A Precious Request

Tuesdays have become the highlight of my week, with Maria's morning visits to look forward to. Usually, she works on me first while Abbie is eating, but this week I had to be at an orientation for the twins' new school at 11, and didn't really want to embarrass them right out of the gate by going down with crazy hair, sticking up and coated with massage oil. So, instead I got to spend over an hour at the kitchen table with her, picking her brain about everything we never have time to talk about.

We had a brand-new nurse on Tuesday, who turned out to be wonderful, but Abbie didn't know that at the start of the day. I left her working with Maria, and by the time I got home, Maria was gone. The nurse was very impressed both by Maria, and what Abbie had done with her, but it would be evening before I got the whole scoop.

Maria called and said, "The most amazing thing happened today, as I was getting ready to leave, Abbie spoke the words, 'Don't Go'!" I was so surprised and asked the nurse, 'Did you hear that?' She said it did sound like words. I think it even surprised Abbie, to have the words actually come out. So, of course I couldn't leave then. I put my bags down and talked to her until she went to sleep. There was little teddy bear on her bed, so I put him on her chest and talked to her about taking care of him, and getting him to sleep because he needed his rest."

I was giggling at this point, for many reasons. So happy for Abbie that she could voice the cry of her heart. So overwhelmed by Maria's compassion. So amazed at the way Abbie can communicate with me, even without words. You see, after she woke up from her normal post-Maria marathon nap, I sensed she wanted the bear. Mr. Bear ended up going to the baseball game with us, and did not leave Abbie's side all night. Now I understood why. She is taking care of him, and he is taking care of her.

Mr. Bear went to Matthew's concert tonight, and is tucked in right next to her now. Even barely awake, she smiled when I laid him on her chest to give her hugs. It makes me happy that she has a special little friend to help her through scary times, like being left, and share happy times like games and concerts.

Maria also shared with me that Abbie made terrific progress with moving specific limbs on command, as in "raise your right arm." When she told me Abbie lifted her arm, I envisioned the small-amplitude lifts she does, mostly to indicate she understands what she is being asked to do. Oh, no. Maria quickly corrected my thinking by telling me she was lifting her arm up to her head. She needed to hold on to Maria's finger to help with the weight, but she did it! At the end of the session, Maria supported Abbie so she could stand with flat feet on the floor. Flat feet is a huge accomplishment for Abbie, as it signals an almost complete recovery of the ankle injuries of last summer!

As I imagine it now, I can hear Abbie's voice, reaching out for Maria, pleading not to be left with a kind stranger. The music of heaven.

Abbie's Outfitters

Aloha! I am typing this at 1:45am for a couple of reasons, neither of which involve Abbie's health. The twins are having a sleep-over birthday party to celebrate turning 11 on May 6th. Our Party Papa is overseeing 12 boys while I tend to one little girl...hardly seems fair! We didn't have nursing this evening, and for some reason Abbie picked tonight to need oxygen, which is rare for her lately. So, we've been camped out in one end of the house while the revelers occupy the other. It has been amazingly quiet so far, but I'm sure the boys will be up with the sun.

The second reason I am posting so late (or early, depending on how you look at it) is that I've finally completed a long-procrastinated task, and I want to share it with you. I find myself recommending so many different books and other products that I've long thought it would be convenient to consolidate them in one place.

Voila! I would like to introduce you to "Abbie's Outfitters", our new online Amazon store.

Abbie's Outfitters

I've selected the books, CDs, and products that have been the most beneficial during our journey. I hope that you enjoy browsing, and find the store useful.

For brain-injury families I do want to point you to some things listed under "helpful products." There are three items there that Maria Margarita has introduced us to: Traumeel, Zeel, and Lymphomyosot. I had never heard of these before working with her, and they have been very helpful. I was glad to find out I could offer them through Amazon.

Abbie has had her ups and downs lately. She and I are really enjoying getting out in the yard in the morning to bounce and stretch on a ball while soaking in the sun. But, it appears that we are back to having a rough time between 3pm and 7pm each evening. We think it may be an after-effect of the MRI and DTI test last week, since they most definitely had an effect on her brain. For the first time in ages I slept to the sound of the concentrator last night. She only needed half a liter, but the machine isn't quieter just because she needs a low flow! When I got up this morning I remembered why I used to always feel so exhausted. The sound that seems like a whisper in daylight, beomes a freight train in the dark.

I want to wish a Happy Mother's Day to all the incredible mothers I know, especially my own. May your day be blessed with the realization of your impact and influence on those you love.

Not a Single Tear

Just time for a quick update, but I did want to share that Saturday, May 3rd was a wonderful day for our family. There was a moment when I was sitting at RJ's baseball game, in the sun, where I could feel it....I knew I was being prayed for. We were able to rejoice in the fact that we have our Abbie, and that she is doing so very well. Thank you all for your thoughts and prayers on that day, but even more importantly, on all of the days of the last four years. We wouldn't have made this climb without you, and the fact of the matter is Miss Abigail Faith Vara would not be alive save for the power of your prayers.

Lots of good things this week, including the final report for this semester of speech therapy (first time yet that I"ve heard multiple times '100% success rate' on numerous goals!) And, much good work with Maria this week to get Abbie's brain calmed down after the MRI and DTI tests last week.

We are very blessed, and you are one of the most tangible proofs of that!

Answered Prayers, and Another Request

A big "Mahalo" to all of you who prayed for Abbie regarding the brain scans we did this morning! It was quite an experience. As I posted earlier, I had been warned that the DTI test was loud. Wow! Jackhammers on a sidewalk would have been crickets chirping compared to that test! Abbie had earplugs in and earphones on over her ears. I think it was the microphone attached to the earphones that really completed the "Abbie as a Cosmonaut" look. She was also outfitted with a set of goggles that allowed her to watch "Lilo and Stitch" during the tests. With all of that on her head, she was then slid into a little basket that held her head still and straight. Not the most pleasant position for a nap.

I had kept her awake all morning, minus a 10 minute catnap, so that she might be too tired to fidget. As I alluded to above, fatigue couldn't have a made a sloth hold still on that table! Our dear Maria went with us, so she and I both donned earplugs as well, and each took one of Abbie's hands and feet in our hands. The noise and vibration were hard on both of us, so I can't imagine what little Abbie went through as she actually lay in the middle of the doughnut. There were times she cried, so I worried about how the images were going to come out. I should have known that with two women holding on to her and praying the entire time, all would be well.

It was more than well, it was GREAT. The radiologist told Ray with a smile, as the DTI and MRI were completed, "Those were just two very complex scans that went very well...now they are going to think we can do this all the time!" The DTI images were just raw data and have to be processed through the computer to give us usable, readable images. BUT, Dr. L. did show us one of the raw images, which was a transverse slice of Abbie's brain (horizontal). The DTI uses colors to indicate direction of connection: green is for front to back communication, while red and blue indicate left to right (and vice versa) communication. I have to say, while this was just one raw image, we saw lots of dots of every color....hurrah!! Abbie's brain is communicating in every direction (my analysis, not the radiologist's) We don't expect her pictures to come back looking like that mohawk DTI image I posted, but there WILL be some wires tying parts of her brain to each other.

Then, the technicians handed us a huge envelope with all of the MRI images...we got to take them home! Maria and I could hardly contain our glee, and hurried home for what seemed like Christmas on May Day. Of course, we don't have a lightbox at the house, so we taped up images all across our sliding glass doors. We got out the films from Abbie's first (and only ) MRI, done three days after her injury so that we could compare them to the new ones.



Several things jumped out as we spent an hour or so with the images. In no particular order:

1. Looking at her first MRI, I could see that the medulla (brainstem) was bent rather than straight, forced to the rear by the pressure of the swelling in the front of Abbie's brain. Knowing what I know now it struck me very hard that we came very, very close to losing her...in fact, looking at those first images, I cannot believe she survived that injury.

2. Her new images are nowhere near normal, but that's not what we were looking for. Her ventricles are enlarged, holding more fluid to make up for the tissue loss as her brain has atrophied. She does not have the same amount of tissue mass that a normal brain does, however, she definitely has grey and white matter, and especially in the upper portions of her brain, the contours are curving and folding.

3. Her cerebellum is smaller, but two important things have happened. One is that a huge gap between the two halves has reduced and is beginning to fill in. The other is that the cerebellum was pushed up out of its normal position by the swelling in the back of Abbie's brain. This left a big gap between Abbie's brain and her skull, where the cerebellum was supposed to be. Her cerebellum (which has a lot to do with motor control) is now back in it's proper place, and the spacing is much more appropriate.

Overall, the appearance of the tissue in Abbie's brain is much, much nicer. Instead of a big bowl of undifferentiated grey mush, it now is very differentiated by color (light and dark) and by contour.



Given all this, it still was not an easy day. Halfway through looking at the images I recognized the irony in the fact that we had taped them to the door I'd run through to give her CPR, and if we looked past the images the pool filled our vision. Maria was a godsend, and once she realized I was slipping down the slope, she intensified her efforts to point out improvements.

Ray and the boys enjoy watching a show called "The Biggest Loser", a weight loss challenge. It always amazes me, at the end of the season, to see the "new" person stand next to his or her "before" photo. I drove home from the imaging office today with that thought in my mind -- these are Abbie's "before" pictures. One day she will stand next to those images and we won't be able to believe that they once belonged to her.

I must give my deepest, most heartfelt thanks (which still seems woefully inadequate) to the entire staff at InVision Imaging. They gave us a profound gift today, with such warmth and caring that I am still at a loss for words.

Abbie also continues to show us each day that she is working hard to get better. Today, Carol came to give Abbie Healing Touch, and was working with her while I cleaned house. I came in to check on them, and Carol exclaimed, "Did you know she can lift her arm all the way over her head???" Why, yes I did, I told her...as of last week that is in Abbie's repertoire.

She went to RJ's baseball game with me tonight and was so attentive. Not only to the game, but to the busses passing behind her and people talking around her. Now she can evidence this attention with movement, which engages everyone around her.

So, it has been quite a day, but I want to wrap this up by asking for fervent prayers for Abbie's buddy Caleb. If you've not clicked on his link in a few days, he could really use your support. He came to our house on Tuesday to use the HBOT chamber and Tesla lights. But, he had a little runny nose, so we skipped the chamber for that day. His mom called the next day, to set up a time come over, I thought. Wrong. She was calling to tell me that she'd had to begin bagging Caleb early that morning because his oxygen sats had dropped so low. They went by ambulance to the hospital where he was admitted to the ICU, sedated and ventilated. I saw him last night, and he looked great, but was still knocked out from all the drugs. It seems that the origin of the problem wasn't respiratory per se, but rather a wave of seizures. I spoke to Kehau this morning and it sounds like his neurologist thinks the seizures were brought on by a quickly spiking fever. This would be good news since that is a transient problem that even happens in kids without brain injuries. I'll be seeing them tomorrow, and will tell them that all of Abbie's Angels are praying for Caleb to bounce back.

We've never had to go back to the PICU or call an ambulance to the house, so I can only imagine the emotional toll this event has taken on Kehau and Brandon, please pray for them as well. They are a blessing to me, as I see God's grace illuminate their way through challenges, reminding me always that we have the same Father, same Hope, same promises....what comfort, what joy.

Need Your Prayers!

After all these years of asking for prayers to help Abbie move her body, I am coming to you tonight to ask you to join us in praying that she will hold very, very still. On Thursday morning we are going to do the brain imaging, and we are going to do it without sedating her.

I had a nice conversation with the radiologist this afternoon, who started by saying, "I see you've been doing some reading..a LOT of reading!" I guess it's a little wierd for a mom to be asking about a brain imaging technique that they are not yet using as a clinical tool, it is limited to research at this point. I suppose that is my reward for reading "Scientific American" instead of "People" on the airplane.

The doctor said the Diffusion Tensor Imaging (DTI) will take about 8 minutes, and that it is very, very loud. This shoots down Plan A, which was to wear Abbie out and hope she slept through it. We are also hoping to do a follow-on MRI, which would take another 25 minutes or so. I am fervently praying we can accomplish this so that we can get some good, clear images.

"I'm not sure what we'll do with these images at this point," was one comment the doctor made. I didn't voice my ultimate goal. To me, these are a marker, a beginning point. I am hoping that a year or two down the road we can do another set, and that they will give radiological proof that a brain can regenerate, even many years after injury. I pray, pray, pray that one day Abbie's story will be in Scientific American in the midst of an article about "New Views on Brain Injury Recovery." Wouldn't that be awesome?

She continues to show us every day, without pictures, that her brain is indeed healing. Late last week Genevieve and I were working with her on the massage table. If we would hold her wrists to help support the weight of her arms, she would raise them all the way over her head by herself. She was grinning, while we were in tears. This new move speaks to improvements in her tone, range of motion, independent movement, and trust in her body.

The vog has been keeping us indoors more lately. (For folks not in Hawaii, that's not a typo, "vog" looks like fog, or actually smog, and is produced by the Kilauea volcano on the Big Island, which has been very active lately). When it got really bad late last week, it made Abbie sick for a couple of days. That's another prayer request...pray for those tradewinds to blow!

We are creeping up to May 3rd yet again. And, yet again I am approaching it the same way I always have, as if the day is going to slip by and it won't seem different from any other day. It hasn't really worked out that way in the past, but I am hoping, given how things are going, that this will be the year of victory over grief on that day.

I wrote to my dear friend Sue (Luke's mom) tonight that we are approaching our "graduation day." We have just about completed our four years of undergraduate work in independent studies, with a focus on nursing, physical/occupation/speech therapy, anatomy, physiology, and integrative medicine...with a minor in stubborn faith and irrational hope. I have noticed that the upper level classes of the past year or so have been more challenging, and the book work and research is certainly more intense...but, I also feel the gratification of having overcome, having persevered, and having grown immensely. Not for free, no scholarships granted, and I certainly didn't apply for this program, but an education for which I am profoundly thankful.

Bless you all for going on this ride with us....here's to exciting days ahead! To God be the glory!!

Before You Call, I Will Answer

This weekend was a huge treat for our family. Ray's company had a retreat for their board members, physician leaders and managment leaders at Ihilani, a beautiful resort on the leeward coast.

My highest hopes were for two consecutive nights of sleep in a bed! (Usually I sleep on a futon on the floor next to Abbie's bed.) Well, I did enjoy the comfy king bed, lots of pillows, and QUIET. But, God had much, MUCH more in store for me.

Last month, while flying to Chicago, I read an article about a new brain imaging technique called Diffusion Tensor Imaging (DTI). The unique thing about DTI is that it produces images of the white matter of the brain, which have never been available before. In reading the article I was sure that only top-flight research centers would have this technology.

I did not know that Ray's company has a joint venture with an imaging company, whose owner was at the retreat to give some presentations. I missed those, but was fortunate to run into him at the pool. I asked him if he'd heard of DTI, and if anyone in Hawaii was doing it. He grinned and said, "We just started using it for a large study that the University is doing. Call me next week and we'll run Abbie through."

Just like that.

All I'd wanted to know is if anyone had it, and now we are going to be able to do it very soon with Abbie! We will be able to see exactly where her areas of injury are in the white matter, but even more intriguing to me, DTI can perform "tractography" within white matter, which means it can follow one fiber its entire length. This will let us see which parts of Abbie's brain are connected. The picture below is a tractographic study.



Also attending the conference was a pediatric neurologist I've heard great things about. I felt as if I were stalking him the entire weekend, but finally got a few minutes to talk with him today. In that brief time he introducing an entirely new idea about Abbie.

He's found that with the CP kids he treats, often, putting them on anti-spasticity drugs reveals an additional challenge they are facing, dystonia. He defined this as when both oppositional muscles fire at the same time, instead of one contracting and one loosening to let the body move. So, instead of fluid movement produced by teamwork, the body is locked as the muscles fight each other. I had never, ever considered that Abbie may be dealing this. He said there are medications that are effective in helping this, so more time at PubMed is in my immediate future. (For my fellow Brain Geeks, the drug he likes is an anticholinergic called Artane.)

When speaking to the group today, Ray said that the weekend was successful if we all laughed a little, cried a little, and learned a little. Watching a DVD of a little boy laughing after his cochlear implants were turned on for the first time brought tears and laughter simultaneously. A widow sharing the story of her critically-ill husband wanting to die in the sunshine, and the staff finding a way to allow that to happen reminded me that our most profound legacies may come through what initially looks like defeat. The hospital is now designing a healing garden in his honor, that will allow so many more patients to feel the sun on their skin when they need it the most.

On Friday I was excited to spend time with my husband, getting a glimpse of his world. On Sunday I am typing this overwhelmed at the veracity of God's Word and His faithfulness to it. With so many things lately, we are receiving more than we ever could have thought or known to pray for.



"Before they call, I will answer, while they are still speaking, I will hear." -- Isaiah 65:24

New Feats

We are having fun now, watching Abbie do new things quite often...things that in many cases we have been waiting years to see.
Last week I was talking with Abbie, and she began talking right back to me. Not so unusual, but pretty soon I realized she was trying to say the same things I was. So, I began practicing with her. I would say a word a couple of times and then say "your turn". Pretty soon Abbie would attempt to say the word. The articulation wasn't clear, but her intent sure was. When I would correct her on the syllables in each word, as in "there are two syllables in 'hungry'", she would answer back with two syllables.

The other day I had her on her tummy on the massage table. She had held her chest and head up for quite a while, after I placed her in that position. Then, she slid her arms out to the side in very controlled manner so she could lay her head down. I was happy with that, but what happened next made me literally jump for joy. She pulled her arms back in and raised her head and chest off the table by herself. Her neurodevelopmentalist told us in March that Abbie would be doing this soon, but it still really surprised me.

Abbie has been working very hard with Maria Margarita. Yesterday, Maria had Abbie doing full circles with her shoulder while lying on her tummy...I could not believe how loose her arms were! Maria also solved an issue that has been bugging me for a while now. On the inside of Abbie's knees there are sharp protrusions, we call them her "pokies". Maria determined that one of her leg bones (I believe the femur) was slightly out of place. She worked a while,and...voila...bone back in place and no more pokie!

Speaking of pokies, Abbie had to have a some blood drawn on Monday. I coached her through the whole thing, and she remained calm and brave, but when the needle was inserted she flinched and tried to pull her arm away -- a totally normal reaction. This may seem like a small detail, but to a mom who's watched blood drawn with minimal reaction, this was exciting!

She has been doing very well with standing in PT -- each week her therapist is amazed at the progress in her ankles. The left ankle, which was injured twice last summer, had built up a lot of scar tissue as a result, limiting her range on that side. In the past couple of weeks that scar tissue has started to break up, and the flexibilty is returning!

While I am having a grand time being a spectator to all this, Abbie is really going through a lot. Please pray for her comfort. The days right after she works with Maria can be challenging as her body detoxs and adjusts to the work done. Yesterday, after working with all her joints, Maria said, "There is absolutely no reason this little girl cannot use her body..all the joints are fine. Her body is just like a house that hasn't been lived in for a very long time, we have to get the cobwebs and dust out and then she'll be fine." Housework isn't normally my joy (ask Ray), but in this case, it's the most anticipated undertaking I can imagine!

One last quick note, I've just begun researching a new medication for Abbie, which has been shown to dramatically help spasticity, as well as drooling, without being sedating. It's a fairly new drug, and these uses are off-label, so I would really appreciate corresponding with anyone who's had any experience with Provigil (modafinil).

My dad just arrived today to spend a week with us, so we are looking forward to lots of cribbage, dice games, and catching up. I pray that you have a terrific week! Oh, one more thing...please notice that there is a new link on the left side of the screen for a little boy named Aidan. He nearly-drowned on 2/16, and will be going home for the first time tomorrow! If you have a moment, would you send his family a note of encouragement as they enter this huge transition? Thank you!

Eternal Easter

I have been waiting to download the Easter pictures before writing an update. Sorry it took so long! As you can see above, we made sure we got in the face painting line early this year, to avoid a Meany Clown vs. SuperDad rematch. Abbie was quite pleased with her butterflies (the other cheek was painted to match.) However, I wasn't able to snap a picture of all the kids before the boys visited the clown as well, hence I share with you our lovely Family Easter photo, 2008. Nothing like a couple of Spiderman faces to proclaim "He Is Risen!!!', right?



Easter was a beautiful day for all of us. Abbie is in such new place as of late, that all the sting of this particularly poignant holiday was taken away this year. I was not holding my breath at all that day, which is unusual. On other Easters I've had to pray for each and every breath to be given, as my strength would fade and despair would rush in. God provided everything this day, right down to Abbie's hair accessory. We were running a bit late for church, since we took the unusual step (for us) of attending the early service. A bit ambitious, but necessary to make it to brunch. Abbie ending up rolling out of the house with just a purple elastic band in her hair -- certainly not up to her standards!! Oh well, I thought...all that matters is that we are going to church. We'd been seated less than five minutes when a member of the hula and sign worship team walked up behind Abbie with an ornate flower arrangement for her hair. Each of the dancers was wearing one, and they had one extra....which they gently pinned in Abbie's hair. Well, my, my...who was the princess now?



At the end of the service, as Pastor was closing his message, Abbie became quite animated. So, she and I carried on a covert conversation, with me whispering and her squeezing my hand. I'd had to disconnect her switch earlier in the service when "Happy Easter" rang out over and over as Pastor began speaking. I was almost certain I understood what she meant, and my heart nearly burst. But, I waited until we were home to confirm it.

As I laid her on the couch I said, "Do you think we should tell Daddy what we were talking about in church." Big grin. "Do you think we should tell Daddy that you asked Jesus into your heart today?" Her body about jumped off the couch.

Tears came as I knew the confirmation was concrete. You see, Abbie became "talkative" in church as the pastor shared the story of salvation: how each of us are created in God's image, beloved by Him, made to have a relationship with Him; but then through our errors and mistakes are separated from Him. Christ laid down His life so that our sins could be forgiven and we could once again have a relationship with God. Abbie was enthralled, and clearly understood what was being said. When the pastor invited any who were willing to accept Christ's free gift of grace, Abbie kicked her legs and squeezed my hand yet again.

Earlier in the week a friend had emailed that she would be praying for "an Easter miracle for Abbie and your family, for a new beginning." You know what I was praying for that new beginning to be, but God had something much bigger in mind. Luke 5:23 says, "Which is easier, to say, 'Your sins have been forgiven you,' or to say, 'Rise and walk?'" God accomplished the impossible for Abbie on Easter, the salvation which makes rising and walking look like a speck of dust.

I suppose because unlike almost all of the rest of us, she has glimpsed Heaven, I somehow thought the eternal transaction had been made there. But, on Easter the Lord showed me that perhaps one reason He gave Abbie back to us is so that she could say "Yes" to Him of her own free will.

On Easter Sunday, 2008 the name Abigail Faith Vara was written in the Book of Life.

Therapy laughter

A warp-speed trip to Chicago, with a one day stop in Oregon that concluded with a flight cancelled as we sat on the tarmac in Portland is this week's excuse for my tardy update. But, Abbie waits for no one, including her dawdling mother, as she pushes forward on this journey.

This Monday was a big day (and we're not even Irish). We saw Linda Kane, Abbie's neurodevelopmentalist, in the morning. She was very encouraged with Abbie's progress and says she loves seeing Abbie because "it just keeps getting better every time!!" She was particularly impressed with Abbie's emerging reading skills, which I gleefully detailed for her. The motor skills....well, we are in just about the same spot we've been all these years. Somehow, though, all the gains Abbie is making in other areas blunts the blow of her lack of progress in this area. And, truly, I know it is just a matter of time until her body catches up with that brilliant mind of hers.

"Brillliant" may sound like a bit of hyperbole, but allow me to explain. On Monday afternoon we went to speech therapy at UH. Abbie had her "yes" switch in her right hand and her "no" switch in her left. April would show her a ball of Play-doh, and then have her select the correct color from flashcards with the words on them. This week all the words were just printed in black -- no color clues on the cards. Abbie correctly identified white, red, yellow, green and blue without a mistake. Then, we moved on to shapes. April would show Abbie a 3-D shape, and then the word cards. Abbie identified circle, square, triangle and rectangle without a mistake. Finally, April made up a story during which she used picture/word cards from Abbie's reading list. After the story Abbie correctly identified all the words: car, slide, ice cream, mouth, hug -- the first time through! Her reaction times were remarkably faster, and her ability to differentiate when she wanted to use her left hand or right hand to answer was much greater that day. I was stunned that she did not mistake a single word. April asked if we'd been drilling on the words quite a bit, and I sheepishly replied that since I'd been out of town, we hadn't really worked on them for about 10 days or so. I guess that turned out to be a good thing, because it showed that Abbie really knows these words!

The supervising professor for that session was a woman who hadn't seen Abbie in several months. When she came into the therapy room from the observation room after the session neither of us could really talk...only grin and laugh. She was amazed at how much Abbie has changed. Things that used to be the only subject of an entire therapy session, like how to use two switches, are now just a given. And, as I thought about it, I wondered if all 6-year olds can read words like "rectangle" and "triangle". Having taught my sons to read, I know the answer to that one, and it makes me smile that, at least in one precious way, Abbie is moving to the head of her class.

As this Holy Week presses the depth of Christ's agony, sacrifice, and love into my heart I rejoice in knowing that even these "Abbie highlights" are just a glimmer of the good He has planned for each of us, for here, and for ever.

The Call and Some Answers

The difficult thing about so many good things happening, is that I am so busy watching them unfold that I don't have the time to write about them, and then they begin to stack up.  I have a whole pile of wonderful things to catch up tonight.

Dr. Tennant was here last week, and in additional to the new knowledge and insights he always brings, he also brought a couple of new pieces of equipment on this trip.  The first one is called an "EIS" (Electro Interstitial Scan).  You can think of it like an ECG for the whole body, with a set of ECG pads attached to the forehead while hands and feet are set upon special plates.  Both alternating and direct currents are sent through the body during the 4-minute scan,  the resulting information is sent through a mathematical program to reduce "noise" and then a statistical program to determine "specificity" or the likehood that the person has specific issues.

The EIS produces so much intriguing information, some of which we've never been able to assess before.  It displayed a three-D image of the body with all the systems color-coded by voltage level.  Red is very high, yellow is high, grey is normal, light blue is below normal, and dark blue is greatly below normal.  Every part of Abbie's initial scan was deep blue...hard for me to see.  Then, as we looked in detail at the brain I saw two little red horns sticking out deep in the center of her brain.  I asked Dr. Tennant what structure that was, and he said, "The amygdala -- they control emotion.  If her body would allow her to be raging, she would be."  Ouch, hard for me to hear.  We also noted that 3 of 4 neurochemicals were well below normal (serotonin, dopamine and GABA), that her hormones were normal for the most part, and that a few of her minerals were low.  One very interesting piece of information the EIS produces is called a "Davenport Diagram".  Typically, this information can only be gathered from an arterial line.  When the PICU nurses would draw blood gases every 4 hours, it was a Davenport Diagram they were creating.  The diagram tells whether a patient is in metabolic acidosis or alkalosis, or respiratory acidosis or alkalosis.  Abbie was deeply into metabolic acidosis...still.  We know it is because she is still working her way up to the proper dosage of Armour thyroid, and the measurements will get better...but still, tough to see after all the efforts we've made.  It was very interesting to me that the program defined Abbie's primary challenge as hypothyroidism, with a specificity of 83%, which means you can bet that it's true.

I went home that night and I don't know how else to say it...my hope was fatigued.  All logic told me this was just one data point in our journey, but my spirit was tired.  Once again, the story of Peter coming in discouraged and exhausted after a fruitless night of fishing came to mind.  Jesus told him to go back out...to do this one more thing, to try one more time.  It's those words I heard in my weary spirit as I mentally grabbed my well-worn oar in my hand one more time.

Which brings us to the second piece of equipment, called Tesla lights (www.teslaenergylights.com).  A modern piece of equipment based on work done by Tesla and Lahkovsky at the end of the 19th century and in the early 20th century.  It would take me a long time to explain, so if you are more curious, there is lots of information at the website.  Abbie was able to sit in front of these lights beginning on 2/20.  After two sessions, we did another EIS, wanting to see if her voltage has risen significantly from her +53mV starting point (remember we are designed to run at -22mV).  Her voltage hadn't moved much, but one part of her anatomy had changed color -- the frontal lobes of her brain were grey!  This explained why she was grouchier and more frustrated.  Her processing was getting better, but her abilities to express and move were not (yet).

On Sunday, 2/24, after six treatments we did another scan.  Dr. Tennant's nurse, Vickie, put it best when she said of my grinning face glued to the screen, "It looks like you are looking at the first picture of your firstborn child!!"  We had raised her voltage 20 points in 4 days -- she was now at +33mV.  A long way to go, but what progress!!  

My visual brain, however, loved the colorful body I saw on the screen.  Her frontal lobes were yellow!!  The thalamus (important deep brain structure) was grey, as were many other parts of her brain.  All the dark blue was gone save for one spot in one lung.  The pulmonary artery of her heart also showed yellow.  Very interesting to me is that her dopamine level, which had been low, was now normal.  The only new input had been the light treatments.  On this day, Abbie made it very clear that her biggest frustration is her inability to speak -- but that is changing as well.

Since we began the light treatments some very interesting things have happened.  Last Monday we had a very difficult PT assessment session -- the measurements of Abbie's range of motion in her lower extremity joints were all worse now than before we started the Baclofen relaxing medicine in December.  She could not wear orthotics (foot splints), and even diaper changes were sometimes challenging because of high muscle tone.

The next day our dear Maria Margarita came to see us.  I did not tell her about the PT session, but she immediately grabbed Abbie's feet and said, "We must start here!"  She felt that the limitations in Abbie's feet and ankles were not so much neurological or even muscular, but rather because Abbie had a "frozen" bone (talus) in her ankles.  We used copious amounts of castor oil and Arnica gel, but two hours later Abbie had ballerina legs...I could not believe it.  We have kept up the work this week with more castor oil (sometimes she even sleeps with castor oil bandages wound around her legs) and a homeopathic gel called "Traumeel" that really helps the discomfort after the hard work.  Abbie wore her orthotics to church on Sunday, and kept them on for hours.  The same little girl whose feet couldn't be coaxed into them for one minute the week before!

Her words have been coming as well.  The other day I suctioned her and I thought I heard her say, "Thank you"..so I asked her if she had said it.  Immediately, a huge grin, dimples and flashing eyes evidenced her excitement at being understood!  Today, her nurse asked Abbie if she wanted to be suctioned, and then waited.  When I looked at Desiree she said, "I always ask her now, because last week she told me 'No!'"  Since Abbie has many ways to get her point across, I didn't think too much of it, but did ask, "How did she tell you 'No?'"  "Oh, I mean, she said 'No' with words.  So, now I always ask first."  Hurrah!

Today brought our afternoon speech therapy session at UH.  We've been trying a new joystick switch with Abbie that can activate a different device in each direction -- for example, the hope was that eventually she will be able to pull to the middle for "yes" and to the outside for "no".  First, though, we have to teach her to use it.  We started by letting her pull to the outside for "yes", because that is the movement her body naturally wants to make.  Last week, thanks to a wonderful switch toy sent to her by Jordan, we motivated her to pull to the middle.  This is really, really hard work for her as she has to overcome a lot of tone to do it.  

Today, we put the joystick in the right hand, with the "yes" requiring her to pull to the middle.  We also put her old-style switch in her left hand so she could click for "no".  We started out matching colors of play-doh.  She did well at this, but really lit up once we said we could move along to reading.  It was when she was matching color words that we began noticing she was pulling the joystick out for "no" --- she was doing the move we'd hoped to teach her sometime in the future!  She matched all the color words and then we moved on to shapes.  The highlight of this part is that they introduced a word we've not worked on, "rectangle" -- after they had showed her, she later correctly identified it.  She LEARNED it in one session!!  All while doing major motor work with her hands.  It seems that she really understands moving the joystick one way for "yes" and the other way for "no" and that her body is becoming increasingly capable of doing this.  What a day!!  I was so incredibly proud of this little girl, who worked so hard that her arm was often shaking with effort.  She is my hero.

When that call to do "one more thing" comes....summon your last shred of strength and answer it.  He who calls is Faithful and True, the Giver of all good things.

A Memorable Weekend

Our family spent a wonderful long weekend on Maui, with a couple of special highlights for Miss Abbie. The first, as you can see above, was her getting a chance to swim with her Daddy.

I was a little concerned about how she would react to the cold water, but as you can see...she loved it! She grinned the entire time she was in the pool, and so did Ray. My smile was pretty broad, as well.

There was some serious love flowing from Abbie to her Daddy, as she made googly-eyes at him. She especially enjoyed when he pretended to be her motor boat, and sped her around the pool.

The travel to Maui could not have gone any smoother, the weather was beautiful and the hotel was lovely. It's amazing when you can feel yourself being blessed as it actually happens. God gave us one giant sabbath to rest and recover, and it has worked wonders.

The other thing that amazes me sometimes is when other people view Abbie through the same lens I do, especially when they are strangers. The day we were leaving we spent the morning hanging out by the pool. A man named Mark walked up with his 7-year-old daughter, Brooke, because her interest had been sparked as they walked by the handicapped pool lift and then saw Abbie's wheelchair. So, they stopped by to say "hello" to Abbie, and ask just a few simple questions. They were so kind, and Abbie loved having a girl to chat with, even for just a few moments, since she was utterly surrounded by boys all weekend.

A while later, Mark and Brooke came back, with Brooke bearing the gift of a cute little penguin water toy for Abbie. Mark started talking directly to Abbie saying, "You know Abbie, when Brooke and I got in the water we started talking a lot about you. We decided that we see a lot of courage in you, a whole lot of courage. And, that you help take our fears away."

I was stunned by his choice of words, because not only is that what I see in Abbie as well, but from the beginning the Lord has been using this whole journey to rid me of every fear except the fear of Him. And, I was so thankful that Mark chose to speak directly to Abbie, and to acknowledge her so powerfully.

I am so thankful when God sometimes uses real people to speak real words that I can really hear. Below is a picture of Abbie, and her new friend, Brooke.

Validation

This past week brought me two types of validation: the opportunity to validate the amazing precision of Maria Margarita's work, and the chance to have professionals validate the fact that Abbie is reading. What a wonderful week!

First, to our dear Maria. In our session last Tuesday she began working intensely on Abbie's chest. In the midst of her work, she paused, looked up at me and said, "There was some trauma here, on the left side of the trachea, caused by the initial intubation, I believe. It is affecting her pericardium (lining around the heart), the pleural lining (around the lungs) and the diaphragm. All of those connective tissues just clamped down after the shock of the injury and then this intubation trauma"

I was speechless. There was NO way she could have known that Abbie's medical record describes the ET tube being improperly positioned just a bit when the paramedics placed it, and it having to be repositioned in the ER...causing some trauma to her trachea.

As she continued to work, Abbie's chest broadened out below her thorax and she began to engage her diaphragm in breathing. Abbie has had a much better week overall in the respiratory department, and I know it's because of Maria's work. There is a slight trade-off, though. After working hard with Maria, Abbie always has a lot of "junk" to dump out of her body. So, on one hand she's breathing much better, but on the other there are times when I am constantly, and joyfully, suctioning.

Maria then did some very deep work on Abbie's brain. I sat, with two neuro-anatomy atlases at the ready, so that I could understand where they were working. At one point they were working on the Thalamic Nuclei (another thing I'd not heard of before). The precise area they were working on projects into the frontal lobes, where Abbie was wanting to do a lot of work that day...it all fit together. I have 3 pages of notes from that session, but I won't include it verbatim here. If you are a brain injury parent, please feel free to contact me for much more detail.

It may sound strange, but Abbie guides Maria to the places in her brain she wants to work. There was one very specific point that Abbie was insistent about, but didn't make sense to me because it was near her right eustachian tube. As far as I know, hearing is the one faculty we've not had challenges with. Maria called me later that night, from the medical library. The point Abbie had insisted she work on was so precise that normal anatomy texts didn't describe it fully. Maria was amazed to find, in the medical text, that the specific point was a key intersection of many cranial nerves (and other important structures that I forget at this late hour.) She just laughed and said, "That little girl is going to grow up to be a brain surgeon, because her knowledge of neuroanatomy is so precise!!"

Maria will see Abbie again tomorrow, and in accordance with Maria's request, I have gotten copies of Abbie's MRI for her to look at. Taken 3 days after Abbie's injury, those images are burned in my mind forever, along with the Lord's whispered words, "It has to be this bad." I haven't looked at them since that dreaded lightbox conference in the PICU. Brimming with my newly-acquired amateur neuro knowledge, I held some of them up to the light tonight. They still make my stomach turn. A perfectly-formed brain just devastated by injury. But, I am curious what Maria will think of them tomorrow.

The second form of validation came today at Abbie's intake interview for the new semester at the University of Hawaii. We met our new student-therapist, April, who was accompanied by our long-time therapist Lisa. Towards the end of the session, I mentioned that Abbie is learning to read. I took her flashcards and books to the session, in case they wanted to see them.

Lisa and April said they'd love to see how Abbie reads. That's when the knot in my stomach formed. I can feel the breeze from the nodding heads of every brain injury family as I say, "Consistency is not our thing, " and what she can do one day, she might not do again for weeks. Rats. I had told them she could read, so now it was "put up or shut up". Plus, Abbie was using a new different switch, so I didn't know if that would throw her off.

I got out the original five flashcards that she first mastered in November. I don't know why I chose those, since she hasn't looked at them much in the last six weeks. But...she did GREAT!! She didn't get them all 100% right each time, but she was engaged, and was able to get most of them right. This great accomplishment by our little smartypants dictated her goals for this semester....LITERACY!! We are going to work reading into as many activities as we can. I am thrilled because Lisa was the first professional to see Abbie actually read. I am glad it was her, because she has been with us since the PICU, through the long days of hoping for any communication at all, and now to have her see Abbie read was a victory for us all!

These days are sweet indeed, but I could use your prayers for more sleep. I mentioned the times of constant suctioning above, and they tend to cluster in the nighttime hours. I have been getting very little sleep for the past several weeks, and it is really beginning to take a physical toll on me. I feel like an old, cranky zombie and I imagine my family would concur with this self-assessment.

But, most of all, even (or especially) during the night watches my soul just sings praises to God. Sometimes for what He is doing for Abbie, but lately I have been especially overwhelmed by the fact that He calls me "friend." Can you imagine...the God of the whole universe would stoop that low, and lift me that high? Perhaps it's because I can't really wrap my mind around the realities involved with Him being my Saviour or Redeemer, but Friend...I can grasp that one, and will never fathom why He would choose me for one. I am just so utterly grateful.

Mostly For Brain Geeks

I've been dying to write an update since our first visit from Maria Margarita last Tuesday. We had our second session with her earlier today. I am astonished. When I read the Brain Curriculum at www.upledger.com I was hopeful but a little reserved, wondering how someone could assess the brain precisely enough to locate specific lesions. Our experience so far has exceeded even my wildest hopes.

This listing is for the brain geeks, and parents who have morphed into such:
(Others can skip everything in italics:)

Todays' work:

Assessed and worked on lesions on the R. cerebellum, R. cerebrum. R. sensory integration area

Abbie's spinal cord had been pulled up through the foramen magnum (hole at bottom of skull), and was swollen, preventing it from returning to its proper place. Maria dealt with this as well as resolving the adhesion that had formed between the foramen magnum and C1.

Noted R. posterior cerebrum / temporal lobe swelling between the atlas and the foramen magnum

Abbie worked on the anterior/posterior mobility of her left cortex, and the midline/posterior rotation of both cortexes.

There was some restriction in the L. temporal lobe area, which is affecting Wernicke's Area (speech). Abbie worked hard to get her L. temporal lobe back into it's proper space.

Much work done on her ventricles (fluid containing vessels in the middle of the brain). There were anterior adhesions, so that the R. and L. were stuck together. The posterior ventricles were rotated in opposite directions: R. was inferior and L. was superior. All of this together resulted in tremendous pressure on Abbie's skull, impacting the vascularization (blood flow) and Wernicke's area, as well as the L. cerebellar peduncle (I did not know until today that my body contained such a thing as a "peduncle"!)

L. cerebellar peduncle had issues at both inferior and superior attachments, but particularly at the superior -- it had been stretched to its max, but not torn

Maria worked on the membranous system to address some of the ventricle issues. The R. middle inferior ventricle stretched to allow fluid back in. The L. side was swollen and the right side had no fluid. The fluid rebalanced very well during treatment.

It was interesting that Abbie's lungs exactly mirrored the condition of her ventricles. The left lung was swollen and the right had reduced volume. We have been observing this for months now, but were at a loss as far as how to treat it.

Maria balance Abbie's lungs, and stretched the Media Stinum (sp) - the connective tissue that runs from the thorax in front to the spine in back to make the compartments for the lungs. It had become quite constricted, which showed in the shape of Abbie's ribs as well as the tightness across her back.


....and that was all just today!

Last time we worked on her occipital lobe, which has been deviated and was compressed, as well as giving her frontal lobe more room and lifting the weight of her forehead off of her eyes, allowing her optic nerve to function better. And, boy..has it ever! Her vision is noticeably better...even the store clerk at Banana Republic remarked about that.

In the first session Maria worked quite a bit in Abbie's mouth and around her cheeks and nose. As with the first session of Rolfing, I saw physical differences in Abbie at the end of treatment...amazing!

It is a wonderful blessing having someone to talk indepth brain stuff with. I have avoided gaining precise knowledge for years, because it just hurt my heart...I already knew many things were "broken", so I didn't want to dwell on it. But, now I am consuming anatomy texts like water.

Maria is an exclamatory answer to a prayer I had not even prayed yet, nor knew how to pray. Her skills, insight, and compassion are remarkable...I feel like Abbie has been waiting around for Maria, waiting for a partner to help her. Abbie knows exactly what she needs to do, and today even turned her head in specific ways to lead Maria to the "next spot" to work on. Maria says she's never worked with a child so committed to working long and hard (1.5-2 hours at a time), and is overwhelmed with how quickly Abbie responds to the work.

After our first session, we went in the other room to chat. Her first impression is that Abbie is "so strong." I just smiled at the validation of all we knew. She continued by saying that Abbie is very, very present, aware strongly of who she is and is adamant that she is NOT a baby, but a big girl. Again..more validation. Maria feels that Abbie is "burning to talk, because she has something very important to say..." Can't wait to hear it!

Maria has worked with brain injury patients for ten years, so I believed her when she said she did not make the following comment lightly -- she has seen too many families sustained only by hope to do so -- she said she feels there is great hope and much promise for Abbie. There is LOTS of work to be done, but Abbie is responding so well.

Maria Margarita is a European woman, imbued with the class and grace that seem to be their birthright. She just moved to Honolulu last month, so if you live here I will gladly put you in touch with her..email me at varasix@aol.com. If you live elsewhere..I would recommend contacting the Upledger Institute to see if a trained provider lives near you.

This is the biggest leap forward, in my eyes, since we met Dr. Tennant. God is so gracious to forgive my weariness and temptation to quit, and send not only sustenance but a renewal of hope!

One last quick note...please pray for my aunt, Lavonne... last week I spent time on the phone talking with her husband, Elmer and Lori, one of her eight children, about putting a trach in...boy, there is wisdom I wish I didn't have. She has since gotten one in, but is still on a vent with heart and lung issues. Many of you know how winding this road can be, so please remember them in your prayers.

New Beginnings

"What to you mean Christmas is over??" Abbie's look of concern at the words "It's bedtime..." But she did sleep very well in her new ballerina flannel PJs...thanks Grandma!

Aloha!! I'm now sufficiently recovered from my Sugar (Bowl) high and low to put together a cogent update. What a couple of weeks for our family! Abbie did wonderfully while we were gone. Fortunately, those caring for her were wise to withhold just a bit of information from me while we were gone. Each day Abbie would cry for a period of time because she missed us. One of the days Debbie finally took her into our bedroom so she could feel "closer" to us...it worked. Most importantly she stayed healthy and looked great when we got back -- thank your for your prayers.
We've decided, despite the outcome of the game, that we would travel to the Sugar Bowl again tomorrow...and I'm sure the reason why didn't make it onto the national telecast. I will never in my life forget what happened as the game ended. Even though we were beaten soundly by a talented Georgia team, I don't think one white-shirted Hawaii fan left early. As the seconds ticked to zero, as one we stood and applauded our boys who'd endured such a rough night. And then came the music...the band sounded the first notes of "Hawaii Pono'i", and again as one we serenaded our boys with love and pride. Many times this season, late-game heroics proved my belief that Love Always Wins. But, in the Superdome, with painful evidence still illuminated on the scoreboard, I was part of a love that transcends winning and losing, which showed me that, all appearances to the contrary, where there is great love, there are no losers

A great blessing of the trip was catching up with our friends, the Garguilos, who now live in Gulfport, MS. They live 2 blocks from the beach, and moved in 24 days before Katrina. They know that number specifically because there was a 30 day waiting period clause in their insurance. The row of houses that used to stand between them and the beach ended up on their house. They could not see their house and had to chainsaw a path to it. With a lot of sweat equity and emotional investment they have rebuilt not a house, but a home -- a mix of new walls and doors and windows salvaged from their yard. Fred and Michelle's friendship was shown as gold in our fire after Abbie's injury, and it was amazing to me the commonality of emotions we share in lives changed so dramatically, and instantly, by water.



We are looking forward to big things for Abbie in this New Year. We continue to pursue the baclofen pump issue. I spoke last night to a mom whose son was traumatically brain-injured 10 years ago, and just had his third one implanted (the batteries last 5 years). It was great to be able to ask another mom questions about complications, effects, and simple things like, "Does it make him resistant to lying on his stomach?" She had glowing things to say about the impact it's had on her son's life. I've also been emailing with another precious mom who has been willing to share in detail the story of her son's implant, even though he passed away 5 months ago. Opening such a wounded part of your heart is a heroic act. ..thank you, Susan. I am hoping to link up with the Medtronic rep next week and move forward as quickly as possible.



I am always in awe of who the Lord brings to this tiny dot on the map...before I even know to ask. Sally, our Rolfer, was telling me about a new friend she made recently at an intensive workship focused on the brain. Maria Margarita has been assisting Dr. Bruno Chickly for several years. That didn't mean anything at all to me until I researched the "Brain Curriculum" being taught around the world by Dr. Chickly, with the endorsement of the Upledger Institute. I went to http://www.upledger.com/ to research this curriculum and was completely fascinated -- for instance, Dr. Chickly teaches methods to identify specific lesions in the brain, and then release them. I instantly began mentally plotting a way to get Abbie to see him. Turns out that Maria Margarita just moved to Hawaii last month, and is setting up a practice here. We had a terrific conversation the other day where she detailed her decade of work with brain injury survivors, including veterans. I am very intrigued by the possibilities in specific areas like Abbie's use of her tongue, and in general areas like figuring out the current status of her brain. Maria will be coming to see us next Tuesday, so I will certainly keep you posted.



New Year's Eve found us in a tiny jazz club, listening to true New Orleans music. As we counted down the seconds I pray with fervor that shook my body..."Let this be Abbie's year." As the trumpeter filled the air with "Auld Lang Syne" I gratefully laid down the weariness of a year's labor, of hope deferred, of joy and disappointment...it is time to begin anew, with lightened shoulders, clear eyes, and fresh hope. I am so thankful for the the turning of the page, the flipping of the calendar, and for better or worse, being able to look at the 2007 box as "completed." Time to move on carrying only the wisdom gained, relationships deepened, and faith matured. We pray that God would bless you abundantly this year, and that you would receive Him joyfully each day. Pressing foward with great anticipation and enduring hope that this will be Abbie's year


More from the Game:

Matthew, all painted and beaded up, ready to go the game. The tattoos on his face required baby oil to remove. Since we got back from the game at 1:30am and left for the airport 2 hours later, the tattoos stayed in place during our journey home. In the New Orleans airport, it made perfect sense to all the other passengers, many of whom were also wearing green, black and sad faces. In Houston we got a few strange looks. By the time we were walking, or actually running, through LAX people were giving sideways glances to Matt and RJ, perhaps wondering if they had very odd, Polynesian birth marks. Finally arriving in Honolulu, we found several news stations waiting at baggage claim. A very insightful reporter picked out Matt and RJ, put them on camera, and then said to Matt, "You look like the talkative one..why are you still wearing your tattoos??" I knew he was my boy indeed, when he answered simply, "Because we still believe."




Not the best quality photo, but I had to post the evidence of Coach Brian Kajiyama on the field at the Superdome!!! Thanks to late-night online chats Brian and I have struck up a special friendship. He is my window into Abbie's world as I ask him things like, "What does it feel like to have spasticity" and "Does it make you laugh when people talk to you LOUD and sloooooow, as if you are deaf?" As I told him, I am so grateful to him for being Abbie's megaphone to a world that doesn't hear very well, and on this night in particular, what I could hear him shouting was, "ABLE!!!!"





Da 4 braddahs, all whited-out and ready to cheer. This was pre-game, so we could still genuinely smile. But, as I alluded to above, although Georgia is a very impressive team, and for the most part their fans were very warm and kind...there's no other team I would have rather supported that night, or any night.

New Orleans aiport, 4:30am. This trip showed me that it is great to be ten. Not only can you still curl up on the waiting room seat, but the boys got a lot of other bonuses as well. Tagging along with their buddy, Kekoa Reinebold (he was the very blonde young drummer during the game, if you watched) they spent New Year's Eve first in the players lounge, playing video games and snacking to their hearts content (not to mention seeing the players), and once they were evicted from there for a team meeting, they headed up to the coaches hospitality suite where the Governor was hanging out.

One last memory...as we came down to the lobby to check out at 3:30am most of the activity had died down. We only saw one player, standing by himself in gray sweats, obviously tired but still graciously signing autographs for the small gaggle that he's never been without this season. Colt Brennan showed his class one last, remarkable time. I can't imagine what he endured that evening, both physically and emotionally...yet there he was, still giving back...a true son of Hawaii Nei.

Spying Out the Land

Last week I got a surprising phone call from the neurosurgeon's office, telling me that they'd received the referral paperwork regarding the baclofen pump and wanted to schedule an appointment for the 26th.  I assumed she meant January 26th...nope, they were able to get us in yesterday!  I was shocked and gladdened to be moving forward so quickly.

I did not have anyone to go with me to pick Ray up on the way to the appointment.  For the first time in all these years, Abbie was having a major respiratory event while I was driving to town.  I was able to turn her oxygen up to 3 liters while driving, but I could not suction her.  She was dipping down the the mid-80s on the pulse ox as my blood pressure rose, and thoughts of pulling over on the freeway rapidly filled my head.

Stopped at a light a block from Ray's office, my heart was groaning from the stress of Abbie's condition and from disbelief that it "had come this"...checking out a baclofen pump.  God spoke to my heart and said, "You are not putting the pump in today, just go gather the information, go spy out the land."  That last part, about spying brought to mind images of the twelves spies sent to the Promised Land.  My stress-induced retort was, "Well, Lord, this sure doesn't feel like I'm looking at the Promised Land!"  I promise, I think I heard a heavenly laugh, and then heard, "Well, what exactly do you think those twelve spies thought as they peeked down on giants in the land??"   Oh yea....gotcha!  I could almost hear Joshua exhort me "Be strong and courageous, be very strong and courageous."

Dr. M, the neurosurgeon was wonderful, and spent 45 minutes with us assessing Abbie, answering questions, and giving detailed explanations.  He was concerned about Abbie's need for oxygen, but I just didn't have the stamina, and did not want to consume appointment time to explain her healing cycles that come at specific times of day as a result of the many things we are doing.  He does think Abbie is a great candidate for the pump, and that it would offer much more relief than oral baclofen with significantly fewer drug side-effects.

The oral form is starting to really kick in as far as loosening her muscles, but I do think she is starting to become a little more glazed and less responsive.  Dr. M. has placed about 100 pumps, and when I asked how many families who had had a good trial (where they inject a dose into the intrathecal space to see if the medication will work), were then dissatisfied with the pump because the results were not as good as the trial.  He thought long about that, and then said he didn't have any patients in that category, and that all the families were very happy with the outcome.

Ray and I both really liked Dr. M, and agree that the pump is the best option for Abbie right now.  Dr. M. agreed that it may be beneficial to have it placed before her hip surgery so that she is as comfortable as she can be during the recovery.  So, in the next couple of weeks he will be determining the best physician to do the trial with us, as well as the best one to manage the refills and dosing after the pump is placed.

I am excited and relieved, which surprises me.  I guess I should have known that sometimes the Promised Land lies underneath some intimidating obstacles with ugly faces.  I also realize that what God  promises is not taken by force, but by faith.  In that faith, with much reassurance, we are going to move forward to the next step in Abbie's journey.  I don't have any sense of when we could actually do this procedure, but I am hoping to have it done by February.

Please pray for Abbie who will be very busy cat-sitting over the next few days to allow the rest of us to go to New Orleans for the Sugar Bowl.  We are THRILLED for the chance to go support our beloved Warriors, but Abbie was getting kind of sad with all the excited travel talk flying around.  Once I "got it", I realized we had to turn the situation into a positive for her.  Taking care of Grace was the answer.  I mentioned this to her physical therapist a couple weeks ago, and she responded by giving Abbie a "Kitty Sitting Survival Kit" for Christmas.  As I would pull each cat toy out of the stocking Abbie would grin and cluck.  She also bargained hard with her Daddy, working him all the way up to $5 per day -- talk about a push-over!!

Please pray for her nurses and friends who will be caring for her in our absence, and pray especially fervently that she stays healthy.  Times like this give me temporary schizophrenia...I am so excited to experience this with our boys, but I hate to leave her here and wish with all my heart that she could go with us.

I didn't write much about Christmas because it is a very tender spot for me.  Still painful.  Still blessed.  But, I hope that you had a wonderful celebration of the Savior's birth with your family and friends.  I prayed much during Christmas, mostly simple short prayers of "Help me" and "Hold me together".  I marvel at the fact that without God's willingness to become that little baby, I would never have had a bridge over which to carry my prayers, no matter how feeble, to the foot of God's throne.  I cannot fathom surviving without that relationship.

Will update after our return from New Orleans.  So, "Hau'oli Makahiki Hou" from the entire Vara Ohana.  May you be abundantly blessed in the New Year.  And, GO WARRIORS!

Backing Up

Yes, the whirlwind of this season caught up with me, preventing timely updates. Now with all the parties and performances done for the most part, I can try to encapsulate all that has gone on the last few weeks.

One of the most important things is that I started Abbie on oral Baclofen, a muscle relaxer, last week. Our talented Rolfer, Sally, has returned from her teaching stint in Buenos Aires, and came by last week to work with Abbie. As we discussed the highlights of the International Fascia Conference she attended in Boston recently, things which I've known for a long time became clearly confirmed. Fascia, or the connective tissue, is one of the primary electrical conductors in the body because it is continuous. Sally told me she learned that once there is a rent, or a tear, in the fascia it never really heals; just like the skin, it scars. Scars, like plastic, are not good conductors of electricity, and can inhibit the free flow. The idea of trying to preserve fascia for electrical reasons is something that western surgeons are not aware of and probably, at this point, couldn't care less about. But, Sally did encourage me that if there is anything non-surgical we can do to help Abbie, we should pursue it.

Sally's comments helped push me over the brink, and give Abbie the first dose of the Baclofen that had been sitting in my fridge for 2 weeks. I gave it to her at bedtime and she slept all night!! She awoke with a smile and with visible relief etched on her face. I gave her the second dose and waited to see if it would put her into a stupor. We played and stretched for over an hour, with her looking bright and cheerful. Perhaps this really was an answer!! Then, at 9am she fell asleep for over two hours, and no matter what we did we could not rouse her. My jubilant hope receded, and I thought again about the price of the trade-off. The second day on the medication though, she did not sleep at all. So, perhaps she was just making up for lost sleep now that her body was finally relaxed. The first three days on Baclofen produced noticeable differences in her tone, but honestly, the last 3 have not.

Seeing Abbie's relief at any measure of help with her tone has convinced me to pursue whatever means necessary to provide it for her. She smiles every time I tell her I am giving her "muscle medicine." She is at 30mg of Baclofen per day, and the max dosage is 40mg, so we don't have that much more margin to work with. This prodded me to go once again to the Medtronic website -- they produce the implantable device that delivers microdoses of Baclofen directly to the spinal (intrathecal) area. Although I've been told over and over that no one in Hawaii does this surgery, I searched the site for a provider. One neurosurgeon's name popped up, so I called his office.

The nurse confirmed that he does indeed do the implantation surgery and then refers those patients to a neurologist to manage the dosing and refills. I asked if he accepted pediatric cases, and the nurse paused and then said, "Well, he is a pediatric neurosurgeon, so of course he does." Wow!! She told me what they needed as far as a referral, and I then made those phone calls. I am astounded that all this time, a pediatric surgeon providing this service has been right down the road! Honestly, my joy at finding him has been a bit tempered with anger at a system that made me find this out on my own after years of telling me that no one was available. So it goes...

Cognitively, she continues to blossom, even with the new medication. She is extremely proud of being a "Super Reader", just like the PBS show we watch while we stretch in the morning. She is bored with working on the phonetic alphabet, and lets me know in no uncertain terms that she would much rather read words. So, I've added her second program book, meaning that we are now working on words from A through M.

Trying to check if she is really "reading" or just recognizing familiar patterns of shapes but not attaching abstract meaning to them, I figured out a test last week. Her word for "F" is "fingers." I showed her the word, but did not say it aloud. I then asked her where these were, and she started moving her fingers. She has done this several times since, although like everything in this journey, it doesn't happen 100% of the time yet. However, it was enough to convince me that she really is reading.

I am finding lately, that when we take things in isolation, out of context, we often miss the overarching theme, and perhaps the most important points. This has been especially hitting me through well-known verses -- you know, the ones we memorize that are a verse or two long because they are so good, and seem so applicable, without knowing what surrounds that particular snippet. The first whack on the head I got in this area was Jeremiah 29:11, "For I know the plans I have for you' declares the Lord, 'plans for welfare and not calamity to give you a future and a hope.'"

Like so many families I know, we have clung to this verse through some very stormy times. But, until my recent in-depth study of Daniel, I don't recall focusing on Jeremiah 29:10, "'For thus says the Lord, 'When seventy years have been fulfilled for Babylon, I will visit you and fulfill my good word to you, to bring you back to this place.'"

The promises in Jer. 29:11 were given to a people in bondage in Babylon, and assured them that their years in exile were carefully numbered by God. He told them that at the end of those ordained years of suffering, He would fulfill His promises and bring them back to the place for which they longed. These specific promises were made over 100 years before the people were carried away to Babylon. Backing up to this verse made me cherish 29:11 even more as we trust God that all of the days of Abbie's journey were divinely numbered long before her birth, each for a specific purpose, and that to us, too, He will fulfill all of His promises as He brings us out.

Knowing that it takes me a while to catch on sometimes, God hit me with this "wait, back up" pattern twice more in the last 12 hours.

"Why do you say, O Jacob,

And why do you complain, O Israel,

'My way is hidden from the Lord,

my cause is disregarded by my God"?

Do you not know?

Have you not heard?

The LORD is the everlasting God,

the Creator of the ends of the earth.

He will not grow tired or weary,

and His understanding no one can fathom.

He gives strength to the weary

and increases the power of the weak..."

If you are wading through some deep water, doesn't that just sing to your heart, like it does to mine? Would it surprise you to know that this passage ends with those familiar words, "...but those who hope in the Lord will renew their strength. They will soar on wings as eagles; they will run and not grow weary, they will walk and not be faint" (Isaiah 40:27-29, 31)

One last encouragement for you to "back up" with some of your favorite verses. On the United Nations building in New York City are inscribed these words, "...and they shall beat their swords into plowshares, and their spears into pruninghooks; nation shall not lift up sword against nation, neither shall they learn war any more" Isaiah 2:4(b)

It's really too bad that they didn't inscribe the whole verse, because perhaps there would be a better understanding of why men's attempts to bring about plowshares and pruninghooks fail so miserably. The first part of Isaiah 2:4 reads, "And He shall judge among the nations, and shall rebuke many people." Only the Sovereign Lord, the Judge of unfaltering integrity, wisdom, and knowledge, is capable of bringing the peace we all desire....and only through judgement. A totally politically incorrect idea these days, but missions begun on half of the story (or verse, as it were), relying on man's intellect and tainted motives are doomed before they begin.

OK..there's the Sunday School bell ringing..sorry if I kept you too late. Just know there are many treasures awaiting you, right behind some very familiar ground.