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On May 4, 2009, Josh and I discovered that our soon to be little girl, due on August 25th, would be born with a CHD known as HLHS (hypo-plastic left heart syndrome). Upon hearing "something is wrong with your baby's heart" our lives changed completely. Our little Ruth Elizabeth was brought into this world on August 18, 2009. She was delivered via c-section and rushed immediately from Barnes to Childrens' Hospital for a cardiac cath intervention. Her arial septum was reopened and a week later, Ruthie underwent her first open heart surgery, the Norwood. Unfortunately, Ruthie was not able to survive on her Norwood heart and the Glenn procedure would not work for her. Ruthie was placed on the heart transplant list Feb.3, 2010. After waiting in SLCH, Ruthie received a new heart on July 5, 2010. We are so humbly blessed to receive this gift of life. We now are on the road to recovery. We have had our ups and downs. We have become SLCH regulars due to countless hospital stays and ER visits. We are learning how to manage life outside of SLCH and with another little girl. Now that we have two children, we are learning the about being a heart FAMILY.

Thursday, August 26, 2010

Slow and Steady!

Ruthie is slowly working her way up the scale.

She is 6.87 kilos, which means she is a little less than 15 lbs. She has gained .17 of a kilo in a day! GO RUTH! Her max feeds are at 36 mils an hour, continuously, through a NG tube.

She is still on 8L of o2 through high humidity nasal cannula. She is stating 98-100%!

She is so happy and so playful. She is working hard on sitting up and coughing. She is clearing most of the "junk" from her lungs.

Ruthie's chest x ray is starting to show some clearing. Her doctors also believe that her breath sounds are more defined on her right side.

We are getting there! Slow and steady is Ruthie's pace. We need not rush her. She will let us know when she is ready for a push.

So, hopefully the end of the this 7 month hospital stay is in sight.

Everyday, we are thankful. We are so blessed.

Thank you for the prayers. We are only as strong as the prayers behind us

Sunday, August 22, 2010

Weekend Smiles

Ah, I love weekends full of smiles and giggles. Ruthie has been rather happy the past couple days.
On Friday, Ruth had a surprise visit from a St. Louis favorite, Chris Carpenter. (For those of you who don't know Chris Carpenter; he is a St. Louis Cardinals' pitcher. He is actually a quite talented pitcher.) Anyways, he was in the hospital and the nurses saw him down the hall. So quickly they flew into action and got Ruthie all dressed up in her Cards gear. She was all dressed up and smiles by the time he hit her room. The St. Louis Post Dispatch took a few pictures and Carpenter gave her a bear with a signed Cardinals jersey.


Besides her meeting famous baseball players, Ruthie's weekend has been good. She is working hard on sitting up and playing with her new birthday toys. She is smiling non- stop and almost laughing out loud.



Unfortunately, her chest x-rays are not showing the same "happiness". They are still a bit cloudy and her right lower lobe is still collapsed. She "clinically" looks good, but her films don't say the same thing.
RT and the nurses have bumped up their attack plan. They are still "vesting" her every 4 hours and giving her breathing treatments. They are now adding chest PD (where they beat on her right side) every four hours (between her "vest" treatment). We are all working on getting her sitting up and moving around. We are encouraging her coughing and suctioning her to keep her clear. With every suction and every cough, I hope we are getting closer to the end of this infection and lung junk.
Ruthie is up to full feeds. She is tolerating them well. She is on pediasure 28 mils an hour continuously.

Please continue to pray for Ruth's strength. Pray that she can continue to heal her diaphragm and clear her lungs out. Pray for the doctors and nurses. Pray for their guidance and wisdom. Pray for courage and pray for understanding. Pray for patience.

Thank you so much for the comments and prayers. We are very blessed.

Hugs!
The Yarbrough's

Friday, August 20, 2010

Happy Birthday, Ruth

HAPPY BIRTHDAY!

Happy Birthday to you! Happy Birthday to you! Happy Birthday dear Ruthie! Happy Birthday to you!

Ah, what we week we have had!

Before I get to the fun, birthday stuff I want to give an update of where Ruthie is, medically speaking.

Ruth's plication of her right diaphragm went as planned on Thursday. There were no major issues.


Ruthie taking a nap before her OR visit! First time sleeping on her belly!

(Oh and don't mind the date on the pictures, the AM/PM mode is messed up!)

She was extubated last Friday.

Ruthie was having a few issues with breathing last Saturday. Her lungs looked more junky and she was breathing much faster and working harder.
So Saturday afternoon, Ruthie was re-intubated!



Feeling a bit better, even with a tube in!


By, Sunday her numbers already looked better. They felt that she just needed a little more time to recover from her plication.

Monday morning hit and the tube was ready to leave. However, we had a scheduled heart biopsy for Tuesday. We felt, and the doctors, agreed that it was not worth pulling the tube to replace it the next day for the heart cath.
So instead of pulling the tube, we went to the Cath Lab a day early!

Ruthie's heart biopsy went well. Her pressures are the lowest they have seen from her EVER! WOO HOO! The biopsy results also came back saying no sign of rejection!

Ruthie was extubated on Tuesday. She was moved to high flow nasal cannula at 10L. She is receiving respiratory treatments every 4 hours. She now is "vested".



She honestly loves the treatments. They shake her up for about 20 minutes.



Then on Wednesday, it was her BIRTHDAY!


Welcome to the party!



Thank you so much CICU staff for decorating her door! HUGS!


And the board in her room


Her birth moment, 9:59am. I found it rather comical that she was crying during that time. It was a nice flash back to me hearing her cry for the first time:)




She was much happier after we got dressed!


Princess Ruth E Yarbrough

She had quite the flow of visitors in and out all day.
Everyone wanted to say hello to the birthday girl and of course check up on the cake!



I made the pinkalicious cupcakes!

Becky, from Child Life, gave Ruthie her first pair of high heels!



Ruthie loved all the attention!
She seemed amazed by all the decorations!


Her CICU bed.





The back of her door!


Her window!

As a special treat, the CICU allowed cake, cupcakes, and many visitors in her room! Ruthie was treated like a princess. She was able to have her grandmas, grandpas, aunts, uncle, mommy and daddy in the room with her to sing Happy Birthday! Her cousins sent love from the Sibling Playroom. They also sent an amazing video to Ruth!

(It is posted below!)

So we all found a pitch, not the same one of course, and sang to Ruthie!
Happy Birthday to you! Happy Birthday to you! Happy Birthday dear Ruthie! Happy Birthday to you!


And Ruthie tried her first pinkalicious cupcake.


She was a little confused with the whole cake idea!

But, it's her party and she can cry if she wants to!

Once she tasted the icing on her pacifier, there was no turning back!






It was amazing. Ruthie really enjoyed herself.
As she started getting settled in for the night, she was all smiles.




Unfortunately, our excitement for the week does not only come from Ruthie's 1st Birthday!
Yesterday, Thursday, Ruth's chest x-ray showed that her right lower lobe of her lung collapsed again.
Right now we are trying a various of respiratory treatments. We are "vesting" her every four hours. Ruthie is also inhaling different antibiotics during her "vest" treatments through a face mask. It is a humidifier mist that she inhales to help break up any secretions.
We are also working on her nutrition. We want her to be as strong as possible so she can start clearing her lungs herself. She is now back up to 20 mils an hour of continuous feeds. Her goal is 28 mils an hour. We are slowly working our way up. She seems to be tolerating the feeds fine thus far.

Long term...
So where does this put us long term?
Well we are still unsure. There are a few options. We are hoping we can optimize her nutrition and make her stronger to compensate for her paralyzed diaphragm. However if we are unsuccessful with this course of treatment, we will start turning to the pulmonary team. We will consult with them and figure out where we need to go next. It is a possibility that we may need to turn to Ear Nose and Throat. If we start to turn towards them, however, that means we are seriously discussing a tracheal tube. The trach would be placed in hopes of making it easier for us to help Ruth clear her lungs and optimize nutrition. The trach could be in for 6 months to a year.

I am not going to sugar coat this, I am scared! I am fearful. I am nervous. I am worried. I feel as though we were so close, so very, very close to the "end" of this all and now WHAM! (Sigh) We have a new, serious issue to discuss.

All I can do is step out on faith. I will pray, knowing that God will provide. It is in His hands. We are here to live out His plan.

Please continue to pray for us.
We still have a long road a head of us. Pray that Ruthie can continue to be a fighter. Pray that she can grow stronger and clear this lung stuff on her own. Pray that we all have the courage to face the next steps.

I feel as though I need to say Happy Birthday to you all as well. You have been here through it all. It has been one miraculous year. You all deserve a pat on the back, a heart-felt thank you for praying her and us through this year.
Thank you! Thank you! Thank you!

HUGS!
The Yarbrough's

Thursday, August 12, 2010

Update: Changing plans, again!

So, a little change in plans.
Dr. H, Ruthie's surgeon, strongly suggests that we go ahead and take care of her diaphragm today. Dr. C and him agree that her heart function is fine. They are more concerned that her paralyzed diaphragm will continue to cause her respiratory issues in the future.

With that being said, here's the plan...

Ruthie will go to the OR this afternoon. She will have a procedure, know as diaphragmatic plication, done today. This procedure will "pin" down the right side of Ruth's diaphragm. This in turn, will help her lungs expand and work much better. They will also re-inflate her lung while in the OR. Right now, her paralyzed diaphragm is working against her lung. It is causing her to have shortness of breath and thus requiring more o2. This is why her lung slighly collasped yesterday.

On Tuesday, August 17th Ruthie will go in (first case 7:30 am) for her biopsy/ heart cath. After we have numbers from the biopsy and after Ruthie recovers from the Cath Lab, she will be able to come home (fingers crossed). So barring any complications, we should still be home either the night before or the morning of her 1st Birthday!

I will let you know once we get in the OR.

Please continue to pray for her strength.
Pray for guidance and wisdom for her doctors and nurses.
We trust! We believe!

Hugs!
Laura

Wednesday, August 11, 2010

Prayer Request

Things have changed slightly!

Ruthie's right lung collasped a little early this morning. She is currently in the CICU and doing well. She is on 10 L of o2. She is receiving PD every two hours to help keep her lung as open as possible.

Tomorrow morning, Ruth is going in for a biopsy and to re-inflate her lung. This biopsy will take the place of the scheduled biopsy on August 17th. They are honestly not too concerned about her heart right now. It just makes sense to intubate her and put her out for everything at once.

We are still planning on leaving early next week. Dr. C feels that we will be ready after we remove her broviac, do a biopsy and re-inflate her lungs.

So please keep Ruthie in your prayers over the next few days.

Hugs!
Praise be to God!

Laura

Tuesday, August 10, 2010

We have a plan!

We have decided on a plan!

Ruthie is going to stay at Children's until her biopsy, which is scheduled August 17th (first case... 7:30am). She will undergo the cath/biopsy and then recover back in 7 West. Depending on how she does after the cath, she may go home that night or early the next morning. Either way, the plan is to have her home on or before her 1st birthday on August 18th!


So, 7/8 days and counting!!

Ruthie is getting pretty excited!



She has been working really hard all around.
She is working on sitting up.
She is working on eating some things by mouth.

She is even practicing covering herself from the sunshine..........................
(that she hasn't seen in months!)



She is slowly coming right along.

Please keep Ruthie in your prayers as we work on a transition from Hospital to Home.
I know she will do it, but it may take her a while!

Thank you so much for the prayers!

HUGS!

Monday, August 9, 2010

On the edge....

It is scary how close we are to leaving Children's Hospital.
I am so excited. I am getting antsy.

However, I am a bit nervous. We have been "living" at Children's since January 22nd. We have come "comfortable" with our surroundings. We know the people there and they know us. We have built relationships and friendships. We have turned floor 7 into a home and community. We have neighbors and friends to support and love us. We have doctors and nurses to keep an eye on us. We have so many people that not only healed Ruthie's heart, but all of our lives. I can't believe I am saying this, but I almost don't want to leave. I really like it there. Its nice. Its comfy. Its homey.

But alas, I am definitely ready to have a "normal" life again. A life that doesn't contain beeping machines, vital checks, weighing diapers, rounds, exams and the list goes on and on. A life free of wires and a stiff hospital bed. A life experiencing the world.

Right now we are waiting on Dr. Cantar's final decision. We have a few scenarios that could play out over the next week.

A... Ruthie gets the biopsy rescheduled for this week(current date 8-17).
She then works on feeds and getting off o2.
She then gets to go home after the cath and come back for clinics.

B.... Ruthie stays in the hospital until the biopsy(8-17).
She then works on feeds and getting off o2.
She would be home a few days after biopsy and return for clinics.

C... Ruthie comes home this week.
She comes back for the cath (8-17).
She would come home on continuous feeds and o2.


Ruthie is tolerating her full feeds (28 oz an hour) in her NG tube. She lost her NJ tube on Thursday and now has an NG tube. Her stomach has not had any issues handling these feeds! WOO HOO!

She is still on .5 L of 02. They haven't wanted to push it yet because they were working on feeds and now weening morphine. They only want to change one things at a time. This way, there is only one variable if something changes in Ruthie's health. It makes much more sense to me to do it this way. I mean what is a few more days in the hospital after 6.5 months?

All and all we are doing rather well. Josh is working. I am being a Mom again and working nights. Ruthie is being an all star:)

Please keep our heart friends in your prayers. Especially our new friends, Dominic, Ella, and Brooke. We pray for strength and courage for them and their family. We pray for guidance and wisdom for their nurses and doctors.

Thank you for the prayers. We are so, so blessed by you.

HUGS!

Laura

Wednesday, August 4, 2010

Whew... Has it really been that long!

Okay... once again sorry for such a delay. It has been a crazy couple weeks.

Ruthie is extubated, which means...

She is out of the CICU and in 7 West!



See look! No tube!


She finally is wearing clothes.
She uses the NJ tube (soon to be NG tube), o2 nasal cannulas, and the broviac IV as accessories.

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No more naked baby!

She is sitting up in a "feeder seat" trying baby food and graham crackers!
And of course loving her pacy!



This thing is awesome! Yummy!

She is playing!
PT and OT come in each day to play with Ruth and work on developmental skills.



Where is Ruth?



She even sleeps.
She is taking good naps and is sleeping through the night:)



Whew! We have been so busy!

Ruthie is currently working on moving her NJ feeds to NG feeds. She is also coming down off of morphine (DETOX!) and the o2 (which is on .5L).
Now that we are in 7 West, I am staying the night!
Oh, it is so nice to be in the same room as Ruthie and to be Mom again. I am starting to do more and more of her care. I give her baths, I put her to bed, I change her diapers and her dressing. I will soon be in charge of meds and feeds. I am so excited to learn everything I need to know about Ruthie to get her home.

That's right, I said it... HOME!
We have a tentative date of August 16th! We hope to meet all of our goals by then so Ruthie can come HOME!!

With that being said, I have been super duper busy. I am in the "nesting" mode. I want everything to be ready for her homecoming. Josh is dealing with it! He is helping me move things and clean up certain areas of the house. It is awesome to have his support. I mean, I am not bringing her home for the first time, but I have all of those emotions again. It is really really exciting!!

Thank you God for giving us this second chance. Thank you for your love!
Thank you to our donor angel! We are constantly praying for your family. We are forever grateful for your generous gift of life!
Thank you to our family and friends! We are so blessed to be surrounded by such love and support.
Thank you SLCH! Thank you for your compassion, your knowledge, you love, your concern and everything in between.

Prayers and Hugs!

Laura