me and kept reassuring me that Evan was okay now. I didn’t believe him.

The next few days were hard. Evan stayed intubated for 36 hours and was so irritable when he got extubated. They had to place a new PICC line for TPN since he was going back to the beginning with his feeds. This was a major setback for him. Not only was he too unstable to reattempt surgery for at least a month, but he also was back where he started in May with his feeding. His doctors came up with an alternate plan. His NG tube needed to go past his stomach into his intestines. This could stop him from throwing up as his food would never be in his stomach. They fed the tube further in and checked it with an X-ray. It was in the duodenum, the first part of the small intestine; he could safely get feeds now. As they weened him down from TPN and up on his continuous ND feeds, something crazy happened. He started to grow. Not only did he start to gain weight, but he also got hair!

ONE MONTH.
Hey, brown eyes.

Things started to turn around. Evan turned one month old, and as a special surprise, on his 33rd day of life, he opened his eyes for the first time! Only for Maegan, of course, that little flirt. But she snapped a picture for us because she knew I would kill her if she didn’t. He didn’t really do it again for a while, so this sweet picture meant the world to us. Just when we didn’t think he could get any cuter!

Now he was growing to be strong enough for another attempt at surgery and beginning to ween his respiratory support.

“You’re allowed to be here now!”

“My ears had heard of you, but now my eyes have seen you.” (Job 42:5) This is one of my favorite verses in the Bible. Job says this after years of tragedy and hardship. He knew God before and even trusted Him, but it wasn’t until he had been in the depths of the valley that he felt he had truly experienced God. True intimacy with Christ can often only be gained after being in the pit, a place where our need is greatest. I have seen the pit several times in my life, and every time I come out more in love with my God despite the outcome of my circumstances. I thought of Shadrach, Meshach, and Abednego going into the furnace when I considered Evan’s life before he was born and there was so much we didn’t know. I thought about them when I watched my son fight his way back from the brink of death on multiple occasions. I think of them now when so much of his future is uncertain. “And if not, He is still good.” A mother’s love is a force to be reckoned with, but God’s love? There’s no comparison. I am not the one who loves Evan most. I never will be. His Heavenly Father loves him with a reckless, never-ending love that I cannot even fathom. So even in the valley, I will trust and praise Him.