TYSON MATTHEW KOTTELENBERG

This blog is about our 14 year old son Tyson. Tyson was born with serious complex congenital heart defects, (Hypoplastic Right Ventricle, Tricuspid Atresia, Coarctation of Aorta, Transposed Great Arteries, with VSD and ASD.) In short, the right side of his heart is completely under-developed (he has half a heart,) his main arteries are mixed up, and his aorta is narrow. He has undergone 3 open-heart surgeries and 5 heart catheterization procedures to try to 'repair' his heart. Tyson also has severe narrowing in his pulmonary veins which are causing higher venous pressures. He's still doing AMAZINGLY well all things considered. We entrust our dear son into the hands of God, knowing that in all things God works for the good of those who love Him!

Three Wonderful Milestones

When you have a child with serious heart defects, every small milestone is worth celebrating.  Depends what you call a 'small' milestone, I guess.  Today we are celebrating three wonderful milestones. 

One is that Tyson has been discharged from the Wee Talk program!  We said a tearful, bittersweet ‘good-bye’ to his speech/language pathologist this afternoon.  We’re very sad because we LOVED him and will surely miss him. This is a man who would lay on the floor beside Tyson as they played their ‘boy’ games together.  He knew exactly what made Tyson tick,  he knew how to push Tyson’s buttons to get him to focus, to get him to continue on with the learning.  Most of all he made learning fun!  As hard as good-byes are, we are SO THANKFUL that Tyson no longer needs to see a speech therapist and will not be referred to CCAC for speech therapy once he starts school!  This means we have one less therapist and one less appointment every month!  I’m so proud of Tyson and how hard he’s worked on his sound and word articulation and how well his language skills are developing and improving. 
The other thing we’re celebrating today is that Tyson has also been discharged from the Infant-Child Development Program.  Obviously, once a child starts school, they would be let go from the Infant Child program as the name suggests.  But to top it off, Tyson will not need further referrals to any other programs.  He definitely has some areas we need to work on with him, particularly his social skills, self-help skills, attention span, memory, impulse control and mood changes J  But we’re getting there.  One step at a time.  The psychologist who signed off on Tyson’s report did indicate that, considering his complex medical history and the number of procedures he has undergone, she is impressed with how well he’s doing.  Man, that’s music to a Mama’s ears J  Tyson’s Infant-Child Development Worker, Chris, will visit us one more time in the fall, and we will indeed be sad to say ‘good-bye’ to her too.  She has been coming into our home almost monthly since Tyson was 10 months old.  She has poured out her heart and soul for Tyson’s well-being, monitoring his development to make sure he’s on the right path, and giving encouragement and support where needed.  She has showered Tyson with love and with gifts, and she even visited when Ty was hospitalized in March/April.  She also facilitated “The Spirited Child” workshop that I attended to learn how to cope with ‘spirited’ kids like Tyson.  We both love her.  (And I happen to know she reads this blog…so to Chris: THANK-YOU FOR EVERYTHING!  Thank-you for loving Ty, and accepting him, and working with him when he wasn’t always willing to work with you.  You will always have a special place in our hearts and you will be greatly missed! 

One last thing we remember today.  Today marks 18 months that Tyson has been free from any heart procedures, surgeries, or interventions.  Of course this doesn't include his regular tests like the ECGs, Echoes, x-rays, etc - those are very common still and will very much be a part of his life forever. But we also pray that someday we can celebrate 18 months hospital-free, or 18 months oxygen-free!  If the LORD wills it, we'll get there someday too.  
Eighteen months ago today,  Tyson had his last heart cath procedure (his ‘last’ but probably not his ‘last.’)  I remember that day so well.  I was 38 weeks pregnant with baby #5 and I'll admit it:  I was a STRESS-CASE.  How could we possibly be having another baby, knowing that the likelihood of Tyson needing a transplant was so high?  For the first three years of Tyson's life, there was *always* another surgery looming in the future...always another heart cath needed to assess his heart status or attempt a fenestration closure...always another hospital stay right around the corner.  What was I doing having another baby?  And Brian and I were both exhausted with all kinds of extra appointments for Tyson and for our unborn baby.  Stress levels in this house were an all-time high.

But look how God has so richly blessed us!  Addisyn turned out to be the best thing for our family (doesn’t He always know what’s best?)  She was a very happy baby right from the start, sleeping well though the night, and very happy during the day.  Tyson was hospitalized when Addisyn was four months old, but Tyson was able to stay at our local hospital so it was much easier for Brian and I to take shifts at the hospital, and my Mom took some night shifts too.  So it all worked out, as it always does. God has a way of doing that, doesn’t He?  Thank-you Father!

I’m getting side-tracked.  Back to the 18 months.

Let's face it.  Eighteen months without any heart procedures is a long time for a kid with Tyson's complex anatomy.  18 months without a general anesthetic.  18 months without a breathing tube shoved down his airways.  It's not just the HRHS which would be reason for multiple heart procedures, but Tyson also struggles with pulmonary vein stenosis, which is our biggest concern right now.  His extremely narrow pulmonary veins cause high pressures in his heart and lungs, which is why his fenestration can’t be closed.  The high pressures also cause his blood to ‘shunt’ through his fenestration left-to-right instead of right-to-left as it should.  The cardiologists aren’t really sure how or why it seems to be working for him, but for now it is working for him.  For the past 18 months, God has given Tyson a 'break' from any open-heart surgeries or heart cath procedures.  And our whole family has been given a break from that worry and stress.  (Ok, so the two hospital stays in the past year haven’t been very fun but at least he hasn’t had another heart surgery.)  We are SO thankful.  
 Speaking of procedures….

UGH.

Tyson has to have a cardiac MRI at Sick Kids in September.  MRI gives a better picture of how his blood is flowing in and out of his lungs.  Compared to open heart surgery, this is a cake-walk.  But since Tyson is so young, he will have to be intubated and under general anesthetic for this.  I asked (begged) the MRI department if they could just sedate him with chloral hydrate (same stuff they used for his echoes when he was a baby) instead of intubating him.  The chloral hydrate makes him sleep for 4 hours and he wakes up a very angry drunk…but at least they aren’t intubating him and messing around with his airways!  Tyson is very prone to pneumonia, so anytime they mess with his airways he’s at risk again.  But MRI department told me they need Tyson to lay perfectly still and calm for over an hour, and at one point during the test he’ll need to take a very deep breath and hold it for about 15 seconds.  If he was sedated with chloral, he can’t take a big breath.  If he’s intubated, they can control his breathing and can get the pictures they need.  *sigh*  I can;t picture Tysonlaying still and calm as they slide him into a tightly enclosed tube...and apparently it's very loud in there too.  Tyson would not be good in this situation at all.  So it looks like on September 20th, he will be intubated and put out again.  Which also means we have to keep him healthy for the procedure, so if he catches a cold they will cancel the MRI and re-schedule.  He’ll likely have to miss a week or so of school to ensure good health prior to the MRI.

Then in early November Tyson will go back to Sick Kids for a bone density scan, some blood work, and an appointment with the thrombosis team.  Kids who are on long-term Coumadin are at risk for bone density so they need regular scans to monitor his bones.  They usually start scanning when they turn 5.  The scan itself is much like an x-ray, so he won’t need sedation or anything for it.  Tyson won’t be too worried about that.  The blood work is another story though.

Then late in November we go back to Sick Kids again for his regular six-month cardiology appt, Echo, ECG, etc.  We have to wait over two months to find out results from his cardiac MRI.  Last MRI he had (exactly 18 months ago!) he had 18% blood flow to his left lung.  I am really hoping and praying that the number does not get any lower.  18% is a really crappy number.  They did try to repair his pulmonary veins when he had his last open-heart in December 2010, but it didn’t go as well as planned, and it didn’t do much to improve his blood flow.  We’ll see what the next MRI in September shows and I’m sure we’ll need prayers as we wait 2 months to find out the results.

Not wanting to end this blog post on a sad note, let me repeat again why I started this update today.

Eighteen months procedure-free!  No more Speech therapy!  No more Infant-Child Program!

God is good. 

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