Saturday, February 2, 2013

What a catch up...

Wow it has been over a few months since I lasted posted anything.  I feel horrible, but things have been happening so fast that I just never have time to do everything that I need to do.  There are time that I struggle to stay up and on top of everything.

We had a very good thanksgiving at my sister in laws house.  The kids had a blast and I was so happy that Dylan stayed dry the whole time!  Well he was pretty proud of himself. :)  Dylan is such a cutie and he enjoys staying dry and in big boy underwear as much as he can.  He likes it so much that he had a very funny expression on his face when he didn't make it to the bathroom after he was in a diaper for the night.  I couldn't help but laugh even though it was almost midnight.  Ha ha ha!!!

Gavin, Nikole, and Rhett had a blast playing with cousins and just enjoying the day which was a blessing to me.  It was great!!

December came and went and it was dragging so bad but now that I look back it was a like a blink of an eye.  LOL!!!  Go figure...   During December we had sickness hit our house really hard the week before Christmas.  I was super sick with something I am not even sure because they couldn't diagnose me at all.  That was super frustrating!  I pretty much stayed home as much as I could and slept oh so much.  The first day that I felt like I could get something done was January 1st.

The kids had a great Christmas thanks to so many people that helped our family.  We have a tradition that our kids will get presents for their siblings even if it is something small.  That way they have to think of other people and it has helped so much.  They actually get so excited to get things for other people it is wonderful.  It makes me smile to see them thinking of their brothers and sister depending on who is shopping.  Then wen they open the gifts on Christmas the watch so happy and excited for those they got the gift for just to see their face.  That is one of the most wonderful things that I enjoy seeing at Christmas.  We also went to the Festival of Trees.  The kids really enjoyed it but I know they with they had enough money to get things that are in the gift shops that they have there, or even buy a tree or something like that.  I just love seeing all the hard work people put into items to help Primary Children's Medical Center.

With the new year brought on even more challenges that we had to deal with on top of birthdays in January.  Dylan ended up with the flu the week of his birthday.  He missed out having treats on his birthday with his class but they saved it for when he was able to go back to school after he was feeling better.  We decided to do cupcakes and have him only blow out a candle on one instead of him blowing out candles on a whole cake and giving us all the flu.  We had a little party with him and it was just us since everyone that was going to come have kids, and I know they didn't want to get sick and I honestly don't blame them.  On top of that Gavin had a virus the same week and then a stomach issue the very next week that caused him to stay home for a while.  He was miserable I felt so bad for him.  When I talked with the teacher there were several kids that were out sick so at least he wasn't the only one that was out sick.

On Nikole's birthday it was about the same as Dylan since Gavin was having a stomach problem and Dylan had just gotten over the flu.  We did the cupcake for her too.  She had a great day.  I cannot believe that she is 11 and is not even 5 inches shorter than I am!  She is going to be taller than me and I think it is going to happen soon.  LOL!  We had a surprise in the form of freezing rain on her birthday.  That was super crazy.  I think if I remember right she came home and told me that she had fallen when she was walking to and from school.  I almost fell while I was outside too.  It was rather funny.  Nikole took treats for her class and barely had enough for her class.  I am glad that I had gotten the big bag, it was treats for Dylan and Nikole and their classmates.

The same week that Nikole had her birthday and right after Dylan's birthday Rhett, Dylan, and Nikole all had doctor appointments that week, starting on Monday.  The first appointment was the orthodontist for Rhett and Nikole,  Rhett just got some more rubber bands and Nikole had a visit with him to see if she is ready for braces.  She has to have 3 teeth pulled if they don't come out on their own. :(  She is not happy about that since she has had so many pulled, but we will see if that is the case.  The second appointment was a well child for Nikole and Dylan on Monday.  We got to the doctor early since we left the hospital early and the wonderful doctor that we have was willing to see us during his lunch so we wouldn't have to wait for a hour to see him.  The appointment went ok. found out that Nikole needs to see the eye doctor.  I wonder if she will need glasses.  Oh well we will be seeing him soon.

Tuesday was a cardiologist appointment.  Rhett had an exercise study with ECHO.  They got him down to 60 without oxygen and walking on the treadmill.  His appointment was a super long appointment and it was just sad, since they wouldn't let me in the room to watch.  When I saw him they were taking him to a room.  As soon as we got to the room waiting for the doctor to meet with us the nurse closed the door and Rhett just broke down and started crying.  I felt so bad for him.  As I talked with him I found out that they made it really hard for him to breath and he was really upset that they had to do that to him.  He was also almost as white as a wall from the lack of oxygen and the exercise that he got walking on the treadmill.  The doctor said that his levels are up when his is without oxygen but it is too small to measure with oxygen.  So he has to take speical meds to help him keep his pressure down.

Wednesday was an audiologist appointment for Dylan and Rhett.  We had to make it out to Taylorsville to see the wonderful audiologist that we saw when Rhett was little, but after we moved it was just too far to drive there so often so we would go somewhere closer but seeing her again was wonderful.  I got some paper work taken care of and we looked over the hearing loss for the boys and  talked about hearing aids types that were available for the boys.  Dylan decided that he didn't like the hearing aid that he is borrowing from school.  It was a good meeting since Rhett's hearing aid is broken and trying to get it fixed doesn't look like it is going to happen anytime soon.

Friday was a pulmonary appointment for Rhett to get lung function and volumes.  Gah!  That was a day I would much rather never repeat, ever!  We got there even after the freezing rain the day before and the snow and everything.  So glad to make it there safe.  They took Rhett back and had him doing a PFT(Pulmonary Lung Function), I waited for what seemed like forever, but more like 1 hour.  After he was done he came back and was playing with his rewards, ie: toys from the reward box for doing a good job.  So before the doctor was able to come into the room Rhett went to the bathroom and within 5 minutes after he left the doctor came in and decided to tell me the results.  He went over everything from the previous 2 PFT and compared it to this one that he just did.  Lets just say that he dropped in function and everything except for total lung volume.  The results for the lung volume just stayed the same from the last time it dropped back in August.  We are going to retest him and Dylan later this spring and see if the air quality had any effect on this last PFT.

This pictures are Rhett's PFT results from August and then again from January.


August PFT
 
January PFT


I also have the terminology that I know will help explain lots of this. I have listed the terminology below, and if you have questions I am more than willing to answer them.

Terminology and Definitions

FVC - Forced Vital Capacity - after the patient has taken in the deepest possible breath, this is the volume of air which can be forcibly and maximally exhaled out of the lungs until no more can be expired. FVC is usually expressed in units called liters. This PFT value is critically important in the diagnosis of obstructive and restrictive diseases.

FEV1 - Forced Expiratory Volume in One Second - this is the volume of air which can be forcibly exhaled from the lungs in the first second of a forced expiratory maneuver. It is expressed as liters. This PFT value is critically important in the diagnosis of obstructive and restrictive diseases.

FEV1/FVC - FEV1 Percent (FEV1%) - This number is the ratio of FEV1 to FVC - it indicates what percentage of the total FVC was expelled from the lungs during the first second of forced exhalation - this number is called FEV1%, %FEV1 or FEV1/FVC ratio. This PFT value is critically important in the diagnosis of obstructive and restrictive diseases.

FEV3 - Forced Expiratory Volume in Three Seconds - this is the volume of air which can be forcibly exhaled in three seconds - measured in Liters - this volume usually is fairly close to the FVC since, in the normal individual, most of the air in the lungs can be forcibly exhaled in three seconds.

FEV3/FVC - FEV3% - This number is the ratio of FEV3 to the FVC - it indicates what percentage of the total FVC was expelled during the first three seconds of forced exhalation. This is called %FEV3 or FEV3%.

PEFR - Peak Expiratory Flow Rate - this is maximum flow rate achieved by the patient during the forced vital capacity maneuver beginning after full inspiration and starting and ending with maximal expiration - it can either be measured in L/sec or L/min - this is a useful measure to see if the treatment is improving obstructive diseases like bronchoconstriction secondary to asthma.

FEF - Forced Expiratory Flow - Forced expiratory Flow is a measure of how much air can be expired from the lungs. It is a flow rate measurement. It is measured as liters/second or liters/minute. The FVC expiratory curve is divided into quartiles and therefore there is a FEF that exists for each quartile. The quartiles are expressed as FEF25%, FEF50%, and FEF75% of FVC.

FEF25% - This measurement describes the amount of air that was forcibly expelled in the first 25% of the total forced vital capacity test.

FEF50% - This measurement describes the amount of air expelled from the lungs during the first half (50%) of the forced vital capacity test. This test is useful when looking for obstructive disease. The amount of air that will have been expired in an obstructed patient is smaller than that measured in a normal patient.

FEF25%-75% - This measurement describes the amount of air expelled from the lungs during the middle half of the forced vital capacity test. Many physicians like to look at this value because it is an indicator of obstructive disease.

MVV - Maximal Voluntary Ventilation - this value is determined by having the patient breathe in and out as rapidly and fully as possible for 12 -15 seconds - the total volume of air moved during the test can be expressed as L/sec or L/min - this test parameter reflects the status of the respiratory muscles, compliance of the thorax-lung complex, and airway resistance. Surgeons like this test value because it is a quick and easy way to assess the strength of the patient's pulmonary musculature prior to surgery - a poor performance on this test suggests that the patient may have pulmonary problems postoperatively due to muscle weakness. MVV can therefore be viewed as a measure of respiratory muscle strength. One major cautionary note is that this test is effort dependent and therefore can be a poor predictor of true pulmonary strength and compliance.

Ok so after having the terminology and the results you can tell me what you think.  It was just hard getting the results and then comparing them side by side like that.

After that appointment I get home and it was a mess.  But on top of that daddy was taking Rhett and Gavin to a scout overnighter at a cabin. I was at a loss.  I was already really upset about the test results and then having to deal with the mess by myself with Nikole and Dylan just put me over the edge.  It was not pretty.

To follow up with all this info here are some pictures to make up for all the missing pictures as I haven't posted any in a while.


Love this Christmas present.  LOL!!  She is funny!
Yummy!  Before school and fresh fallen snow.
One, two, three... jump!!  Loves swimming.
Love Christmas eve!  So happy.
It is hard to do face time if you don't have your hands.  LOL!
So there are some more recent pictures. I will have to take more pictures and post them soon.

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