Collin's Surgery

So I realize it has been almost a year since I blogged last.  Now that pretty much everybody is on facebook or has access to it I have become seriously slack with my updates.  Also with work and the boys and life everything has just been so busy.

I really want to document the next few months of Collin's surgery so what better place to do it?  For those of you who do not know, Collin has been diagnosed with Craniosynostosis (explanation coming soon).  Here is the story so far:

Matt took Collin to his 4 month checkup with our Pediatrician.  Dr Shepherd spent some time looking at Collin's head and mentioned that he wanted to watch it because it seemed shaped a little funny.  Without knowing anything about it, we assumed he was talking strictly cosmetic and maybe would involve a helmet.  I pretty much dismissed it all together, thinking as most moms do, my little boy is perfect and doesn't need a helmet to make him look better!  At Collin's 6 month appointment, we asked Dr Shepherd about his head and he told us he thought everything was fine but we would continue to watch.  Finally at his 9 month appointment, Dr Shepherd spent a lot of time again examining the shape of Collin's head and asking us questions about speech and motor skills (more than usual).  He again said he thought everything was fine.  The next day he called us to say that he had gotten home the night before and started worrying about Collin and wouldn't feel right until we had some tests run and we saw a pediatric plastic surgeon to rule out any problems.  Still at this point we believe this is either a) nothing at all to be concerned about or b) something cosmetic that we weren't really keen on fixing as long as it didn't cause any long term problems.

Fast forward a couple of weeks to Collins CT scan.  It was done at Vanderbilt Children's Hospital and he had to be sedated.  Luckily there was no IV, he just had to drink a sedative that took about 20 minutes to take effect.  Then we got to be with him the entire time he was being scanned.  The scan took about 5 minutes and he woke up as soon as it was over.  We had to wait about half an hour for observation before they sent us home.  The nurses told us when we left that we would hear something from one of the doctors in 24-48 hours. I didn't think we would because we already had an appointment with the plastic surgeon the following week.

The next Wednesday we had an appointment with Dr Kelley, pediatric plastic surgeon at Vanderbilt.  I really had no expectations of this appointment, other than at the very worst he would tell us Collin would need a helmet.  Even that I thought was a long shot because, again, my baby is perfect the way he is, right?  When we got checked into the room to wait for the doctor, we noticed the nurse had left Collin's CT scan up on the screen.  We snapped a picture of it because we thought it was kind of cool.  Matt told me later that he knew as soon as he saw the scan that something was wrong.  I still had no idea at all.  Here is the picture we took of the scan.  Sorry if this is disturbing...if so, you probably don't want to check back in the coming months because there could be more disturbing pictures after surgery.

So Dr Kelley came in and looked at Collin's head for about a second and then started talking about surgery in 6-8 weeks.  We were more than a little in shock, and didn't hear much of what he said after that point.  I never even heard him say the name of the surgery or Collin's condition, but I'm sure he did.  He rambled off about a million stats and facts and instructions, none of which sunk in at all.  I just kept looking at Collin then at Matt and it was a struggle just to keep it together.  Finally he told us we would see the scheduling nurse and get everything set up.  In a daze, we went back to the waiting room.  I called my mom to tell her what was going on, tried to get through it without losing it, and failed miserably.  Matt took Collin home and I waited for the scheduling nurse.  When I met with her, we set the date for May 3 (we wanted sooner but this was the first available they had).  She also showed me some pictures that other families sent in before, during recovery, and after.  While it was hard to see some of them, it also really helped me process more of what is about to happen.  I left still upset, but much more calm.

So, after some research and emails with the scheduling nurse, we now know that Collin has Metopic Craniosynostosis.  Basically the Metopic Suture, the space between the two bones that form Collin's forehead, fused early.  It most likely happened before he was born, but there is really no way to know.  Nobody really knows why it happens, but some stats say that it happens to 1 out of 250 babies in the US, with 1 out of 4000 needing surgery.  If you look back up at the picture of Collin's skull, you can see that the sutures on the sides are still open while the one on the front is completely closed.  Dr Kelley explained to us that if we do nothing, the rest of his head will continue to grow as normally and his forehead will remain the size it is now.  We can already tell that the front of his head is much more narrow than the back (pic below).  Dr Kelley believes that brain growth has not been negatively affected up to this point, but it is only a matter of time before that starts to happen.

I'm not sure of all of the details about the surgery, but I know they will separate the bones and reconstruct his forehead to allow his head and brain to grow normally.  The surgery will be performed by a pediatric neurosurgeon and plastic surgeon and will take around 4 hours.  He will be in the ICU for up to 3 days and will be sedated most of that time - they will wake him enough to eat but other than that will keep him sedated for pain management and to keep him still. We will be able to stay with him in the room in the ICU (something special for Vandy from what I've seen about other hospitals). From the pictures I've seen, immediately after surgery he will look almost completely normal but will then begin to swell.  Most likely his eyes will be swollen shut.  After ICU we will be in a regular room for 4 or so more days.  Some people I have read about or talked to have said they were able to go home on the 4th day.  I believe that depends mostly on when the swelling goes down enough for him to open his eyes.  I hope the estimate of 1 week in the hospital is worst-case scenario, but we are prepared for that or longer.  Dr Kelley told us that he will need to be home (not in daycare) for 4 weeks after the surgery and will be fragile for up to 12 weeks...not so fragile that he can't walk and play as normal, but we will need to pay closer attention to him to make sure he doesn't fall on his head or run into anything (easier said than done with a 12-14 month old I'm sure!).  After the 12 weeks he should be completley back to normal, only a scar on his head which should be covered by hair.  He will continue to see the plastic surgeon for 6 years (I believe) for observation but otherwise should be able to live a completely normal life.

One of the things we do remember the doctor telling us is that this surgery is performed at Vanderbilt 2-4 times per week.  This was also shocking to me!  Now that I know about it and can research online, I see there are so many "Cranio kids" out there and all the stories I've seen have been so positive.  I know he is in the best possible hands at Vanderbilt.  We are so blessed to live just down the road from one of the greatest children's hospitals in the country.  We are also so blessed to have amazing family and friends who have offered help and prayers during this time.  I have to remind myself almost daily that while this is big and scary, it could be so much worse in so many ways.  As someone pointed out to us...we got bad news, we didn't get tragic news.  This is something we can get through and come out on the other side relatively normal. 

So now we wait...I don't know if there will be much to post about between now and the surgery.  We have a pre-op appointment on April 30 to meet with the neurosurgeon and become acquainted with the hospital.  Between now and then we ask for your prayers that everything will go as smoothly as we believe it will and Collin can very quickly go back to being the happy, smiling, energetic toddler he is now. 

More to come!

Here is a picture from the top.  It is amazing how you never realize something is wrong or different until you're told so by an expert...I just assumed he had a narrow head/face.  It will be very strange seeing him with a round head!

(pic by Leila Hunt Photography)

Looking back at pictures from months ago, now I can tell how much smaller his forehead is than the rest of his head.  In this one you can see that there is some stretching around his temples...this apparently will no longer be there.  I've read that his eye shape may also change, becoming more rounded.



Welcome Collin!

Better late than never right?  For those of you who don't know the whole story of Collin's birthday, here goes...(FYI, I am using terms like dilation and cervix, so if that makes you squeamish, skip ahead to the part after the line).

We were scheduled to be induced at 5:30am on Thursday May 12.  We got to the hospital at 5:15 and got checked in.  After answering about a million questions (you'd think they would have kept all that information from 2 years ago), they checked my cervix to discover I was 2 cm and about 50% effaced just like I had been the week before at my dr appointment.  I was afraid this meant we were in for a long day.  They put in my IV and started fluids and the pitocin (this is the drug that causes strong contractions to get things moving).  This was around 7am.  They told me that my doctor would be in at 9am or so to break my water and to let them know when I wanted my epidural.  I had planned on laboring for a little while without the epidural, but I knew I didn't want to feel her breaking my water so I told them just to make sure I got it before then.  The anesthesiologist must have been bored because he was there about 5 minutes later to give me the epi.  It was a little more painful this time than I remember with Max, but maybe that was because I wasn't having any contractions to distract from the pain of the needle.  The nurses kept telling me that Joel (the anesthesiologist on duty) tends to be pretty heavy handed with the drugs, and they were right!  Pretty much immediately I lost all feeling in my lower half.  My right foot hung off the bed for about an hour and I tried everything I could to move it but had no luck.  These were good drugs.  I also was having contractions fairly consistently but couldn't feel anything.  That was a little bizarre, to see them on the monitor but not be able to feel them at all.  At 9am, my dr came in to break my water and at that point I was 3 cm dilated, so we had made progress.  I was only at a level 6 on the pitocin drip then, which is pretty low (the nurses can take it up to a 20 without dr approval, or a 40 with it!), but the 6 was doing what it was supposed to do, and by 10am I was dilated to 4-5 cm.  This is when things got a little crazy...

Three times between 10 and 11 Collin's heartrate bottomed out when I had a strong contraction.  Each time it came back strong as soon as the contraction was over.  It helped when my wonderful nurse (Teri) rubbed my belly after the contraction to soothe him and calm him down.  They also had me on oxygen to help get more air to Collin.  After the second time, Teri decided to insert an internal monitor (on Collin's head) to be able to better monitor his heartrate.  She also called the dr to get her input on what our next steps should be.  After the 3rd time this happened, at almost 11am, the dr and nurse decided to prepare an operating room in case I had to be moved back for an emergency c-section.  There was a scheduled c-section at 11am and they actually pushed it back 15 minutes to make sure they wouldn't need the OR for me.  The dr told me they believed Collin was perfectly healthy because his heartrate kept recovering so well after the dips, but too many dips could begin to cause problems so the next time he had a dip they would decide to go into the c-section.  This was a little scary, but we trust our dr to make the right decision.  They turned off the pitocin in case the artificial labor was what caused the dips in heartrate and Teri told me to keep rubbing my belly where Collin was laying since it seemed to keep him calm.  They also pushed a lot of warm fluid through me to hopefully move some things around inside and give Collin a little more room to move around.  After that we had to just wait, hoping we wouldn't have another dip in heartrate.  For the next hour, there were no dips, but no progress on my labor either.  A little after noon I was still around 5 cm dilated and he was still pretty high up.  They decided to go ahead and re-start the pitocin and increased it slowly back to a level 5 over the next hour.  Around 1:15 I started feeling pressure with each contraction and at 1:45 Teri came in to check my cervix again and discovered that I was fully dilated and ready to push!  She called the doctor and had me do a couple of practice pushes...on the 3rd one she told me to stop and not push again because Collin was ready to be born and the dr wasn't there yet!  The dr came in a few minutes before 2 and they spent 10 minutes or so getting everything ready.  The dr told me to start pushing with my next contraction but I couldn't feel the contractions (that Joel sure knew what he was doing!).  It took only about 9 pushes (3 pushes through 3 contractions) and Collin's head was out!  After a little suction she told me to give one more push and out he came!  He started crying right away and was checked out by the nursery staff then given back to me for a little bonding time before he had to go have a bath and spend some time under a heat lamp to warm up his body temp.
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We had a very easy couple of days in the hospital and got to come home around lunchtime on Saturday.  My recovery started off going really well; I had a little cramping and soreness but overall was bouncing back pretty easily.  Unfortunately Max came down with a virus while we were in the hospital so we came home to a sick toddler and we had to try to keep the two of them separated for a couple of days.  I ended up getting the fever portion of Max's virus and Oma and Daddy ended up getting the congestion and sore throats.  We were hoping Collin missed the illness, but last Thursday he started getting congested and still today he's fighting a lot of drainage in his head and throat which makes it hard for him to eat and sleep.  Until the last few nights he had given us at least one 4-hour stretch of sleep per night, but since he's been so congested it's been hard for him to rest.  We feel like he's been a little better today and he's definitely been able to rest better most of the day so hopefully the worst is behind us.  Let me tell you, after the past few months we are ready to have a healthy household again! 

Despite all the stress of being sick and having sick babies, we have been so happy to have Collin home with us.  Oma has been with us since he was born and is staying through this weekend.  I'm still trying to figure out a way for her to never leave, because I'm not sure how we'll be able to handle it without her!!  One of our biggest concerns with bringing Collin home was how Max would react to not being the center of attention.  He has been a wonderful big brother!  He always wants to hold Collin (or Col-Col as he calls him), or bring him a blanket, or kiss him on the head, or give him his pacifier.  He's really sweet with him.  We've had a few moments where he seems to be testing his boundaries and acting out, but that could be just as much being 2 years old as having the new baby at home. 

Speaking of Max, he continues to amaze us every day with his vocabulary and mental ability.  One day last week he was sitting in his high chair eating dinner and started counting.  I had only heard him count to 3 by himself, but he counted all the way to 10!  I asked Oma if I had heard what I thought I did and she said she'd heard it too!  He was so proud of himself!  He knows almost all of the alphabet by sight...he mixes up a few of the similar letters like K and X but for the most part can identify all of them with little or no help.  He's also gotten a lot better with his pronounciation of most words.  I think he probably knows as many words as we do, he just can't always make them come out the way he wants them to.  He gets better with it every day though.  We really can't believe how much he's grown physically and mentally just in the past few months.  I guess having a newborn makes him seem so much older and bigger as well. 

Here are some of my favorite pictures of the past couple of weeks.  I've posted a ton of pictures on the shutterfly site - click the link on the left side of the page to view. 

1st Family Picture (believe it or not this was the best one!)

Big Brother/Little Brother

Gamma & Poppy

Oma & Jiggs

Sucking his thumb right away.  The nursery nurses said it's rare that they see a thumb-sucker so early.

Max wanted to show how much taller he was than baby Collin

Aunt Em

Aaaaaaaggghhhhhh!

So peaceful

Wish Mommy could get this kind of sleep...

Max's Birthday, Easter, & Updates

Max is TWO!  Can you believe it?  It's been a couple of weeks now and it's hard for me to believe it myself!  It's been amazing to see the transition from baby to boy over the past few months.

Speaking of the past few months, they have been crazy busy around here.  We've been trying to prepare for Baby Collin's arrival.  It's also hard to believe that he will be here in just a couple of weeks!  The current "plan" is a scheduled induction on May 12.  If I haven't progressed any more between now and then, it will probably have to be pushed back.  So please send some positive baby vibes our way to get things moving.  Of course we want him to come when he's ready, but it would be really nice if he was ready sooner rather than later. :)  I'm definitely finding out that being THIS pregnant while also having a 2-year old is a lot more of a challenge than doing it the first time.  Luckily Max has an amazing Daddy to do most of the taking care of him. 

Backing up a few weeks, we've had some rough days & nights with illnesses around here.  It started out with Max getting the Roseola virus and his temperature staying very high for a few days.  It topped out at 105.3, which was terrifying for us.  We're so thankful Oma was here that week to help care for such a sick baby.  About a week after he was over the Roseola, he came down with a stomach virus that lasted for about 5 days.  Aunt Em got the pleasure of being here for the worst part of that virus (the many, many diapers).  As a thanks for helping out, Aunt Em came down with the virus herself.  I also had it the same weekend.  Unfortunately this was the weekend of Max's birthday party, which Aunt Em had to miss because she was still sick in the bed.  We had a good time at the party (more to come on that later), but were so sad Em had to miss it.  Oma had the pleasure of again taking care of the sick ones that weekend, and came down with the same virus a few days later (on her birthday, no less).  Since Max's birthday, all 3 of us have had a cold that lasted for 7-10 days each.  FINALLY, we all seem to be pretty healthy.  Fingers crossed we all stay that way until after Collin gets here.

The week of Max's birthday party, we were so happy to have Nicola & Thomas come visit from Germany.  Max got to meet his foreign Aunt & Uncle for the first time.  Unfortunately that was the same weekend Emily & I were sick, so we didn't get to spend nearly as much time with them as we wanted to.  It was still such a blessing to have them here for Max's birthday party.  We hope they get to come back soon to meet baby Collin.  Or maybe we'll finally make it to Germany.....it shouldn't be too hard to travel overseas with an infant and a toddler, right? :)

Max had such a good time at his birthday party.  BIG THANKS to Gamma and Poppy for letting us hold the party at their house.  I wasn't sure I could manage it at our house this year (and good thing, since our house turned out to be full of viruses!).  We had 2 delicious cakes - one each from Nicola & Stacia.  They were both so adorable.  Poppy made his famous homemade chocolate ice cream and Max had a blast opening presents and playing with Caitlin.  Here are some pictures from the party. 

Max loooooved his new Lego set from Nicola & Thomas.

Playing with his Legos in his new Cars chair from Aunt Em!

Cars cake - made by Stacia - so cute!

Nicola worked really hard on this adorable (and yummy) ladybug cake.

Max & Caitlin had a mini Easter Egg Hunt at the birthday party.  This is them enjoying the chocolate inside the eggs.

Max is a big fan of the Easter Eggs, as long as they have candy in them. 

Eating Nicola's lady bug cake



When everybody was in for Max's birthday, he also got to enjoy his first zoo experience.  Aunt Em & I were really looking forward to going, but unfortunately that was the day we both came down with the stomach virus, so we had to enjoy it through the lens of Thomas's (amazing) camera.  Here are a few of the things Max got to see along with Oma, Jiggs, Nicola, & Thomas.

Last weekend was Easter, and Max had a blast hunting Easter Eggs again (twice) and hanging out with the Colberts & Greers at Uncle Adam & Aunt Bri's.  Here are some pics from that weekend.

Sad face - empty basket before the Easter Egg Hunt at Westland Methodist Church

Decorating a rice krispie treat.  He ate more of the icing and jelly beans than he put on the cookie.

Finally getting some eggs for that Easter Basket!

Family pic - Easter 2011

The Colbert Clan

A little rough-housing with Uncle Ken

Max wants his own Barbie Jeep now...think they make them in something other than pink?

Hope you've enjoyed the pictures!  Maybe next time I won't have 2 months of updates and it won't be as long.  There are a lot more pictures up on the shutterfly share site.  Click the link to the left.  Enjoy!

It's Official...Collin James Greer

So after months of indecision, we're happy to annouce that Baby Greer #2 will officially be named Collin James Greer.  Collin is in honor of the Collins portion of Matt's family, and James is in honor of both my grandfathers - Jimmy Ward and Jim Hamilton.  Both names are derivatives of James.  Max is learning how to say his little brother's name.  It mostly comes out as Coll-Coll or Coyin (the L is still hard for him).  We're about 9 weeks away from my due date, and I know it will come so fast.  We can't wait to meet little Collin and have our family complete. 

We've got a really busy next couple of months coming up.  Matt has a couple of trips planned to Atlanta and Louisville for work, so Oma and Aunt Em are coming to stay for those weeks that he's gone.  Nicola and Thomas are coming to visit from Germany the 2nd weekend in April and we are so excited to see them and let Max meet his German family for the first time!  We'll also celebrate Max's and Oma's birthdays that weekend.  A couple of weeks after that is Easter, then only a few weeks until Collin is here!  We started our busy weeks off with a visit from Aunt Gwen, Mariah, Erica, Maddie and Rivers.  Matt and I got a (very small) taste of having more than 1 toddler to take care of when we watched the 3 kids last night.  Here are some pics and a video of the fun they had.

Max and Maddie hanging out on the body pillow...after taking turns jumping on it.

Max decided to have some alone time reading so he climbed up on the pillows and bean bag and covered his face with his book.  Rivers tried everything he could to get Max's attention...with no luck.

Almost all three smiling!

I'm not sure which boy hit Maddie, but this was the beginning of the end of our photo session.