Thursday, May 24, 2012

Still Inpatient at CHW


This past week has gone by relatively fast and smooth as well, which is nice because I’m not keen on the roller coast ride we usually have when Caitlyn is admitted to Children’s. 

Over the weekend, Caitlyn opened many presents that I was able to wrap and bring with us.  Just to give her something special each day and also a way to keep her entertained.  Grandpa Dave came to visit us on Sunday morning and was nice enough to bring her a bear from the Milwaukee Brewers stadium.  That afternoon, Grandma Louise and Grandpa Dave left for home.  I was incredibly disappointed to see them go but I knew my father and step-mom would be joining us for a visit on Monday.

Through the weekend, Caitlyn’s VAC started to give us problems.  It wasn’t holding a seal very well and continued to leak air.  We kept getting messages on the machine saying there was a blockage.  Her VAC dressing change wasn’t scheduled until Tuesday, I personally felt it should have been changed on Sunday, no later than Monday – her nurses agreed.  But she toughed it out and surgery stayed scheduled for Tuesday.

Papa Al and Grandma Fern joined us on Monday afternoon.  They were nice enough to bring me the few things that I had forgotten at home.  The plan was for them to get a hotel and visit again on Tuesday, unfortunately that did not work as planned – they left for home during Caitlyn’s late-afternoon nap. 

Tuesday afternoon was Caitlyn’s VAC dressing change and also a little more debulking of her leg.  She was scheduled for 1:30pm however, Dr. King was running late doing a big case over at Froedert so she didn’t go back for surgery until 4:30pm.  Caitlyn slept from 1:20pm until we went down to the pre-op holding area so at least she wasn’t awake asking for food and drinks. 

I requested to have Caitlyn put on dilaudid for pain instead of morphine.  This is because of the extreme side effects she gets from the latter.  Surgery lasted for three hours.  Dr. King said her tissue inside of her leg looked great and only a small piece of skin died by her knee.  He extended her incision down across her knee and was able to debulk a big portion of tissue in that area.  He then removed malformation all the way up the lateral part of her thigh.  Once the debulking was done he placed two JP drains, brought her flaps of skin together, sewed her closed, and placed just a skin VAC on her leg which only covers her incision.  Friday she will be back in the OR for a VAC dressing change and then Tuesday she will be in the OR to hopefully removed the VAC completely and the plan is to then go home on Wednesday!

Caity's leg today. It is swollen now but that will go down
R leg: ~34cm around thigh/25cm around knee
L leg: ~38cm around thigh/29cm around knee
Dr. King took me back to the recovery room where Caitlyn lay in her bed waiting patiently for me.  Not a single tear was running down her cheeks.  I pulled back her blanket and my jaw dropped.  Her leg really did look like a little girl’s leg!  THIS is what I was looking for on Thursday; THIS is what we have been working so long and so hard for!  It kind of feels as if we have crossed the finish line.  There is obviously still more that needs to be done to help Caitlyn but her leg looks incredible and I’m not sure I want to do any more surgeries like this any time soon. 

I ran around the bed and threw my arms around Dr. King.  There is nothing that I could ever say that would express how thankful I am.  As I have said before, her life has now been completely changed because of what he and her entire team has done for her these past two and a half years.

She was put back on a PCA (pain pump) but with dilaudid in place of the morphine.  She has handled this incredibly well.  She has experienced zero body spasms and only a little bit of itchiness on her face.  Benadryl was unable to relieve her of the itching so she was put on a continuous infusion of Naloxone; this has now eliminated her itchiness.  Her night after surgery went really well.  I did not sleep a single wink.  I was just too excited for her and for her future.  My mind was racing and I just could not seem to calm down.  Around 2am, her nurse took vitals and we realized that Caitlyn had started with a fever.  Ibuprofen did not help so she was given Tylenol.  Tylenol took care of the fever for a while.  By Wednesday morning, she was still running a fever.  We gave her Tylenol again and she has not had a fever since. 

Yesterday morning I spoke with Dr. Kelly.  He agreed to hold off on the chemo until her fever was over and to see how much fluid she put out in her JP drains over the next day.  We talked about whether or not to do quarterly ultrasounds of her kidneys to check for Wilms tumors.  I told him I would feel more comfortable if we did continue to keep an eye on her kidneys while she gets older, just to be safe.  He said that would be fine and decided to put in an order for a kidney ultrasound that day.  We also talked about Caitlyn’s spine.  He said he looked at her images and she definitely has scoliosis, which is common in children with vascular anomalies who is so asymmetrical with their body.  We will be following up with Dr. Thometz to see what needs to be done – if anything right now. 

Shortly after my talk with Dr. Kelly, Caitlyn’s nurse brought us down to radiology to meet with Dr. Moe (Caitlyn’s new interventional radiologist) to do an ultrasound of her mons and of her kidneys.  He informed me that although doing more sclerotherapy on her mons would help her flare-ups he is pretty confident that it will not help the size of her mons decrease – which is our goal.  I have now decided to not waste time and not put Caitlyn through more sedations doing sclerotherapy when in the end we will just be performing a debulking of that area anyway.  I will wait until she is completely healed from this surgery and then talk with Dr. King about when the best time would be to debulk her “little lady area.”

Today has been a good day.  I noticed a bruise forming across her knee and her leg is starting to swell.  It still looks good but just a little swollen.  It has now been a week since she has walked.  Each time I try to stand her up she cries and says it hurts, or “I can’t!”  Dr. King said he would look more closely at the bruising tomorrow when she goes back into surgery for a VAC dressing change. 

Her nurse, Sarah, and I took Caitlyn for a walk on the skywalk and then downstairs to see the fish.  In the lobby the annual Dave & Carole Miracle Marathon for Children's Hospital was going on.  I talked to a couple people there and agreed to come down and share Caitlyn’s journey with them and all the listeners.  While filling out paperwork Caitlyn got the wonderful opportunity to meet Miss Wisconsin!  She wasn’t feeling very well but really made the best out of taking pictures with her. 

Once back in our room, it was music therapy time!  It took a little while for Caity to warm up to the playing the instruments but once the big drum was brought out Caitlyn was all smiles!!  She was able to follow the dynamics of the music and even listened to the instructions of the lady who was playing music and singing with her.  The woman was very impressed and said three and a half to maybe four years old are able to follow her lead and follow the dynamics, not a two year old.  I called it from the time she was a baby, she is very musically inclined and I’m sure will grow up to do something artsy!  After music, it was naptime.

Soon after getting Caitlyn asleep, they said they were ready for me to come down for the interview.  Dave and Carole were great!  They asked so many great questions and allowed me the opportunity to share Caitlyn’s wonderful and amazing journey with so many people that otherwise would not have known!  Thank you!

If you are interested in donating to the Dave & Carole Miracle Marathon for Children’s Hospital please do so my calling: 1-888-414-9554 or by visiting this website: http://www.chw.org/miraclemarathon

Thank you all again for your continued support!  Caitlyn will be able to look back one day and read this and read the comments that people post and know that she was loved by so many, even people that don’t know her!  Please feel free to post comments to her, share her story with others,  and post a link to her blog on your social networking sites.  I love educating people on her condition and showing that heroes can be as little as 2 ½!

Sunday, May 20, 2012

Caitlyn's 3rd Debulking - Her First 48 Hours

I have decided to do something a little bit different for this blog post.  Because I updated so often, in quite detail, and received so many wonderful comments on Facebook, I thought I might share them all here.  Names of friends have been removed for privacy except for a friend's first name if there was a conversation going on back and forth.  Mine and my husband's comments have been underlined to easier decipher who is writing what.  It's been a roller-coaster of a ride these last couple of days so read along and join the ride of emotions with me.

Posted: the morning of Wednesday, May, 16.
I can't believe it, the day is finally here, we leave for Milwaukee this afternoon and won't return for quite a while. Tomorrow is surgery and in a few days my little lover starts chemo once again. This is not going to be an easy road these next few months. My stomach is feeling very uneasy at the moment. Stay calm Mama and stay positive, it will all be worth it in the end. 
o   ill be keeping u in my thoughts & prayers! plz keep me posted! much ♥ & im always here if u need to talk! my # is on my profile. 
o   meant u all• 
o   Thinking of you!!! 
o   Hope all goes well. U will all be in my prayers. 
o   Thoughts and prayers are with you !!! Please keep us posted.. 
o   You and Caity are in my thoughts and prayers. Good luck hun and let me know if there is anything I can do for you at all. :-) 
o   All my love and strength I'm sending with you! Call me text me whenever! You can do this. Mommy power is stronger then anything. Hugs for both of you! 
o   Praying for your little on Sondra! Hope all goes as smooth as possible!! 
o   best wishes 
o   Thinking of you and Your Family in your time of need! Keep ur Chins up and try and Stay Positive! Give Little Miss Caity my Love! Hang in there Momma it will be ok! 
o   Sondra Gruenwald: Thank you everybody for all your kind words and support! We made it to Milwaukee and I will update tomorrow as I get updates from the OR. She is strong and I know will do GREAT!

Posted: evening of Wednesday, May 16th
made it to Milwaukee, along with losing my wallet, money, debit card, social security cards, car and health insurance cards...fml. But, we made it, went swimming, ate unhealthy pizza, then had baths. Caity and I are pooped and ready for bed....I will update tomorrow 
o   hope things get better 
o   crappy! try and sleep well tonight you two and digest that darn pizza ;) and start fresh tomorrow with cold pizza and cartoons..... still prayin for ya. We will pray harder. :) *hug* 
o   Hang in there.Tomorrow is a new day... You both Will be in my thoughts.. 
o   You guys will be just fine......sending happy thoughts your way!!!!

Posted: morning of Thursday, May 17th
Caity likes her versed, her face in on the ipad!
at Children's Hospital of Wisconsin with Louise. Let's hurry up and get here just to sit and wait. It's a good thing Caity is such a good girl about it all.
o   Sondra Gruenwald: And cue [my] heart racing and elevated blood pressure
o   Best of Luck with Everything, let us know what's going on as soon as you find out. ♥ ya lil miss caity!

Posted: Early afternoon of Thursday, May 17th
Update #1: PICC line went in smoothly, only one poke - HURRAY for that! Dr. King is starting to work his magic as we speak. The plan is to make two incisions on her leg. One running down right in between her "x" scars and another one down the lateral part of her leg. So lots of healing and she will be back in the OR every 3-4 days while we are here. Then, as I said before, chemo will be started in just a few days. Oh Lord, please give me the strength to make it through this day!

Posted: Mid afternoon of Thursday, May 17th
Update #2: I heard from the nurse a while ago but just now got a chance to update. Caity-bug is doing really well, her vitals are all staying stable. Dr. King is still (or he was when I talked to the RN) working on her first incision and will be starting on the second shortly. So it will be another couple of hours before he is finished. We did get a room number so at least Louise and I were able to lug all of our belongings to the room, it literally feels like we are moving in. 
o   Good to hear! Keep us updated!

put your hands in the air and raise the roof for an AWESOME new leg!
Posted: Late afternoon of Thursday, May 17th
Surgery is over and she is doing GREAT! Dr. King only made one incision and was able to get around her whole leg with just that opening! She did lose some blood so she may need a blood transfusion in a little while. I will post pictures as soon as she is settled. I can't wait to go back in recovery to see her! 
o   Cait we love you! ♥ 
o   Yay what great news, give her my ♥ 
o    
o   What great news! 
o   I love you guys! I hope recovery goes well, I miss keeping you company during these hospital visits. My heart and prayers are with you. 
 Bottom of Form
Posted:  Evening of Thursday, May 17th
she had to sleep with her balloon!
Update #4: We are settled in our room and Caitlyn is still asleep. This is really unlike her to sleep so long after sedation/surgery. We are having an issue with her O2 stats dropping and staying low. She does have a pain pump and is on a constant drip of morphine so this may be contributing to both her excessive sleepiness and her oxygen levels. The nurse is calling the pain management team now to discuss slowing her dose down a little bit. Also, she is losing quite a bit of fluid and blood into her VAC so the possibility of a blood transfusion is increasing by the minute. I will update if anything changes. Thank you all for the continued support! Now if only I had my damn wallet! 
  o   Debbie: prayers and hugs your way!!!
o   Sondra Gruenwald: Thanks Debbie, we are still fighting these oxygen levels, ugh!
o   Hey you how is baby girl doing? Keeping U n ur Family in my Thoughts and Prayers. Wishing my Little Peanut and Quick and Full Recovery. Let me know if you need anything.
o   Hannah: Sending prayers/good vibes your way.. And let me know if you ever need/want company on a hospital stay.
o   Sondra Gruenwald: Thanks! And we always want and need visitors! We are so far from family that most dont make the trip down. But we are here for two to three weeks if you would like to come be bored with us! Lol
o   Hannah: Which hospital are you at?
o   Arianna: omg thinking of you guys llove you and praying for you always <#!!
o   Sondra Gruenwald: ‎Hannah: we are at the childrens hospital in milwaukee, right next to the froedert hospital and clinics.
o   Sondra Gruenwald: ‎Arianna: love you dearly!
o   Lord we pray for your healing power to permeate Caitlyn.
o   Ohhhh gosh I am praying for Caitlyn .....you both have such strong souls... You are both warriors♥

Posted: Early morning hours of Friday, May 18th
Caitlyn still hasn't peed so we are talking to the resident on-call about putting in a folly, she is in quite a bit of pain which breaks my Mama's heart, and now she has started with a little bit of a fever. I'm so tired I just want to sleep but now I'm just focusing on her so my eyes will have to wait their turn.
o   Thinking about yall!
o   Crappy, but at least it will take away some pain for her. Did your docs reduce the morphine drip? Hang in there lady.

Posted: Early-morning of Friday, May 18th
Caitlyn has had a pretty rough first night. We did reduce her constant morphine drip but her oxygen levels have still staggered on the low end. She continues to have muscle spasms that cause her quite a deal of pain, we will discuss using a muscle relaxer with the pain management team this morning. She slept all day and now all night. Waking only for two banana popsicles, when they put the folly in, and briefly when she has pain. She is now on oxygen through a nasal cannula and she is wheezing quite a bit, especially in her right lung, I pray this is not the onset of pneumonia. 
o   Heavenly Father....we just lift Caity up to right now Lord, touch her little body....and heal her ....Lord You have said that if we come to You in 3or more....well Lord Im sure there will be and are plenty of us that are praying for her and Sondra. Please touch her body and heal her and take these muscle spasms away, and clear her lungs, and take away all her pain....Lord keep Your calming hand on Sondra and Peter as they stumble through thos ordeal with their baby girl. They are very good and strong parents and can come through this!! We thank You for ALL that You do and for Your healing power.......in Your name we pray......AMEN!!!! 
o   Lord nothing is impossible for you! We agree for Caitlyn's lungs to clear and pain be gone in Jesus Name. Caitlyn's muscles relax and spasms stop. Mercy and goodness will follow this family all the days of their lives. Peace be still.

Posted: Mid-Morning of Friday, May 18th
Her tears and cries of pain cut clear through my heart, without a second thought I would trade places with her...if only it were that easy
o   ‎:( hang in there girly, I know if I were you I would feel the same way, but its when Caity sees you breaking down, that's when its going to make it hard on her. Just take a deep breath and know that you are doing this to better her in the future! Give Caity my Love and if u ever wanna chat you have my number.
o   so sad about that...give her a lot of hugs, it´s not going to be easy, but you have to be strong girls!!!! you can do it!!
o   I'm so sorry you have to go through this. But it will all be worth it. Just try to be strong for Cait ♥
Thank you Leeanna for making this for me!

Posted: Late-Morning of Friday, May 18th
poor girl is out and about but not feeling the best
We were actually able to get Caitlyn out of bed and into a wagon for a walk. It wasn't easy and I'm sure it was painful but she really wanted to go for a ride, so we did! She still hasn't eaten anything but I think that will come with time. She is off the nasal cannula, for now, and doing really well. So far, no blood transfusion, I think we are going to do another CBC later and see where her levels are at. She is in bed now but having a hard time sleeping because the morphine keeps making her body jerk and then she cries out in pain...it's like a catch 22. I will update again after we see Dr. King and Dr. Kelly (her oncologist) this afternoon. Thank you all again, for your continued support, prayers, and kind words!

Posted: Early-Afternoon of Friday, May 18th
What a horrible day this has been. The morphine is kicking Caitlyn's ass. The poor girl jerks and jerks in her sleep and she scratched her eyes so bad that she started pulling her IV out. It took every ounce of my being to not take the chocolate pudding cup and throw it against the wall. I don't know what to do for her! And then I turn around and get frustrated with her when I know she can't help it. Oh, damn. She is FINALLY calm and settled...still jerking but the pain team ordered a different medicine other than benadryl to help her (because the benadryl didn't do a damn thing). Why does she have to go through this!? We have only been here a day and I'm ready to pack her up and run away! 
o   Mary: Try to stay calm Sondra. Caitlyn can sense your anxiety. Play music or take a walk for 2 minutes. I remember when I came out of brain surgery and was on my way to neuro ICU there was one nurse who calmly told me I was going to be better! Her encouragement gave me peace to make it! 
o   Sondra Gruenwald:  Music is a wonderful idea. Louise keeps telling me to leave for a while, I just can't. I feel like I fail her if I just turn my back and walk away. Maybe that stems from my mother when I was a child. Either way, I can't just leave her. I took a moment outside the room and called Peter. He let me vent and cry so now I feel a little better. We have only been here a day and I already feel so drained...how will I make it for 2-3 weeks? 
o   Mary: You are a great mom. Don't look back! Never compare yourself to anyone. You are confident and capable. God chose you to be Caitlyn's mom because He enables you to love her. We all had mom's and had difficult times growing up. Each time you forgive yours and others mistakes from the past you grow more to be like Jesus. His love is perfect and overcomes fear. Do not fear for you, Caitlyn or Pete. He will never leave you nor forsake you. He is always with Caitlyn...take a breather and show her you are confident. Love you.
 o   Peter Gruenwald: You don't have to make it for 2-3. You just gotta get through One then I'll be there with ya babe. I'll do everything I can I promise. Get what sleep you can and know you are and have been doing the right thing. Caitlyn will thank you for this for the rest of her life. Kisses. 
o   All I can say is breathe and then breathe some more. Sometimes you have to take things day by day and other times its hour by hour or minute by minute. This "IS" hard but just think about how much better she'll be when she's healed. You are an amazing mom!!! It takes some pretty special people to deal with kids and stress like we do. You CAN do this!!! Sending hugs, love. Prayers, and everything else!!!

Posted: Mid-Afternoon of Friday, May 18th
Finally snuggling with Caitlyn. That's all the poor lover wanted, was to hug her mama. If feels good holding again and having her sleep in my arms.

Posted:  Evening of Friday, May 18th
after all that, that horrible night and day, and Caitlyn didn't want to sleep with me, she wanted Grandma instead. Kinda breaks my heart 
o   Arlene: Sometimes i thought I saw my daughter's heart break too. I truly believe that a child who has suffered allot is close to Jesus and knows when mommie needs a break and needs more energy and who in the room needs to be able to give or be given to by the child. Don't worry she'll always want you when she is at her worst. She knows who takes care of all her needs all the time. 
o   Peter Gruenwald I second that. 
o   Mary:  Get your rest and be thankful Louise is there. 
o   Sondra Gruenwald I agree Arlene I just felt hurt, stupid I know to feel that way from a 2 year old, but I did nonetheless. But 20 minutes later she woke back up and asked for Mama to sleep with her. :o) I said,"Don't you want your Grandma?" "No, my Mama sleep in the bed." I can't stay mad for long with a sweetie like that! 
     Mary: I am incredibly thankful Louise is here. I don't know how I would have gotten through today without her. She is a blessing in my life, one that I will be forever grateful for! I will be so sad to see her go on Sunday. :o( 
o   Arlene:  Feelings aren't stupid, we can't help what we feel. I just know that when I am stressed and overly tired my emotions seem to take control and get the best of me. You are a mom, so strong even in your weakness. God certainly is with you.
Posted: Late-Evening of Friday, May 18th
We are having a MUCH better night. The morphine is finally leaving her system and her body spasms have slowed down drastically. She still has them but at least they aren't causing her pain or waking her up. The nurse came in a while ago so Caitlyn could have a dose of medication, I woke her up and asked if she could sit up to take her yummy medicine, she says, "sure mama," and sits herself right up in bed! HUGE improvement from this morning and amazing since her incision goes all the way into her groin and almost to her left flank. Hopefully, she does well over night and her pain stays at bay. She is still itching her eyes, belly, and mons quite a bit...I really do think she is allergic to the morphine. She did just get another dose of meds in her IV to help with the itching, let's pray it works better than the damn benadryl did! 
o   Thinking of you guys. Hope you guys get some sleep. Keep us updated. I will continue to pray for the little angel.

Posted:  Late-Evening of Friday, May 18th
From across the room, in a hospital bed, I hear the most beautiful sound coming from the most beautiful girl, "Ahhhhhhh." As if sighing in relief at last and a good, uninterrupted, night's sleep. Sleep sweet my sunshine-babe.

Posted:  Early-Morning of Saturday, May 19th
What a wonderful night Caity-bug has had; in fact, she is still sleeping soundly. She woke up only once, at 4am, to get a dose of medicine. She was so sweet and so good about it. Then I told her it was time to go back to bed and she laid back down and had to have her grandma's blanket. After laying back down myself, I hear her from across the room, "Caitlyn have her animals? Mooooom, I have my animals, please?" So of course I got up to give her all her stuffed animals. She fell right to sleep after. Praise the Lord I have my girl back! 
o   Sondra Gruenwald:  Rise and shine my pretty girl. She woke up and decided to play and talk with herself for a while...I miss listening to this when she was a baby! 
o   Lean not on your own understanding...His ways are not your own. He is good all the time. Rejoice and be glad. Love is your greatest weapon.

Posted:  Mid-Afternoon of Saturday, May 19th
Caitlyn's CBC levels were pretty low. She is now getting an adult size unit of blood which will take about three hours to transfuse. 
o   Arlene:  We really didn't mean to stay so long. Caitlyn is precious and so cute. She is a very strong person, taking things in stride. I really meant to talk to you more Sondra, so that I could have gotten to know you better while we were there. Louise has got my number, so if you want to chit chat call, I don't work. Hope she feels better after the transfusion. she must have felt so drained. You are a super mom. 
o   Sondra Gruenwald: Thanks Arlene! No worries, we really enjoyed your company!! Louise told me that she has your number and please feel free to come visit this week if you want, I would love to just sit and have adult conversations once Louise leaves! :o) The transfusion is going well, she isn't having a reaction which is good because she has in the past. And she is still sleeping soundly - she needed it. 
o   Arlene:  Really enjoyed being there. Called up my daughter Jennifer and asked her to have Sophia draw a picture for Caitlyn and send it to her, hope she follows through with it. Take care, I know that I'm going to miss Louise this week allot. It was so good to see her. she has always been so special to me. 
o   Arlene:  I feel honored and blessed by you allowing us to visit today. 
o   Sondra Gruenwald: I'm glad you both were able to reconnect, I could tell it was really nice for you and her. And THANK YOU for coming, it's nice for Caity to get visitors, especially since our family lives so far away. The dress was beautiful, too! And thank you again for the book!!
Caity found a star but couldn't find "her" moon

Posted: Evening of Saturday, May 19th
had a wonderful walk outside with Caity tonight in the cute little garden at Children's Hospital of Wisconsin. The air was warm and breezy and Caity-bug didn't want to come back inside. I think another walk like that tomorrow night will be really nice for her, especially since she is able to use a wheelchair instead of a little wagon!

Lovin my girl!

Sunday, May 13, 2012

We're BACK!

That's right, Caity is now 2!!!


After taking a year off of blogging and documenting Caitlyn’s journey I think it’s time I return to the keyboard and start tracking her life again.  It’s been a wild ride, so let me start from where we all left off.

Before Debulking #1
Caitlyn went off of the chemo in the middle of last May, 2011.  Towards the end of June we met up with Dr. King and his fantastic team for Caitlyn’s first debulking of her leg.  I don’t think I can perfectly explain the rush of emotions I felt that day.  It was like a whole new life was beginning for Caitlyn.  I was so incredibly worried but I knew Dr. King had the skills to do wonderful things for her and I just put my trust in that, (I suppose it also helped that I knew he was rated one of THE top doctors in the United States).  In just a few hours of taking her back they were ready for me to see her in recovery.  When the nurse pulled back the blanket I was in utter awe.  I just looked up at Dr. King and smiled; there was nothing I could say that would really express my thanks to him and his team.  We spent only a few short days in the hospital and we were then sent home.  Caitlyn came home with a JP drain coming out the top of her leg.  From there on it was a roller coaster ride and I was just trying to hang on without a seat-belt locking me in place. 

After Debulking #1
Some days were good and she would only drain a minimal amount of fluid into her drain but most days it was a never ending extreme amount of fluid coming from within her leg.  Then, one day Caitlyn got fed up with the tubing and decided to rip it out.  From there, her leg began to swell.  We were making the eight hour, round trip to see Dr. King about once a week.  At one of the appointments he decided it would be best to start wrapping her leg with an ACE wrap.  I was not thrilled with the idea but I hesitantly went along.  By the next day all the fluid that was sitting in her leg was now pushed up into her mons.  Her mons was bigger than a softball; it was purple and kind of red, she couldn’t even walk.  She screamed all day.  I noticed she felt warm so I took her temp: 102.  I called Dr. King’s office and I took the wrap off of her leg, I couldn’t sit there and watch her in that kind of pain and do nothing.  Milwaukee called me back and said to bring her down to their ER.  Caitlyn cried most of the way down from all the discomfort in her mons.  I hope I never have to make a drive like that again.

Once there, she was admitted.  For the next five days we alternated the ACE on and off just hoping to get her incision from the debulking to heal.  The incision started to leak but nobody seemed too concerned.  On our fifth day, our insurance said they would not cover the cost to keep Caitlyn in the hospital anymore since all we were really doing was monitoring her.  Of course, they were told the risk of infection if she was sent home without close monitoring of her wound – they would not waiver.  As the next few weeks wore on, I noticed a strong smell coming from the dressing changes covering her incision.  But because she didn’t have a fever and the area around her incision wasn’t too red, again Dr. King wasn’t concerned.  I, however, knew something was wrong. 

After Debulking #2
In the beginning of August, we went back for another debulking surgery.  Once in the OR, Dr. King came upon quite a surprise.  In fact, in his own words, “the biggest shock I’ve ever had in the OR.”  He reopened her original incision, because it still had not yet healed all the way, so he was planning to fix it.  From there a fowl stench and a huge abscess of infection was there within her leg.   The good thing about this is that her body blocked off the infection, keeping it from spreading.  It stayed localized and was therefore easier to remove and treat.  The operation was a success and her leg was once again reduced dramatically in size.  Unfortunately, instead of our five day stay that I was expecting we had to stay for close to three weeks.  A VAC was used to help promote good blood flow to her leg and skin.  This was in order to aid her in healing and keeping her skin alive and well.  Every three to four days she was back in the OR to do a VAC change and to perform a procedure to clean up in side of her leg, this is called irrigation and debridement. 

Almost ready to go home!
It was not an easy three weeks.  In fact, it was quite literally the worst three weeks of my life.  Trying to entertain a toddler, in a hospital, when you are quite unprepared for the stay, is almost impossible.  However, my husband’s aunt and uncle came to visit and we were even able to leave the hospital for a few hours to go out to lunch and do some shopping at the mall.  It was a wonderful and much needed break from the hospital atmosphere.  Their company was such a blessing and much appreciated. 

Finally, on the day that I was supposed to start my fall semester of nursing school Caitlyn had her last surgery and we were discharged just a few hours later.  Her antibiotics were over and her PICC was removed.  We were set to go home!  We didn’t stop one time the entire way and Caitlyn never cried or whined the whole drive.  She was as happy as I was to be gone.  It had gotten so bad at the end of our stay that whenever we came back to our room from a walk she would start screaming and crying because she just didn’t want to be in there anymore – it must have felt like jail to her.  She would look at me and say, "Go home, Mama. Mama, go home!" But now we were gone and just couldn’t wait to get back!

Wearing her tights...kinda hot in the summer but it worked
I started school the next day and we made a few trips to Milwaukee during the semester for check-ups with Dr. King.  In the middle of September, Caitlyn’s JP drain clotted off and I had to cut the stitches from her leg, connected to the drain and then pull the drain out myself.  Usually this sort of thing would not bother me in the slightest, but because it was my own daughter, I literally almost threw up all over her.  I became sick and started to cold sweat - it was not good.  Once the drain was out the hole where the drain was profusely leaked fluid.  This stopped after just a few minutes, I was able to put a dressing over it, and she was fine.  Now that the drain was out Dr. King wanted some kind of compression on her leg, but I refused to use an ACE wrap.  Dr. King’s resident came up with the wonderful idea to use a size smaller tights for Caity to wear.  It really did seem to work, and it definitely did not cause the complications that the ACE wrap did. 

During these months, Caitlyn started at daycare for the first time and Peter and I decided to start trying for a little brother or sister for Caitlyn.  Thanksgiving and Christmas was great!  In the middle of December, we were in a car accident and totaled our vehicle.  Thankfully, nobody was hurt and the other driver’s insurance agency gave us a nice settlement.  On Christmas, we started our first round of fertility treatments because we still were not pregnant.  Then, in January Caitlyn had an MRI of all her malformations as well as an X-ray to determine how extreme her leg length discrepancy really was.  Her LLD is about 2-3cm, which causes her to limp while she walks.  It also showed that her right hip is still not looking very good.  A major reconstructive hip surgery may be needed sometime in the near future (possibly this summer).  We will determine that, as the middle of summer gets closer.  We then met with most of her doctors and decided to start some sclerotherapy again with Dr. Johnson.  

We did sclerotherapy in February.  Caitlyn also had an ultrasound done of her kidneys to check for Wilms tumors (a childhood form of cancer, which is quite possible to develop in patients with vascular malformations such as Caitlyn).  That test came back negative.  In March Caitlyn had an MRI done of her brain to make sure there were no malformations growing there – thankfully, that too, came back negative. 
this is how she sleeps...too cute!

At the beginning of April we regrouped with the entire team to determine where to go from here.  I had struggled for weeks to try and come up with a decision of what to do next for her; especially when it came to putting her through another debulking.  I have felt angry and sad because I know how hard this is on me but to put my own daughter through that is just terrible to think about.  However, I was also excited about the new possibilities and a completely new life it would bring to her if we just went through with it again.  I turned to family and friends for advice.  I received mixed feelings on the matter.  My husband was more than willing to do the surgery again but my mother-in-law was more conservative.  She felt we should give Caitlyn another year and a summer to just be a kid with no worries about surgery and to just stay away from the hospital for a while.  Then, we could regroup again next year.  To say the least I felt quite torn.  The weight in my heart was unbearable.  Of course, I did not want to put her through another three weeks in the hospital along with the pain and discomfort of surgery.  I also felt that I never want her to remember any of this and if I wait too long she will remember, and I so badly do not want those memories within her mind. 

So, after speaking with most of Caitlyn’s doctors I still was unsure.  Dr. Kelly (Caitlyn’s oncologist) was the last to see us.  He made a very good point and that is what I really made my decision off from.  He said, “It’s not a matter of if she will have the surgery it’s all a matter of when, because it does need to be done.”  We went on to discuss the risk and benefits of doing the procedure now or waiting until she is older.  He helped me to see that it really is a good idea to do this now while she is young and while she still won’t remember any of it.  It wouldn’t be wrong to wait, but it is just more right to do this now.  Other than Dr. Johnson, Dr. Kelly really gave me his heart felt opinion on what he would do if Caitlyn were his child.  I felt relieved that somebody finally told me how they felt instead of saying, “It’s all up to you Sondra.  Go ahead and make a life changing decision for your daughter all by yourself, Sondra.  Let’s wait, let’s not wait, you decide.”  Ahh, I finally made up my mind.  We all agreed to start sclerotherapy on her mons, do laser treatment and cortisone injections into the large, keloidal scars of her leg, and then schedule a third debulking along with chemotherapy as soon as my semester of school was over.   Caitlyn will go back on the Sirolimus/Rapamune a few days after her debulking to try and limit the amount of fluid she produces.  Once on the chemo she will be on it for at least a couple of months; I truly hope it works!

In the middle of April, Dr. Johnson did another sclerotherapy and he really focused on her mons because it is still quite swollen from her last debulking.  When Dr. Johnson was finished, Dr. Drolet came in to the surgery suite to do the laser and injections.  We stayed a single night and left for home the next morning.   Before we were discharged, Caitlyn and I got to meet a new addition to Caitlyn’s team: Dr. David Moe.  Since Dr. Johnson has decided to leave Milwaukee Children’s and move to Flordia, Dr. Moe will now take over Caitlyn’s case.  He will be her new interventional radiologist.  He seems very nice but I do not think Caitlyn and I will have quite the relationship with him as we did with Dr. Johnson or Dr. Kelly, or even Dr. King.  He will now be a big part of her health care plan so who knows – hopefully he doesn’t up and move either, then it will be off to Boston for sclerotherapy.


My semester has ended and Peter and I have finished our third round of fertility medications, still no luck in the baby-makin’ department. Hopefully soon!  Caitlyn’s debulking is scheduled for Thursday, May 17th.  Another three-week stay is more than likely the plan.  At least this time I will be prepared.  Thank you to all the ladies who helped me come up with amazing ideas to keep Caitlyn busy and occupied while we are there!  I will make a point to keep Caitlyn’s website up-to-date from now on.  Please feel free to pass on her web link and share her story.  She is incredibly amazing and everything I wish to be! Love to all!!!
Mommy and Caity-Bug
Daddy and Caity-Bug