Nightmares and neurotic dogs. Happy 4th of JULY!

Its the Fourth of July, the national holiday that appears each year as a cheery frenzy of red, white and blue and explosives. In Seattle, the tradition is to BBQ something under light showers of rain and afterwards gather in the glooming dark rainstorm to watch a well-regulated firework display set off on a barge on one of the city lakes. Personal fireworks are illegal which does not stop people from enjoying them on a small scale which lead to this belly-holding paragraph in the local paper. Friends on other continents, you will surely sense the absurdity here:

Thunderstorms Wednesday night also had an unexpected effect on pet owners' Fourth of July preparations, said Khadijih Harding, a veterinary assistant at Seattle Veterinary Associates' Ravenna-neighborhood hospital.

Many pet owners who had bought sedatives and anti-anxiety drugs for the cats and dogs before the Fourth exhausted their supplies during the night's erratic weather.

"We had prescribed medication for people weeks in advance, and they ended up using most of it because of the thunder," she said Thursday.

Apparently this is a well documented issue for American dogs who not only obtain prescription mood regulators but in Seattle can also enjoy dog naturopaths, dog accupuncture and dog massage.

Speaking of medical issues, Wren still had a fever this morning but it is lower, around 100, and he seems energetic but a little sombre. He is now napping.

For the past few nights I have been plagued by nightmares and last night was no exception. I dreamt that there was a huge downpour and the street filled up the water. One of the manhole covers lifted up and water poured out of the sewer. There had been a car crash on the street moments before so there was a debris field as well as the flood.

I watched out the window while neighborhood children came out of their house across the road [a house which in reality has no kids] to play by vortex of water.

Predictably [told you this was a nightmare] the toddler fell into the manhole and was sucked down after an awful almost-rescue swirling around in there. Then he was washed back out and his big brother who was about 5 tried to save him but fell in too!

Finally, both were rescued.

By this time I was outside and moved the children away from danger and went into the house and shouted at their mother. I can still remember fragments of the tirade but it was mainly stuff like "what are you thinking???" and it felt very liberating to castigate her for not looking after the kids. I was the Good Mother and Protector of Babies.

The previous night I dreamt that I took WrenFrost swimming in the Ganges in India and he drowned. I was carrying him out of the water [supposedly dead] when I realised he was breathing and injured by being in the water. So then Joshua and I had to decide whether to have him undergo surgery at a hospital in India or to risk flying him to a hospital near home [in the US].

I am sure you can see the themes here but it is still interesting to see my mind processing them. The dreams aren't frightening as such, just disturbing.

Frost had a hard time getting to sleep last night. He woke from light sleep crying and yelling and told me that he wanted a "private conversation". Joshua left us alone and he confided that he often had nightmares but they were not normally as scary. However, when I asked him what the nightmare was about he said "I don't want to talk about it". He repeated this with increasing vigor and my probing produced no results although I learned his nightmare was about "people". I tried to prompt more details but he said that he didn't want to have a "question and answer" conversation either.

I was a bit frustrated. I mean, isn't the conventional wisdom of nightmares that the fears are real until shared? How am I supposed to help diffuse the terror if he won't even talk about it? He doesn't write a blog. Argh. Why won't he talk about it? He's my son, right?

Blood draw results later

The pediatrician took a blood sample for CBC. This would identify bacteria in his blood which can indicate endocarditis. The blood draw was traumatic and Wren developed petechia in his arm and under his eyes from the pressure of the tourniquet and screaming. She said we needed to be a big aggressive in treating Wren and because it is a holiday weekend we may have to go to Children's if we did not do a draw today.

We should hear back by later in the day.

I since read that petechia are a symptom of endocarditis but I think in Wren's case it was due to the blood draw.

Update:
Wren's white cell count was normal! That means no endocarditis and this fever is probably viral. However, his hematocrit was a bit low (32) as were his platelets (153). She suggested we start Wren on iron to give him higher iron stores before his next procedure.

Fever and wren is caught by a homonym

Wren has had a fever since yesterday and I will be taking him to the doctor in the late afternoon. Since his fever is not high they were not going to see him until tomorrow but its a holiday weekend (isn't it always when they get sick?)we are going in today.

There is always a concern about endocarditis until a symptom emerges to explain the fever. It is not too high (101.6 last night and 101 again by 9.30am) and its probably a virus but I feel OK about letting the pediatrician do the worrying about the important things.

Now, the funny stuff.

The Bread Making Fiasco

This morning it was time to make bread. Wren loves when I make bread - he stands on his stool and helps by pouring ingredients into the bread machine. While the dough spins around he stands on tippy toes to watch it. After he had stood like that for 10 minutes I decided to move the bread machine to the floor and he sat mesmerized as the KNEAD cycle progressed.


Wren watching the dough go around.

After a while I ducked over to my laptop to check my email. This is what any parent of toddler does the moment their child is engaged in an activity that does not require their attention. I could see him from the desk so I felt fine about it. Eventually, Wren tired of watching and came through to see what I was doing. The dough had quieted down and was rising so I suggested we have one last peek at it and then it was naptime. The next picture shows what I saw when I opened the bread machine.

This is what we saw.

I shrieked and scooped the dough out. There were veins of bright purple and orange running right through it, not just on the surface, so there was no way to save it. My reaction saddened Wren and he was very sad when I told him the dough was no good and we had to throw it in the yard waste with the "yuck yuck". He cried and said "dough? dough?" as if to figure out what had happened.


"Dough, dough?" "Dough yuk yuk"

Of course it was not his fault that Wren had been confused by a homonym. Before we started making dough he had been playing with playdough which we also call "dough". He has seen me add flour and water to the breadmachine to get the dough the right consistency and while I was inattentive he had been innovating a tiny bit.

I did not have enough yeast to make another batch so I told Wren we would make a small bread. The small bread was fun to watch also and although nap was delayed a while the Maple Oat Sampler loaf is rising on the stovetop as I type.

Wren is napping, dreaming (no doubt) about multicolored doughs which invite retribution.

Bite me!

It was very hot on Sunday and the boys spent a lot of time outside playing with the hose. One game was for Frost to climb the tree and Wren to try and squirt him with water while he was up there. Josh came out and let Wren climb the tree.

While I was filming Frost went up to Wren and said "bite me" and stuck his finger into Wren's mouth. As Frost explained later "he never used to bite that hard!" Here is the hilariously painful movie of Frost being bitten by Wren (at his own request). In the second movie Wren is down from the tree and goes to find Frost who has run off crying due to the lack of sympathy from Josh. In the first movie Josh is heard to say "you asked him to bite you." Frost was not expecting the natural consequences. Wren is very sweetly seeking Frost calling out "ROST, ROST" as is his way.

Bath Tigers

Here are the boys bathing together and biting bath tiger. I thought it was such a cute photo that I couldn't resist giving it its own post.

BackYard Tourism #1: Rose Hill Woodland Park

This afternoon I took the boys to the East side [of Lake Washington] to try out a new playground in Kirkland called North Rose Hill. Frost, Alex and Wren had a great time in both play areas and on the walk across the middle of the park, through winding trails and wetland. Here is the new part of the park, opened a couple of years ago.



In the first playground the bigger boys had me set up obstacle races for them. Alex counted loudly while Frost raced and announced how many seconds he took. Frost responded with hostility to the anxiety this produced and kept arguing about the times Alex made up. He did not count for Alex but kept trying to negotiate on the 'scores'. I had no part in this argument because I was help Wren to play on the firetruck/aka digger he liked to climb all over.



Wren loved Kirkland because there are so many construction sites. He saw some of the biggest diggers ever doing road work and leveling large construction sites. Every corner has a mail truck parked alongside green lawns and even the houses seem more 'storybook' archetypal than those in Seattle. At one point I wondered whether Wren found more to look and shout about because the physical environment of the East side is like life in flashcards: things are spaced out with borders, created from the catalog imagination and very repetitious. OK Eastsiders you can heap it on me now.

Other things I noticed was that nowhere else have I seen kids with as much bling in their Crocs. In some shoes there was not a hole free! One little girl let me count her charms and she had 16! I am buying some for Frost for his birthday and he will thoroughly cherish the 4 he is getting.

Other than my moments of critical observation we had a fabulous visit. The parkland is lovely and the bigger boys loved running ahead and having Wren chase them. They also helped him find salmonberries in the wetland, or rather he found the salmonberries and ate them and they picked them for him. There was a great abundance of salmonberries and they seemed very sweet to me. Wren likes them more than raspberries and it confirms my intention to take them berry picking the week after next (next week Frost will be in camp). If your kid would like to come berry picking with us, let me know. Here is a picture of Wren pointing to the salmonberries he wants Alex and Frost to pick for him.


During the day I couldn't help but think about Wren's heart condition and whether he had any trouble with exercise, tiredness, rapid breathing and all those awful details I was asked at cardiology clinic. Just to reassure myself of his energy levels I have this movie of Wren running.



Here are some photos of him too. In the one he is running towards me being naughty. I can't remember what his game was but he has a rascally expression on his face. In the other picture he has a toy snake in his mouth. He found this in the grass walking to the playground and we were sad when he dropped it. When it was found on the way back he realized we were upset when he dropped it and made a big play of holding it and dropping it then running away. No matter how closely the boys "spied" on Wren they seldom noticed the moment he dropped it and I would not let them take it away to save it. So, here Wren enjoys teasing the boys by holding the snake in his mouth.





FACTS:
It was developed in 2006 and is called North Rose Hill Woodland Park.
Address: 9930 124th Avenue NE
It is 20 acres.

Freaking out a bit

PS. I am trying to Have A Good Time in summer but I am freaking out a bit about Wren's cath. Yesterday, I asked the pediatrician if we could really wait a month for the cath and she said that from the notes it looked as if he was stable enough to wait and that if Dr Lewin knew then that was fine. He knows.

Even so, this morning I had to fight the urge to call and reschedule - to get the cath done ASAP so I can know what the facts are and get this surgical or non-surgical planning going - not necessarily surgery but the plan. On the other hand, I have heard many people regret rushing into scheduled surgical plans, especially when they are complicated and invasive and once I have a plan I will probably worry even more.

Wren is enjoying his summer right now so much (sun and brother home all day!) so... I guess. Still, its very stressful and I worry.

Don't say yes to a goose [egg]

I have a goose egg in the fridge. It is wrapped in a paper towel and nestled in a plastic cup because it was too big for the egg shelf in the fridge door - a goose egg is three times the size of that of the typical fowl. This goose egg is from our visit to Moonshadow Farm. All the way home from the farm Frost and Alexander (who also has a goose egg) were planning how they would keep their eggs warm under a hot light and then build cages for their baby geese. Alexander was sure his mother would let him raise a goose in the yard while Frost nagged and begged for the Right To Raise the Goose.

The whole business was made more poignant because they saw the egg being layed and the farmer reached in and stole it for them. Also, he told them it was a fertile egg and that they had a pair of geese raising goslings. Then we walked around to the coop and run where another pair of geese had about 8 two-week old goslings waddling around. The male stuck his neck out and hissed with a wide pink mouth, his tongue quivering. Its also hard because I want Frost to be a boy who has a pet goose. I can see him with his goose following along behind. Josh and I are the type of people who want to incubate eggs that have fallen from nests, even if they have (perhaps) been pushed by forces of nature. We tend to the sentimental.

It was with faux conviction that I persuaded Frost to put the egg in the fridge. Now, I am going to have to get creative with my baking because there is no way I can eat a scrambled goose egg. It's weird, but I am squeamish about it - even the very fresh chicken eggs with their bits of feather and bright orange yolks give me pause. I have become used to my food coming in a aseptic packaging - being deanimated and removed from the source, processed and presented as inorganic matter. So much for the notion of being a farm girl but perhaps it is not too late for Frost who is so squeamish about anything from animals that he can detect cows milk in a smoothy and rejects butter on his toast.

Otherwise, we could just (re)embrace veganism and own our squeamishness as conscience and be done with raising fish, hoof and fowl on our future land.

Happy Day at the Farm

Yesterday we visited Moonshadow Farm and had BBQ and icecream on the way home. Frost's friend Alex joined us for the drive and they boys loved running around the small farm feeding chickens, petting bunnies, seeing the new chicks and goslings, eating salmon-berries and yelling a lot when the peacocks flew up onto the roof with their shrill yelping cries.

Wren did not appreciate the peacocks although he loved the donkeys, the salmon-berries (at more than a handful) and liked the bunnies.

Joshua and I appreciated the BBQ sandwiches in Duvall.

Here are the pictures from our day. Frost and Alexander enjoyed feeding the chickens:

Wren and I walk back from the yurt through the buttercup meadow. There is also a geodesic dome residence to our left. Wren was seldom content to walk. All the peacocks and strange animals made him uneasy but he was happy to run across the meadow down the path back to the salmon-berry patch. "More, more!"



Back to the chickens. Wren clings to Joshua as the chickens circle round. Joshua was interested in their advice on what breed of chicken would be best for our backyard chicken coop and they recommended Arucanas.



Here are the offending peacocks. There was even a pea-hen brooding on her eggs.



Finally, back at home Wren will only eat in his high-chair if maximally distracted and entertained. Here the big diggers gather around to keep him content to eat a few minutes longer.

18 mth ped visit - more information on bad news

Wren had his 18 month pediatrician appointment today along with his MMR shot. He was very brave and gave almost no complaint after the moment of the shot. His development is great along all normal measures:

Height: 33" 75th percentile.
Weight: 25 lbs 13oz - 5oth percentile!!!!
Head: 19 5/8" (85th percentile)

He has met or exceeded expectations for walking, running, climbing, speaking, understanding and communication in general. Dr L was very happy with him other than the sound of his heart which is "like a machine".

Uh oh.

And now the bad news... or rather more details on the bad news. At the appointment I received a copy of Dr Lewin's chart notes. These contain a lot more detail than the conversation we had at the appointment. They also make Wren's condition sound more serious.

Main BAD points:
* Wren has develop supravalvar aortic stenosis as well. The chart notes say that this requires investigation.
* He has stenosis in the aortic arch (again!) which was not mentioned.
* His aortic valve is thickened. This is a secondary aspect to aortic stenosis. Although he does not have regurgitation this is not a good development and may be due to the velocity of flow through the valve.
* His aortic valve is not only bicuspid but "domed". I have no idea what this observation means.
* Wren has mild "hypertension" (ie high blood pressure 118/67) in his right arm and slightly raised in right leg. They are delaying treatment (what? why?) until the cath is concluded and surgical path discussed).

There are GOOD points to:
* No regurgitation.
* Mitral valve behaving itself.
* LV normal size and only mild hypertrophy, good function.

Here is the concluding paragraph for those medical among you:

Wren is now 17 months old and carries a diagnosis of Shone's complex with multiple-level left heart pathology. This includes a bicuspid aortic valve, subaortic stenosis, coarctation of the aorta, an initial mitral valve abnormality and possible supravalve aortic stenosis. Wren is status post initial coarctation of the aorta repair with subsequent balloon aortic angioplasty as well as balloon aortic valvuloplasty. His echocardiogram today shows progressive left ventricular outflow tract obstruction which is now moderate to sever in nature. This progressive finding does place Wren at risk, and therefore I have recommended that we proceed with follow-up cardiac catheterization in order to better elucidate the level of maximal obstruction. My impression is that the subaortic process is quite significant but there also may be a major contribution from the aortic valve. I am hopeful that ballooning of the aortic valve will relieve the gradient such that we can avoid surgical intervention. However, I believe that we will be left with a significant subaortic process and there fore surgical intervention will be imminent. In addition, Wren has developed a supravalvar aortic process which also requires investigation. While Wren has only a 9mmHg blood pressure gradient [was 6mm before - my note] and his aortic arch appears only mildly turbulent by echo assessment, Wren has developed mild systemic hypertension in the right arm. I would suggest that we hold off on treating this until we have a better understanding of where we are heading regarding catheter-based intervention versus surgical.