Riley Moon

I took this picture because right before this Riley looked at me and said "Mom, I look funny."  And then she laughed.  

I've resolved that there will always be something to talk about with Miss Moon's heart.  It's always going to be doing it's own thing, much like Miss Riley.  For now it all looks good.  Of course, it's still beating in reverse.  That was explained in more detail here: Miss Riley Keeps us on Our Toes.  

She had to wear a monitor again, and while her heart beats inefficiently, everything else about her heart looks good.  This time, Riley did not like wearing her monitor though.  Matter of fact, she rather hated it and asked over and OVER AGAIN if she could take it off.  

Support The Troops

From COL Ostlund
ROCK Paratroopers –
Sadly, we lost another ROCK Paratrooper. I was going to say to his own hand, but that is only partially true. We likely lost him in a firefight that raged internally to him – maybe known to others, maybe not. As tragic as the human toll of our collective deployment was – 26 killed and 143 wounded – it pales in comparison to the preventable losses we have racked up since redeploying. Before a ten year reunion, we could surpass losses in combat with losses in “garrison” – tragic.
While deployed to fight the demons of Kunar, all ensured the billions of dollars-worth of assets our great nation has were on standby or readily available – and when “in contact”, we brought them to bear with lethal results. When fighting internal demons we have to do the same, BRING TO BEAR THE BILLIONS OF DOLLARS OF ASSETS – military and civilian – THAT OUR GREAT NATION HAS AVAILABLE. Reach in to our no virtual formation – and reach out for the assets to suppress, fix, then destroy the demons that are killing our brothers. We have to do better and collectively we can.
Justin, Destined Company – RIP..
ROCK

     This was posted recently to a Facebook page I am a member of.  I'm sharing it because I think it is perfectly said.  The Rock is the nickname of the 2nd battalion, 503rd parachute infantry regiment, out of Vicenza Italy.  David was a member of The Rock.  We didn't personally know this solider, though we've known too many like him.  
     I recently read an article, quoting Clint Eastwood about the movie American Sniper.  I'll post the article for those who want to read it in it's entirety.  However, for those that do not, I'll paste a few excepts from the article here:

"We tend to talk about “the troops” only in an insistent plural, distancing ourselves from them—their complexity, their individuality, their humanity—through the lens of the heroic collective. "

"Not only because the world isn't a Toby Keith song, but because the easy, empty logic of “supporting the troops” gives civilians leave to do a disservice to the people we reflexively thank for their service: It allows us to be ignorant of what that service entails in the first place."

As Fallows summed it up: "We love the troops, but we'd rather not think about them.

Original article can be read here: http://www.theatlantic.com/entertainment/archive/2015/01/beyond-support-our-troops-the-admirable-complexities-of-american-sniper/384574/

     My take on this: civilians do not really want to know the ugly reality of what our soldiers endure.  But it exists, and it changes soldiers.  Some may seem to deal with it better than others but I know the struggle exists in them all.  What is normal life to someone who has seen the things our soldiers have seen in the last 15 years?  Furthermore, are you ever really normal after living through war?  My best guess is no.  Somewhere along the lines, we are failing our veterans.  Maybe because society expects them be something they aren't.  Another fantastic quote that stcks out in my mind right now comes from the movie Korengal, also about the 2nd Battalion, 503rd Infantry Regiment out Italy, discusses the nature of the phrase "You did what you had to do."  Have you ever said that?  Because to the soldier, they volunteered to join the army, they choose be an infantryman.  They made choices that put themselves exactly where they are.  They did not "do what they had to do."  Now consider the impact of that statement (you did what you had to do) on someone who believes just the opposite.  Maybe it's not the most appropriate thing, maybe it's not even the right thing to say.  
     I don't profess to know all the answers, I just know that something needs to change because I'm tired of seeing soldiers survive a firefight, only to succumb to an internal battle upon returning to civilian life.  

Miss Riley Keeps Us On Our Toes

Right after her dance class.  She's wearing a 24 hour monitor.  

Riley recently had her annual cardiology appointment, which revealed something new about her little heart.  She has an accelerated junctional rhythm.  This definition here, pulled from Wikipedia no less, is the simplest and plainest breakdown I've found so far:

Junctional rhythm describes an abnormal heart rhythm resulting from impulses coming from a locus of tissue in the area of the atrioventricular node,^[1]the "junction" between atria and ventricles.

Under normal conditions, the heart's sinoatrial node determines the rate by which the organ beats - in other words, it is the heart's "pacemaker." The electrical activity of sinus rhythm originates in the sinoatrial node and depolarizes the atria. Current then passes from the atria through the bundle of His, from which it travels along Purkinje fibers to reach and depolarize the ventricles. This sinus rhythm is important because it ensures that the heart's atria reliably contract before the ventricles.

In junctional rhythm, however, the sinoatrial node does not control the heart's rhythm - this can happen in the case of a block in conduction somewhere along the pathway described above. When this happens, the heart's atrioventricular node takes over as the pacemaker.^[2] In the case of a junctional rhythm, the atria will actually still contract before the ventricles; however, this does not happen by the normal pathway and instead is due to retrograde conduction (conduction comes from the ventricles or from the AV node into and through the atria).^[3]

Junctional rhythm can be diagnosed by looking at an EKG: it usually presents without a P wave or with an inverted P wave. Retrograde P waves refers to the depolarization from the AV node back towards the SA node.^[4]

So what this means for us, right now, is watching how this plays out.  From our end, we'll monitor Riley and contact her doctor if she begins to tire easily, experience dizzy spells or anything else that indicates her heart is working too hard.  Everything else about Riley's heart looks great, which is good news for us.  And this could be something we don't ever have to fix.  We just don't know right now.  We do know that we trust her cardiologist.  So when he said "Let's just watch it and see what happens" David and I are happy to agree.  

The Standard American Diet (S.A.D.)

I recently read this article: http://www.thedailymeal.com/why-healthy-food-deemed-elitist, which talked about why eating properly has become synonymous with an elitist attitude.  The author opens the with a story about a friend rolling her eyes when the author pulled a kale smoothie out of her refrigerator.  I can completely relate to the things the author said in this article.  I have often said when did it become necessary for my to apologize for eating the way we should all be eating?
The author reminds readers that junk food isn't always cheaper.  And people who have access to good food that is reasonably priced will buy it.  However, marketing has turned eating well into the trendy thing to do.  I couldn't agree more.
Here's my deal: I started eating healthier when Hannah was a baby.  My tastes slowly began to change.  I began eating more and more healthy.  My tastes continue to change.

 And you know, I actually like, really like, eating the food I choose.  I like kale.

  I winter squash, it goes great with Quinoa. 

 I love soy nuts, they're good on salads. 

 I genuinely think that greek yogurt spread on a bagel is just as good as cream cheese.

  Keep in mind, however, that I eat greek yogurt 2 or 3 times a week.  I eat cream cheese 2 or 3 times a year.  My taste buds have changed.  Don't misunderstand me, I'll eat all the other stuff but when given a choice, I will choose "healthy food."  And I'll choose the "healthy" option not because it's trendy or not because I'm watching my waistline but because it is what my taste buds prefer.  Anyways, the article is a good read.  Check it out.  

Riley's latest trip to the ER

Sunday:  Riley woke up cranky.  Really cranky.  Sunday afternoon, she spiked a fever.  She took a long afternoon nap, woke up and still had a fever.  We cuddled with her, and gave her motrin.  Her fever went down and she acted semi normal.  She went down for the night at regular time and slept through the night.

Monday:  I called to cancel a doctor's appointment for Riley.  She was supposed to get a vaccination booster but they won't give a kiddo shots if they've had a fever in the last 24 hours.  The nurse asked to me to go ahead and bring Riley in.  This was early in the morning. before Riley woke up.  Since she had slept through the night, I assumed her fever had broke and thought the appointment was unnecessary but obliged the doctor's office.  The appointment was at 2.  In between that phone call and her doctor's appointment, Riley literally did nothing but sleep.  I tried rousing her around noon to eat, but she had no desire.  So we take her in.  The doctor does labs and a urine culture but gets negative results.  However, she doesn't like Riley's lack of energy and lethargy and recommends that we take her in to the ER because they can run more comprehensive tests than a pediatrician's office.  We get to the hospital around 4 pm and are taken back pretty quickly because our pediatrician had called the ER about us.  We're admitted around 7 pm for dehydration concerns.  Sleep was not much that night, as they had her IV line going off (beeping) every 2 hours to check on her.  That meant she was up, and cranky, every 2 hours.  Sleep came in 1.5 hour increments for me.

Tuesday: Everything is negative but she's still acting out of sorts; she's not smiling and playing.  However, her fever breaks that evening.  When we learn that we're not going home on this day, David begins to ponder if there's something they're not telling us.  The pediatrician who does the evening rounds recommends another lab in the morning to compare to Monday's lab work.  Another sleepless night.  She seem uncomfortable and had a hard time drifting into solid sleep.  It took a very long time to put her to sleep that night, only for the nurses to come in at midnight for a weight check!  It took David and I an hour and a half to get her back to sleep.
Wednesday: We get a call around noon about Riley's lab.  Her white blood cell count and her platelet levels had both dropped.  These two levels were normal when she was admitted.  One of her infection markers, the CRP level, was high.  The concern was something happening in her body, but the doctor's can't figure out what.  The super scary moment was when they told us that if things did not improve by Thursday, then we would have to transfer her to Chapel Hill for bone marrow testing to check for things like leukemia.  Talk about terrifying.  It was hard to not get carried away and terrified.  Not that long ago, my baby girl did not beat the odds for heart surgery.  The next 24 hours were long.  Wednesday afternoon, she had a spinal draw.  At 4 am Thursday, they did another blood draw.  Doing it this early meant that the results would be back by the time our pediatrician did morning rounds.  However, because she'd had so much blood taken from her arm, the veins were shot and they could not draw blood from them.  Which meant that it had to be taken from her head.
Thursday:  Results from her blood work had IMPROVED!!!  While not in the normal range, they had gone up.  We get to go home that afternoon.

What this all means:  We went Friday to see the pediatrician.  All the lab results were negative.  They have no idea why Riley's blood went all weird that Wednesday.  That CRP level was what tested very high in Hannah's blood when she ran that fever of 106.1 and was admitted back in July.  I asked the doctor if it were possible for my girls to have some genetic disposition that might cause this to get out of whack when they get sick.  She said "That's a good question, I don't know.  You would have to ask an infectious disease doctor."  After chatting with her, it was concluded that if this happens to either of the girls again: very sick, funky blood work and unexplainable, then we should go see an infectious disease doctor.  In the meantime, we'll go back in two weeks to see the pediatrician and have labs done again to make sure they have returned to the normal range.          

How I Got Here: Samantha's Story (Pt. 1)

As I sit to type this, I feel a small tightening in my stomach.  Partly because I can't believe I'm going to do this, partly because I still feel shame about what I did to my body and partly because I just don't like talking about  myself!  To be honest, I'd have to go back to my child hood.  I was taught to clean my plate because "there are starving kids in _____."  There was a game played at the dinner table, the "bet you can't eat one more bite" game.  Don't get me wrong, there were good things about how I was raised in terms of eating.  We ALWAYS ate at the table.  That's something I instill in my family.  But I was taught to clean my plate.  Leftovers were being wasteful and we didn't have the money to be wasteful.  I also grew up in, and am still in, a very southern family.  I love my dad, but that man has fried food every day!  Sometimes every single food item in a given meal is fried!  We love our southern roots, and our southern food even more!  Anywho, I was never one of the skinny girls in high school.  I was never a big girl either.  The older I got, the more self conscious I became of the fact that I was not a "skinny girl."  My dad, being the big, strong, southern mind set man, wasn't exactly free flowing of compliments.  I didn't grow up hearing my father tell me I was beautiful.  I don't have resentment or animosity towards my father for these things, however I think they molded me.  As a teen, I remember being ok with my size.  I wanted to be "skinny" but I didn't diet or become physically active to accomplish it, so I'd say that I was content with my size.  Over the next few years, this continued.  After I married David, I started going to the gyms on post.  I would go a few times a week.  When he deployed to Iraq, I went even more because I had lots of free time.  

David and I, Christmas of 2003

Overall though, I was happy.  I would have liked to been smaller but I was ok with my size.  And I had David, who has never made me feel anything less than beautiful.  He has always expressed his strong attraction to me, one of the things I love so much about him.  We move to Italy and I get more "into" exercising.  This is when I really learned the meaning of an intense workout!  And I liked it!  I began to run, after years of saying that "I'm not a runner.  I'll never be a runner because my legs are too short."  My girlfriend Claire started it.  She lived next to us and was trying to lose baby weight.  She invited me to go run with her, around the Grisignano neighborhood.  David offered to go with me and assured me that he could pace me.  At this time in my life, I'm very physically active, about 140ish lbs, no muscle.  So we all go run.  I ran 4 miles that day.  That was a light bulb moment for me.  David was right, I could run.  It was all about pacing myself.  So I began to run.  Claire and I would leave the daycare we both worked out and run Mount Berico.  This is a well known loop from the base to a church in Vicenza and back.  Then I got pregnant.  At the time I got pregnant with Hannah, I weighed more than I had in my life, 152 lbs.  That's a lot on a 5'2 frame.

This was in July of 2006.  I got pregnant in August.  

In order to avoid a lengthy blog posting, I'll pick up on Part 2 tomorrow.  

Stuff That Works

Hannah has had a cough for weeks now.  There's nothing else with it, just a yucky cough with normal colored mucus coming up.  And just the other day, I started to feel the cold symptoms come.  So I went to the drug store to look for something to kick it in the butt before it goes raging out of control.  I really prefer to stick with herbal remedies so when I saw this, I decided to try it.  Yep, Hannah and I are taking it, and it works.  And tastes really good.  

In other Cernock news, it's going to be a busy day today.  David's working on the outside of the house and this afternoon we have 2 birthday parties.  One for Hannah's friend, Kyle, and one for my friend, Noelle.  In between will probably be some school work.  And slaw dogs.  We're making them for lunch with my dad.  We don't get as much time with his as we would like, so we try to make the time we do get special.  Then tonight we're going to party it up, kinda.  As much as two kids and mom and dad can!  

Have a happy Saturday. 

Start Your Day Out the Right Way

Not all breakfast's are created alike!  

Starting your day with this much cereal will only cause a sugar crash hours later.  

10 Worst Children’s Cereals Based on percent sugar by weight
1.) Kellogg’s Honey Smacks	55.6%
2.) Post Golden Crisp	51.9%
3.) Kellogg’s Froot Loops Marshmallow	48.3%
4.) Quaker Oats Cap’n Crunch’s OOPS! All Berries	46.9%
5.) Quaker Oats Cap’n Crunch Original	44.4%
6.) Quaker Oats Oh!s	44.4%
7.) Kellogg’s Smorz	43.3%
8.) Kellogg’s Apple Jacks	42.9%
9.) Quaker Oats Cap’n Crunch’s Crunch Berries	42.3%
10.) Kellogg’s Froot Loops Original	41.4%

Some cereals are better than others. Nutrition expert Marion Nestle recommends:

1. Cereals with a short ingredient list (added vitamins and minerals are okay).
2. Cereals high in fiber.
3. Cereals with little or no added sugars (added sugars are ingredients such as honey, molasses, fruit juice concentrate, brown sugar, corn sweetener, sucrose, lactose, glucose, high-fructose corn syrup and malt syrup).

Among the best simple-to-prepare breakfasts for children are fresh fruit and high-fiber, lower-sugar cereals. Better yet, pair fruit with homemade oatmeal.

Borrowed from :http://www.ewg.org/release/kids-cereals-pack-more-sugar-twinkies-and-cookies

The fastest recovery ever

Riley spent two days in the PCICU.  By the time she left the PCICU, she had everything removed except for the heart monitors (which could not be removed before she was released) and her nasal cannula.  She could have moved into a regular room with more than that still attached to her, that's just how good she was doing, recovery wise.

Here she is the night of her surgery.  You could see her trying to regain full consciousness, especially when David and I were talking to her.  

Sleeping peacefully the next day.  

We got to hold her on Wednesday.  It was little nerve racking, because

we didn't want to do anything to hurt her.  But the nurses helped out by letting us get situated in the chair and then handing her to us. 

For the first time in David's life he was able to successfully feed one of our children.

He was pretty emotional about it.  

More peaceful sleeping.  She did a lot of that the first two days

following surgery.  

The wing in between the PCICU and the 

children's hospital.

Into a regular room on Thursday.  It was a lot different than the ICU ward.  

I mean there was a 1 to 1 ratio in the PCICU.  But we couldn't sleep there.  

As mom and David, we were nervous about her getting moved too soon.  I mean, 

just as we had been prepared for, we expected her stay in the ICU to be a little longer.  

Friday.  Notice the TInkerbell picture behind her, Hannah made 

that for Riley's hospital room.

In the next two photo's, you can see Riley's incision.  You have to look closely 

though, because it's very thin.    

Showing signs that she's ready to go: she's trying to get to the fingers attached to that 

arm board.  

And we were released on Saturday.  It was a remarkable turn around for a 3 month old that had heart surgery 4 days prior!

David and I could not be happier about the turn around.  Matter of fact, we 

went to church the next day, as a praise to all the people who had been praying for her.  We wanted them to know that we believe our prayers were answered.  Our church was such a sense of support for David and I.  People reached out to David and I from all over, offering kinds words and prayers.  Thank you from the very bottom of our hearts.  

The longest day ever

The day started out early but only because I couldn't sleep.  I didn't fall asleep until after midnight and I was wide awake around 5.  I got up and started the house coffee and took a shower.  Riley's last feeding had to be over with by 8 am, so I hoped to wake her up at 730 and feed her then.  She actually woke herself up just after 7.  Our morning went really smoothly. We were right on time at the hospital, arriving at 0850.  

Her doctor was Andrew Lodge.  You can learn even more about him here.  David and I agree that we could not have asked for a better doctor.  We met with him 2 weeks prior to surgery and then we spoke with him again, right before they took Riley back.  This guy was surgeon to the T.  He was not a communicator.  He kept telling David and I "Well, you know...." and David kept saying "No, I don't know.  I've never done this before."  There is no doubt in my mind that this guy took medical school very seriously.  And that is exactly the kind of surgeon you want operating on your 3 month old!  

The waiting was rough.  There was some miscommunication about when Riley's surgery would start.  See she drifted off around 10 am, while we were in the waiting room.  We had been told that the first surgery had run over, but that's all we knew.  She woke up around 11, hungry.  It was bad.  I was uptight and anxious.  My baby was hungry and they wouldn't let me fix it.  David tried consoling her.  A nurse tried giving her glucose in a bottle but Riley had never successfully taken a bottle.  Plus, she was really ticked off at this point.  I walked away because I felt like I was torturing Riley.  She knew I was there, and I could just imagine her thinking "why isn't mom feeding me."  It felt cruel.  While I was taking my time out, another woman in the waiting area approached me.  She stood with me for a few minutes and offered comforting words.  I walked back over to David and Riley, who was still screaming, and another woman approached us.  She said she was a nurse who worked in the pediatric ICU and also a lactation consultant.  She wanted to know if it would be okay for her to try and comfort/feed Riley.  I welcomed someone else trying.  This lasted for what seemed like an eternity but probably about 30 minutes.  Riley eventually wore herself out crying and fell asleep.  Right at 12 we were called back.  They prepped in the back and the anesthesiologist came back to talk to us.  Around 1245, the anesthesiologist told us to say good bye to Riley.  I have not done anything that hard in my entire life.  Even writing about it now is causing me to tear up.  David and I said good bye to Riley.  Then we took 10 minutes in the private room for ourselves.  The strangest part about that moment is that David and I really didn't cling to each other, like I had imagined.  We stood across from each other, lost in our own private thoughts and concerns.  As we walked back into the waiting room, I saw my pastor's wife.  She had come up to be with us.  Our pastor was unable to come because of a conference.  As soon as I saw her, I broke down crying even harder.  

And then we waited.  We walked around, a lot.  We played Scrabble and Monopoly.  We read but not really.  Left the hospital to eat twice.  They called every hour to let me know how things were going.    

At 5:45 pm, they called to tell me that Riley was out of surgery and the doctor would be out to talk with us in a minute.  He came out and said that surgery had been what he had expected, with no surprises.  The patch was closed with the exception of a very small, less than a millimeter, residual hole.  Over time, the cells of the heart would grow over the entire patch, which is made out of Gortex by the way, and close up the very small residual hole.  

We headed to the PCICU, where we would meet Riley.  At 630 pm, they told us we could head back and see her.  This time, there were no tears, only smiles.  

My baby, right after surgery.  

She looked so much better than we ever imagined.  I expected her to look puffy and bruised.  David expected her to look as if she had been beat up.  Yet here she is, somewhat alert and looking like herself.  It was such a relief.  

She still looks a little dopey.  She had short moments of being alert, with bouts of trying to come off the anesthesia.  

She was hooked up to so many machines in the PCICU.  

So happy to see her.  

It felt so good to see her.  We hung out for a few hours, then opted to leave as they attempted to remove some of the things she was hooked up to, like her breathing tube.  

David and I walked to TGI Frdays.  Remember me mentioning that nice lady that came up to me and talked to me while we were in the waiting room.  Her husband is a pastor.  David had been chatting with him in the waiting area.  As they said good bye to us, he slipped David some money and told him to take me out for a nice dinner.  We felt like it was necessary to honor his wishes.  So while TGI Fridays is not a fancy place, it was the nicest sit down place within walking distance.  On the way there, David and I agreed how we both felt like a weight had literally been lifted of us, and comforting to know the constant care she was receiving.

The longest wait ever

Remember when I told you all about Riley's heart defects.  Well the week before last was her surgery.  Our long adventure started out Sunday November 6th, when we drove to the Ronald McDonald House of Durham.  It's hard to explain how David and I felt.  For myself, there was this giant ball in the pit of my stomach.  I felt kinda queasy and I felt like I had all this nervous energy balled up inside of me.  We ended up just driving around Durham for a few hours late Sunday night.  We love just driving, it calms us.  We found a Whole Foods, which was mildly exiting.    

Monday morning was Pre Op.  Pre Op consisted of a chest x-ray, EKG, lots of blood, vitals, weight and height.  All the normal doctor stuff and then some.  We spent a good 5 hours at the hospital taking care of it all.

  Even Riley looks stressed.  But she's not, she's just tired here.  Every time she drifted off, they called her back to do something else.  

David playing a game with her while we were waiting for the 

PCICU (Pediatric Cardiac ICU) nurse to come in and talk to us.  

She was nice, but a little OVER optimistic.  You know what I'm talking about, the overly "everythings going to be alright" attitude.  It was a reminder to us of the seriousness of Riley's surgery.  She explained the details of Riley's surgery and recovery.  She said that "on bypass" and "off bypass" were two important things that would happen.  On bypass would signify that they had successfully stopped Riley's heart and put her on life support.  Off  bypass would mean that they had successfully taken her off life support and her heart was again beating on it's own.  The expected stay in PCICU was 2 to 3 days and another 6 to 7 days in a regular room.  She also talked to us about how Riley would look when we saw her.  Outside of the machines and monitors she would be attached to, she would be puffy and bruised from fluid and surgery.    

We took in all the information, and had very little questions.  Truthfully, her cardiologist had prepared us and we knew as much as we wanted to know.  The nurse asked that her last feeding be over with by 8 am and told us to be at the hospital by 9.    

Monday night, as happy as can be.  

Riley's self soothing technique.  

We tried to busy ourselves that night.  The Duke's Women's Lacrosse Team cooked dinner at the Ronald McDonald house that night.  The commotion and conversation was a welcome distraction.  We stayed up pretty late, playing games on our Ipad and Iphones.  Whirly Word is an awesome game, by the way!  David and I both drifted off sometime around midnight.  

What it's like: having a child with congenital heart defects

I've waited a long time to make this public.  At first, it was because we didn't know how serious it would turn out to be, and it could have been a relatively simple fix.  Heck, it could have fixed itself.  But it didn't.  So here's the breakdown.  When Riley was less than 24 hours old, David and I were told that she had a medium sized Ventricular Septal Defect.  It was terrifying.  It felt like someone had ripped the bottom from our world when they told us.  I'll never forget sitting next to David after the doctor left our room.  The expression on our face was one of pure shock.  How could Riley possibly have something wrong with her, she looked perfect.  Our pediatrician came back to see us later, and talked some of our fears down.  At that time the diagnosis was a 6 mm hole in the wall separating her right and left ventricle.  Sometimes, the hole will close up on it's own.  In those instances when it doesn't, and surgery is required, it can be put off for years as long as symptoms don't become present.  On August 16th, I took Riley to see her cardiologist for a routine checkup.  At this appointment, we discovered that the hole was larger, over 7 mm and another defect was found, a problem with her mitral valve.  Surgery was talked about.  We knew if it didn't start to close up on it's own that this size hole would need to be fixed with surgery.  We knew the call would be made at her 6 month visit.  So David and I began to mentally prepare for open heart surgery in January.  On October 12th, her cardiologist said that he could feel her liver, a sign that it had enlarged.  This is a direct problem of her VSD.  I had also noticed some changes in her breathing while eating, another symptom associated with VSD.  Now surgery is next month.  David and I are traveling to Duke Children's Hospital to meet the surgeon. We'll schedule the surgery that day.  Miss Riley will be in ICU for a couple of days following surgery, then moved to a regular room before being released.  It looks like we'll spend at least a week at Duke. All in all, it's terrifying.  I think about my baby, less than 4 months old being hooked up to a bunch of machines.  I think about her possibly being chemically paralyzed while in ICU.  Doesn't that sound lovely.  I think about being there when they put her under and then having to walk away.  It's more than I think I can bear, but I do.  And then, I think about Hannah.  Mostly about being there for her less as I tend to Riley.  David has thrown himself into work.  Sometimes I look at him and can see him completely zoned out and I know what he's thinking about.  Through all this, an amazing support group has surrounded us.  Now, if we could be a little better about accepting help, things might actually get a little easier!  This is our life for the next couple of months and I hope that you'll all take a minute and pray for my family, if you're the praying type, because this is certainly the hardest thing we've ever faced.