Thursday, April 22, 2021

Past, Present and Future

FIVE years since I posted last? Time to catch up!!

Wow, shocking that I just quit updating Faith's blog and right in the middle of her last jaw surgery! Embarrassing! Writing has always been therapeutic for me - it helped me so much when Faith was little and I couldn't think about anything else besides what we should do for her.  Medically first and foremost, but socially and academically as well.  I used this blog to think through so many of those decisions, while hopefully providing good updates for family and friends.  I think technology took over to a large degree, it just got easier to upload pics from my phone to group texts or FB and when your child is in the hospital it's hard just to find time to eat or shower, let alone find time to sit down and write.  Writing requires concentration and time - something you just don't get a lot of when you're in the thick of it.

Anyway, I will eventually take some time to catch everyone up on how her 5th jaw distraction went in detail and with pics, but as a quick summary - it went a lot like her others, she was an amazing trooper as usual and even went back to school off and on wearing her RED (Rigid Extraction Device) halo, which is rather barbaric looking.  Since it was in October, she decided to be Frankenstein for Halloween - and I have to say - it was like she was making fun of my biggest fear when she was 2 and we decided to get her hearing aids implanted which meant putting 2 screws into her skull, one on each side right behind the ears.  After the implants were in though, I never thought about it again, it was so important to her hearing and it felt like they were just part of her.  Life is very strange! Anyway,  I will have to find those Halloween pics.

The jaw distraction itself seemed to go well, Dr. Gordon over distracted as he usually does, but for the first time when he took the hardware off, he decided to wire her jaw shut for another 3 weeks to help the new bone solidify.  She was so upset waking up from the hardware removal surgery to discover her jaw was wired shut.  I remember it well because it was a week or so before Thanksgiving and she couldn't eat and she was devastated.  We'll probably never do another surgery right before Thanksgiving again!! 😂

Much to our disappointment just a few months afterwards, her jaw seemed to lose all of the growth and possibly more.  This was the first surgery out of 5 that didn't seem to be worth doing it.  I know so many families that have had plenty of bad surgeries and it just scares the crap out of all of us as parents to know whether any of these surgeries are the right thing to put our kids through or not.  You can never be sure - there are no guarantees and you get different opinions from every surgeon you talk to and in the end you have to make the decision based on your own gut and from all the information you have. 

For Faith, each jaw surgery she has been through helped her on her journey, the first one helped her start vocalizing around her trach and beginning to speak (she couldn't make any sounds most of her first year - meaning she never cried as a baby), her second was her big scapula bone graft at 5 years old when they took the bottom of her shoulder blade to build the part of her missing lower jaw, that one really improved her airway and maybe was when she first began to smell (due to her nasal passage finally being open), the third one was another jaw distraction and around the time she finally began to swallow real food!  I remember my fairly new neighbor taking Faith to the movies with her girls and texting me to say Faith had a slushy and I replied "no she didn't" - she thought I was mad at her for letting her have that, but I was saying she couldn't swallow that much and then discovered she really did!! 

Her 4th jaw surgery was her mid-face advancement, the surgeon cut both her upper and lower jaw and grew new bone resulting in advancing the lower half of her face.  It was one of the harder ones to watch her go through, but it was so successful and that was when she was able to start capping her trach all day and only needed it at night for sleeping.  That was also when we began doing sleep studies to start trying to see if it was enough to get her trach out completely.  It was so close!!!

Which is why she made the decision to have her next (last) jaw distraction in 2016.  Her reason for wanting her trach out has been for a single reason for many many years - she wants to learn to swim and she just can't with a hole in her neck (although she tries and it scares the sh*# out of me all the time)!  So after the last (5th) surgery was done, she had her 2nd sleep study and it just wasn't much if any improvement from the last one.  Faith kept hoping it would get better but we did another sleep study last summer (2020) and it was her worst one yet - something like 70 apneic events per hour (over 30 is bad), and I'll tell you trying to sleep in the same room as your child and listening to them gasping for air is anxiety-inducing and not much of a sleep aid!! About half-way through the night they gave up on it and opened her trach back up and put her on oxygen.  It was kinda devastating how much worse it was than the last one.

So that's the background the led up to last night...

Sleep Study #5 - Last Night

Before Faith's last sleep study, her ENT mentioned to her that if her sleep study wasn't good enough, that CPAP could possibly be an option to get her trach out and start using CPAP.  When I heard it I thought, why would would do that?  She has a really great airway with her trach, and at night all she has to do is take her cap off and put a filter on the trach - about 10 seconds.  I couldn't imagine anyone wanting to be connected to a machine if they don't have to be.  Then she had the study and it was so bad we knew we would have to wait until she had another jaw surgery before doing anything else.  But somewhere in the back of her head was the ENT's comments about CPAP and she never forgot about it.  So at her last appointment with him she brought it up again and told him she wanted to try it out.  And he thought it was a good idea and that it is very likely that she will need CPAP for a transition period after getting her trach out anyway, so it would be good to practice wearing it.

So for the last month or two Faith has been wearing the CPAP headgear (covers her nose) and seeing if she could keep it on all night. And she did! So then they scheduled her sleep study, which was last night.

As prep for doing a sleep study they put about a dozen electrodes all over your head and face and then wrap your head like a mummy - it looks super uncomfortable, but she handled it just fine. Here she is sleeping with both her head wrapped and the CPAP on.




And SHOCKER of all shockers - she slept really well with it on!  I never heard her gasping for air even once.  So now we wait to hear the results and what's next.  She still won't get her trach out until she has at least one more major jaw surgery, which we are waiting until she is done growing (maybe next summer).  

But it's super exciting for her to have a positive sleep study after all these trys.  

And now I'm falling asleep - so it's time to call it a night and I will try to write again soon.

Thanks for reading!
Robin





Friday, October 14, 2016

Jaw Surgery #5 Starts Today!

Hi, it's Robin. I'm writing for Faith as we go through yet another big jaw surgery (5th major jaw surgery, 4th jaw distraction).

As Faith mentioned in an earlier post, she made the decision last spring that she didn't want to wait till next summer for her next big jaw distraction.  In fact, she wanted to have it over the summer, but since we already had plans to go to Cali to celebrate Grandpa's 90'th birthday (Wow!!) and go to Disneyland, we had to wait till fall.  And here it is!

We left Colorado Wednesday evening, flew to Indianapolis getting in just before 1am on Thursday and drove to Cincinnati, arriving a bit after 3am.   We checked into our hotel and slept until 10am! We went to the Newport Levee for lunch and then drove out to see Dr. Gordon at the Liberty satellite campus and talked about the details.  After that, we drove back to the hotel, met up with my cousin Lynda and her husband Rich who happened to be at a conference up in Dayton and went to dinner at the rotating restaurant on top of the Radisson hotel where we are staying.  Then Faith talked me into taking her to the pool for a late evening swim and finally off to bed by 11pm just to get up around 5am today!

During her clinic appointment, Dr. Gordon thought Faith's jaw opening looked really good, so he decided to not do one part of the surgery, a coronoidectomy that he thought he would need to do from looking at her CT scans.  So her surgery this time includes:
1) removing some hardware from the mid-face left behind from her last surgery,
2) doing the lower jaw distraction with placement of the Rigid Extraction Device (RED) and
3) adding some bone paste to her cheekbones to make up for some deficiencies in that area.

Here are Faith's before pics this time around:





Compare these to her before pics from June of 2015: (http://kargoll.blogspot.com/2015/06/before-surgery-pics.html)

One of the biggest differences is the chin advancement he did last time.  It's harder to really see the result of the mid-face advancement, but below are the pictures from her latest CT scan.  Note these are a little icky to look at, but it's the best way to explain how challenging her anatomy/skeletal structure is that we are trying to have fixed.

As shockingly underdeveloped as her left side is, you would be surprised to know just how happy Dr. Gordon was when he saw her scan.  Most of that pencil thin bone is actually from her scapula graft back in 2012 and he says it has grown significantly.  You can see the hardware that he is removing on her cheekbones and on her chin.  





Post-Surgery Update:
Surgery went very quickly this morning.  We arrived just after 6 am and she went into the OR just before 8.  For the first time she decided not to have Versed (an amnesiac that usually helps her relax and get a little silly before going back to be put under) and she really wasn't anxious at all until we finally had to say goodbye outside the OR.  Then she started crying a bit, but  after a couple hugs, she was ready to head back.

The ENT came out around 9am and gave us an update on her airway.  He said it's a grade 2 on a scale from 1 to 4 and that we want her to be at a grade 1.  Then Dr. Gordon came out at 11am and said everything went really well.  He mentioned that a number of her baby teeth came out but we were kind of hoping for that for at a least a couple of them!

Here's a pic of her just out of surgery.  After the last round, we thought she looked GREAT, so much better (and less bloody) than the last time.  There's actually a chance she could be discharged as early as tomorrow which would make Faith super happy because she would get to spend 2 nights at the Ronald McDonald House! Also if she get's out tomorrow or even on Sunday there is a possibility we could fly home on Monday instead of on Wednesday!



Well, that's enough for today, I will try to post another update tomorrow.  Time for us all to get some rest!  Thanks for reading and please leave a comment for Faith.



Monday, August 8, 2016

Hi everybody I just meet my new teacher today she is nice i love her I CAN NOT WAIT TO GO TO SCHOOL. It was a long time since i went to school and I am ready to go back to school:)  ok well better let you guys go see u next time 



                                                                 by,

                                                                        Faith Kargoll 

Saturday, July 16, 2016

hi everybody it is me faith we are going to do another srgrie in otober so ya i can not blevele that we ole have 1 moth left of brake and i am going to be in forth grade alred :(:(:(:(:(::(:(:(:(:(:(:(:(:((:(:(:(:(:(:(:(:(:(:(:(:(:(:(:(:(:(:(:(:(:(:(:(:(: bye,
                                           faith kargoll :)

Friday, May 6, 2016

MY NEXT POST
By,
Faith kargoll

It has been a short school year this year and I got a great teacher this year.

First, my teachers name is Mrs.Bauer she is a great teacher. 
Next, I have a great class and that is all I want right now.
Last, I have a great friend named Ellen we new each other sens we where little and we are back together again :)

Wednesday, May 4, 2016

Faith is taking over blogging

Faith is starting to have lots of her own ideas about her surgeries, what she wants to have done next and when, like getting big ears, opening her ear canals and her next jaw surgery; and since I can barely keep up with my own email, I think it is time to let her take over this blog!  Here goes...

In Faith's Words

First, I had this idea that I would have my next jaw surgery in October.
Next, you know that when I have a surgery I always get scared but not this time because I have a lot of confidence in side of me.
Then, I know I will not be able to eat and drink but as my dad says "get it done now or get it done when you are older."
Last, it will be all done and hopefully I can get my trach out and take some swimming lessons like my brother Anthony.

                                                                                 by,
                                                                            Faith Kargoll