More oldies but goodies!

I have a friend who shall remain nameless, but she is apparently an email pack rat and she has my missing emails from Parker’s first four weeks! Thank you!

In order, from the first announcement of his birth to where we started yesterday:

Date: Saturday, November 4, 2006, 7:54 PM
Hello Friends,
I wanted to send a quick note out to tell you all that baby Parker has arrived.
Parker Edwin Upton was born at 10:07 a.m. (I think!) on Thursday, November 2nd. He weighed 8 lbs. 1 oz. and is cute as a button.
Parker did not take a breath for the first three minutes of his life and required quite a bit of work, including oxygen and chest compressions to get him going. After that he was fine until about 8 p.m. that evening when he turned completely purple and was taken from our room and admitted to the nursery. By 11 p.m. the decision was made to have Parker transferred via ambulance to Sick Kids hospital in Toronto- the hospital where he was born did not feel they were adequately equipped to handle an emergency situation with him should he require more significant intervention than was needed to break him out of his now common “purple spells.”
For those not familiar with Sick Kids it is one of the pre-eminent pediatric facilities in the world.
An acute transport team from Sick Kids arrived, assessed Parker and assumed his care and took him downtown. Ian and I headed home to try to get some rest, we knew he was in good care and we didn’t know what kind of road laid ahead.
The next day he saw a LOT of specialists and it was ultimately determined that his left vocal cord was not moving and when he cried the lack of movement of the left cord combined with the normal movement of his right cord meant that at times his airway was entirely blocked leaving him unable to breathe and his oxygen levels dropped significantly.
So, right now we are trying to figure out if the problem is damage to the cord associated with the work that was done on him just after birth or if there is paralysis caused by structural abnormality or nerve compression. The former is more likely, given that there was a lot of work done on him at birth and also given that most of the abnormalities that would cause the paralysis would also manifest in other ways but thus far he is a totally healthy, normal kid unless he cries and then he can’t breathe!
We are awaiting an MRI tomorrow or Monday so they can finally rule out structural problems. It is better if the problem is associated with damage from birth as it will likely resolve itself fully in a few weeks. Unfortunately, that means that he would have to stay in the NICU for a few weeks because even though the episodes are now resolved quite easily with oxygen and calming him down, there is always the possibility that that wouldn’t work and he would need to be intubated or require something even more drastic.
There you have it. The story of Parker’s arrival. We are thankful that Ian’s mom is here to help us with the big kids while we spend time at the hospital with Parker. My mom is coming early next week and will be here for a few weeks as well. Grandmothers and great neighbors and friends here mean we are able to juggle everything we need to for now!
Attached are some pictures from Parker’s first day- from birth up until his departure  to Sick Kids. He sure had on a lot of bells and whistles! We will keep you posted on his progress as we learn more about what is going on.
Suzanne & Ian


Date: Sunday, November 12, 2006, 9:40 AM

First, my apologies to those on this list that are just now hearing about our newest addition. Things have been a little crazy and we’ve only sporadically had time to “officially” and “publicly” welcome Parker to our family.
A little re-cap: Parker was born on the 2nd after a complication free pregnancy and delivery. Unfortunately, he didn’t take a breath for about three minutes after birth and required some intervention to get him going, but after that all seemed quite well until about 10 hours later when he turned purple and his airway closed off entirely.
Within hours he was transported to downtown Toronto to SickKids Hospital and has been in the NICU ever since. For those Americans who constantly ask us about the state of Canadian healthcare: we only have glowing reports to give about the care he has received at SickKids. We are indeed very lucky to be so near a hospital with such a remarkable staff and amazing reputation worldwide!
Here is the update since my last e-mail: previously, we thought only his left vocal cord was paralyzed but in fact both are. From the beginning, the assumption has been that the work done on him at birth caused damage to the cords that would just need some time to repair, but obviously, we and the doctors want to rule out any other issues that might cause or complicate the issue. He’s been through many, many tests and all but one have turned up nothing unusual. In addition, his “purple” episodes are becoming fewer and farther between and require less intervention on the part of the nurses. Some even resolve themselves without the oxygen mask. This is good news and is one very strong indicator that we are dealing with damage and not structural abnormality.
The cardiologists performed an echocardiogram where they learned that Parker has a blood vessel that is in an unusual place (for those interested in medical terminology: aberrant subclavian artery). They described the vessel positioning as a variant of normal because it is believed that nearly 1 in 200 people have this kind of artery. In most people, the artery is asymptomatic. In Parker’s case, the artery slightly compresses his esophagus. This is not likely the cause of his episodes but it can be exasperating the situation, in which case surgery may be required to tie off the artery. (Apparently it is not medically necessary.)
So, as of today, we are waiting to hear the cardiologist’s thoughts on whether or not the artery is complicating Parker’s case and if more tests (MRI and CT Scan) are in order to make further assessment. Additionally, he is still fed through the nose tube and will have an upper GI/feeding study on Tuesday to see if it is safe to start trying him on a bottle.
He is more awake and alert each time we visit him and he definitely very aware of and interested in his surroundings! The nurses suggested we bring a mobile for him to look at so he doesn’t get too bored in his little crib.
More updates to come as soon as we get more details!
Ian, Suzanne, Berkeley & Griffin


And this last one is from my mom to her circle of family and friends:

Date: Monday, November 27, 2006, 8:25 AM
Hi all,
So much happens so fast! Last I wrote Parker had begun to develop signs of oxygen deprivation in his intestines. They believed they caught it very soon, and indeed they did. He was off his feeds for seven days and on three antibiotics. The condition did reverse itself and my understanding is that today they will begin to slowly reintroduce his formula along with the antibiotics and then take him off the antibiotics.
Last Friday they took him to surgery to do a rigid bronchoscopy. Apparently that is the gold standard for determining what is going on in the neck/throat region of the body. It came as no surprise that they simply could find no cause for the paralyzed vocal chords. All the research we have read is that in many, many cases they simply are not able to pin point a cause. The cause is idiopathic. The research also says that for no known reason this condition can just reverses itself, sometimes in weeks, sometimes in months or years, and sadly, sometimes never. I am praying for weeks!
What did surprise us was the doctor did not put in the trach at that time. He felt if he held off for one to three more weeks that hopefully Parker would be one that would begin to show signs of recovery and maybe the trach could be avoided all together. As it turns out, Parker apparently had a rather severe episode Saturday night along with some bradycardia (slowing heart rate) and they called Suzanne and Ian to say they were going to intubate him and put him on a ventilator, and now he is back on the fast track to get him into the OR again to do the trach for sure.
Suzanne has been the picture of grace under pressure, but this has put her in tears. She still has tremendous confidence in all that is happening, but as she said, to see her little Parker with his hands tied so he doesn’t pull out his vent, his head shaved for the IV, and not to be able to hold him is breaking her heart. Please keep praying for everyone involved in this entire picture!
Thankfully, Ian’s sister is there right now and will be there through yet another surgery. I am going back up next week.
Hope everyone had a wonderful Thanksgiving and long weekend…..Chris

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