ANNA RECOVERING FROM SUTURE RUPTURE

ANNA WHEN SHE WOKE UP THIS MORNING, TUESDAY, SEPTEMBER 9...I'M A HAPPY LITTLE GIRL!

HAPPY BIRTHDAY TO YOU, HAPPY BIRTHDAY TO YOU!... HAPPY BIRTHDAY, NANA!
SAMUEL EATING MY SOUR CREAM AT RED LOBSTER ON NANA'S BIRTHDAY!

Anna's lip and skin where the sutures ruptured looks much better than it did one week ago. I wanted to show a picture so everyone could see her progress.

Anna went to the doctor Saturday, September 6 because she was leaning her head and ear into her left shoulder and rubbing it. (She is still having to wear the "No-No" arm restraints, so she is unable to reach her ears with her hands). She had drainage and the pediatrician was unable to see into her ear, so we are treating it with Ciprodex drops as well as the Amoxicillin she was already on for her lip infection. We took her back today to have her checked again. Her ear has cleared up so we are hoping to be competely well in a few more weeks. Thankfully, the tube that was placed in her ear has not come out. She looks so different now that her skin above her lip is healing and is no longer infected. She is very happy and playful...just spoiled where we hold her all the time!


We received some encouraging cards from a church member and former pastor Mark served on staff with. Their scriptures were a blessing to us.

Acts 17:28
..."for in Him we live and move and have our being..."

Lamentations 3:22-24
"Through the LORD’s mercies we are not consumed, Because His compassions fail not. They are new every morning;Great is Your faithfulness. The LORD is my portion,” says my soul, “ Therefore I hope in Him!”

What a blessing to have brothers and sisters in Christ uplift you with the use of their spiritual gifts!

"Oh, give thanks to the LORD, for He is good! For His mercy endures forever."
I Chronicles 16:34

FOLLOW UP VISIT AFTER SUTURES RUPTURE

We went back to Dr. Sargent's office on Friday, September 5th to determine if Anna's infection had cleared up in the area where surgery was performed on her lip. Dr. Sargent felt like it looked much better and should continue to heal after continuing the antibiotic and cleaning/treating the area. He explained to us that the skin should contract over time and that it should heal on its own without attempting to restitch it at this time. We are unsure if the area will completely close and reattach, but we go back for another follow-up visit in 2 weeks and may know more at that point. He said that we should be on schedule to continue the other procedures as planned (palate repair on December 3rd and columnella lengthening next year). He may decide that it is necessary to do some repairs to this area at those procedures-He will make those decisions as we get there.

Anna is still having to wear the elbow restraints and eating through the Soft-Sipp bottle for another two weeks to try to ensure that the area does not tear any further and that no other damage is done. She is also still sleeping in her car seat, which is the most annoying part of her recovery. She prefers to sleep on her side and would love to be able to play and sleep on her belly, but will have to wait a few weeks to get back into this routine. I have been placing her car seat in the play pen to keep Samuel from touching her face for the last few weeks, and this is how she has been sleeping, as well. I heard her wake up this past week and start to cry. When I went to get her, I noticed a musical toy was turned on that was hanging from her play pen. A button has to be hit in order to turn it on and it is out of her reach, which was quite puzzling to me. When I looked down, she had her legs kicked up in the air and was practically standing on her head where she had scooted down so far in her car seat. She had used her little legs to kick the toy on and her head was laying where he bottom normally rests in the seat. Needless to say, I am no longer able to sit her in the car seat without strapping her in because she is such a "little wiggle worm."

She has done well with all of these precautions and has not been very irritated by the confinement. Please pray that she will continue to heal and keep the happy spirit she has had through all of this.

We will keep you posted and update you with pictures of her progress in the next few weeks. Thanks to everyone for all the visits to the hospital and the phone calls to check on her progress. It means so much to have the care and concern that has been shown by friends and family members. We were especially moved by the number of former church members at Hixson First Baptist that dropped by to check on her during her operation and hospital stay in Chattanooga. God has been so gracious to us through this whole process.

I will close by sharing a verse I read this morning in my devotion....it is one Mark and I have come across numerous times through this journey. May God complete the work He is doing in us and develop the patience in us that He desires. "My brethren, count it all joy when ye fall into divers temptations; Knowing this, that the trying of your faith worketh patience. But let patience have her perfect work, that ye may be perfect and entire, wanting nothing.” James 1:2-4

DR. VISIT FOLLOWING SUTURE RUPTURE

ANNA WITH "NO-NO" ARM CASTS TO KEEP HER FROM PLACING

HER HANDS IN HER MOUTH...RUPTURED SUTURES ABOVE HER LIP

We went to see Dr. Sargent, Anna's surgeon, on Tuesday, September 2nd. He removed the "scabbing area" from Anna's skin just above her lip and told us that the area was infected. We are continuing to clean the area and applying Neosporin. She is also taking an antibiotic to treat the infection. We are hoping to see some improvement by Friday and I have an appointment to see Dr. Sargent in Chattanooga again this Friday to have him look at the area to see how it is healing. The area is very swollen, red, and irritated. Dr. Sargent felt like we may be able to attempt a repair when we do her palate surgery in December, but we definitely have to get the ruptured area to heal before he can attempt any repair. We are just following his advice in seeing that the area heals and know that we have another step towards the repair to her cleft.

Thanks for your continued prayers for Anna and especially for her infection to go away!
........................................................................................................................................................................
I had the following quote and scripture in my flip devotional I keep at the kitchen window sink: (It was a great encouragement on the day that we realized Anna ruptured her sutures.)

I need a faith that nothing can shake. Emphasis on NOTHING. Even when I do not know why, I can endure with a faith like that-even if I never find out why! -Growing Wise in Family Life p. 247

Be strong and courageous...for the Lord your God goes with you; He will never leave nor forsake you. Deuteronomy 31:6

ANNA'S SUTURES RUPTURED...SKIN ABOVE LIP IS NO LONGER INTACT

Unfortunately, the dissolvable sutures that Dr. Sargent placed on Monday, August 25th have ruptured and Anna's skin above the lip repair is no longer intact. We knew that there was a good chance that this could take place because the skin was so tight once he had sewn the lip and gum in place. This can take place when a child has as severe a case as Anna's bilateral cleft lip.

We did not realize that the sutures had actually ruptured until the dermabond glue adhesive covering the sutures dissolved and fell off on Friday, August 29. We have talked to the surgeon on call and there is nothing we can do until we can call Dr. Sargent's office on Tuesday and have him see her. We are trying to just keep the area clean and free of infection. We are uncertain whether Dr. Sargent will be able to restitch the area or whether we will have to let the area heal until a procedure can be performed at a later time. This is all uncharted territory for us...please pray for Anna that she continues to go without pain and that the surgeon is able to make the best repair possible with what he has there to work with. We will let you know if we are looking at another surgical procedure due to this incident. Our palate repair is scheduled to take place on December 3, 2008, but this date could change now...we will not know until we consult with Dr. Sargent.

It has been a long few days. We appreciate your thoughts and prayers and will keep you posted this next week.

Sheri

ANNA LIP SURGERY AUGUST 20, 2008

THE DAY BEFORE MY LIP SURGERY AT DR. COX'S OFFICE...

HAPPY I'M GETTING THIS LATHAM DEVICE OUT OF MY MOUTH

Anna had surgery to repair her lip and gum on Wednesday, August 20th at T.C. Thompson Children's Hospital. The surgery was successful and Dr. Sargent was able to get a great repair on Anna's lip and gum, but Anna had a limited amount of skin to use to get a final repair on the nose. Dr. Sargent will need to perform an additional surgery in approximately a year to lengthen the columnella (skin from the tip of the nose to the lip) to complete Anna's repair. The skin that had to be sewn was very tight. We felt like Dr. Sargent did a great job with the limited amount of skin to work with.

We stayed in the hospital until Friday afternoon and were able to take Anna back to the hotel to stay in the area until Monday, August 25, for her suture removal. My mother was able to stay the weekend with me and Anna so that Mark and his mom were able to bring Samuel back to Knoxville so that Anna could get the rest she needed to recover. Anna was very agitated by even the slightest sounds so we had to keep things very quiet for her over the weekend. Our parents have been a great help this past week...we are grateful for the help both of our mothers have given! Our church family has been such a blessing, too...bringing meals, coming to clean our house, or just sitting with Samuel to give me time to tend to Anna. How grateful we are for everyone's care and concern for our baby girl!

Anna rested well over the weekend due to her taking Tylenol/Codeine that the doctors prescribed, but she did not start taking her milk back until the stitches were removed on Monday. She drank Bubble Gum Pedialyte for 5 days and began to take milk back early this week. We had to take her to the Emergency Room on Sunday night because her temperature was above 102 degrees but they ran tests to make sure she was okay before Monday (since they had to put her back to sleep for a few minutes for the stitch removal). There was no sign of infection but they did determine that she was anemic. We addressed this with her pediatrician this past week.

She has especially not eaten well the last two days (Thursday, August 28 and Friday, August 29). We tried to mix her milk with Pedialyte to get her to take liquids, but she was just not interested in eating the last few days. She was refusing juice and straight Pedialyte. PLEASE CONTINUE TO PRAY THAT SHE WILL HAVE A DESIRE TO EAT. She had lost 6 ounces as of Tuesday, August 26. I took her back to the pediatrician today,Friday, August 29, and we determined she has thrush in her mouth which is causing her discomfort and ,therefore, no desire to eat. She has eaten small amounts since this afternoon and we are giving her medication to clear this up, so we hope she does better in a few days. She had not had a bowel movement since Tuesday, August 19 and this concerned us, but she finally had one today. I think that helped her to feel some relief due to her having a lot of gas the last few days. She had lost 7 more ounces as of today so we hope to keep her weight stable since she has lost almost a pound.

RECOVERING ON THE DAY OF SURGERY...STILL VERY SWOLLEN

Her lip is healing and we will be going back to Dr. Sargent's office to have them look at her on Monday, September 8. The dermabond they applied over the area where the stitches were is peeling off and it looks uncomfortable, but all in all she seems to be dealing well with the lip and the pain. I think it looks worse than it actually feels now that we have gotten past the first few days. We had to clean a couple of spots that had some infection above her lip last night-we called Dr. Sargent to make sure that this was normal. He said that there can be a spot that gets infected where he placed some disolvable sutures on Monday, so we are watching it closely.

DAY OF THE SUTURE REMOVAL...

VISITING DR. COX'S OFFICE FOR PHOTOS

We appreciate your thoughts and prayers and will keep you posted in the next few weeks.

Sheri Carr

SAMUEL LOVES PLAYING HIS GUITAR FOR ANNA

LIP AND GUM SURGERY ONLY ONE WEEK AWAY

SAMUEL AND ANNA PLAYING EARLY THIS MORNING

We are exactly one week away from our second surgery in Anna's journey to repair her cleft lip and palate. We go to Chattanooga next Tuesday, August 19 to see Dr. Cox and have him make any final adjustments to the Latham device in her mouth. Then, we will go the next morning, August 20, to T.C. Thompson Children Hospital to have Dr. Larry Sargent perform her lip and gum repair.

It has been a long month. I appologize for not posting any updates this past month. I am very tired and trying to get rest after being sick for a few weeks. Trying to pump milk, taking care of Anna with occasional feeding challenges and the lack of sleep that can bring, plus trying to be a decent mother and wife for Samuel and Mark has kept me busy. I am surviving...The Lord has really helped me the past few weeks and I have encountered strength only He can give. I was especially ministered to by the book "The Bumps are What You Climb On" by Warrren Wiersbe. I read it the past few weeks and it was a great encouragement. I have been blessed to have Mark's mom come two days each week to help with the kids so I can try to accomplish needed tasks around the house through the week. Mark has really pitched in with Samuel and helps with Anna when he can (in the evening and during the night when she chooses not to sleep or when she is just restless.) My family and church members have been such a help and encouragement, too.

Anna has been sick with sinus problems for the last few weeks but is much better now. We go back Friday, August 15, to our local pediatrician to make sure that they feel that she is healthy enough to undergo the surgery. The pediatrician is keeping her on an antibiotic until the surgery so she will not get sick from exposure to anything else...we are keeping her out of crowds, not taking her to church the last two weeks, etc. to make sure she stays well and does not get sick. She is really growing and changing. She is reaching for things, holding things and she is smiling so BIG now...it is hard to imagine her not being able to smile for a few weeks.

ANNA SITTING IN HER BED...ALL SMILES!!!

We will have 2 1/2 weeks to recover which means no bottle (tube feeding with a hand-held bottle we squeeze, giving her small amounts of liquid at a time) and Anna has to wear "No-No" elbow restraints to keep her from bending her elbows for two weeks to avoid tearing her stitches and sutures (which I am sure will make her very mad). So, I covet your prayers that I get through these few weeks. I especially ask you to pray that she will eat well. I plan on having my mom and mother-in-law help with Anna and will probably send Mark away for a few days with Samuel to take a mini-vacation so that Samuel does not get upset if Anna is really fussy and irritable for the first few days home...he does not like his sister crying. He has been eager about her getting her "Boo Boo" fixed, as we have talked about the hospital and the doctor with him the last few weeks. He has a book that he reads called "Miffy Goes to the Hospital" and he tells us about the doctors fixing Anna's lip when we get to the page with the hospital on it. It makes you wonder what he thinks and how much he understands...I think he will be amazed when the lip has healed after a week or two.

SAMUEL READING A BOOK...ONE OF HIS FAVORITE THINGS TO DO!

We will stay in the hospital until about Friday, August 22 and then come home for the weekend if all goes well. We will then return to T.C. Thompson for another day surgery on Monday, August 25, for them to remove her stitches. They will have to put her under general anesthesia again for a brief time to remove the stitches, not wanting to damage or scar the lip. They will cover the area with Dermabond glue adhesive and allow the area to continue healing for the remaining 2 weeks. We should not have to stay in recovery for more than a few hours for this procedure and be able to come home that evening.

We will keep you posted during the next few weeks and try to update you throughout her recovery following the surgery. THANKS FOR ALL YOUR PRAYERS! The Lord has been a refuge-we could not make it without Him.

The Carr Family

Mark, Sheri, Samuel, and Anna

ANNA'S FIRST ADJUSTMENT OF LATHAM DEVICE

Anna went for her first adjustment of the Latham device on Wednesday, June 25 at Dr. Cox's Office. She had just had her 4 month old visit at the pediatrician's office the day before, so she was very sore from the three shots they gave her at that check-up and had a low-grade fever. Dr. Cox, Anna's dentist that performed her first surgery, had to cut and remove some of the chains that exist on the device in her mouth. Dr. Cox explained to us how the device works.

These are the three functions that are taking place as he/we adjust the device:

(1) The device is pulling her premaxillary segment (what you see protruding underneath her nose) back into her mouth using pressure from the chains that he adjusts.

(2) The Latham device is widening the space between her gums so that the premaxillary segment will fit between the gums once it is pulled down.

(3) The device is pulling her gums forward, as well, so that her gums meet and touch when the premaxillary segment is in a flattened position for Dr. Larry Sargent to do her lip repair. He will sew her gums together at that surgery, as well.

We have begun to turn the tiny screw that rests on top of Anna's tongue twice a day. She was awake most of the night after her first adjustment. I believe that she felt so much pressure that she was not accustomed to, that it kept her from resting. It made her quite belligerent at times throughout the night. She eventually went to sleep on Daddy's chest and slept in hour intervals as long as she was held. There was really no resting that first night for her when you laid her down in her bed..she wanted to be held (understandably wanting someone to comfort her.)

Anna's nose appeared much more deformed and unsymmetrical after the first adjustment because too much pressure was applied from the nasal stints. It is hard for Dr. Cox to know exactly how much pressure is on the stints so it is sometimes necessary to readjust the stints. We went back to his office on Friday, June 27 to have him readjust the nasal stints and he decided to completely remove any pressure on the inside of the nose. This photo was taken after we returned home from Chattanooga. It was good to see her give us a big smile after a few rough days and her nose looks normal again.

We are so grateful that Dr. Cox made a special trip to the office to see us and make Anna's needed adjustments. He normally does surgeries on Fridays and does not have scheduled office visits, but he made arrangements to accommodate us. He left for vacation that night and called to check on Anna while he was gone, which was very thoughtful. We have been very pleased with the doctors in the Craniofacial Team at T.C. Thompson Hospital in Chattanooga, TN, that are performing Anna's surgeries.

The nasal stints are bent and moved weekly to various positions as the Latham device moves everything into proper position, and we go back to the doctor on Monday, July 8th, to adjust them again. We were supposed to continue turning the screw until Wednesday, July 2nd, but I took Anna to the ENT on Tuesday and dropped by Dr.Cox's office while in Chattanooga to have them adjust a wire on the nasal stint that was rubbing her gum. They decided to have me wait to adjust it anymore so the wire would not continue to rub. Anna's ENT appointment went well. They did her follow-up appointment from the tubes they placed in her ears. She passed her hearing screens and the tubes looked fine.

Samuel is doing well. He attended his first "Camp Meeting" where he heard various preachers this past week. Daddy took him overnight on Tuesday for this experience. He has become quite the daddy's boy! He is talking all the time and repeating everything you say. His latest obsession is with airplanes and helicopters right now. He listens for them passing by when he plays in the back yard and looks for them flying overhead in the sky. He is always looking for one in his books, as well, and wants to watch a video about them as often as we will let him. Anna watches everything he does and her eyes follow him all around the room. He is an energetic little fellow, keeping Mommy very busy, too! The "terrible twos" have arrived in some capacity. We are working on sharing, and he is beginning to take an interest in potty-training. Most of our time is not that "terrible"...He gives Anna good share of kisses on her head throughout the day and loves on her constantly. His greatest enjoyment comes from clapping her hands together as he sings the last word to every line of "Patty Cake". Time has flown by the last few years watching him grow and change, and I'm sure they will do the same with Anna.

Love and thanks to you all for your continued thoughts and prayers!

The Carr Family

"I will refresh the weary and satisfy the faint." Jeremiah 31:25

Oh, thank goodness for His times of refreshing! This week brings thoughts of words to a song that has prodded me through the days that have been difficult..."I need Thee, O, I need thee, Every hour I need thee. Bless me now, my Saviour. I come to Thee." I sing these words and pray them repeatedly lately. I realize more and more how much I need the Lord and how sufficient He is to help us through all that we face. Praise God for His goodness!