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signmeuptoo
Folding and Crunching Not just Breakfast
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| Update on Colin: heartwrenchs and hopes
This is from Colin's mom:
"The unlayering of knowledge and understanding that comes with the process of an unfolding medical situation is distressing, frustrating and immutable. The challenge presented itself from the first moment when Dr. Michelin in the Danbury Hospital emergency room said, "it's not good news." A second instance was when Dr. Wisoff revealed that the tumor had metastasized and was showing up in scans of Colin's spine.
Individual pieces of information that reveal a dramatically negative change in the situation (or at least a change in how we understand it) are rare. An abrupt shift like that drops the bottom out of the world. The heart forgets to beat, lungs forget to expand. But even this fails to turn back the clock to a time before the truth revealed itself.
The bulk of information dribbles in slowly and unreliably.
Having passed the initial recovery period following surgery, we know the list of deficits that Colin is currently experiencing, but we do not know how long they will last. We are talking about days, but more likely weeks and months. In the meantime, we hang onto the smallest inklings of future trends. In the absence of science, there is a more vague exercise in the extraction of speculation from doctors and nurses or whiffs of change in Colin's condition.
The most significant question that hovers over Colin's bed is whether and when he will swallow well enough to receive nutrition orally. Following his failure of Friday's swallow test, we were told that he would repeat the test on Monday, but over the weekend it seems that the consensus is to put the test off until later in the week in order to give him a chance to improve.
We were already prepared for the idea that the surgery (temporarily) affected Colin's swallowing, though it was impossible to guess the extent of the effect or its expected duration. The hope is that the aftereffects of longer-than-usual intubation are pushing his incompetence at swallowing over the edge. If there is some indication that the neurological deficit may take some time to resolve, however, Colin will have to get a g-tube installed so he can receive nutrition safely.
For the time being, a nasal gastric (NG) tube is sufficient, although it is extremely irritating to Colin. During the day, we have to keep a hawk eye on him or mitt his left hand so he doesn't pull the tube out. Perhaps the only positive aspect is the fact that he is motivated to try to get his weaker hand working in order to get the tube out, which he's so far done twice successfully.
Virtually every conversation with his nurses involves his swallowing. How well is he dealing with secretions? Are they suctioning him more or less because of a change in the secretions or a change in his ability to manage them? Gee, he's been coughing more -- that's a good sign, isn't it? The biggest question and the one that is hardest to measure is whether the trend line is heading in the right direction and, if so, if it is doing so quickly enough to indicate that he will soon be able to eat.
The weekend was filled with this kind of mundane and vague inquisition and speculation. Colin has been gradually emerging from the fog and has been fairly dolorous about his circumstances, although he does laugh about silly things and enjoyed watching Aidan play with another 5-year-old who is here for epilepsy treatment. His returning awareness has been a relief but also brings with it a different set of questions and concerns. What is he aware of; is he uncomfortable/in pain; is he sleepy or sad?
Looking at him and seeing how healthy his body appears, we often fail to appreciate the extent of the surgery. The brain is a mystery, even to its most avid students. A child's developing brain and the strange combination of delicacy and resilience add to that fundamental enigma. Add on top of that the inscrutible behavior of the cancer and its interaction with Colin's body and immune system, and we are left bereft of definitives and conclusive science.
This environment lends itself to magical thinking and a pervasive tendency to identify omens in daily life. Omen hunting is a particular occupation during momentous days, such as that of Colin's surgery, but can crop up at any time. It can be either positive or negative but in either case needs to be understood for what it is, the yen for more information.
The reality and truth are that time will peel away the darkness that obscures Colin's destiny. Simultaneously, new questions will arise adding their own set of possible outcomes and decisions to our path.
For now, Colin is out of PICU and medically stable with unresolved questions about his ability to swallow under the assumption that this will recover over time. We also assume that his other deficits (sixth nerve eye movement and facial paralysis) are temporary. We will regard preservation of any degree of hearing as a miracle.
On the less medically intense front, Aidan is now in New York with the rest of the family, staying at the Ronald McDonald House. He has come to learn the particular benefits of staying there, namely a video game room in the basement equipped with a Star Wars game and X-Box and (so far) elaborate nightly craft-desserts -- decorate-your-own cupcakes twice and sundaes on Sunday. Aidan also went on an outing to Rye Playland with Mom, where they particularly enjoyed Starship 2000, a centripetal force-based ride that totally rocks. At the top of the log flume, he started shouting, "I'm the King of Playland!" But best of all, he must have boned up on the Heartstring Tugging Playbook when he said, "It doesn't matter what we do. It's just nice to be together with you."
With the kids installed in different locations, it has been an interesting logistical exercise to get around. On Sunday afternoon, Colin moved out of PICU (possibly never to return again during the course of Colin's treatment) onto the general pediatric floor. In Westchester, this had meant moving from one private room to another private room with more privacy. Here, we moved from a quad with one other patient to a quad with two other patients (one of them, oddly enough, had been a roommate in the PICU). However, the accommodations seem more spacious. Some of this may be the ceilings, which are much higher, but the room layout is quite different. The bedside accommodations are more bedlike as well, with chairs that unfold into a flat sleeping zone as opposed to frustratingly upright reclining chairs.
The nursing on this side is expectedly less intense with higher patient-nurse ratios. This and Colin's increasing wakefulness also mean that it is much trickier for us to leave him with the nurse while we go out for a meal or go to Ronald McDonald House together as a family. We are not sure how long to expect to be here, though obviously we will remain as long as it takes to resolve whether Colin will need to get a G-tube or not and probably through the first round of chemotherapy.
If anybody is interested in sitting with Colin so both Mom and Dad can get out together, we would greatly appreciate it. Please let us know by email/text/phone. One benefit of the regular pediatric floor is that here we are allowed to use our cell phones and computers. (portion edited)"
--Colin's mom
Oh Lord please let Colin swallow and heal.
--
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rfhar
The World Sport, Played In Every Country
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Buicktown,Mi
clubs: | Thanks for the update. I will keep praying twice a day for Colin and his family. | |
Inchworm
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| reply to signmeuptoo
Praying for Colin!
I had a nasogastric tube for a number of days after stomach surgery when I was a teenager so I have particular empathy for the uncomfortable, almost claustrophobic feeling it can cause. I hope his swallowing soon returns to normal. 
--
Dare to make a difference here or here | |
mig
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join:2000-10-26
Anytown, USA
clubs: | reply to signmeuptoo
Our thoughts and prayers are still out for Colin and the family. | |
Vtblues
if you can't get out of it, get in to it
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Brookfield, VT
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I'm still praying for Colin, my heart hurts to know of what he's going through | |
usa2k
Please PRAY for Rebekah
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join:2003-01-26
Canton, MI
clubs: | reply to signmeuptoo
Still cheering for miacle upon miracle! | |
onDvine
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So. CA, USA
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Appreciate the update. Positive thoughts still coming his way. | |
signmeuptoo
Folding and Crunching Not just Breakfast
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| reply to signmeuptoo
No changes as far as improvement yet. We are in limbo and beside ourselves hoping for him to swallow and regain his other abilities.
Colin is such a wonderful little guy, I wish you all could meet him! His smile is infectious and charming, his strength is just plain great, and his personal grace is very evident, even at his age.
When Colin was a bit younger his mom handed him to me. She always made sure that Colin was a community baby, much to her credit. Well, if any of you know me like Cory does, you'll know I am an easily befuddled and uncoordinated softy. I was just this side short of terrified to hold a baby, let alone of my family, and not drop him! But don't you know, Colin and I connected so especially that, though he wouldn't fall asleep with anyone else but mom at that time, he zonked right out after only a couple minutes and remained in my arms while my eyes welled up with tenderness. I am crying thinking about it right now.
There is something inexplicable about nurturing a child, protecting it and caring for it. And a child as charismatic as Colin, well... His brother is equally wonderful and special and it breaks my heart that poor Aiden has to endure being a witness of a brother's illness. One of my sisters says Colin takes after me as a baby, and after his dad as well.
I want you all to know something: Although I don't actually know each of you personally that well and I am often just a bumbler around here, I truly love every one of you and thank you from the bottom of my heart for all the prayers. With your help, no attack from the darkness, be it Colin's cancer or my wife's recent attack from a rat, will succeed.
Bless you all. And sorry I come to all of you so often for mojo and all.
--
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usa2k
Please PRAY for Rebekah
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| Re: Update on Colin: heartwrenchs and hopes
You know,your posts can be eloquent and poetic. The love you show for family and the likes of us here make you so easy to like, and so easy to care for. Be it your wife, you Colin ... it is easy to send prayer and well wishes to you and those you love be cause you yourself are so lovable. Just like family.
More prayers for Colin!
--
Jim, VoIP 12/2002, VOIPo 2/2007
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signmeuptoo
Folding and Crunching Not just Breakfast
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LOSTinSpace
clubs: | Wow, gee, thanks. But the real writer in the family is Colin's mom, her dad was a Pulitzer winner, what a guy he was!
If it wasn't for my mood issues, ah well...
I'll post an update ASAP. | |
Vtblues
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| Mark, your writing skills are nothing to be minimizing. I do understand that much of what's updated about Colin is in his Mom's words but you make it very clear when using your own.
--
I'm folding and crunching to try to help prevent stories like »Update on my son who has cancer
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signmeuptoo
Folding and Crunching Not just Breakfast
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| Thanks very much guys. Funny thing is, I've always been a bit awkward socially. I admire the cute, very friendly type "retorts" (for lack of me knowing a better word) that all of you friends share with each other when kidding around. I am not too good at thinking of cute responses and joking around, I kind of envy people that are good at it, it's a real social skill!
By the by: Colin's mom has recently posted an update, and you can read the hurt in her words for her baby. Through all of this she has maintained a cool, logical head and I am so very impressed with that!
Here:
"Colin may have a budding career as a Geico caveman, or perhaps a more mundane sideshow act as a wolf boy. We have noticed thick hairs sprouting on his forehead, giving him the beginnings of uni-forehead (forget uni-brow -- we've moved way beyond that). Dark whorls grow like moss on his back.
The new hirsuteness is one side effect of the steroids, which are finally being stepped down. Although they have been important in controlling swelling related to the hydrocephalus and surgery, it is time to wean him from the medication. Because Colin has been on them for so long (over a month now), they are bringing in the endocrinologists to manage the decrease.
As a parent, it is reassuring to have pediatric specialists of various disciplines available for Colin's treatment. It is also daunting to have so many new faces and names visiting him bedside. Each discipline has its own collection of practitioners, usually including a faculty member physician, a fellow, and one or more residents.
The pediatricians on the floor present additional complexity, as there are also senior medical students circulating around. It remains unclear if they have the ability to do anything besides run and get somebody else (sometimes useful in and of itself) or act concerned (beneficial if not overtly useful). While our participation in the pedagogical experience represents a valuable contribution to a future generation of doctors, there is a certain cost to it as well.
To make matters worse, we have evidently been switched from pediatric care under the oncologists to the neurosurgeons, for some reason involving a change in the covering pediatricians. Therefore, whatever doctors/proto-doctors we have been working with are no longer the ones that are responsible for Colin.
On Monday, we met with Dr. Magill, who comes from the in-patient rehab facility, Rusk. In addition to coordinating care there, he supports rehab during hospitalization. Colin is now being seen daily by a physical therapist, occupational therapist, speech therapist, and psychologist. Martha, one of the local music therapists, also works with him daily (Rusk has its own child life staff, including music therapy).
The famous swallowing study is now scheduled for Wednesday. Earlier, the thinking was to put it off as late as possible, but now that Colin's swallowing recovery looks fairly slow, they're leaning towards installing the G-tube before he goes to rehab so as to make the best use out of his 30 days of acute rehab that are covered under insurance.
The idea of marring his body with the tube, which will surely leave a permanent dimple, is difficult to digest (no pun intended!). However, it may be the best choice for him and he certainly doesn't enjoy having a tube down his nose. From the standpoint of his comfort, if his need for tube feeding is at all attenuated, the G-tube makes sense.
All day, Colin has been salivating profusely. Although Luigi, the neurosurgery resident, pointed out that he has facial paralysis that lends itself to drooling, saliva has been escaping from both sides of his mouth nearly equally. Given the basic input-output equation related to his secretions, it is clear that either he has been outputting more saliva or is doing a worse job in swallowing it.
Thus, hopes for the necessary miraculous improvement in swallowing are small indeed. Colin is able to swallow to some degree, but he has to do so competently enough to not just take in a mouthful without aspirating any food but actually maintain a nutritionally sound diet. Therefore, if he could only eat very slowly, he would still need tube feeding.
On the other hand, we now realize that Colin has likely been experiencing nausea all day, which could also account for the increase in saliva. We suspect that this could be due to nystatin applied to his tongue from thrush (the steroids increase the risk of this). They decided to temporarily stop the feed and give him anti-emetics and see how he does.
Colin has been unsettled in the time since we identified the nausea (he regurgitated a bit of the feed). Compounding his own internal discomfort, another patient in the quad is quite miserable and moaning. When relatively calm, he sounds like Dorie from the movie Nemo when she is speaking in whale. However, his discomfort periodically reaches less comical and distinctly painful pitch at times.
Life in the quad always relaxes when there is at least one open bed and is simpler when the patients don't have acute problems. Every bed generates its own native sounds, those that are organic and others related to entertainment and chatter. One patient has baby music, another Yiddish programs, and Colin's area radiates Handy Manny and other animated shows. We were relieved when the teenaged boy who spent all night watching Spongebob and playing video games was finally discharged.
On Monday, Mom had the opportunity to sleep at Ronald McDonald House. Aidan had no excuse to stay up late, since Mom was anxious to maximize the use of that quiet sanctuary for sleep. The hospital is fine for working and writing but less ideal for rest.
Wednesday is the day the neuro-oncology group's weekly tumor board meets. They will discuss Colin's case and provide their recommendations for his treatment with the understanding that the information is not perfect. For example, Dr. Allen said that the pre-second-op scans that show enhancement in two places on the spine are not definitive for disseminated disease, since it is possible that the enhancement is a surgical artifact. He hadn't seen the original pre-op scan that included the full spinal, so the board will be taking a close look at that.
Colin will get a spinal tap done (possibly) on Thursday, which is the day they usually do outpatient taps but can accommodate inpatient procedures if there is availability in the schedule. A positive cytology finding means that there are cells in the fluid and therefore there is disease in the spine, but a negative cytology finding means that they can't quite be sure.
Confirmation of disseminated disease, presumably through the scans (since the spinal tap is only definitive if it detects cells), means that Colin will probably receive a more aggressive chemo protocol. Generally, ependymoma calls for a less aggressive protocol, but metastasis is fairly uncommon. This is all a matter of research for the oncologists.
Also, Dad heard of an intrathecal radioimmunotherapy program at Sloane Kettering that Colin may be a good candidate for. The new therapy uses antibodies to deliver targeted radiation to cancerous cells, useful in cases of disseminated disease because the patient doesn't have to be exposed to widespread radiation. This isn't generally used for ependymoma because of the rarity of dissemination and the efficacy/safety of focused radiation even in children under 3. The therapy can be used as a replacement for chemo if there are small enough amounts of residual disease, or it could follow up chemo.
The doctors at both institutions work well together and they have evidently referred other patients there, but we will certainly raise the question ourselves when the time comes. It has only been used on recurrent disease so far, but Colin's case may be a good one, especially once we get a definitive idea of what is going on in the spine.
The idea that the disease has not disseminated into the spine is an attractive one, but not something that we can hold onto. For one thing, it is a thin straw at best. For another, hope that is founded on the idea that the thing we dread and fear simply isn't there feels childish in a way. Also, several professionals who saw the original scan did identify "suspicious" areas, so there was no particular conflict among the tumor hunting pros.
The real hope for Colin's future is that all of the people involved with his care will help carve the right path for his treatment and that he will be strong enough to endure it. Cancer treatment is a barbarism to its beneficiaries, and many current innovations are focused on ways of making the things that work do so less toxically and painfully.
They say that children are the most resilient patients, but repeated fights against recurrences leave their marks. It is not capitulation as much as it is battle fatigue. Of all things that we see, this is the hardest to imagine for Colin -- and all of the children who manage serious illness -- as he grows up."
As health care looms so huge on the national debate, I sit here struggling with my own feelings, concerns, and needs related to it, and my hopes and aspirations. With health issues so huge in my circle of life, AND my circle of friends here, I struggle with the debate and my hopes of what it will yield.
In the mean time, bless Colin (and all of you here who are or know those who are struggling with health issues, as well as my woman and boy) with the best care possible in a world where it isn't readily available to all...
--
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usa2k
Please PRAY for Rebekah
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clubs: | More prayer! | |
signmeuptoo
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Re: Update on Colin: heartwrenchs and hopes
So much is in the air. Colins parents are deeply considering ways to go while watching Colin recover, with a great deal of grace, from surgery.
Here is the latest from the mom:
"On Wednesday, Colin was schedule to repeat the swallow study, though it was widely thought that he would likely fail. Melissa, who did the first swallow study, sensed this and asked to visit him clinically before conducting a study. She suggested that he needed at least a week before retesting.
However, we realized that the question wasn't whether he could now competently swallow, which he certainly couldn't, but whether he would do so quickly enough to avoid the G-tube. Subjecting him to the study now would needlessly expose Colin to radiation and put him through a process with a risk of aspiration.
Instead, we could simply decide that the G-tube would help him receive tube feedings more comfortably than the current NG-tube. The procedure to insert it is relatively simple and easily reversible. Doctors of the various disciplines agreed that Colin's recovery of his swallowing function would take some time and that the G-tube is a good solution to help him in the meantime.
Furthermore, it is not uncommon for chemotherapy patients to require tube feedings in order to receive nutrition while feeling awful. The oncology dietician described the G-tube as an "insurance policy" to bolster Colin's nutrition during treatment.
Colin will get the G-tube placed before starting acute in-patient rehab, though it is not clear exactly when that will be. Today, he also had the lumbar puncture (spinal tap) performed and a CT scan of his head to compare the ventricles with earlier scans.
The results of the spinal tap should be in within a few days as the fluid is tested for the presence of cancer cells. While we agree that it is important to perform the test, it's unclear how much of an impact it can possibly have in the treatment plan, since it can only confirm the presence of the disease, not eliminate the possibility of metastasis or even suggest that.
The doctors will assess Colin's CT scan. Clinically, he shows no signs of hydrocephalus and has actually in many ways improved since the surgery. Most dramatically, he has stopped grabbing at the back of his head. Generally speaking, he is less irritable, though he does express the desire to leave the hospital and sometimes complains about being returned to his bed.
The Head Start III chemotherapy protocol is shockingly harsh, involving the destruction of Colin's bone marrow and replenishment through autologous stem cell recovery, meaning that they harvest his own stem cells and use them to regrow the marrow. While we recognize the need to address the metastasis, we feel that there may be other good treatment options for him that would be less toxic.
Namely, the interthecal radioimmunotherapy program at Memorial Sloan Kettering could be quite useful as long as he does not have any chunks of tumor. We need to discuss the feasibility of reducing the size of any physical tumor in his system through chemo (this assumes that the tumor will respond to chemo, which it often doesn't with ependymoma).
Much of our reluctance to dive into Head Start III is based on the results of work using the earlier protocols for ependymoma, which were not promising, to say the least. But if he does at least initiate Head Start (beginning the protocol does not mean that he is absolutely required to continue), he needs to begin the chemo within 42 days of the surgery.
Within that window of time, the doctors want to conduct a more definitive post-operative MRI as late as possible to minimize the effect of surgery on imaging. Blood and swelling in particular can be difficult or impossible to differentiate from disease.
Today, opthalmologists assessed Colin's papilledema again and did not see any evidence of it, much as expected. Placing a shunt to manage hydrocephalus is a much more involved issue than the G-tube, since it can create long-term dependence and carries many more risks.
Considering the value of avoiding procedures during chemo that might disrupt the protocol is valuable, but it cannot utterly drive other decisions. The G-tube is much less onerous a device than the shunt, so it was much easier for us to opt to have that procedure performed sooner rather than later.
Not having a concrete treatment plan is both unnerving and paradoxically reassuring. The team here is interested in making the best decision for Colin, and this is not a situation where there are pat solutions. We appreciate the equivocation on the issue of metastasis as well as the consideration of smoothing the path to treatment.
One amusing effect of the ophthalmological exam was dilation, which is necessary for proper assessment. The opthalmologist taped a note to the wall indicating the application of dilation drugs so that anybody conducting a neurological exam would not become alarmed by the dilation and lack of pupilary response. Even so, Dr. Magill (rehab) became concerned and initiated an inquiry regarding the half-life of the medication used, which was longer than anybody had expected.
This incident underscores the importance of the coordination of information. With so many different practice areas involved in Colin's care, it is impossible for all of the information to be managed efficiently. We serve as an important hub and can facilitate or hinder the process depending on what information we have.
For example, today Colin was scheduled for an upper GI study related to the placement of the G-tube. However, nobody informed us or let us know anything about the utility or requirements (i.e. sedation) of this study. When Colin was in recovery from the mild anesthesia related to the lumbar puncture, we were told that he was to wait in the day surgery area for the upper GI study. However, since we were unaware of the study or what it was used for, we did offer resistance when the day surgery nurse sent us back to the general pediatric floor. His concern was that we be monitored by a team that knew us well, not one that had just met us in the short time around the procedure.
Also, the CT scan, which we went out for not long after the spinal tap, ended up being more involved because we were taken to the wrong floor by mistake and the person who was supposed to receive us didn't realize that we were waiting on a different floor. Because waiting is a natural part of the process, we did not question the delay in getting the CT scan. Plus, Colin had fallen asleep and was comfortably resting in Mom's arms.
Overall, Colin continues to improve and enjoys new activities every day. He seems reluctant to initiate play with new items but can often be encouraged if somebody else uses them. He started using a shape sorter and some other toys in the play room.
The continued flat affect makes it difficult to figure out if he is actually enjoying himself, in the absence of an actual half-smile (the right side of his face doesn't work properly). The most reliably means of communication is finger squeezes, which he administers with surprising vigor.
Colin independently turns his whole body from side to side and has started using his right hand in objection to procedures that he doesn't like that require the restraint of his left hand. The fine motor skills are not there at all and even gross motor is not fully in play, but he can certainly wave that arm around.
Colin can also be quite fickle in his interactions with people here. He still loves Martha the best and can be coaxed to do just about anything in order to see her. Sometimes, he refuses to high-five somebody he doesn't know well, though this is also a gesture he tends to be fairly free with.
We cannot believe what an incredible patient Colin is. He has stopped trying to remove the NG tube and even volunteers to have his mouth suctioned for excess secretions, (presumbly) knowing that it may be uncomfortable but ultimately makes him feel better. He definitely can be reasoned with in a lot of circumstances and always should be explained what is happening, as he clearly understands and benefits from communication.
Over the past several days, we have been lucky to have evening visitors to stay with Colin while the rest of us spend time together as a family. This has facilitated some firefly catching in Central Park as well as a wonderful performance for children by a New York clown/magician couple, Sammie and Tudie (their clown stage names, not their real names). The Ronald McDonald House does have some great events for the kids, and Aidan now knows some of the children from the day camp there.
Evening meals up at Ronald McDonald house have also been a good opportunity for Colin to see familiar people who want to play with him and simply spend some time together. Given his unhappiness about his incarceration here and our inability to even take him off the floor (at Maria Fareri, we were able to take him outside when he was on the general floor), this is a big boon for him.
Even with the treatment plan on hold, Colin's progress trudges on and we are considering the decision to put him into acute in-patient rehab. The Rusk center next door offers the opportunity for him to be followed by the various practitioners here at NYU, so it is an obvious good fit. Also, the therapists who have been seeing him from there will be able to continue to work with him. However, the decision is not set in stone and we need to find out more about Blythedale and the children's hospital in Hartford before moving him.
The questions continue, many unresolved. The current holding pattern is a busy one, with a steady traffic of practitioners at the bedside and trips around the hospital for one test or procedure or another. I am almost surprised when I hear other children of Colin's age fuss and cry, as he is unnervingly cooperative. His complaints about going outside are almost reassuring that he still has distinct preferences to express. The unanimous consensus is that he is a better patient than most, if not all, adults. This observation has earned him many admirers here at the hospital, not the least of whom are his parents, who have watched him endure so much and who know that he has a long road yet ahead of him."
--Colin's mom
Whew! So much to take in and deal with, to consider. I can't imagine what it is like for my smart and caring brother and his wise, nurturing wife.
My own boy, in the Philippines, is sick with some phlegm supposedly in the lungs, so he is on meds and under my instruction to rest a lot, not something a boy his age likes to do.
Life is just so fragile, health such a precious and valuable thing. Thanks for your continued support!
--
Join Teams Helix and Discovery. Put that fancy computer to good use helping to find a cure, your mom will love you for it. »Team Helix »Team Discovery | |
usa2k
Please PRAY for Rebekah
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join:2003-01-26
Canton, MI
clubs: | More prayer for Colin and family.
Prayers for your kid and family. | |
onDvine
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join:2005-01-29
So. CA, USA
clubs: | reply to signmeuptoo
Thank you for the update. Positive thoughts going out to both boys. | |
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