Mason's Seattle Update

We made it to Seattle! We have loved it so far.  Here are a few of my first impressions:

-It's beautiful!
-Mt. Rainer is HUGE and breathtaking!
-Seattle is a melting pot which means there are so many awesome places to eat (i.e. tons of good teriyaki places and Indian food).
-Everything is expensive here (i.e. Little Caesars hot and ready pizza are $5.99 here!!!! The nerve!)
-There are tons of Costcos and Fred Meyers.
-I went to turn on the A/C in our house when we first moved in and it was nowhere to be found! Come to find out almost no houses have A/C here.
-Tillamook Ice Cream is heaven
-Traffic here is nuts!

We have spent most of our first three weeks here traveling to and from Seattle Children's hospital for appointments for Mason.  We live about 45 minutes away from the hospital but I found out quick that that 45 minutes can turn into 90 minutes at any given moment. Before we moved I made sure to set up as many appointments I could here in Seattle for right when we moved so that we could get established with all the new doctors asap. Since we've been here we have had 7 appointments. We've met with general surgery, ENT, nutrition, neurology, EEG, social work and sleep medicine.  So far I've been really impressed with Seattle Children's.  Their home health and nutrition have been super helpful and great to work with. Here's a recap of Mason's appointments if you're interested:

ENT
We met with Dr. Inglis and his nurse practioner to go over options for treating Mason's severe sleep apnea. Mason got a sleep study done a few weeks before we moved and we found out he had 32 apnea episodes which is pretty bad. Since we were moving so soon we had to wait to see an ENT until we moved.  Dr. Inglis didn't sugar coat anything which is good and bad. He put a scope down Mason's throat which was very traumatic for Mason (i'm sure it would be for any child!). He said after looking over Mason's file and test results we have a few options all of which made me want to cry for my poor baby. Note: In his opinion, taking out his tonsils and adenoids isn't an effective option because they're so small it wouldn't make a big enough difference. Option 1: Shaving part of the tissue above the vocal folds to increase breathing area. Option 2: sewing part of the epiglottis to the wall of the throat to help stabilize it (the epiglottis is the main culprit to his breathing issues.  It's supposed to be strong but Mason's is floppy). Option 3: Cpap and oxygen at night which is by far the least invasive but it would be hard to keep the equipment on him at night and therefore wouldn't be helpful enough Option 4: Something I won't even write because it freaked me out and it would be a last ditch effort.
Dr. Inglis said he of course wants to try the cpap first and then if that wasn't successful we'd have to explore surgical options.  He said we'd need to meet with sleep medicine for a consult and then down the road we'd come back to him if sleep medicine wasn't successful (hopefully not!). In all this appointment wasn't good. It was all bad news :(

Surgery
We met with general surgery for Mason's G-Tube.  I wanted to make sure we saw them soon after our move so we could get Mason's tube changed out.  It's supposed to be changed every 3 months and we were going on 4 months.  I met with the nurse practitioner in surgery and she said they didn't carry Mason's brand of tube (mini) so she'd show me how to change it by taking his current one out and putting it back in and then once I got home (I have a spare tube a home that I didn't think to bring to the appointment) I could change it myself.  She assured me that it's not hard and I could handle it (I'd been so worried about changing it!).  She took out Mason's tube and couldn't get it back in!!!! She went and grabbed the other brand of tube (mic-key) and taught me how to put that one in. She told me I could keep that one in for 3 months or change it out for the spare tube I had at home once I got home.  I'd be fine keeping that one in but it was a lot higher off his stomach and harder than his normal tube. She sent me home even more worried about changing it because she couldn't even get it in herself! After a few days of Mason using the new tube his stoma was bloody (it hadn't ever been before even after surgery) so I decided I needed to take matters into my own hands and change the tube myself. I did it in less than 3 minutes!!! It was 10x easier than replacing an NG tube.  I was so proud of myself.  Now hopefully I won't ever have to go back to general surgery!

Nutrition
Mason is gaining weight awesome and is staying right on the 50th percentile curve.  The dietitian said he technically should be taking in more than he's getting (he gets 115 ml every 3 hours-should be getting 130 ml every 3 hours) to maintain weight but since he can't move much he isn't burning calories as much as a normal 11 month old child.  So he gets to stay on his current regimen which I'm super happy about because whenever I try to change things he seems to start throwing up his feeds. He gets to change formula once he turns one which I'm also pretty excited about because it will be a ready to feed formula and not one I have to reconstitute like I have to now. It will also be a formula that's has fruits, veggies, and meat in it-sounds disgusting but it's great for him to get as close to a normal diet as possible through his tube.  We don't need to meet with nutrition again in a long while, I'll just stay in contact with the dietitian through email yay!

Neurology
I was super anxious for this appointment because I loved Mason's last neurologist at Cleveland Clinic (Dr. Moosa) and I was worried I would hate our new one. Mason's new neurologist is Dr. Bozarth.  She's a younger Chinese woman and she was very sweet and she seemed extremely smart and helpful. This appointment went really well.  She wanted to get an EEG done to see if the hypsarrythmia is gone.  If it's gone Mason can come off Sabril, if it's still there he has to have his dose increased. Sabril is a kind of scary medication because it can cause permanent peripheral vision loss but it's been the only thing able to treat Mason's seizures. Sabril has other side effects that aren't good like it makes Mason super sleepy. Random people are always mentioning that Mason looks sleepy.  I know they mean well but it annoys me.  Yes he's tired! He's always tired! He has epilepsy! The Drs aren't as worried about vision loss as seizures but they still try to keep Sabril therapy to less than 9 months to minimize the chance of vision loss.

A few days after the neuro appointment we got the EEG.  EEGs aren't fun.  They want your child to be sleeping during them so they tell you keep your child from napping 2-3 hours before the EEG and then a tech takes a while putting the leads on which gets the child wired and upset and then they all the sudden turn off the lights and say your child has 40 minutes to sleep. During the whole testing time the tech is in the room with 2-3 bright computer screens typing loudly.  Then every few minutes the tech comes to push harder on one of the leads on your kid's head because it's signal isn't picking up strong enough...and they expect you to get your child to sleep with all of this going on!  Thankfully Mason is the BEST BABY in the world and just goes with the flow but it still took him about 20 of those 40 minutes to fall asleep.  I'm praying they at least got some info because if not we have to go back! We're supposed to get the results from the EEG back on Monday and that will tell us a lot about what treatment in the next few months will be.

Sleep Medicine
We met with the sweetest sleep medicine nurse practitioner to go over minimally invasive options to try to treat Mason's sleep apnea. She suggested getting another sleep study here in a few months.  In the interim she wants to start Mason on inhaled steroids in hopes that they'll open his airway passages and therefore help him to breathe better.  Mason is sick a lot with upper airway stuff and she thinks the steroids will help to clear a lot of that out.  The plan is to do that for a month and then start reflux meds again.  She thinks reflux meds could help a lot in reducing congestion but she wants to try each separately so we get a better idea of what's actually working. I hate the thought of more meds but I'm all for trying reflux meds again for Mason if it means they could potentially make it so he didn't need surgery on his throat! After the steroid and reflux treatments and another sleep study then we'll try a cpap.  Mason also got a bunch of labs done at this appointment and he didn't even cry at all.  Him not crying made me cry because I'm so heartbroken that he's been through so much that getting blood drawn doesn't even phase him!

Social Work
Something awesome about the neuro clinic at Seattle Children's is that all new families are required to meet with social work which I think is awesome! I need all the help I can get.  The social worker gave us a lot of info on how health care works here in Washington and resources for special needs kids.  Thankfully we have private insurance through Casey's work but private insurance isn't good at covering medical equipment and medical equipment isn't cheap.  My main questions were how in the future do we go about getting medical equipment like wheelchairs etc. We found out that when Mason turns three he becomes eligible to go on a waiver. The waiver will provide some medical equipment for us each year which is such a relief!

So that's the long winded summary of what we've been up to.  Mason got his first hair cut a few days ago and for documentation's sake here's the before and after pic:

We sure love this little bundle of love.  I can't believe he turns one in 2 weeks!

Cortical Visual Impairment and SPTAN1

We finally have some big answers related to Mason's diagnoses. They aren't the answers that we necessarily want to hear but we'll take any answers we can get! First, we've always known that something is wrong with Mason's vision. He's never made eye contact for very long and he won't focus on toys or books. We've taken him to two pediatric ophthalmologists and had an MRI of his brain. The MRI showed everything was completely normal. The ophthalmologists have dilated Mason's eyes and told us everything is normal anatomically and the only explanation they gave us was that he has visual processing issues. Being told that your child has visual processing issues is tough because we know he can see, but we have no idea how much or how well he can see. I'd rather them just say he has very poor eyesight so we can put some glasses on him! There aren't easy or insurance-covered tests that can be performed on children to figure this out what he can process visually. His brain just has difficulties making sense of what he sees due to the brain damage epilepsy has caused. I haven't known at all where to go or how to help Mason see better, until I found the Cleveland Sight Center. Mason's early intervention therapist who comes a few times each month told us about it and our service coordinator sent in a referral. The sight center has various type of therapists and resources to help all ages of people see better! Better yet is that all services are free! A few days ago a visual therapist from the sight center came to our house and after playing with Mason for a few minutes and asking some questions she said that Mason has Cortical Visual Impairment (or CVI). A lot of kids with infantile spasms have CVI, and I've thought for a few months that he has it but didn't know what to do because both ophthalmologists we've seen have been extremely unhelpful. You can go to www.littlebearsees.org to learn more about CVI, but in short Mason's vision is like he's looking through a piece of Swiss cheese... Certain things in his field of vision are clear and easy to focus on, but most of his field of vision is blurry. Because his vision is so patchy he can't make sense of what he sees. Kids with CVI see bright, single-toned toys best-which I have realized most of his toys have complex patterns with multiple colors, ugh! Red and blue are usually the easiest to see and his therapist suggested getting Elmo, Cookie Monster, and Big Bird toys and stuffed animals since they are the easiest for Mason to see. The amazing thing is that vision CAN improve a lot with therapy, but of course it also takes a lot of time.

Also, we finally got to meet with Mason's geneticist (Dr. Moss) to get the results from the blood draw Casey and I had at the end of January. The results showed that Casey and I both don't have the gene (SPTAN1) misspelling that Mason has, which means that Mason's health issues stem from that gene misspelling.  So his diagnosis of infantile spasms is genetic and had nothing do with a birth injury! This is such a relief! If we have more kids their chance of having the same gene misspelling is 1-3%, the same chance as anyone else. This confirms what we already knew: that Mason is really 1 in a billion! I know nothing about genetics but what Dr. Moss explained to us is that because of this misspelling Mason has epilepsy. Infantile Spasms, Mason's specific type of epilepsy, causes the other issues that Mason has such as hypotonia (poor muscle tone), CVI, feeding difficulties etc. All kids with Infantile Spasms have varying degrees of effects from it. Unfortunately Mason has horrible effects from it, BUT his seizures are under control now thanks to amazing medications and he can grow and develop at whatever pace his little body will let him. We'll take whatever we can get and be so excited for any development we get to see.

As for how we're feeling...we take each week and sometimes each day at a time. We always try to stay positive and grateful, but it's not always easy. Although I feel like I've lowered my expectations I still hang on to every ounce of hope I have left that Mason will be able to have some normalcy in his life. Lately it seems like this hope gets taken away from me little by little at every doctor appointment and every therapy visit. Although it is comforting to know that Mason's condition is genetic and not caused by some error on my part or my OB/GYN's part it also means that epilepsy is ingrained in his DNA. His brain will ALWAYS be prone to having seizures, and he will always have to take seizure medications which all have their own horrible side effects. Every time he gets sick or has a fever he'll have a higher chance his seizures will creep back in. All of this has been tough for us especially lately because Mason isn't a baby anymore... My back and neck hurts from carrying him around everywhere. He can't support his head so I have to cradle him like a newborn baby or carry him in his car seat. It's hard to carry a 20 pound baby around like that! His physical and occupational therapists have started recommending buying medical equipment.  I can't wrap my head around buying my child a wheelchair, leg braces, and walkers in the future, it's too hard for me to think about. In a way having him be a baby up until recently has made his physical ailments easy to work around, but now everything has gotten more real. So real that we have to start thinking about things in the future we don't want to think about! We know our sweet little guy has an important purpose here on earth. We love him so very much and are so grateful we get to be his parents. He has already taught us so many important lessons! Good thing he's so cute ;)

8 months old!

This past week we have seen miracles happen for our sweet little Mason. A month ago Mason was still having spasms and his EEG showed no improvement. Dr. Moosa increased Mason's Sabril dosage to the max amount for his weight and age at this point.  Last week Mason had been on the max dosage for 4 weeks and was still having spasms (although they had reduced a lot).  The max dosage of Sabril knocked Mason out.  For 4 weeks straight he slept about 22 hours a day.  He would wake up when it was time to eat and then fall back asleep right when we started feeding him. He even slept through therapy:

He woke up so I started taking pictures. then within 10 seconds he was back asleep. haha.

I kind of think he looks like Chris Soules in this pic. See any resemblance?

Dr. Moosa didn't like that the Sabril made Mason so sleepy so he decreased his dosage last Wednesday a little bit. After a few days of the dosage change Mason smiled and laughed!!!!!!!!!!! He hasn't smiled in 4 long months!  He also started sucking on his hands again and batting at toys.  Although the dosage is lower he hasn't had any spasms either.  This is HUGE progress! We meet with Dr. Moosa on Thursday and he might want to do another EEG to see if it's improved at all. We are so excited for this progress! Go Mason! What's cool is that Casey's parents have been visiting us and they've gotten to see all of these awesome changes in Mason too! 

Mason and Holland kind of have the same look going on. 

Love these sweet kids.

Mason is a little worried...

Happy 8 months sweet boy, we love you so much and we're so excited to see what next month brings! 

Mason's G-tube

Mason finally got a G-tube! I say finally because he originally was supposed to have the surgery the first of November but then he got pneumonia...so we waited until he was all better and rescheduled for the end of November. 10 days before the scheduled surgery he got diagnosed with Infantile Spasms and got hospitalized.  He got put on the ACTH injections and we had to wait until 2 weeks after he was done with the injections to schedule surgery again! So 3 months later he finally got the surgery! We didn't want him to have surgery until he was healthy enough but boy was it a pain to have to keep rescheduling!
We had to be at Cleveland Clinic at 6 am so we had to leave our house at 5:15. My amazing friend Teri came over to our house at 5 so we wouldn't have to wake the girls up early.  She stayed at our house all morning and got the girls all ready for school and drove them around.  Thank you Teri!
I was pretty impressed with how efficiently everything ran when we got to CC at 6 am.  Mason's surgery was scheduled at 7:30 ( he couldn't have anything to eat after midnight) and I was expecting to be sitting around waiting forever like I have had to in the past when I've gotten surgery.  However, after getting all registered and getting our pager we were in pre-op at 6:30! The nurses checked Mason all out and asked questions, then the anesthesia team came in and went over more stuff. I was pretty anxious because a poor child in the room next to us was extremely upset (probably starving) and I was worried Mason would be so hungry he would start crazily crying too but he just slept in Casey's arms while we waited for everyone to come talk to us. At about 7:15 Dr. Seifarth (pediatric surgeon) arrived and went over what the surgery would entail. He said they would perform the surgery through endoscopy.  He would put a camera down Mason's throat and into his tummy to identify where the G-tube should be placed. Then he would make a small incision and place the G-tube. He said in about 5% of kids he cant place the tube through endoscopy so he has to go laproscopic through the belly button.  I handed Mason to an anesthesia resident and they sent Casey and me out to the waiting room. We got our first page at 8:00 saying that surgery started.  Our next page at about 8:30 said Dr. Seifarth couldn't place the tube endoscopically so he had to go through the belly button (of course). At about 9 Dr. Seifarth came out and talked to us. He said everything went well with the surgery but he had to put a lot of air in Mason's stomach (because its so small and never had much food at one time in it) to get it to reach the wall of the belly to be able to put the tube in. He couldn't get it far enough so he had to go through the belly button to see better.  He told us Mason will probably be in a lot of pain from all the air but he should be able to pass it and be fine.  We got to go back to the PACU to see Mason in recovery.  He was already awake and just looking around.  After about an hour in recovery we got transferred to our room where we would stay overnight.

 

 When we saw Mason after surgery he just wanted to stare at Casey and listen to him.  Its was so sweet.

 Mason in the PACU.  He got a few stiches in his belly button, and a few in his tummy to hold the stomach wall against the belly and to hold the g-tube in place.

 Our room ended up being the same exact room that we stayed in for a week when Mason got his NG tube! It was fun to see a lot of the same nurses who helped us 4 months before.
We could start feeding Mason through his G tube at 3 that afternoon, but he could only have 10ml an hour for 4 hours (he normally gets 100ml every 3 hours).  Then 20ml an hour for 4 hours. He handled the 10ml just fine but when the nurse switched him to 20ml he started throwing up. He kept retching even when he didn't have any food in his tummy.  He started to act like he was in a lot of pain so the nurse started giving him morphine which should have calmed him down and made him fall asleep but he just seemed more uncomfortable. At about midnight he started acting really uncomfortable. He was super stiff, his legs were straight out and his feet pointed and his arms straight out and his hands clenched.  He kept moving his head back and forth while he was crying... he did this for about 2 hours.  The nurse paged the hospital pediatrician to come check him out because she thought he might be having seizures. He had no idea what was going on so he ordered an EEG. The EEG techs came at 3 am and put the leads on Mason's head.  After being awake for about 6 hours Mason finally settled down and slept for about 20 minutes then he started doing the same thing ALL NIGHT LONG.

 

  I ended up sleeping through his cries because I was so exhausted.  At 7 am the surgery resident came and checked Mason out and said he looked extremely bloated and he'd send Dr. Seifarth up to see us when he was out of surgery.  Dr. Moosa came in too and said the EEG didn't show any new seizure activity, just his normal spasms and hypsarrhythmia. That was a relief! I had been a crazy mess at 3 am worried that Mason had new seizures and wondering if I made a horrible mistake subjecting him to surgery, I'm glad my worries weren't justified.
That morning Mason kept throwing up.  He still seemed very uncomfortable and it was so sad! I couldn't soothe him because when I held him it seemed to make him more uncomfortable. Later that morning Dr. Seifarth came and said we needed to stop all feeds and vent (leave his g-tube open to let air out) all day. He also said the morphine probably made him more bloated so he could only have tylenol from then on and he had to have gylcerin suppositories and tylenol suppositories every 4 hours to get his bowel going to push all that air out. He also said we couldn't leave that day since Mason wasn't tolerating feeds.  I was fine with that because I didn't want to go home and have Mason get dehydrated and end up having to go back to the hospital.

 

 Thankfully I learned from past hospital stays that snap jammies are a must in the hospital.  He had his IV coming out of his right foot, pulse ox on his left foot, tube coming out of the center and EKG monitor on his chest. Good thing he didn't really feel like moving around too much because he wouldn't be able to!

 

The next morning Mason was doing a lot better and Dr. Seifarth came in and said Mason could start feeds again but we would slowly have to get back to his normal amount.  He wouldn't get back up to his normal amounts until that night so I just decided to stay another night to make sure everything was good (and so I could have more time to have the nurses take care of Mason!).
After a long stay we ended up leaving on Thursday afternoon, and Mason has been doing really well. He's been tolerating his feeds and he seems so much happier without the NG tube, and less gaggy and raspy. I've been loving the G-tube already.  It's so much easier to give meds through, and I don't wake Mason up every time I hook up his feeds.  He hasn't seemed to be in any pain and the g-tube site is healing well.  Overall everything has been great! Now we get to focus on controlling those nasty seizures.

Dr. Seifarth took out Mason's stitches the last day we were at the hospital, but all those red dots were stitches. When Mason needs to eat we just hook up the extension into the button and feed him. When he's not eating we can unhook the extension and close up the button.  The button is really soft silicone and is really low profile so it doesn't stick up much.

Where we're at now

The past few months have been a roller coaster ride. Mason finished the ACTH steroid injections right before Christmas.  The injections were supposed to 1) stop the spasms and 2) clear up the hypsarrhythmia. ACTH is a first line of treatment for Infantile Spasms (IS) and it's effective in treating many children. The steroid injections had horrible side effects but they got rid of Mason's spasms.  However, an EEG showed that Mason still had hypsarrhythmia (hyps for short), so we started to wean him from the steroids and went to plan B.  As we started weaning him from the ACTH his spasms started coming back. The hyps is the horrible part of infantile spasms. Hyps is what keeps Mason from developing mentally and learning new things. The spasms on their own don't cause harm but they are an indication of hyps.

After the EEG still showed hyps we met with Dr. Moosa and talked about Plan B which is the medication Sabril. Sabril is also a first line treatment for IS and is popular because it doesn't come with the annoying side effects that steroid therapy does and it's still very effective in treating IS. However, Sabril does come with a rare but scary side effect: peripheral vision loss. We have to take Mason to monthly ophthalmology appointment while he's on Sabril and I had to sign a paper stating that I couldn't sue the pharm company if Mason goes blind... Dr. Moosa assured me that he's never seen a child lose their vision while taking Sabril but it still scares me. He told me that chance of vision loss is better than IS.

Mason started Sabril right before Christmas. After 3 weeks he got to the therapeutic dose so he got to go in for another EEG.  The 3 weeks he had been on Sabril he was having spasms so I wasn't hopeful at all that the EEG was clear of hyps.  Right after the EEG I met with Dr. Moosa and he gave me the results that the EEG hadn't improved at all, and we had to go with Plan C. Plan C is increasing Sabril to the max dose.  Of course increasing Sabril to the max dose is scary because it increases the chance of vision loss even more, but it still has a good chance at getting rid of hyps.
Dr. Moosa also delivered the bad news that ACTH and Sabril work for most children, but since ACTH didn't work and Sabril hasn't worked yet the chances of other medications being effective are low. We still have hope though, and we won't ever give up until we find something that works. Mason gets another EEG in 3 weeks to see if increasing Sabril has worked. The good news is that since increasing the Sabril dose Mason hasn't had any spasms! I'm always cautious about not getting too excited though because the spasms can still come back at any time, but we're at least hopeful. If Sabril hasn't cleared up the hyps in 3 weeks we're onto Plan D.

I'm actually pretty excited about Plan D.  Plan D is the Ketogenic diet. The ketogenic diet is a high fat, no sugar, no carb diet.  The ketogenic diet makes the body have to use fat for energy instead of sugar which reduces seizure activity. If you want to read more about how it works read this article: (http://www.hopkinschildrens.org/high-fat-diet-can-reduce-of-end-debilitating-seizures.aspx).  It sounds pretty simple but the diet is very strict because any sugar even in medications and fruits etc. can start seizures again.  To start on the diet Mason would have to be hospitalized for a week.  His blood sugar levels have to be checked regularly and a dietitian has to make sure he's receiving enough fat for his body to reach ketosis. The ketogenic diet is proven to treat seizures, and many children on it are able to stop taking other seizure medication because the diet alone is so effective.  How awesome is that!?! The diet isn't as popular as medication because it's so difficult to monitor everything the child eats, and they don't have many options (butter, cream cheese, whipping cream etc). It makes sense that tube fed children are the easiest to put on the diet because there's a formula that they can get through the tube that's ketogenic.
I don't want to have to think a lot about Plans E, F, G or H yet but I have a little bit. I'll leave that for another post.

We got a fun surprise while we were in the hospital last week, Dr. Moss (geneticist) came and saw us and gave us the results of the epilepsy panel that Mason got drawn just before Christmas. We weren't planning on seeing him until the end of March, but his wife was Mason's hospital pediatrician and she told him to come see us.  In short the results were that a misspelling of a gene came up and 2 other kids with that same misspelling have IS. Casey and I got out blood drawn while we were at the hospital so we can be tested and see if we have the same misspelling.  If we do, the gene isn't important because Casey and I don't have epilepsy. If we don't have that misspelling then Dr. Moss will delve deeper. The hope is that this gene can give us answers on what treatments could be effective. On the other hand, there is still the chance that Mason suffered brain damage at birth from lack of oxygen, but that's another post too.

Dropping an NG tube (like it's hot)

In case anyone is dying to know how to put in an NG tube, Casey recorded me putting in Mason's tube a few days ago to hopefully be able to help someone and because this is hopefully THE LAST TIME (YAY!!!) I'll have to put it in. Sorry in advance for our coughs, my raspy voice and lack of makeup...

A Day in the Life of Mason

Have you ever woken up in the middle of the night worried that if you got hurt or died or something horrible happened OR you just want to go to IKEA alone for a day no one would know how to care for your high maintenance child(ren)?  Casey is amazing and would be able to do this, but this has always been a fear of mine and it may sound silly but since Mason was born I have felt even more worried.  To help with this I am always telling Casey how I do things.  He laughs at me but a huge weight is lifted off my shoulders when I know I'm not the only one that knows how to do something.  Worrying aside, I just wanted to document all the fun new-to-me ways I get to take care of the sweetest little boy in world. 

Schedule

7 am- Wake up, change Mason

8 am-pull ACTH out of the fridge to warm up, get 3ml Topamax and 1ml Vitamin D in syringes

Mix 1 packet Prilosec with 15 ml of water.  Let sit for 2 minutes then draw up in a syringe. Give Mason the Prilosec FIRST since he has to take it 1 hour before next feed starts.  Slowly squirt it out in his mouth or put it through the tube. Give him the rest of the oral meds. If anything was given through his tube make sure to flush with 2ml water. 

Get supplies ready for ACTH injection: 2 alcohol preps, 1ml luer-lok syringe, needle, and tissue. Give injection. Put needle and syringe in sharps container. Put ACTH back in fridge! Give Mason big loves. Get food ready for other kids

8:30-Get Carly on the bus

8:45- Get Mason's formula measured out so it can start warming up. Add it to the feed bag and prime the tube. Hook it up to the pump and hang on pole. 

9:00- Start Mason's feed.  He needs to be elevated while he eats. Run the feed over 40-45 minutes. 

9:45-Unhook Mason and rinse out bag. Keep him sitting up for at least 15 minutes or else he'll throw up the feed. 

Next feeds are at 12,3, and 6. Make sure pump charges when not in use.

8 pm-pull out ACTH from fridge and get injection supplies ready. Also get Topamax ready.

Give injection and give Mason big loves. Change him into his jams. Get night feeds ready. Measure out formula needed for 9, 12, 3, and 6 o'clock feeds and pour into bag.  Put the bag into backpack with an ice pack behind it. Zip it up and hang it on the pole.  Connect it to the pump and make sure to set pump to feed him every 3 hours and slow rate of feeds down to an hour. Carry pole upstairs and put Mason in bed. 

relax, then fall asleep on the couch ;)

Food

Mason is fed on a pretty strict schedule every 3 hours (even throughout the night). He gets between 90 to 120ml.  It's a wide range because sometimes he'll throw up if he gets more than 90ml, but other days he seems super hungry and he'll only relax after 120 ml.  On most days he gets 100 ml.  He gets Similac Sensitive and thankfully our insurance covers it.  To make things easy I mix a large batch of formula every morning. I used to have to fortify Mason's formula to different calorie densities. The normal calorie content of formula is 20 calories per ounce but for a few months I had to mix his formula differently by adding less water to equal 24 calories per ounce.  As he started gaining weight better the dietitian lowered it to 22 calories and now he's on normal 20 calorie (thank goodness). I weigh out his formula to make sure he consistently gets the same amount of calories.

Then I add a 1/4 tsp of probiotics to the formula

Meds

This is the $30,000 per vial stuff.  ACTH a a corticosteriod and works very well at treating infantile spasms. It has a honey consistency, and is solid when cold.

The glorious Prilosec packets.  These keep Mason from throwing up constantly.

Side effects of ACTH: All day irritability, no sleep, no smiling, high blood pressure,  and high blood sugar, but IT'S WORTH IT! (only 2 more weeks of injections)

Topamax. Long term medication to control Mason's seizures. He'll stay on this for years.