Tuesday, June 27, 2017

Casts in progress

Hawk is now on his 5th set of corrective casts for his feet! The process to correct his "inverted talus" started when he was 3 weeks old (the same time as babies born with club feet, at least here in a country that has the medical care to correct the feet so early on), and the orthopedic doctor anticipates approximately 8 weeks of weekly soft casts, which slowly angle his feet down and inwards. Babies' bones are mostly cartilage at this age, so they are pliable and correct much more easily, and heal more quickly. This procedure is called "Ponseti casts". At the end there is a surgery to insert a pin up his heel, through his ankle and into the base of the leg bone; they also will cut the Achilles tendon so it can lengthen as it heals. After the surgery Hawk will have his final cast for 3 weeks.

Dr Raustol has seen a lot of success in children that go through this process, though he is a bit uncertain of how Hawk's body will respond, considering the tightness in joints that he was born with. It may mean the reshaping will take some extra time, or that Hawk will be more prone to regress in the future and will likely wear orthotics once he starts walking (we hope and pray!). So far the process has gone quite smoothly and we are already seeing the changes in his feet. Just today they took x-rays of his feet and saw the talus bone has moved the right direction, but still has some movement to make, so Dr Raustol has added two weeks to his casting process and then will take x-rays again.

We are SO thankful for the access to quality medical care, which hopefully means that Hawk's feet and legs will work properly and he will be walking and running normally in his life!!

Here are some progress photos. The first two show what his feet looked like when he was born.



And - photos from his first set of casts. He has done SO WELL and never even cried while they put on or take off the casts. The first week he pooped and peed all over the table (because they have to loosen the diaper to put the casts on high enough) and got quite a reputation... but he hasn't done that again. The casts go all the way from toes to thigh to ensure that he's not making any movement in his legs to disrupt the bones.



In the meantime, Hawk has started smiling! And he has long periods in the day when he is alert and happy and looking around. He seems to like to hear his brothers and will turn his head to see them. He also loves lying down, stretching and making cute noises and listening intently.



And two photos from today. He gets a precious 10-15 minutes between casts to stretch out his legs and get some nice touches and massages from mommy. It's really amazing to see him kick his legs and stretch out, because when he was born he didn't do any of that! The nurse also weighed and measured him today: 3.62 kg/8 lbs and 20.5 inches long. (That's 2 inches grown since birth!)


Look at the change in his left foot! (and a lot of dry skin)


Good job, little Hawk! We are so proud of you!



Saturday, June 24, 2017

Creek walk with cousins

Summertime means family time! We LOVED having the Weltys here for two days - if only it could have been longer. They are on a break from Texas for the summer and spent a couple of weeks in nearby Montreat, so twice they were able to come over for the day to hang out. The boys really hit it off with legos and good guy/bad guy games, and once again Lillian was adored by her younger cousins (Mattias followed her around and she was very patient and helpful with him).

Meanwhile Rachel was also here with us (on her own! party!) for 5 days. The boys were so, so excited to have her - and Timo barely stopped talking her ear off or asking, "Auntie, do you want to play with me?"



It doesn't take long to get to it with legos!

On Saturday we all trooped along Fisher's Creek (trail just on the edge of town). It was a bit cool and cloudy but still great to be on the trail and near (or in!) the water. I think this counts as Hawk's first hike.


this is Timo's new "explaining" posture
 

Cold!






Back home for the afternoon. The sisters got to go out together for coffee during naptime, while the Welty kids checked out the public library. And then it was time for smiles from Hawk and supper outside.






Time for a little Far Side before bedtime and good-byes

Sunday, June 18, 2017

Visit from Mom and Dad G

We really appreciated and enjoyed having Dad and Mom G here earlier this month! Mom stayed for a week, and Dad joined for the weekend. Mom even had her birthday while here! Timo and Mattias loved having them - and it was fun to reminisce over last year's visit, which also coincided with Mom's birthday, and realize how much the boys have grown. And now another little brother to join the fray.

As soon as Granddad arrived, it was time to wrestle! Timo remarked, "He has some strong moves." Timo 'bothered' Granddad all weekend to play soccer or beach ball or basketball or tee ball or Legos or watch him ride his bike. It was non-stop action.


 We had a lovely morning for a stroll and picnic lunch on campus. Even baby Hawk cooperated (riding in the stroller) for his first time to visit Western. It was SO quiet without students around and none of the fast food or coffeeshops open.

 


 

Naturally, Nonna had some good snuggle time with Hawk during her stay. At four weeks old, he  likes to be held a lot (even for naps) but is starting to have longer periods of "happy, alert" time, like lying on a blanket on the playroom floor while Timo and Mattias make a ruckus with Legos.


How GREAT is this!! Granddaddy bought a soccer girl and size 3 soccer ball for the boys! Fits perfectly in our fenced side yard.



picnic lunch outside - and looking at Nonna's pictures

Time to eat lunch, Mattias!
So relaxed!

Saturday, June 17, 2017

Outing to Darnell Farms

On a Saturday morning in late May, Jim took the older boys to a nearby farm for their Strawberry Festival. There was a plowing competition (non-mechanized); antique tractors; bouncy houses; kettle corn; dancing; pony rides; and a hay ride. And of course, local farm produce and strawberries!






Friday, June 16, 2017

First bath!

He was so calm and alert to the feel of the water.



We are looking forward to being able to give him baths again once all his casting is finished!

Brothers and Legos (of course)

Just for fun, all the brothers next to each other!



At a recent check-up (for WIC), Timo was 36 lbs, Mattias was 31 lbs, and Hawk - at 3 weeks old - was just under 7 lbs.  This photo was taken a few days before Hawk started his feet casting (and he's now on the third week of that process). This was also pre-haircuts, as you can see.


Such gentle kissing from the older ones!


Timo and Mattias have spent MANY, many hours with Lego Duplos in recent weeks. Naturally they get along great and create vast airports/cities/parking lots/electricity centers/water treatment facilities etc and then in the next moment they are yelling at each other and crashing everything down...




We have a photo of newborn Mattias in this outfit so I wanted to get one with Hawk, too - but he is so much smaller at 3 weeks!! Even though it may look it, his feet only came down to the leg/pant and didn't even come to the footholes! He's not much bigger than Gemma's doll.

 


And here is one of the main uses so far for baby Hawk's crib - Mattias's big parking lot (and a quiet, uninterrupted place for him to play by himself)! - since Hawk has been sleeping in a mini-crib in our bedroom so far.



Friday, June 9, 2017

Exhausting but Fortuitous


Oh, the 2nd week of Hawk's life - phew!!! Now that he is 5 weeks old, perhaps I can think back on it - three weeks ago - and not feel too personally the intensity of the stress and exhaustion. After a routine weight check at the pediatrician's office when he was five days old, we were recommended to take him immediately to the pediatric unit at the hospital in Asheville. He had lost a pound and a half since birth and had a high bilirubin number (jaundice). As quickly as we could we left the Dr, went home and packed a week's worth of clothing, and said good-bye to Jaja, Timo and Mattias. It was a scary, confusing day. We didn't understand what was going on with Hawk's little body; we didn't know what to expect at the hospital; and we didn't want to leave our two older boys for days on end. Most of the hour's drive to the hospital I was frantically calling/texting our family and trying to take deep breaths to calm down.

When we arrived at the hospital we immediately walked right into our room (already assigned) and the nurses got to work settling us in. They were calm and friendly. Thankfully Hawk was pretty subdued and cooperative (we learned that high bilirubin often makes babies lethargic). He started on the UV light therapy bed that afternoon. It was SO hard to have him on that bed 24 hrs a day, which meant that we couldn't hold him (unless he was wrapped in the UV blankets, and then only for brief periods) or try to nurse him. The pediatric hospitalist and the feeding team (lactaction consultant and nutritionist) agreed that we needed to feed him with a bottle rather than nursing him, as it was clear that he hadn't been nursing properly and able to get enough milk, most likely because of the high palate in his mouth (fortunately not a cleft palate). However we were very thankful that he didn't have to be admitted to the NICU but just to a standard room, where Jim and I could also stay and sleep.



The priority while we were there was to get his bilirubin numbers down and get him eating enough that he would gain weight (and eat the appropriate amount at each feeding for his weight). It was a slow process on both accounts. He took to the bottle well (which meant I was spending a lot of time every day and night pumping milk, and with the stress my supply dwindled) but he was so tiny that he could only take small amounts at a time.

Meanwhile - and here was the unexpected good fortune of returning to the hospital - an array of doctors and specialists came to see Hawk every day, to assess his different physical needs: geneticist; pediatric orthopedic; physical therapist; occupational therapist; lactation consultant; nutritionist; and pediatrician. There was also a case manager from the hospital to help us understand the process and help us with health insurance and paperwork. Every morning the team of doctors and residents would also visit during their rounds. Every day was full and exhausting - and yet, we were very grateful. When he was born we knew Hawk would need extra care and eventually need to see all those specialists, but we didn't know when or how the process would get started. For one, we thought we'd have to wait several months before seeing the geneticist, but because we were back in the hospital, we saw him right away and started on the process of bloodwork to try and determine if he has an underlying condition that has caused the different physical problems in his extremities. To a person, the specialists were kind, gentle, patient, and willing to spend time with us answering questions (sometimes the same ones over and over).


From the geneticist and orthopedic we learned that Hawk's tightness is called "contractures", which means that in the womb he wasn't moving enough (the reason behind it is what we are still waiting on from genetic testing) and so he didn't develop his joints, tendons, and muscles properly. Starting now he needs therapy to help relax the contractures and gain that range of motion; to what extent that will be successful long-term we don't know - though already in the last three weeks he has improved, especially in his arms and neck. Hawk also had x-rays that revealed a dislocated left hip and vertical talus (ankle/heel malformation) in both feet. Learning that is what has led us already to start the corrective casts on his feet. We have to wait until at least 1 year old before any correction to his hip. His hands have what is called 'ulnar deviation' so it is a priority to get therapy to stretch the hands and develop them properly; it is uncertain what kind of facility he will have with his thumbs.

We had never bottle fed any of the three older children before, so this was a learning experience for both Jim and I!!


Carolyn, occupational therapist; fitting some soft splints on Hawk's hands to help stretch them out
Another wonderful thing of being in the hospital was the support that we received. We had visitors every day and more delicious food than we were able to eat while there!! (Which was good because boy was that hospital food terrible.)

Darryl (pastor at the church we attend) and Blake visited us one morning and brought us donuts and lunch from Trader Joe's

The best visitor was Grandpa!!!! It was a huge relief to have Dad drive out for a few days. He visited us in the hospital before going to our house in Sylva.


After nearly four days, Hawk's bilirubin was back to normal and he was drinking enough milk from the bottle that he had gained some ounces and we were released to go home. It was great to see him looking a bit more alert! One of the conditions for going home was that he have an NG tube (feeding tube) inserted, to pump in additional milk if he did not drink enough by bottle. Thankfully, after four days at home, we only needed to use it twice and he continued to eat more every day, so the pediatrician took it out at his 2 week appointment.


Two very attentive, gentle older brothers


A quiet moment with Grandpa

Still such a tiny squirt!

Ten days old! Grandpa headed home again, while Jaja stayed on another week.