Wednesday, September 30, 2015

Tuesday, September 29, 2015

September 29 - Dear Nicholas Sparks (Guest Blogger Shereen Kostmeyer)

Dear Mr. Sparks,

    I want to tell you about the “best case scenario” of CDH. This is the phrase that both the pediatric surgeon and the neonatologist used when it was time to release my Micaela from the NICU.  My daughter is a 17 year-old CDH survivor.  She is spunky, musically gifted, an intellectual high achiever, kind-hearted and giving, the kind of kid that everyone loves. You know, the one who has every teacher in the school wrapped around her finger.   Her personality usually fills the room the second she steps in.  That personality is HUGE, yet she is a tiny little thing at 5’1” in height.   And, she just makes me smile.

    Most CDH babies are diagnosed in utero.  Micaela is in the 15% who are not.  I was a first-time mom, and was expecting a perfectly healthy pregnancy and birth.  That was terribly naïve.  I went into labor at 33 weeks, and arrived at the hospital too late to successfully stop my contractions.  My OB doc prepared me by explaining that she would most likely be just fine, but would be transported to our closest NICU an hour away to receive the best care possible for a preemie.  She was born only 4 hours after arrival at the hospital.  She only took a couple of breaths before stopping altogether.  She didn’t even cry.  It was like a scene out of a movie, the kind of movie that may or may not have a happy ending.  
     Although the hole in Micaela’s diaphragm was small enough to be closed without the use of a GoreTex patch, it was indeed large enough to allow the migration of both her stomach and intestines into her chest.  The surgery to place the organs back into her abdomen and repair her diaphragm went beautifully.  The left lung was comparatively large and healthy.  It was explained to me that this was due to a late migration of the abdominal organs, allowing the lung to develop fairly well.  She did, however, need a small piece of it removed so as not to allow this dead lung tissue to appear like a cancerous lesion on x rays later in life.  The appendix was also removed, which I believe is performed routinely to prevent later disease.
    Nearly every day in the NICU proved to be a progressive trend towards going home.  She was gradually weaned off of the ventilator, she never needed ECMO, she graduated from the NG tube before release,  she came home completely tube-free, with only 2 oral meds for reflux.  The first 5 years of her life were a bit of a struggle with asthmatic problems, bronchial spasms, severe gastrointestinal problems, and mild reflux.  The problems became less and less frequent over the years, and she has never required any further hospitilizations or surgeries.  This IS best case scenario for Congenital Diaphragmatic Hernia.  This is as good as this birth defect can possibly be.  She knows it, and she is grateful.  She does not waste the gifts that she has been given.  In fact, she is on a mission to share her gift with the world.  And she will tell the world about her fellow cherubs.  She lives her life mindful of all of the non-survivors, and all of the babies who are FIGHTING.
    Micaela is a student in the vocal department at the Mississippi School of the Arts in Brookhaven, MS.  
She dreams of a Broadway career in musical theatre, and she will do what it takes to get there.  She is a high school senior this year, is ranked 3rd in her class, and is currently applying to college musical theatre programs.
    Mr. Sparks, thank you for your kindness.  Micaela and I humbly ask that you join us in the fight to tell the world about CDH, and the need for more research.  Just one mention of Cherubs and CDH would do a ton of good.  And thank you for bringing YOUR gift to the world.
                               
With kindest regards,
Shereen Kostmayer
Mom of Micaela Kostmayer, Cherub
Owner of Southern Bound Book Shop
Biloxi, MS
    
    
   

Monday, September 28, 2015

September 28 - Dear Nicholas Sparks

Dear Mr. Sparks,

Hello, my name Kimberly Hager and I would like to tell you little about our journey with my son Jayden.  When I first found out I was pregnant with him I was strict with everything I done!! I watches what I ate, what I was around and took my vitamins just the way my midwife told me to.  Around 18 weeks I had an ultrasound and everything was alright and I wouldn't have to go back for an ultrasound.  I was fine up until 20 weeks and I had a strange feeling to change my doctors because I felt like something was wrong!  And that was the first motherly extinct that I started to have. I had another ultrasound because the second doctor couldn't see the the kidneys very well.  After 2 days of having the ultrasound I had a call at work from my doctor Mary.  She suggested I be seen by the University of Kentucky OBGYN because my son had a Diaphragmatic Hernia. At that time I never new what that was or what that meant for my baby's future!   I was scheduled 2 weeks later and had another of a many ultrasounds. This one was performed by one of the OBGYN and she was very blunt and didn't beat around the bush to my husband, mom, mother-in-law and I that day!  She explained that Jayden would be very sick when he would be born because of how his lungs were forming and that he had a 50/50 chance at birth.  Still, at this time I was not understanding why this was happening or how!! She proceeded to tell us that there really is no known cause for this happening and suggest we speak to a geneticist to see her opinion! The geneticist really didn't do much but take our family history down and ask if we wanted to "abort" the pregnancy! NO why should we he's still got a chance he still moves and is doing fine in the womb! Days, weeks and months past and he keep growing and growing! And I knew the days were ending when I went to my 3 to last appointment and I was having contractions. I was placed in the hospital and had him at 36 1/2 weeks!  That was an exciting but also a scary day!  He was delivered via C-Section and weighing in at 8lbs .7ozs!  There were no cries or whimpers from him and no holding him in my arms for the first time. No known skin to skin contact with him. He had a breathing tube places in the OR immediately after he was born.  He was on a convictional vent for a few hours blood gases where not good so he had nitric gas and isolator that put many breathes in at a time!  Later that evening the Peds Surgery Joe Iocono and Sean Skinner came to talk to us and explained he needed ECMO!  He was placed the next day on it and was on it for 17 days!  His surgery occurred while on ECMO 2 days of being on it! He went from 8 lbs to 45lbs total of fluids!  He was giving less than a 10% chance at this time!! He recovered from that and gotten a hematoma on his back from all the blood thinners giving because of the ECMO.  It was about 6 inches across by 7 inches pretty good size!  It busted that morning they were going to go in and fix it. Doctors had told us that morning it's less than a 5% chance to survive!  We prayed and that day our little Jayden came off of ECMO! But had a very long road ahead to fight hard and get where he is today!  He stayed with the nitric gas and isolator for 2 weeks and he pulled his breathing tube out! And was placed on a conventional vent.  The doctors decided we could do all his meds and treatments at home all we had to do is maintain a good air way because he wasn't coming off the vent!  So we choice for him to have a trach and vent placed so we could go home. He never took a bottle so he had a duo tube instead of a gi tube or a NG tube. So we had to learn to take care of all this equipment plus take care of his baby needs to.  It was very hard to understand why he couldn't come off the vent. So 3 weeks prior to him being discharged they did MRI. That confirmed he had more intestines up in his chest plus his white matter of his brain was damaged therefore the doctors claimed he would walk ever or have the same abilities as other kids his age!  We were sent home to do First Steps which is a program to help kids to do therapy.  Jayden begin in October around 9 months coughing and having problems we go back to Dr Skinner and he explains after looking at an X-ray more intestines is up in his chest! We were scheduled to come back the next day and have it repaired! We had a 50/50 chance of having a reherniation or having a Bilateral Diaphragmatic Hernia which is not common to see babies survive with!   We wait like it seems forever and the doctors and nurses come out with him in his bed coming back from the OR and our Dr Iocono came to me and my husband and explained he had. Bilateral Diaphragmatic Hernia!! As for those doctors Jayden was the first baby to survive with a BiLateral meaning he had a Left and Right diaphragmatic hernia. Trach and feeding tubes came off that day through the day and about 7 months later no vent at all. And in July of 2013 he had his trach removed and started walking 2 weeks later!  To this day Jayden walks, talks, has no sensory problems more and eats whole food. We had a journey worth him but he is a fighter but a loving fighter!!! But he is the toughest kid I know because most adults couldn't take what he took. I wanted to share our journey because there needs to be more awareness of this horrible monster.  Please help us spread awareness!! Thanks so much!!!

Sincerely,
Kimberly Hager

Sunday, September 27, 2015

September 27 - Dear Nicholas Sparks (Guest Blogger

Dear Mr. Sparks,

My name is Melanie Parsons and this is the story of our baby son Jak.

Everything seemed OK when I had my first scan, where they confirmed my due date as 1st August 2001. Apart from bad morning sickness, all seemed to be going well, but at 21 weeks I went for my second scan which detected a problem in the baby's chest. I had to go back 6 days later to have another scan with a specialist, who confirmed that our baby boy had a condition called Congenital Diaphragmatic Hernia. We had never heard of this, and didn't have a clue what it was. The doctor explained it to us and then said that I would be referred to St. Mary's Hospital in Manchester, the only hospital in the north west of England that can deal with CDH. My appointment was made for the next day, so off we went for yet another scan.

The doctor there explained everything that could be wrong with our little boy and advised me to have an amniocentesis to see if he had any chromosome defects. I had this done and went home to wait the two weeks that it takes for the results to be known, two weeks that seem like a lifetime when your unborn child's future is at stake. It was after 13 days when I received a message saying the test was ok, the baby had a normal chromosome count. So, happy again for a while, having overcome the first obstacle.

We decided to call our son Jak Thomas Roy, and some of my friends made fun of the way I spelt Jak. Thomas was a friend's little boy who is now an angel baby, and Roy is my late brother. A special name for a special little boy.

I had to keep going to St Mary's for regular scans and check-ups and we even met one of the surgeons who would operate on Jak after he was born. It made things easier when we were shown around the Neo-Natal Surgical Unit (NNSU) where Jak was going to be cared for after he was born.

The doctors decided to induce me a week early so that the medical team would be ready for Jak. So on the 24th July I went into hospital and the next morning went up to the delivery suite where my waters were broken. Then I was given a drip to start contractions. Each contraction caused Jak's heart rate to drop, so he had to have a test to see if he was getting distressed, but he wasn't. My friend Wendy, and Paul, Jak's daddy, arrived while I was having this done and came in to me after it was finished.

Jak Thomas was born at 12.38pm on 25th July 2001 weighing 6lb 2oz. I held him for a couple of seconds before he was taken to have medical attention. We heard him give out a little cry, which was a brilliant sound to hear, as at the time, we didn't realise that it could be many months before we would hear him again. He was taken to the NNSU and we were told we would be able to see him in about 30 minutes. Two hours later we were still waiting. The midwife came in and explained that Jak's right lung had collapsed and he had to have a chest drain put in, but we could now go and see our little boy.

The first thing we did when we saw him was to take some photographs of him. He was connected to lots of monitors. An oscillating ventilator was supplying him with nitric oxide, and he had the drain in his side. The nurse explained all that was going on with Jak and what each thing on him was for.

I think it was at this point that it really sunk in as to how serious his condition was. Even though the doctors had kept us fully informed from the moment he was diagnosed, I suppose like most parents, we assumed he would be one of those CDH babies who have their op within a few days and go home after two or three weeks. In any case, although his insides were all messed up, to us he looked like the most beautiful baby in the world.

The next night, one of Jak's nurses, Louise came to me on the maternity ward to explain that Jak's condition had worsened, and suggested that we consider having him baptised in case he didn't make it through the night. So it was panic stations as I contacted Paul, who came back to the hospital bringing Jak's two grandmothers. We chose to have Jak blessed, and at 12.30am the chaplain performed a short service. But Jak, being a little fighter, slightly improved.

The next day Jak was very poorly again, and one of his doctors said that the best option for Jak would be to transfer him to a hospital in Newcastle for ECMO. Jak had to come off the oscillator and onto a conventional ventilator before he could be transferred, but he only lasted an hour before his SATS all dropped, and he had to go back on the oscillator. So, no move to Newcastle.

On the Sunday after Jak was born (4 days old) the doctors told us yet again that he may not make it through the night. Again we all prepared ourselves to say goodbye to Jak, but once again he improved slightly.

Jak eventually came off the nitric and back on conventional ventilator. There was another little boy with CDH who was 4 days younger than Jak, but little Louis is now an angel baby and left us at 10 days old. We will never forget him.

We were told that because Jak was so poorly, they did not think having surgery to repair the hernia would help, as out of 250 babies as poorly as Jak, only one had ever got better, so the odds were stacked heavily against him.

However at 5 weeks old the doctors decided that surgery was worth a try after all, so they could say in their hearts they had tried everything possible for Jak. He had his operation on 30th August. It was carried out by Mr Adrian Bianchi, the surgeon who separated Siamese twins Gracie and Rosie Attard, from the Mediterranean island of Gozo, in November 2000, an operation that received worldwide media coverage at the time, due to it being one of the most emotive cases in medical history. It was reassuring to know that Jak was under the care of such a world-renowned surgeon. We were told Jak should be ok through the op, but moving him to theatre would be the difficult part, as they would probably need to keep stopping on the way to let him stabilise. When they wheeled Jak off the ward to go for his op, it was one of the worst moments of my life.

The operation lasted 3 hours, and immediately afterwards, Mr Bianchi, still in theatre gowns, came to us and explained that the hernia in his diaphragm was very large and they'd had to graft some muscle from under his left arm to mend it. He joked that Jak and he were fine during the op, but they'd given his anaesthetist a few scares between them. As he said this, the anaesthetist, standing beside him, pretended to wipe the sweat from his brow. We knew from their reactions that the operation had been a success.

After the operation Jak was put on a course of steroids to help boost his lungs. He improved with all this and the next step was to take him off his paralysing drug, which at first he didn't tolerate, but they left him a while and tried again. The second time he came off and it was brilliant to see him moving about.

We had good days as well as bad ones. He was still on morphine and got down to 0.3 but had a bad reaction when it was turned lower. So they left him on it for a while longer. In the meantime Jak decided one night at 2.45am when all was quiet on the ward, to pull his ventilator tube out which knocked his progress back a bit. A new vent was put in and Jak seemed to be improving. They made a more diluted morphine so they could wean him off it more slowly, and this time Jak finally got off his morphine.

After his op he was not gaining weight so he had to go on special baby milk called infratini, which he did not like as it gave him bad colic. So they changed it to something else, as he needed high calorie food so he could put weight on. He now weighed 8lb 6oz which was good for Jak as he at one point went down to 6lb 4oz, just 2oz heavier than birth weight.

Jak gave me a big smile when he was 13 weeks old when I told him off for keeping on grabbing at his ventilator. As I kept moving his hands away, Jak must have thought it was a game as he started to smile. Another milestone for Jak. Jak was still on his ventilator and still making very slow progress when he decided he'd had enough of his vent and pulled it out again, so it was panic stations yet again.

Jak was put onto normal baby milk which seemed to agree with him better than the high calorie milk. He still suffered with colic, just not as bad, and still had to have Infacol colic drops.

Still on steroids, Jak had a very good Christmas. The week before Christmas the

Family Circle (a support group for families with babies in special care, run by parents who have been through the same) visited with Santa. Jak knew something different was going on and fought to stay awake, then fell asleep as soon as he had his picture taken with Santa. On Christmas day, his daddy and grandparents and I went to the hospital to see Jak. We had lots of presents for him. Again he was aware that something was going on and was overwhelmed with all his new toys and teddies.

Jak was now five months old, learning new things all the time. Even though he could not make a sound he would sing along to his nursery rhyme tapes with one of his favourite nurses Ian, who also taught Jak to blow raspberries. Another nurse Caroline was teaching him naughty things such as pulling hair.

Jak loved music and noise and would dance to his musical toys which sometimes set off the alarm on his SATS monitor. Another of Jak's mischievous tricks was, if he was not getting all the attention that he thought he should, to pull down the headband that held his ventilator in place. Jak did this lots of times and would laugh when he did it. One time he watched his nurse Tony walk away from his cot, waited until Tony had his back to him and pulled the headband over his eyes. When Tony was putting it back to the correct position Jak was giggling and kicking his legs about; he saw this as a funny game.

Jak had been on the steroids for a long time and could not stay on them any longer, as long term use could cause problems elsewhere. So he had to come off them after doing so well on them. He had improved so much his vent came down to a rate of 3.5 per minute. The doctors were very pleased with how much Jak had improved and things were looking positive. They explained that the next step was to have a tracheotomy, then be moved to another hospital, as he was getting too big for the ward at St. Mary's. We didn't want him to leave the brilliant nurses and doctors but it was what was best for Jak.

Unfortunately, before the move or the tracheotomy could happen, Jak began to deteriorate, which came as a shock after all the progress he had been making. He was started on a course of inhaled steroids, but did not cope well with these. The doctors got us in for an update on Jak and explained that they did not think he would get well enough to come off his vent, that his lungs could not support his body as they were too small and under-developed. We asked lots of questions such as could a lung transplant be done, but Jak was too poorly for this.

On the 23rd of January I stayed overnight at the hospital with Jak, and the next morning one of the nurses woke me at 6am to tell me he was very poorly. His daddy came in to the hospital and we spent some time alone with Jak. As he lay in his cot, he looked up at us and his eyes seemed to be telling us that he'd had enough, that he couldn't fight anymore.

We got his grandparents in and at 10-30 am in his daddy's arms and mine, Jak fell asleep for the last time. He did not suffer or gasp for breath, he just went to sleep and his hard long fight was over.

The nurses and doctors at the hospital have been brilliant throughout and remain to be there for us. Six nurses came to Jak's funeral. It was a special day for a special little boy. We played Eternity by Robbie Williams, as this had become known as Jak's song, because it was number one in the music charts when he was born.

One thing that I have noticed about having a poorly baby is who my real friends are. Some had never even bothered to go and see him and if I had £1 for everyone who said they'd get Jak a present when he came out of hospital, I'd be a very rich person. He has been treated differently from babies that are lucky enough to be born in perfect health.

The day before Jak's first birthday, we had a memorial service in the hospital chapel, as a lot of the nurses wanted to say goodbye to Jak but could not come to his funeral. Jak will always be our special little boy who will remain in our hearts forever and everyone that met him will remember his big brown eyes and long eyelashes, plus his gigantic smile that could melt the heart and seemed to light up the room. We'll always love our little spud Jak Thomas.

We have since had another little boy, born on the 27th July, 2 years and 2 days after Jak was born, who we have called Ben Jak Thomas. We chose to give him Jak's names as his middle names in memory of his big brother. The pregnancy and birth were problem-free, but that did not stop the worry and concern. We were given the option of going back to the same hospital where Jak was born but we chose to go to our local hospital.

Even though we were told that everything was fine with this baby, we could not help but worry in case they had missed something and fate would repeat itself. At the back of my mind I thought that something would go wrong. It was only after the doctor had checked Ben over that I was happy that he was fine. Ben is now a happy, healthy 2 year old and has no problems at all, which we are very grateful for.

We have told Ben all about Jak even though he is too young to understand properly. When we ask him who Jak is he replies "Jak is Ben's big bruvver". When he is old enough to understand properly we will explain all about Jak and why he is an angel baby. Also we have memory boxes for both Jak and Ben which contain everything from birth congratulation cards and name bands from the hospital, to Jak's sympathy cards and Ben's birthday cards, which Ben will be given when he's old enough to look after them and understand what they are.

I hope Jak's story has not been too long and that you have enjoyed reading it as much as I have writing it, even though it has been hard to sit and remember everything without getting upset. That is why it has taken three and half years since Jak died to finally finish it.


Written by Jak's mom, Melanie Parsons (Great Britain)

Saturday, September 26, 2015

September 26 - Dear Nicholas Sparks (Guest Blogger Jodene Forsythe)

Dear Mr. Sparks,

My Name is Jodene Forsythe and I am a mother of 2 boys who both had diaphragmatic hernia. When my first child, Dylan, was born it was not detected on the ultrasound. When he was a newborn to 4 months he could not burp, pass gas, or have a bowel movement rarely on his own. I told his doctor and health nurses on every visit and they told me it was normal (even though I was breastfeeding) and to use suppositories to help him. At 4 months of age (the day I fed him his first pablum) he screamed in pain lifting his legs. I thought he had gas pains from the pablum. 12 hours later he was to the point of exhaustion we took him to a near by hospital. At this time he was throwing up everywhere. The doctor there told us he had a throat infection and flu and gave us a prescription and sent us home. We went to my parents who lived near by to drop Dylan off so we could pick up his prescription my Dad told us he wasn't breathing normal and we should take him to the children's hospital. When we got there they took x-rays and were shocked (as were we) when they saw his bowels up to his collar-bone, his left lung collapsed and his heart shifted into his right cavity. They did emergency surgery and told us if his bowels twist he will not make it. We were very fortunate and thankful that the surgery was a success. Two months later at home, Dylan started screaming in pain and lifting his legs up. I phoned my husband to see what I should do and he told me to take him to the hospital. At the hospital they took x-rays and his diaphragm had herniated again and they had to do emergency surgery. The surgeon said she had never heard of someone having it happen a second time. She also told us that if we were to have more children the chance of it happening to that child is 2%. Well when my second son, Ryan, was born 19 months later he had RSV and we took him to emergency because he looked so sick. They did x-rays to see if he had ammonia but what showed up instead has a diaphragmatic eventration. I asked to see the same surgeon to see what she thought. She was very surprised. She said because Dylan had had an actual hernia she was afraid Ryan's diaphragm would herniate, so she wanted to do surgery to make his diaphragm taunt. It worked but unfortunately when Ryan was 7 months old I couldn't wake him one morning- he was moaning and dry heaving but almost unconscious. We took him to the hospital and they found through a cat-scan that he was bleeding in the brain AVM not an aneurysm. He is fine but has epilepsy. Last December 1997, Ryan had the croup and started throwing up. They did x-rays and his diaphragm had broke and had to have emergency surgery. Needless to say 5 surgeries in 4 years has taken its toll but my husband and I have gotten closer and the children are my angels from God.

Sincerely,
Dylan's mom, Jodene Forsythe (Canada)

Friday, September 25, 2015

September 25 - Dear Nicholas Sparks (Guest Blogger Corin Nava)

Dear Mr. Sparks,

I found out I was pregnant in March of 2006. My husband and I had just started trying and were thrilled that it happened so soon. It was defiantly not an easy pregnancy as there were minor complications such as bleeding in the beginning and than gestational diabetes later on. I had bad heartburn, was sick a lot, and gained more weight than I should have. But throughout the pregnancy, although I was having some problems I was continuously assured that my baby was doing great and was healthy. I was scheduled to be induced on November 21, right before Thanksgiving, because of the diabetes. However, Gabriel had a different idea. The Saturday before my scheduled induction, my water broke at 5:40 in the morning. I called my doctor and he told me to go in immediately so they could monitor my blood sugar. We drove to the hospital and got ready to meet our baby. The labor was relatively easy and fast. I didn't start active labor until around 3 in the afternoon and at 5:55pm Gabriel Eric Nava was born. That was when everything started spiraling down. Immediately Gabe was having problems breathing so they took him away before I got to see him. After over an hour of waiting a doctor finally came back and gave us the news. Gabriel had CDH and had to be transferred immediately. They brought him in for me to see in an incubator where I was able to touch his hand before they took him away to Women & Infants hospital. When we arrived there later that night they had Gabe semi-stabilized and started to explain what was wrong and what needed to be done. They hoped to be able to stabilize him there for a few days and than do surgery. The next two days were awful. They tried desperately to keep him stabilized by trying different ventilators and settings but his O2 SATS kept drifting down. He needed to be transferred again to a hospital that had ECMO. They took him by helicopter up to Mass General Hospital and the doctors there put him on ECMO. From then on it was a roller coaster ride of emotions. Some days he would look like he was doing great and improving, but there always seemed to be another complication that needed to be overcome. Gabriel showed he was a fighter and surprised the doctors a few times by overcoming an obstacle they didn't think he would. He was on ECMO for 36 days, which was one of the longest stays on ECMO. After multiple failed attempts to take him off he finally came off the day after Christmas and things looked good for a while. We were able to hold him for the first time on New Years Day and he seemed to be getting better. The problem that he could not overcome was his kidneys. He had become very swollen in the beginning and they couldn't seem to get the fluid off of him after his repair surgery. They ended up having to put him on a dialysis machine (CVVH). While he was on ECMO it pulled the fluid out of the tubes already attached to him and it worked beautifully. However it also shut down his kidneys. When they took him off ECMO they also took him off the CVVH in hopes that his kidneys would start working again. After a while when it was clear that they still needed help they tried to put him back on the CVVH. They tried three times to hook him up to the dialysis but his body couldn't handle the new demand of the machine. The night of January 11th he took a serious turn for the worse. He was severely swollen and now they couldn't keep his O2 SATS much above 70 even on full support on a Jet Ventilator. There was nothing more they could do. We knew Gabe was telling us that he couldn't fight anymore. We had to let go. Early in the morning on January 12th we held our boy for the 2nd and last time as he passed away peacefully in our arms. Although he was only here for a short time, he touched so many lives as all of these Cherub babies do. He was loved by so many and will always be in our hearts.



Sincerely,
Gabe's mom, Corin Nava (RI, USA)

Thursday, September 24, 2015

September 24 - Dear Nicholas Sparks (Guest Bloggers Mark & Beth Fogelgren)

Dear Mr. Sparks,

In late June 1998 our OB doctor observed that Beth's stomach was too large for the gestational age of the baby. This condition known as polyhydramnios is the result of extra amniotic fluid. At this point our OB felt that an in depth ultrasound was needed by a perinatalogist. On July 1, 1998, 28 weeks gestational age, Michael was diagnosed with Congenital Diaphragmatic Hernia (CDH) from the perinatalogist at Va. Beach General Hospital. We came home devastated not knowing what to do or where to go. Mark got on the Internet and began doing research and found the CHERUBS support group. He sent out a message requesting information from anybody. We received 30 plus responses within the next 2 days.

Those responses along with discussions with our OB, Perinatalogist and the Neonatalogist at Children's Hospital of the Kings Daughters (CHKD) convinced us we should not deliver Michael at any of the local hospitals. All of the sources said we needed to deliver in an ECMO (extra corporeal membrane oxygenation) facility. The closest facility for us was UVA Medical Center in Charlottesville, VA. We contacted some friends in the area to stay with and of course had to get permission from the (HMO) insurance company to be referred to UVA. Prior to leaving, we established an e-mail prayer network with over 100 families and friends. Through our family's entire ordeal we knew that thousands of prayers were being lifted up to the Lord on a daily basis. This network reached across the world to three continents.

We left Va. Beach on August 3, 1998.Beth had her first doctor appointment at UVA the following morning. This began a 6-week wait for the C-Section delivery of Michael. Each Monday we would go to the hospital for an amnio, in order to check for surfactant in his lungs. Each time the index number was not high enough to induce labor. The last week before delivery, Beth received steroid shots but the index number still did not increase. Delivery was scheduled for Tuesday, September 8, 1998.

Michael Christian was born at 12:01pm, 9lbs. 6oz. and 21 inches long. At birth both lungs collapsed, his left was the best and the right one was smaller than normal. Michael was put on ECMO when he was 15 hours old, because of pulmonary hypertension, a condition in which blood does not flow well through the lungs. He stayed on ECMO for 21 days, during this time the surgeon fixed the hernia on the right side of his diaphragm with a gortex patch the size of a fifty-cent piece. Also, the ECMO canullas wouldn't go in the correct place in his neck vein. Many attempts to correct the blood flow to the ECMO machine failed. The surgeon performed thoracic surgery twice in a 10-hour period before the ECMO pump would work properly. As a result of these ECMO problems and the need to infuse saline into his blood stream, Michael became swollen to an indescribable size, his ears and eyes all but vanished. Because of the thoracic surgery and the need for blood thinning drugs to prevent blood clots in the ECMO machine, Michael started to bleed into the sack around his heart. This again caused more problems with blood flow to ECMO. Michael's swelling was so bad that weeks later his nurse told us that she didn't think he would survive. The bleeding from the chest surgery went on for several days, with some days bleeding more than 1 pint per day. But once the ECMO machine and the related blood thinner was removed, the bleeding stopped within an hour. We calculated that Michael used 5 gallons of blood product while on ECMO, through the circuit changes and blood transfusions.

We thought we were out of the woods once Michael was off ECMO, but within 24 hours, he had to be placed on Nitric Oxide gas because of pulmonary hypertension. He was on this gas for 27 days. Again we were told weeks later by his doctor that he had not seen a child survive that showed signs of pulmonary hypertension after ECMO. Finally, when he was 7 ½ weeks old he was extubated from the ventilator and we got to hold him for the first time. We had the best smiles that day from everyone, but
think Michael's were the biggest. The next 3 weeks would be spent weaning him from the narcotics and attempting to teach him to drink from a bottle. Both were very hard. We all left the hospital on November 20, 1998, 75 days after Michael was born. He was released though still on 75 ML of oxygen and with an NG feeding tube for supplemental calories. We drove straight home to VA Beach. Within 3 weeks of Michael's homecoming he was taken off of oxygen and his feeding tube. We kept him at home for the most part until the end of April, because we didn't want him to catch a cold, virus or RSV from anyone.

We made monthly trips to CHKD to receive synogis shots to prevent RSV. Michael did have one more surgery in March 1999 to rewire his sternum together. Because of 2 thoracic surgeries his breastbone did not fuse back together properly. Just two days after this surgery, 2 of the 3 wires placed around the bone broke again. The surgeon said we would just wait until he is older. Michael was behind with his motor skills, but with the help of physical therapy and the early intervention program he caught up by the age of 9 months. Michael is such a blessing; we refer to him as "Michael the Miracle Baby."

Sincerely,
Michael's parents, Mark & Beth Fogelgren (Virginia)

Wednesday, September 23, 2015

September 23 - Dear Nicholas Sparks (Guest Bloggers Denise Dunfee & Tony Mudderman)

Dear Nicholas Sparks,

I became pregnant with my third child after losing a baby, Jesse, a year and a half before to anencephaly. On June 23rd, my water broke, and we went to the hospital in Waterloo to deliver what we thought was a healthy child with no problems. We were going to have a repeat C-section (I had a C-section with my first). I was prepped, and we were giggling and having a good time. I was giving Tony a hard time because I wanted a girl, and we didn’t know at the time what we were having.

The baby came and Ryan Matthew Mudderman was born into the world at 4:00 in the afternoon. He was blue minutes after delivery, and I was told he was having trouble breathing. I didn’t know all the details because I was still on the operating table. Later I was in my room, and the priest was in the NICU baptizing my baby. They called specialists to take Ryan to Iowa City by helicopter because he was diagnosed with CDH. I hadn’t seen my baby yet, and the nurses were telling me that I wouldn’t be able to see him until I got to Iowa City. I told them that he was not leaving this hospital until I saw him. Well, you’ve never seen nurses move so fast-- two hours after a C-section I was on my feet in the NICU.

My little boy was so full of tubes and wires, it was like a nightmare. I saw Ryan’s doctor Nicole, who flew directly to receive her little patient. She told me that Ryan might not make it through the helicopter ride, and I lost it. I was transported an hour after that by ambulance to Iowa City, and there I asked to see my little boy and wanted to know how he was. They said he was holding his own. My little angel was never coherent after that; they had him on so much medication, and he was so sick they could not stabilize him enough to have the surgery that he needed. They said they could not do anymore for him, and he was put in my arms, his tubes removed. Before he went to heaven, he was visited by all his family, and his big brother Jayson held him and counted his little toes and kissed him goodbye. Jayson gave Ryan three toys to play with in heaven-- Thomas the tank engine to remember his brother Jayson, a John Deere tractor to remember his daddy because daddy makes them at work, a helicopter to remember his first flight, and I gave him a stuffed rabbit that was made by me before we knew that he was a boy so it had ribbon flowers on it.

Sincerely,
Ryan's parents, Denise Dunfee & Tony Mudderman (Iowa)

Tuesday, September 22, 2015

September 22 - Dear Nicholas Sparks (Guest Blogger Becky Fleming)

Dear Mr. Sparks,

Benjamin was our first pregnancy. We had been trying for 3 years to have a child. We did not use fertility drugs however. I had the perfect pregnancy. I was never sick and felt full of energy the whole time. I gained a total of 16 lbs. even though I looked like I had gained 40. During the entire pregnancy I had only had one ultrasound. There was just no indication that there was a problem. When I went into labor I was five days late. When the nurse was checking me in and attaching me to the monitors, she had a hard time picking up Benjamin's heartbeat even though when she could find it, it was strong. This would later turn out to be because his heart had been pushed to the opposite side of his chest. My labor was 12 hours long. Benjamin let out a small cry. He was laid on my chest for a fraction of a second. In that second, his brown eyes and mine connected and I memorized his face. That would be the last time I saw that face without tubes for the next 3 mos. He was rushed to the nursery to be worked on. A nurse manager came and told us that there was a hole in the diaphragm that would have to be corrected with surgery. At this time, I still did not realize he might die. He was put on a ventilator and transported to a wonderful hospital in Sacramento. My husband James went with him that night. By this time we knew it was serious and I had to have James with him just in case we lost him. I was isolated from the other mothers and within half an hour was receiving calls from surgeons asking for permission to do all kinds of things. I was still so drugged from the birth that I had to grab a pen and paper to write down what they were saying so I could read it later. What did stick in my mind though was that they kept saying "It was never detected? Didn't you have an ultrasound?" My blood boiled and my head was saying "If anything happens to my son, I will sue Kaiser and every doctor and radiologist who touched my file." Later I learned it was that cut and dry. Benjamin held his own on the ventilator until early the next morning. My parents came and checked me out of the hospital (I was pacing the halls waiting for them) and drove me to Sacramento the next morning. I realized that I had not taken any pain medication since the labor and was beginning to feel it. We met James and his brothers who had gone up to be with him. James and I went to the NICU together. I will never in my life forget the smell of the disinfectant soap that was used to scrub everybody up. We put on gowns and went to find our son. He had begun to deteriorate so he had been put on ECMO aprox 4 hours earlier. He looked lifeless and I was afraid to touch him. His machines took up half a room and he had two nurses devoted to his care alone. We met with the doctors who were very blunt about the fact that he was not responding well at all. They did keep mentioning how he would move even when he was given a paralyzing drug. That had to be a sign of strength, didn't it? We stayed only a short time. James was sick to his stomach and I was weak. We went back and forth several times that day. We had tons of family all around us and no one knew what to say. My sister in law was able to let us stay in an apartment she had been using. That night after everyone left, we finally talked about what could really happen. James reassured me that we would have a family and that Benjamin would always be a part of it even if it had only been for a short time. He reassured me that our marriage could handle it and that we would survive. We sat on the living room floor and prayed out loud. Then we cried. That became our routine for the next few days. Benjamin didn't improve by day 7 and I was running out of hope. I finally asked a nurse how long the doctors would let Ben stay on ECMO before turning off the machine. She felt that things would be decided around 10 days. Luckily on about day 9 Ben started making some improvement. By day 11 they were ready to take him off. They had done a trial run. His heart stopped. They did CPR. Ben had a new nurse that night and when I called to check on him (I was very up because of his progress) she informed me that they had just had to perform CPR and that he was on 100% oxygen. A total setback. I was devastated. Luckily Benjamin bounced back within hours. They cut back the rates and let him stabilize for about 24 hours. They took him off successfully. They kept him stable until day 13 and took him to surgery. We watched as they wheeled my infant into the operating room. We talked with the surgeons and nurses. We were confident that he would come through with flying colors. The entire family was there. I was starting to feel pressured by this so I was extra nervous. Finally the surgeon called us into a separate room and told us the status. Benjamin had survived the surgery, but had had such a small diaphragm the surgeon didn't know if he would survive or not. His left lung was only a bud and there had been very little room in the belly for the rest of his organs. He said we wouldn't be out of the woods for six more weeks at least. The next six weeks brought about staff infections and a second surgery for pyloric stenosis. Finally on oxygen and a g-tube with a feeding pump we took Benjamin home. He thrived at home. We still went through our share of infections and panicked moments in the middle of the night. We have been to two different emergency rooms three different times. The last time, interns were called in to observe because Benjamin was so rare. Our last major infection was with the g-tube itself. I finally scheduled a doctor's appointment and when the doctor came in I said, "I'm removing the g-tube, what do I do after that?" He was so flabbergasted that he had to go check with another doctor. When he returned, we removed it together. Since then Benjamin has become a major bottle baby, growing to 22 lbs. We just celebrated his first birthday.

I could go on for days about Benjamin and his story. I feel like it is my job now though to help others going through the same thing.

Sincerely,
Benjamin's mom, Becky Fleming (California)

Monday, September 21, 2015

September 21 - Dear Nicholas Sparks (Guest Blogger Michelle Motley)

Dear Mr. Sparks,

Hi my name is Michelle Motley. My son Brandon was born on 5/13/94. During my pregnancy everything was "normal". I was seeing a midwife and my husband and I expected a healthy baby boy. When Brandon was born everything seemed normal until the nurse said that he was making gurgling noises that weren't normal. They took him to the newborn ICU and did some chest ex-rays. My Mother in Law was getting worried and I told her that there was nothing to worry about (little did I know). About 2 hours after he was born the doctor came in a confirmed that he had a diaphragmatic hernia. His left lung was only 20% developed and the right was 80 % developed. They also said that they weren't sure if he had eyes. Brandon was then taken to Primary Childrens Hospital. And had repair surgery when he was 12 hrs old. During all this time I didn't realize how bad things were. Brandon came out of the surgery and he looked so helpless. The hardest thing for me as a Mother was watching the nurses and the doctors poke him. Brandon led a very eventful life. After he came home from the hospital we tried to make things as normal as possible. When he was 5 months old we packed the car up with oxygen tanks and went to California to visit family. My dad had gotten a full size tank for his house. When he was about 6 months old he got sick and went into the hospital for the last time. While there he was trached and never got off ventilator support. He was back and forth between the hospital and a nursing home. Brandon continually worsened and I knew that there was nothing that the doctors could do. My husband refused to let the doctors take him off life support. Finally after the doctors explained to my husband that his kidneys were failing and everything else was going my husband agreed to let go. Because we were afraid of Brandon turning blue when he was taken off we decided not to be there. A family friend was there. Let me tell you that was the biggest mistake of my life. I saw my son the day before and kissed him 80 times (to symbolize every birthday that I felt that he should have had). I will regret not being there for my son that day, but I know that he has forgiven me and his dad. We buried him in California and we plan on moving there soon so that we can be near him. Brandon was the best thing that ever happened to me. He was a happy beautiful little boy. He did things that no one thought he would ever do, like smile …because of no eyes they said that he wouldn't smile, of course he proved them wrong!!!!! We have 2 more children who are perfectly healthy and I am grateful for them, but I know that Brandon is always with me and I know that I will be with him again someday. I'm sorry that this was so long, there are still so many things that could be said about Brandon but there isn't enough time in the world to write then. Thank you

Sincerely,
Brandon's mom, Michelle Motley (California)

Sunday, September 20, 2015

September 20 - Dear Nicholas Sparks (Guest Blogger Sara Ysasi)

Hello Nicholas Sparks,

This is my daughters story with CDH. I remember going for a routine sonogram at 24 weeks. I remember laying there and feeling her go over the same spot on my belly over and over. She then said I need to go get my boss; I see something that isn't right. The other lady came in and took a look herself. She then began to tell me what she saw and how it wasn't right. They told me they would have to send me to see a specialist in Dallas. A week later I went to see a doctor who specializes in sick babies. She told me that my daughter Aubrey only had about a 30-40% chance of making it. They told me that she had her liver, spleen, stomach, small and large intestines all up in her chest cavity. So every month I would go down to Dallas and they would tell me each time things didn't look good but as long as she stayed in me she was safe. At my last appointment they told me I would be induced in a week. I had my daughter on February 25th. She was intubated right away. They doctors where very impressed with her because she only required a high-frequency oscillator.  At four days old they tired to change her to a regular ventilator and she did wonderful. At six days old they did surgery to repair the whole, the hole was so big the had to use a gor-tex patch to close the hole up. A week later they took her off the ventilator and put her on oxygen. At first she did good the they had to got up on the amount of pressure they were giving her. A couple of days later she was down to almost room air. So we worked of feeds and she did great! She then came off oxygen too. A month later on March 25th we got to take are baby home with no medical equipment. She is now seven months old happy and healthy as could be! I'm writing and sharing my store so that maybe one day we can find out with cdh happens to these sweet babies, and better way to safe them!

Sincerely,
Sara Ysasi

Saturday, September 19, 2015

September 19 - Dear Nicholas Sparks


Dear Mr. Sparks,

I am driving back from the Toronto conference with my mom and my aunt.   My family is French Canadian and I couldn't not take them with me to see the land that my grandfather was from.

Driving back home we drove through Acadia and by pure luck (or God's guidance) we stumbled upon a reenactment village.   And in the village was a restored ancestral home of one of my great-great-great... great-grandfathers Theriault.

We got to visit inside the house, met a distant cousin who sang a song to us about our family in French, ate bread baked in the fireplace and got to raise some CDH Awareness.

The only thing missing was my grandfather and my son, bless their souls.  But they were there with us.  And these Save the Cherubs photos with wings are very dear to my heart.








Sincerely,

Dawn M. Torrence Williamson
Grieving CDH Mom

Friday, September 18, 2015

September 18 - Dear Nicholas Sparks (Guest Blogger Angie Finley)

Dear Mr. Sparks,

Our son Tyler Anthony Finley was born May 9,1998 with a diaphragmatic hernia. We were very upset to learn that our baby was sick. Troy and I found out that Tyler had a hernia when I was 4 months pregnant through a routine sonogram. My OB/GYN sent us to a hospital in St. Louis Missouri to get monograms and an amniocentesis. We live in Centralia Illinois approximately 77 miles from the hospital.

The ultrasound tech and doctors confirmed Tyler did have a diaphragmatic hernia. They gave me several options. Carrying him to full term, possibly terminating the pregnancy or sending me to Colorado for an in utero surgery. The only option for us was carrying him to full term. If we lost our baby we would deal with that when it happened, if it happened. I went for sonograms once a month. Then it turned into once a week. When I was 36 weeks pregnant an amniocentesis showed lung maturity. The doctors, in St. Louis, where I would deliver, scheduled me to be induced on May 12,1998. On May 9,1998 I went into labor myself. Tyler was on his way. We were nervous and excited all in one. Tyler was born at 10: 16 p.m. He weighed 6lbs and 4oz. The doctor who delivered Tyler didn't want him to cry, but he did. We didn't even get to hold Tyler when he was born. The staff took him to another room to intubate him and prepared him for the transport to Cardinal Glennon Children's Hospital in St. Louis. The nurses even wheeled my bed to the NICU so I could be with him while they were getting him ready. The transport team even brought him into my room before they left.

I went to CGCH after I was discharged from the hospital. When I walked into the NICU and saw Tyler I sat in a chair and cried. Troy had already been up to see him, but he couldn't explain how many tubes and monitors were hooked to Tyler, and he knew what to expect, I didn't. He tried to prepare me, but I didn't think Tyler would look like he did. He looked so helpless. My baby did not even look sick, but he was. Tyler underwent surgery to repair the hernia when he was 5 days old. After that they had their ups and downs with him. He'd do really well one day and bad the next. He had to have one blood transfusion and his oxygen levels went up and down. They tried to turn the oxygen level down but his blood gases would come back bad and they would have to turn it back up. When Tyler was 2 weeks old we finally got to hold him. It was so wonderful to hold our son.

A few days after that we got to try to feed him but he couldn't get the concept of sucking, swallowing, and breathing at the same time. Finally around July 98 he finally started to suck a bottle briefly. He did well but not much stayed in his stomach, he had reflux very bad. He'd drink 1 ounce and 7 would come up. Tyler had a Nissen Fundoplication and a G-tube inserted on July 17,1998.

Then everything stood still. I became frustrated with everyone, especially the doctors. I was upset about everything. I felt I wasn't being a mother and that Tyler wouldn't even know whom his mother was. I couldn't stay at the hospital with him because I had to work so every night we would make the hour and a half trip to see Tyler. We'd only get to stay a little while because we had to get home because we both had to go to work the next morning. Finally I told the doctor's exactly how I felt and 3 short weeks later Tyler came off the oxygen and on August 1,1998 he got to come home. He came home on an apnea monitor and of course he had his feeding tube

He was hospitalized in our hometown in September 1998 with pneumonia. A week after he was discharged he was admitted again. I thought to myself, here we go again. But it was a short stay and he got to come home. Tyler started taking a bottle when he was nine months old and we didn't have to use his feeding tube anymore but the docs would not take it out until he was a year old. His feeding tube was removed two days after his first birthday. Tyler is going to be twenty months old on the ninth and he eats like crazy. He has a partial right lung and a fall left lung. His weight is lower than most 20 month olds but we figure he has conquered so many obstacles in his life so far who cares if he weighs only 20 pounds and just recently started walking by himself. He breaths heavier when he plays and things but that doesn't stop him from having fun and acting like a healthy baby with two lungs. Tyler is our miracle baby and we are so happy to have him in our lives.

Sincerely,
Tyler's mom, Angie Finley (Illinois)

Thursday, September 17, 2015

September 17 - Dear Nicholas Sparks (Guest Blogger Carrie Morton)

Dear Mr. Sparks,

Fourteen years ago, I was told I would never get pregnant-- you can imagine our surprise when I discovered on July 16, 2001 that I was eight weeks pregnant. My 20-week ultrasound was perfectly normal, as was all the other testing done (I am 37 yrs old). My pregnancy was uneventful until I went into preterm labor at 32 weeks. I was measuring about three weeks ahead for my dates, and my blood tests for glucose showed borderline gestational diabetes. So they did an ultrasound to see how big the baby was. It was at that time that they discovered he had a left-sided hernia. I was alone at the hospital when they gave me the devastating news, and I had to break it to my husband.

The next couple of days were a blur as we talked to several different doctors who felt that things would be fine as all other tests on the baby were normal. We continued the pregnancy until 39 weeks when I had to have a C-section due to breech presentation, and I went into labor. Spencer was born Feb 21, 2002 at 10:30 a.m.-- we heard him cry as they whisked him away to NICU. He was initially on a ventilator but was quickly put on an oscillator with 100% oxygen. He was doing okay until the next morning. He developed a hole in his right lung (his left lung was under developed). Again with the help of a chest tube, he stabilized, and then three hours later he had a massive pulmonary hemorrhage, which eventually took his life. The doctors and nurses tried everything, but we had to make that horrible decision to turn off the machines. He died Feb 22, 2002 at 2:30 p.m.

Three months later I still struggle everyday-- why my son? We waited so long for this little miracle, and now he is gone. I spend a lot of time with the pictures we have of him, but what I would give to have him in my arms again.

Sincerely,
Spencer's mom, Carrie Morton (Canada)

Wednesday, September 16, 2015

September 16 - Dear Nicholas Sparks

Dear Mr. Sparks,

We didn't get much time to see Toronto at the CDH Workshop Conference, but that is just fine because we are here to work, but Josh and I did get to see a few things while walking back and forth to the conference.

And we did get to meet CDH Survivor, Edwina Chu, and see our friend, Kristin Aigner, who heads the CDH Clinic in Peoria. 

We also managed to raise just a little bit of CDH Awareness.

Sincerely,

Dawn M. Torrence Williamson

CHERUBS President and Founder








Tuesday, September 15, 2015

September 15 - Dear Nicholas Sparks

Dear Mr. Sparks,

Today was another incredible day at the International CDH Workshop.  Josh and I got to present more research in the form of a poster presentation.

CHERUBS alongside research by Harvard, Columbia, Children's Hospital of Philadelphia, Great Ormond Children's Hospital in London and so many other incredible institutions.  What a dream come true. 




 

Our very first accepted medical research abstract from our very own Congenital Diaphragmatic Hernia research.  This was an incredibly big deal for a little mom from North Carolina without a medical degree.  This is a incredibly big deal for every mom and dad, grandparent and survivor at CHERUBS.  It was a huge team effort.

But I must say that without Jason Miller, our office manager who tirelessly worked on this data for months... we never would've pulled this off.    We are blessed to have him on our team.

What a blessing all around.

Sincerely,
Dawn M. Torrence Williamson
CDH fighter






Monday, September 14, 2015

September 14 - Dear Nicholas Sparks

Dear Mr. Sparks,

Today I am in Toronto and gave my very first speech on CDH research at a medical conference.  I was overwhelmed and terrified.   But I did it.  It has taken 20 years to get here and WE did it!



We spent years on our research abstract that we have a poster presentation for but just 2 weeks before the conference we were asked to present a speech on

Our families rallied together and we had a great response on such short notice.

Why is this research so important?  Why was this speech so special?  Because CDH families have never had a collective voice in research before.  Because families are blindly raising their children not knowing what to expect because most of these children did not live until the 1980's.   Because as a bunch of moms and dads, presenting research data at the same podium as surgeons, pulmonologists, neonatalogists and fetal doctors... this was the first step to being able to help our own children on a much larger scale.

A first step, but a tiny one.  They still need research funding.  They still need awareness.  They still need more hope.

My job is no where near finished.

Sincerely,
Dawn M. Torrence Williamson
Determined CDH Mom

















Sunday, September 13, 2015

September 13 - Dear Nicholas Sparks

Dear Mr. Sparks,

Still on the road and today we raised some CDH Awareness in the Rock 'n Roll Hall of Fame in Ohio.

Wings beside Elvis' army uniform, costumes worn by the Supremes, Taylor Swift and Michael Jackson and even Lady Gaga's famous "meat dress".











Why did I take these photos?  

Because people recognize celebrities.  They don't recognize CDH.  Someday they will.  Someday everyone will know what these wings represent and why these children need help.

Sincerely,

Dawn M. Torrence Williamson

CDH Mom Raising Awareness

Saturday, September 12, 2015

September 12 - Dear Nicholas Sparks


Dear Mr. Sparks,

Still on the road...











Still raising CDH Awareness

Sincerely,

Dawn M. Torrence Williamson

CDH Mom Raising Awareness