Medical Update

The wait in a Drs office sure is alot more fun with Olivia around...


Big hugs!

Neurologist (check), Ophthalmologist (check), Gastroenterologist (check), Cardiologist (check), Endocrinologist (check)…the only one we’re missing is the Pulmonologist and we’re still working on getting that appointment with the new pulmonologist at UCLA so our checklist is nearly complete.  Ha Ha

Our week of appointments for Rudy is over and most everything is checking out okay – no major changes but there is some new information. 

Rudy’s seizures have stabilized and so Dr. Corazza (neurologist) would like to keep Rudy on the same dose of Keppra until we see him again in December. 

I was eager to talk to Dr. Silverberg (ophthalmologist) as we hadn’t seen him in a year and I wanted to update him on the information we got in May about the brain insults to Rudy’s occipital lobe from his stroke activity since this is the part of the brain associated with vision.  He’s so good with Rudy and so skilled in his exam.  Unfortunately there isn’t much we can do at this point to determine if any of Rudy’s fields of vision have been affected by the brain damage…we just need to wait until he gets older.  The good news coming out of ophthalmology is that Rudy doesn’t need glasses at this time after all.  Dr. S felt his astigmatism was significant enough last year to warrant glasses but wanted to wait to prescribe them and now he feels the astigmatism is lessening which means no glasses – yippy!  🙂

It’s always good to check in with Dr. Kelts (gastroenterologist) as he is my “big picture” guy.  Although he helps us manage Rudy’s g-tube and feeds specifically, he also keeps an eye on Rudy’s overall condition and addresses specifics as needed – so helpful.   For example, we’ve been concerned that Rudy’s chest incision has never fully healed…there is a pesky little suture that never dissolved or receded as it should have and I was advised to trim it the next time it surfaced but because of the perpetual oozing wound and scab it produces, I could never get to it to trim it.  It’s kind of a minor issue and somewhat unrelated for the majority of Rudy’s specialists to address but Dr. Kelts noted it immediately and when he asked me about it, I asked him if we should try to find a wound care specialist as we were having a tough time resolving it ourselves to which he responded “I’m it”…he quickly prescribed a topical medication and said if we can’t get to the suture after it heals, then we’ll take care of it surgically once and for all.  THANK YOU!!!  It sounds simple and stupid but there are certain things in Rudy’s condition that don’t fall under any specific doctor’s umbrella and because we have, essentially, two teams of doctors in LA and SB, there are times when a doctor is reluctant to act as not to step on another doctor’s toes or interfere with another doctor’s treatment.  It is an interesting little dynamic we deal with at times which is why I appreciate it so much when a doctor like Dr. Kelts comes in, takes the bull by the horn and attempts to make things happen for Rudy that are long overdue.  🙂

The other symptom Dr. Kelts noted was how dusky Rudy looked which brings us to cardiology…It has been a subtle change but I’ve noticed in recent weeks that Rudy is a bit bluer than usual although his O2 sats aren’t dramatically different.  Dr. Harake took his time and did a thorough echo.  He didn’t see a huge change but he would like to see Rudy again in a month and he would like to get a heart cath scheduled for this fall.  Eventually, Rudy will outgrow the shunt that was placed in his heart during the Norwood procedure when he was 5 days old.  It will be a gradual process and could be happening now which would explain him getting duskier.  Right now Rudy’s O2 sats register between the mid-70s to low-80s.  The need to act will come when his sats drop down to the low-70s to high-60s.  When that time comes, there could be the option to put in a larger shunt.  We always assumed that putting in a larger shunt would buy us more time allowing Rudy’s lungs to mature and get him “Glenn-ready”.  However, in talking with Dr. Harake yesterday, he explained in more detail that choosing to replace the shunt would actually put the Glenn further out of reach as a larger shunt would increase Rudy’s pulmonary pressure which is why he’s not a candidate for the Glenn now.  Wait…What?  This is a new and very significant piece of information that changes the mental game for me and Rolf…we need to take the time to research this and understand it better but it is a bit sobering.  We always thought the decision to get Rudy a larger shunt would be a way TO the Glenn not instead of it.  The reality is we’ve never really had “choices” where Rudy is concerned…all throughout this journey we’ve only had one treatment option when the need to act came along and so there is no point in obsessing over the “what ifs” to come but it was nice to feel like we had a “safety net” of sorts…to feel like we could buy some time with a shunt replacement.  As Dr. Harake reiterated yesterday, we will make the best choice for Rudy with the treatment options that are available to us at the time we need to act and that needs to be our focus but it sure is hard not to get consumed by the frightening unknowns hidden in that simple objective!  Although not panicked, our minds are swirling again and my heart is burdened – at a time when I want to emotionally circle the wagons and protect Rudy and our family, it’s actually time to start another school year and physically scatter everyone all about…to different schools and all kinds of activities. 

Today is one of those days when I don’t want to be a grown up!   🙂

The first available heart cath is October 6th which is only two days before the Heart Walk so we’re hoping for an alternative date…we’ll keep you posted. 

We’re bracing ourselves for a full fall…thank you for supporting us in prayer!  How indescribably grateful we are!!!  🙂

15 thoughts on “Medical Update

  1. Of course the prayer support will continue… and I would like to remind you that I live pretty close, I am “retired”, and would love to be available for “logistic” support if a day gets overwhelming. Rides for the kids, run to the market, you name it. Please don’t hesitate to call me any time. Blessings to all.

  2. The Rudy-coaster rides again, another dip and curve! You all have been so good at holding on during this journey, even when the ride causes your stomach to churn. Keep holding on and trusting! Rudy is a prince and the King is not unaware of what is going on with His child. Virtual Hug!!!

  3. Oh my dears….so much to process and with the craziness of fall, I pray for God’s peace for you….may you enjoy the snapshots of love and beauty that come from Him in the midst of it all…. I tear up from your blog pictures….the love just oozes…

  4. Praying for you guys, for peace and for wisdom too. Wow, this is a lot with everyone going back to school. I keep hearing that song “Blessings” on the radio and thinking of you. Love you guys.

  5. Rolf and Trish….so admire your strength and trust in the Lord. I’m learning so much from watching/talking with you guys in navigating these rough waters. In a weird way it’s comfortaing to have others close that are traveling in the rough seas…..although a different boat, the same sea. We pray for you all often and are faithful Rudy bloggers. Thanks for sharing your journey. Love you guys,
    Bryan, Cinthia and Kaila

  6. Sigh. This old roller coaster is getting OLD, isn’t it? So sorry for this latest stomach-churning dip along the way. Always, always, there is the mental adjusting to do, the releasing, the opening your hands and relinquishing the future. It just goes against every parental instinct, doesn’t it? We want to hold on tight, to protect, intervene, find a way. And sometimes we just cannot. Many prayers for you, dear ones, as you move into the fall. It truly boggles my mind that your sweet boy functions as well as he does with O2 sats in the 70s/80s. It is amazing how his body has taken these insults and handled them so well. I just wish – with you – that there were no more to come. Sadly, that is out of our control, too. Love to you all – and that second picture of Livvy with Rudy is worth framing – wow – just gorgeous.

  7. Dearest Trish and Rolf and all-
    we’re keeping you in our prayers and even more today. Big hugs to all for the start of the school year.

  8. Yes, Trish, its hard to be “Grownup” Maybe they have room for you at La Patera !!!! You can solve those problems there 🙂
    Praying for you ALL. What a sweet picture !!
    I do need to see a picture of Rudy and the Butt-scoot !!!
    Bussi O + O

  9. Am praying for you…grace and peace. I identify with your comment
    about “hard to be grownup”…I’ve felt it too and may God do it through us!!

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