Sunday, October 15, 2006

Eliza update 10/13


Dear family and friends,

There is not much to report as far as medical news goes; the primary purpose of this email is to pass along the attached photo of now-three-year-old Luke holding eight-and-a-half-month-old Eliza ("his favorite sister," he told me yesterday, as he composed a song for her on his keyboard about Tyrannosaurus Rex). He can elicit a smile from Eliza with a kiss on the head almost any time he tries.

As for what's new with Eliza, there's not much. As of this coming Tuesday, she will be completely weaned from all anticonvulsants without any sign of increasing discomfort on her part. This means that as of Tuesday, Eliza will only be on four medications: two for reflux, one for breathing, and one for sedation. What a change from the dozen she was on when she came home six months ago! It feels like a small victory to have finally reached this point.

We'd particularly appreciate your prayers for us as we struggle with what often feels like treading water: we know we're not making any real progress in the sense of Eliza "getting better," and we also daily must face the reality that we have no idea how much longer she
will be with us. As is often the case in so many circumstances, the waiting is the hardest part.
Scripture reminds us to trust that God's timing is perfect ("Be still before the Lord and wait patiently for him" Ps 37:7), and we appreciate your prayers as we struggle with this each day, even as we treasure the moments we have with Eliza.

Love,
us

Thursday, September 21, 2006

Eliza update 9/21

Dear family and friends,

Many apologies for being so delinquent in keeping you up to date with Eliza; things have been busy as Sam has started back to school, and it hasn't felt like there has been much to report. As I look back, though, on our last updates, I suppose there have been some significant changes worth sharing.

First of all, Sam's younger sister (and one of Eliza's godparents) Sylvia is now living with us to help care for Eliza. This has been a huge blessing, particularly to Luke and me, who have benefitted greatly from having someone to stay home with Eliza while we enjoy our usual outings to the park, to the museum, even just to the grocery store. Eliza, too, has benefitted from having another adult who loves her in the house: she is held more, and Sam and I are able to spend more quality time with her now that we're afforded small regular breaks from her care.

In addition, as we mentioned considering in our last email, we have made some changes to Eliza's medical care. Having long accepted that Eliza will not be cured in this life, we have made the gradual transition from agressive medical care to, as our hospice organization referred to it, "agressive comfort care." What this means is that we have carefully considered all of the medical treatments Eliza is receiving and have eliminated or decreased those of dubious worth that do not provide her any comfort. For example, during Eliza's waking hours, she is no longer connected to oxygen and oxygen/heart rate monitor. There have been no apparent negative consequences to this change and significant positive ones: "Eliza unplugged," as Sam has called her, is now able to be carried around the house, taken for walks with significantly less hassle, and held without restrictions due to the positioning of cords and tubes. Similarly, we have weaned or discontinued other medications and treatments with no apparent ill effects and much benefit to Eliza. From day one, we have made all our decisions prayerfully considering what is best for Eliza, and for the first time in a long time, we feel like we're finally acheiving that aim.

As for Eliza herself, it occurs to me that she is quite a different baby than she was when we last reported to you. Eliza does not--in fact, is apparently unable to--cry at all. In fact, it has been months since Eliza has cried even once. This change is not due to an increase in medical sedation; her doses of clonazepam (her sedative) have not been changed in a very long time. We can only attribute this change, then, to a continued worsening of her condition, which is also evidenced by an increase in her seizure activity. On average, I'd estimate that Eliza has four seizures an hour, lasting several minutes each. Some hours she has many more; others, particularly when she's sleeping, she may have fewer. The severity of her seizures has also increased. Seizures require a tremendous amount of energy, so Eliza appears exhausted most of the time, the curse of which is that the process of falling asleep and indeed even the state of being tired makes the brain more vulnerable to seizures. It seems a vicious cycle that we cannot break, and it can be heart-wrenching to watch, knowing that there is simply nothing we can do to help. As hard as they can to be watch, though, the doctors assure us that Eliza does not experience any pain or discomfort during the seizures.

Being so tired, then, as well as very sensitive to stimulation, Eliza spends a fair amount of time away from noise and activity. She rarely wakes up in the morning before 10, often as late as 11 or 11:30, and she is generally back upstairs in bed for a nap and a quiet evening/night by 4pm. During her time downstairs, Eliza is sometimes held (which she now clearly enjoys), at other times receives physical therapy or sits quietly in her cradle swing. It is not uncommon for her to snooze during those hours as well. As for feeding, Eliza is still hooked to her feeding pump from 4pm to 10am and still receives a special formula called Pregestimil, as this system is what she seems to tolerate best. Eliza does occasionally fuss a small amount, often in response to a simple discomfort such as hiccoughs or a dirty diaper, but never complains more than a little bit.

On the other hand, Eliza does smile daily now. Most, if not all (and this is the subject of constant debate), of her smiles are connected to seizures, but we have made the decision to take even these "smiling seizures" at face value (no pun intended) and just enjoy how cute Eliza really is. I have attached a photo that a friend who is a professional photographer took of Eliza about six weeks ago; if you'd like to see the rest of the wonderful pictures she took of our family, go to: http://www.pictage.com. The event title is Baby Eliza Jackson.

As for the rest of us, not much has changed. Sam is adjusting to being back at school, teaching and coaching soccer, and Luke and I are redeveloping a routine of playgroups and morning outings. Luke occasionally makes statements like, "I've never been to heaven; where is it?," or, "Soon Eliza will go to be with God," or, "Eliza had a few seizures today," but seems fully his happy-go-lucky chatterbox almost-three-year-old self as usual. We've begun teaching him to read, and he thoroughly enjoys card games like "Go Fish" and "Old Maid" ad infinitum. He's itching to get out on the soccer field with the boys on Sam's team, and has a pretty mean kick himself. He doesn't mind a few daily somersaults and loves to swim, too, both of which placate the diver in me. He has adjusted remarkably easily (as have we all, I might add) to having "Auntie Sylvia" here, and often remembers to thank her for staying home with Eliza so that we can go out to play. Auntie Sylvia considers it a small victory that she has discovered a candy that Luke actually enjoys--he's not big on sweets (or vegetables, fruit, meat...)--so we're all getting along just fine.

If you believe, then what utter insanity it is to question the Master Builder. With Jesus as the cornerstone, He is building us up into a glorious structure. If we live by things that are seen, it is hard to accept Eliza's condition. If we live by what is unseen, then we understand she is another of these personally crafted building blocks--a living stone, as Peter puts it. And what a precious and strong stone she is! Eliza, consecrated to God, beloved by him. All hail King Jesus, may His kindgom never cease.

Love,
us

Tuesday, August 15, 2006

Eliza update 8/15



Dear family and friends,

Thank you to so many of you who have responded to our
email from last night. We're grateful for your prayers. Just a quick note of clarification: we are not considering "terminating life support" as in so many cases we hear about in the news. What we are faced with deciding is whether to continue a range of medications, some of which, all along, we and the doctors have agreed may not be doing her any good at all. Discontinuing medications would, nonetheless, constitute a significant change in her course of care.

We shared with you many months ago, for example, that we have questioned the usefulness of anti-convulsants in Eliza's case, since no combination of these drugs has ever managed to stop her seizures for a significant period of time. We have reached a point, then, at which the doctors agree that one option among many is to begin weaning these and other medications. We are not at the point of considering withdrawing nutrition or hydration, which, unlike some of the medications, clearly are enabling Eliza to live
comfortably.

We appreciate your sensitivity to the deeply personal and private nature of these decisions.

"Praise be to the God and Father of our Lord Jesus
Christ, the Father of compassion and the God of all
comfort, who comforts us in all our troubles."
2 Corinthians 1:3-4a

Love,
dixiejax

Monday, August 14, 2006

Eliza update 8/14

Dear family and friends,

A short update after a full couple of days:

On Sunday, Eliza was baptized. The celebration
couldn't have been better: Eliza slept peacefully
through the entire thing (water and all!), we were
surrounded by so many family and friends who have
loved and cared for Eliza and our family over the past
six months, and the service was a beautiful
celebration of God's promises and grace concerning His
children, and in particular, His child, Eliza. We
hosted eighty-five people at our house following the
service, which, those of you who have been at our
house will know, is quite a few for our small space!
But God provided even in this detail a beautiful day,
so we were able to use the backyard and welcome so
many of Eliza's faithful friends. We'll send out
photos just as soon as we get them organized.

Then this afternoon, we met with Eliza's pediatrician,
neonatologist, and social worker to discuss Eliza's
future. Rather than go into a lot of detail at this
point, when we haven't yet had a chance ourselves to
process what was discussed, we have a simple request:
please pray for us as we begin to face some difficult
decisions about how to continue with Eliza's care. We
have reached the point that we have long known was
coming, when we must decide whether to continue with
medications and life support, and to what degree. We
covet your prayers for wisdom and comfort as we begin
this discussion.

Oh God, You are my God, and I will ever praise You.

With love,
dixiejax

Monday, August 07, 2006

Eliza's baptism

Dear family and friends,

Eliza will be baptized this Sunday, August 13, and we would love for you to join us. We will be hosting an open house following the service. If you would like to come celebrate with us, please email us at shdbjackson@yahoo.com and we'll give you the details.

Love,
dixiejax

Monday, July 31, 2006

Eliza update 7/28



Dear friends and family,

Boy, where did we leave off? Many of you have stayed
informed through the phoneline or the grapevine; many
more have no doubt wondered when the next email would
bring you up to speed. We are thankful for those who
have inquired out of love and for those who have
abstained, again out of love. Thank you, also, for
continuing in the mysterious and essential work of
prayer.

Eliza will be six months old on Saturday. She has
grown to exceed 15 pounds, and her height has
increased as well. Other than these physical
dimensions, Eliza shows no signs of development.
Mercifully, she does enjoy being held now--and
sometimes cannot be calmed otherwise (a mixed
blessing). With the help of a 3x/day dose of a
sedative, in addition to spending the bulk of her day
removed from all stimulation, Eliza does not have the
prolonged screaming fits she once had. Even when Luke
more-or-less gently shakes his little sister's leg
(before the powers-that-be admonish), she bears it
patiently. Perhaps it's the southern belle in her.
In general, caring for Eliza does not present
excessive physical challenges, once you get used to
it.

On the other hand, caring for Eliza does continue to
present significant emotional challenges. Anyone who
has cared for a newborn will attest to the fact that
the first month is intensely trying: here is a being
who demands all your energy, deprives you of sleep,
and gives nothing in return. Having cared for a
newborn before, I know that to survive the first month
one must keep in mind that "this too shall pass," this
baby will learn to smile, giggle, coo...and will,
before you know it, grow into someone whose company is
truly enjoyable. Eliza, on the other hand, has been
functionally a newborn (though less responsive and
with less recognition of Mom and Dad even than that)
for six months now. Six months of giving all you have
without even a smile and no expectation that this will
change--physically difficult, no, but emotionally
quite a load to carry. Add to this the cabin fever
produced by parenting a baby who is not only difficult
to take out but who makes it very clear that she
cannot handle the stimulation of going out and you can
begin to imagine the state we're in.

On the medical front, Eliza continues to have
seizures, averaging 2-3/hour, depending on the hour,
despite three anti-seizure meds: phenobarbitol,
keppra, and her sedative, clonazepam. Eliza receives
1/8 liter/minute of oxygen through her cannula. We
sometimes increase this to 1/4; other times she can
get by without a cannula at all, as you may have
noticed in pictures (link at the end of this email to
photo album--updated photos to come soon).
Eliminating the oxygen entirely would require
decreasing the sedative. We tried this once and
suffice it to say that we won't be trying it again
soon. Eliza is fed through the tube in her stomach 18
hours/day; we do not plan to resume any attempts at
feeding by mouth. She still vomits occasionally,
usually following a seizure. Her difficulty in
clearing her airway makes these occasions rather
dramatic at times. She still receives physical
therapy twice a week at our house, though we have
discontinued speech/feeding therapy and, as of today,
occupational therapy, neither of which seemed any
longer to be beneficial.

As I gazed into the beauty of a Carolina summer sky
this afternoon, wisps of clouds floating above, I
sought God's face. He directed me to lower my eyes to
see him aright. There are times to ponder the majesty
of creation and its Creator. Today, the Spirit
testified to my spirit about the marvelous lowliness
of the Son: "...one who in every respect has been
tempted as we are, yet without sin." God knows this
struggle first-hand ("every respect"!). We are
fighting an excruciatingly unique battle, but it is
not beyond the scope of what Jesus Christ faced and
overcame. "Let us then with confidence draw near to
the throne of grace, that we may receive mercy and
find grace to help in time of need."

We confess a temptation to hate Eliza, and to curse
the God who has the power to end all suffering yet
delays. We receive mercy. We desire to love Eliza,
and to praise the God who works all things for good
for those who are called according to his purpose. We
find grace to help us.

We pray that you may know the hope we have in Jesus.
In his name alone, we stand before the Creator of all
and receive immeasurably more than what we ask or
imagine, in this life and the life to come.

Love,
dixie jax

P.S. Luke continues to enjoy thoroughly his summer,
having just today spent hours slipping and sliding
down a 98-foot waterslide (with mom along for every
ride, of course). He appears satisfied with the
explanation that Eliza's "brain doesn't work," and
with the assurance that, when she goes away to God,
she will get a "good brain."

Monday, July 03, 2006

Eliza update 7/3

Feeling mostly exhausted and uninspired tonight, but
wanted to share the news: the results of Eliza's
latest muscle biopsy show that it's unlikely she has a
mitochondrial disorder, and if she does, it's a very
mild one that would not cause seizures or her other
symptoms. This is good news all around, as she'll now
take two fewer medications; also, it means her
disorder may not be inherited.

Love,
us