Costa Rica

Ava: Update

Ava got another CT scan on Tuesday and met with the doctor for a follow-up visit on Wednesday. While there is still evidence of the crack in her skull and trauma to the brain, no one is worried. She is acting normally and is slowly healing. Unfortunately, heads do not mend as quickly as arms or legs, so it will still be a few more months before we can let her go full steam. Now, if I could only get Casey to slow down. He loves to run, but his top half gets ahead of his bottom half, and next thing you know is that he is doing the flying Superman into the floor head first.

Back to Reality

After returning from Costa Rica, we quickly jumped back into our normal routine of laundy, dance class, and birthday parties. Ryan and Casey stayed home to watch college football, while I took the girls to a birthday party for one of Elizabeth's T-ball teammates. The little boy's grandmother loves to take pictures, good ones at that. I thought I should share the pictures of our fun afternoon with all of you.

The Gang!

Cupcakes, Yum!

Candy, Yeah! More cupcakes. A little discussion about sharing and not whining. Everthing is good now. Some serious bouncing! I think she could pass for Supergirl.

Taking a swing at Batman.

Looking out for her little sister when a boy tried to cut in line.

Ava finally gets her turn.

By the way, if you didn't notice, Elizabeth loves superhero birthday parites.

Sound Familiar?

Backlog

That is what happen when mom gets sick. 8 loads of laundry, dishes piled in the sink, messy house, crabby kids, and no blog updates. I am caught up on almost everything now, and looking forward to my vacation next week.

Dancing Fools

Elizabeth and Ava started their dance class this past weekend. It has re-energized their love for music and movement. Casey just never seems to stop moving. Finally, he slows down.

Golden Ticket

Despite the accident, this has been Ava's lucky month. Since the 1st of August she has been showered with gifts, cards, and food from family, friends, doctors, nurses, etc. With all of the excitement, her birthday could have just been an after thought. However, we are very glad she is still with us, and wanted to give her a party with her friends this year like we did for Elizabeth's 3rd birthday. Even though, she seems like she has been three forever.Ava has always been independent, so a good question is who are her friends. First there is Analiese, her best friend from pre-school. Then there is Jena (5) and Ben (4). Elizabeth and Ben played T-ball together, but I think Ava has a bit of a crush on him. Jena and Ben have a brother Ryan (2), Ava really doesn't really like him but he got invited by default. Ava is also friends with Abby (5), Natalie (4), both from Elizabeth's gymnastics class. We have also done play dates together and all the girls have a blast. Abby and Natalie have a little sister Madeline (2) who once again was only invited by default. Since a gymnastics party was out of the question, we opted to take the kids to musical "Willy Wonka" at the San Antonio children's' theatre. It was suppose to be "Beauty and the Beast," but it got switched up last minute. Hey, who doesn't like a show about candy and chocolate. The kids all behaved beautifully during the performance. I am sure it helped that I put little bags of candy on their seats to munch on, and they all really liked the show. However, Ava was quite concerned why all the kids were disappearing when they ate too much candy. She wanted to know if they were going to come back. Luckily, they all re-appeared a the end of the show. I am sure there are good lessons to be learned. Ryan who has become quite the Betty Crocker made Ava's birthday cake. It is something he enjoys, like I enjoy making the kids' Halloween costumes. Elizabeth went for Spiderman back in February, Ava has a bit more girly taste and opted for a princess cake. Ava got the doll in the hospital from a nurse, it was the only one she owned that fit in the cake. Otherwise, we normally wouldn't have chosen a character from High School Musical 3. She enjoyed cake and chasing balloons with her friends in the theater lobby after the show. I think she would give this birthday a standing ovation. We did a family party on Sunday with Gram, Andrea, and the rest of that side of the family. Ava did some swimming, and even jumped off the side of the pool. I would say that she has recovered over the trauma of her accident. The kids decorated cupcakes, and successfully managed to make a whole weekend out of gorging themselves on sweets. Luckily, no one had to be juiced, stretched, or rescued from being turned into fudge.

One year ago!

Now!(Note the T-shirt)

Bad Luck

They say bad things usually come in 3's. I hope these three count, and we now start a run of better luck. 1. Ava fractured her skull. 2. The kids' daycare center had a fire (luckily after hours), but I had to find new childcare arrangements for the next 4-6 weeks. 3. The dog got sprayed by a skunk, so now our dog and our house smell horrible. Plus, we think she broke her toe.

Headbangers

First, it was Casey. While we were at Canyon Lake, Casey tripped on a concrete picnic pavilion and got one humdinger of a bruise on his forehead. A day or so after we got home, he was playing under a table and stood up and spit that big blood filled bruise right open. I yelled for the girls to get Ryan, not because I was overly concerned about Casey's head, it was more that fact that I needed an extra set of hand to wrestle Casey because he was bleeding ALL OVER the carpet. The girls were less then helpful. They stood there playing twenty questions about Casey and blood before finally getting Ryan who was half sleep from working the night shift. The words "blood" and "eye" finally got him out of bed. Then instead of helping me control the bleeding, he grabs the camera. After grabbing this great shot. We bandaged up Casey's head, cleaned the carpet, and did some laundry.He is doing fine, no glue or stitches on the kitchen counter needed. He has just a small scab left. One of these days he will learn to control that big head of his.

Ava on the other hand, looks perfectly normal on the outside. However, she received a much worse injury. She was at her best friend's birthday party, which was being held at an indoor swimming school. The kids were taking turns on the water slide, and had already completed many successful trips. Next think we know, Ava is flying through the air off of this 8ft tall water slide and lands flat on her back at the bottom of the ladder, luckily on a 1/2 inch foam mat. Ryan picks up a crying and stunned Ava, checks her over, gets her (and the staff) calmed down, and lets her have some juice. However 10 minutes later, Ryan gives me the nod that it is time to go. Ava started vomiting profusely. Elizabeth wanted to play twenty questions again, but some how I manage to get her and Casey changed and ready to go. I never thought we would get to the hospital. The drive seemed to take forever and Ryan is trying everything to keep Ava awake. I drop Ryan and Ava at the door and by the time we park the car and get inside they are already in a room. Sometimes, it is good to have a husband who is an ER doctor. She gets scanned right away and that is when we found out she fractured her occipital bone (blue line). Here is your quick anatomy lesson. The occipital bone forms part of the base and the back of the skull. The basal part of the bone forms a ring (the foramen magnum) through which passes the spinal cord. On the inside surface of the occipital bone venous drainage from the brain runs in the transverse sinuses. Ryan can answer any further questions you have.Now Ryan is really worried. He is thinking of every possible bad outcome of traumatic brain injuries. Sometimes, I think no medical knowledge is a good thing. I thought, how bad can it be? There was no blood or bones coming out, and her head wasn't dented. She is just tired and her head hurts. I also didn't realize the crack is about 3 inches long and in a place where a lot of important things run down and out of the brain. Ava had to be transfered to a hospital that had a trauma team and pediatric neurosurgeons, so Ryan and Ava took an ambulance trip over to University hospital. Elizabeth really wanted to go for that ride. I got the other kids settle in back at home with a family friend and then rejoined Ava and Ryan at the hospital. They were still in the ER, Ava had received another head scan and a couple of bruises were noted on the front part of the brain and some minor bleeding. The trauma bay was starting to fill up with gun shot victims (Saturday night 10pm), so they finally got Ava moved up to the Pediatric Intensive Care Unit. Poor little girl was so tired, scared, and hurt. Plus, she was still throwing up. She would answer Ryan and I with a head movement or maybe a one word answer but that was it. She was hooked up to machines that tracked her heart beat, blood pressure, and pulse. She also had an IV and the nurses came in and checked on her every hour. The worse part was that Ava just wanted to curl up with her blanket "Ba" and suck her thumb, but every time she tried to bend her arm she would kink her IV line and set the alarms off. I spent the night with her in a chair next to her. It was tough form me to hear that their was nothing that could be done for her, and that they were just watching her so they could intervene quickly if something bad happened. I finally grasped the severity of the situation when Ryan and the neurosurgeon were looking at her head scans, and the doctor was saying that he was most concerned about a vein bursting near her fracture line, and that would become a surgical emergency which didn't always have a good outcome. That is something, no parent ever wants to hear. Ava spent two more days in the hospital under surveillance. On the second day, she started to eat some food and keep it down. Ava also started talking to us and laughing. Yeah! They let me sleep with her in bed the 2nd night, something that I hadn't done since she was a newborn. Her hourly checks, became every 2 hours, and finally every 4 hours, and most of her wires were disconnected. Her head had not magically mended itself, but the risk of very bad things was diminishing. Here she is in the PICU on the road to recovery. I am glad I don't have a picture of her hooked to all the wires, looking so sad and pathetic. It really isn't an image that I want to remember. When she got to the Transition Unit, Ava and Casey came for a visit to entertain and terrorize her. She was discharged from the hospital after a 3 day stay with no restrictions on activities. Just the stern warning not to get another head injury in the next 2-3 months. Easier said then done with an active three year old, but we are trying to get her to slow down. We took the ladder away on the trampoline, enrolled her in dance instead of gymnastics. She is not allowed to run on hard surfaces or climb on or jump off of anything over 3 feet high. So far, so good. She will go back in mid-September to make sure everything is healing correctly. We are just very thankful that she can walk and run, no seizures, she doesn't have her head held together with plates, screws stitches, and staples, and she has stopped complaining that her head hurts. It could have been so much worse, but she should be just fine! The most we had to do was re-teach a little potty training after the hospital stay. My co-workers at Deloitte were great and brought us meals for the week. Plus, enough leftovers that I haven't had to cook all this week. Ava got lots of cards and little gifts from friends and family. She thinks that she has been celebrating her birthday all month long. For those doctors out there, here are Ava's official CT findings: There is a non displaced fracture in the midocciptial bone extending to the formaen magnum. There is posterior scalp soft tissue swelling. There are small foci of high density superior to the left orbital roof and along the right ryrus rectus. No evidence of mass effect, midline shift or hydrocephalus. No abnormal extraaxial fluid collections are present. The visualized paranasal sinuses and mastoid air cells are clear. Bilateral globes, optic nerves, and retro-orbital soft tissues are unremarkable.

Last (K)night

Last night, Andrew and mostly Lauren were busy having a baby. This morning they welcomed Oliver John Knight into their family. Congratulations! Big brother, Milo is estatic, and the "Cousin Clan" now stands at 4 boys, 3 girls. Gina-Mom and Michael-Dad are going to have their hands full when they open up Cousin Camp.

Never play summer T-ball in San Antonio

Well, we survived the season. Elizabeth had such a great time playing T-ball in the spring. I thought sure why not sign her up again. Somehow, I must of forgotten how hot it gets in TX during the summer, or maybe this summer is just hotter than last. We have had something like 25/30 days over 100 degrees. Even with practice at 6:30 at night, it would still be 95 degrees. All of the kids were hot, tired, and cranky. Games were worse, as the kids baked in the sun for an hour or two on Saturday mornings. Elizabeth really didn't show any enthusiasm for the game or her team until the end of the season. It also helped when Ryan was able to make it to some of the games she wanted to impress her dad big time with how far she could hit and how fast she could run. The Mighty Casey already loves baseball and runs out to the T with a bat and ball every time I set his little feet down on the ground. Ava has also started to express interest in T-ball for more than just the juice and snacks. I figured it would be good for her to try a team sport, so she is now signed up for Fall T-ball. It works out well because it is for 3-4 year olds, so that Elizabeth can be on the same team. Plus, the season doesn't start to mid-October when it much cooler.

Canyon Lake

After working 24 shifts in the month of July, Ryan got a block of 4 days off. I figured we better make the most of it, so I took some time off from work and booked us a cottage at Canyon Lake. Canyon Lake if a popular recreation spot about an hour north of San Antonio, and Ryan and I had previously talked about taking a trip up there with the kids. We had a good time, but I wouldn't necessarily recommend Canyon Lake to others. At least not the way we did it.OUR ACCOMMODATIONS: I rented a cottage through the recreation office at Fort Sam Houston. I use their term "cottage" loosely, because in all actuality it was a trailer. Now, I am not one who needs or wants 5 star accommodations, but if I am paying $75 a night would expect a clean room, decent sheets and a lake view. Instead, what we got were bugs in the kitchen and bathroom, rubber pillows and torn sheets, plus our trailer circled with others like a mobile home park. It was a bit disappointing, given that the Army charges $75/night for their hotel on Waikiki Beach. The only redeeming features were 3 bedrooms, so we had plenty of space for the kiddos and a giant covered playground right off our picnic area. I think the kids will tell you that the playground was the best part of the trip. They played on it about 4 times a day during our stay. I think roasting marshmallows was the runner up. The girls couldn't get enough of the sticky gooey treats. Ava would toast her marshmallow for about 2 seconds and then proclaim it done, so that she could eat it and move onto another. Elizabeth was much nicer and actually roasted marshmallows to share with mom and dad. We also had to eat the burnt ones for her. THE BEACH: San Antonio is in Stage 2 drought conditions, Canyon Lake is one of the water sources that feeds our aquifer. Needless to say, the lake was down about twenty feet. In fact there was a whole section of lake that was closed off because of low water. Most boat ramps were closed, beaches were 100 yards from any water, and trees and rocks were sticking out everywhere. When the girls think of beaches, they think of the ocean and white sandy shores. They were not impressed with rocky shorelines where you had to keep your shoes on and it was tough to find a flat spot to sit down. Lizzy had some fun swimming, but Casey and Ava didn't spend more than 5 minutes in the water before whining. After one day of trying the beach, we opted for a boat the next two days.THE MOTOR BOAT: The second day, we rented a little motor boat to putter around the lake. All of the kids though this was great fun. No tears, no whining or complaining all day. We stopped at an island to look for treasure, and of course have some snacks. Plus, the girls got to drive the boat.THE PADDLE BOAT: On our last day, we rented a paddle boat. We should have done this one before the motor boat, because the girls just wanted the boat to go faster. Elizabeth and Ava both agreed on a pirate ship paddle boat. We squeezed everyone in and set off around the marina. We had some fun chasing ducks, and Captain Elizabeth was shouting out orders as we navigated our way through a sea of trees.

Dora Day!

After waiting almost two months, the day finally arrived. The girls were going to see Dora the Explorer at the theater. We got a baby sitter for Casey, so that we could lavish some time just on the girls. They were amazed by the production. They will talk to the Dora TV show, but they were just awestruck most of the time at the theater. They like seeing the different lights projected around the stage and ceiling and watching some of the characters fly through the air. I am most impressed that they sat still for 1 1/2 hours. After the show, we went down to the River Walk and shared a bowl of ice cream. It was a nice afternoon together, and the perfect start to our mini-vacation.