Home! Home! Home!

Shayna and Becca picked Elijah and I up this morning.  It was the fastest hospital discharge I've ever experienced.  We were home by 11:30, enough time for me to play with Shayna a bit and enjoy lunch with her.  It's wonderful how cuddly she is with me.  We all took afternoon naps.  Afterward, I made dinner for my family.  It's wonderful to feel a bit normal again.

Feb 18: Dr. Shayna listens to Elijah's heart.

 Reading Ima's Jane Austen book.  She loves to take these books off the shelf and "read" them.

Feb 26: Aba and Shayna visit Ima and Elijah at the hospital.

Feb 28: Elijah gets his daily EKG.

Happy Birthday Shayna!

Happy 2nd Birthday to my little girl!  She came with Aba to the hospital again today.  We threw rocks in the river and I made the cafeteria staff nervous by throwing her in the air.  I love the way her hair flies and she grins right before I catch her.  I bought her a cookie just to give her something but we'll be celebrating with friends next Sunday.  She loves parties and singing so will be thrilled when everyone sings happy birthday to her.

What a difference a year makes.

Hospital Home into Next Week

Elijah keeps having SVT episodes; though, they are much less frequent than they were in the first 24hr period.  There were 12-14 during that period where the last 3 have been spaced at 11 and 14 hours apart.  We need to be 48 hours out from the last one to go home.  We're also going to experiment by giving him 5 minutes to get out of the next one on his own.  They just upped the dose of Flecainide and we'll also be going home on a beta-blocker whose name I forgot.  He'll be on the Flecainide for 6 months to 2 years and we won't know when we stop until we're there. (Usually, the dose is left the same, the kid will just out grow the dose, not have any episodes, and then it's stopped all together.)  I don't know how long for the other one, but it seems it just may be a short term thing.

I had an amazing visitor yesterday and today, Shayna.  Today Nahum brought her down today.  It was his first big outing with her all on his own.  Luckily, Becca helped him get set up for today's trip yesterday.  Shayna and I threw rocks in the river both days.  She was insistent that we go to the river again today.  We collect rocks in my jacket pockets, I hold her while she sits on the rail of the footbridge, she throws/drops the rocks in, and we both enjoy the splashes.  She enjoyed climbing in and out of the 2 little plastic cars in the regular pediatric area toy room.  She also got a lot of stickers as anyone with stickers offers her some.  The whole front of her shirt was covered by the time she and Nahum left.  We've been able to say hi to a lot of the doctors that treated her when she was a patient and couple of the nurses.  We even ran into the pediatric surgeon who'll do Shayna's hernia repair.  Nahum, being the wonderful Israeli that he is, asked if the doctor would just look at Shayna now so we don't have to bring her in Monday afternoon for her pre-op appointment.  He did! and now we don't have to haul her down to Roanoke except to visit me.

I've got a few pictures and a video but they're all stuck on my camera as the cable is at home so you'll just have to wait till we're home to see my wonderful children.

Paroxysmal Supraventricular Tachycardia (PSVT)

Paroxysmal: A sudden attack, recurrence, or intensification of a disease


Supraventricular: Located or occurring above the ventricles (the upper 2 chambers of the heart)


Tachycardia: a rapid cardiac rate


You guessed it.  More big medical terminology means more hospital fun for the Arav family.  Currently Elijah and I are in the Roanoke Carilion Memorial Hospital PICU due to his sudden attacks of rapid heart rate (above 300 in his case).  Other than the fact that we're in the hospital and I have to keep smothering my child with bags of ice to get his heart rate back down, we're doing well.  I'll try to make a long story short.


Shayna spiked a fever in the night Tuesday so I took her to see Dr. Berry in the morning.  Poor child had massive ear infections again, probably originated from last month's.  While we're waiting for her antibiotic shot, I notice Elijah is awake yet calm so figure it's a good time to check his heart rate like I'm supposed to 3x a day.  300+ so I grab the doc to listen too and he says, "pack up, we're going to the ER."  So I have a miserable, crying Shayna, a baby in PSVT, and Dr. Berry in the front seat directing us through the parking lot to the ER doors.  Dr. Berry stays with us for the next 3 hrs in ER directing Elijah's care, which was a blessing beyond belief as Dr. Berry knew what to do, how to do it, and what to monitor when it seemed the ER staff was overwhelmed and lost.  Vagal Maneuvers were used every time (3 ER episodes of PSVT) to get his heart rate down, the effective one being a bag of ice pressed to the face and head.  Becca came to help with Shayna and eventually took her home once it was clear that I would be allowed to ride down to Roanoke with Elijah.  (Shayna spent the rest of the day snuggling on the couch with Becca and watching Curious George or sleeping.  She's doing a lot better today.)  Since we got to the PICU yesterday afternoon, Elijah's had 8 more episodes so I've become quite a baby-smoothering-with-a-bag-of-ice expert.  (It was scary to watch Dr. Berry do it the first time but after he explained what he did to the transport crew so they could repeat it if necessary, it became fairly easy though still a little nerve racking for me to do.)  


In Elijah there appears to be an extra electrical circuit that originates above the ventricles that gets stuck in an infinite loop until either a vagal maneuver or iv drugs are used to stop it.  (Thankfully the iv drugs were never needed as they could have also stopped his heart (In the ER, he had little shock pads stuck to his front and back just incase he needed the drugs and the drugs stopped his heart, they could shock it back).)  Elijah is now on oral meds (flecaninide) 3x a day to control his heart rate.  Once he's bigger (20-25lbs), they can take a look inside to see what's wrong if we're still having issues.  At the end of the day, there's a 99% chance that he will simply out grow the PSVT around toddlerhood.  Until then, we will walk around with a stethoscope and 2 kids on drugs.  The good thing about Elijah's condition is it would take 12-24 hours to begin to kill him by just tiring out his heart.  This gives us plenty of time to get to the appropriate medical facility without much stress.  We should be able to go home Saturday or Sunday.

My day is going well as I got a visitor who brought real food and company.  Both beautiful blessings in my current state of living.  My friend even got to experience the thrill of 2 PSVT episodes.  She also has a good sense of humor so could laugh with me about our current situation. Tomorrow Becca will bring Shayna down for a visit so I can play with her & she can have some Ima time (I really missed holding her yesterday and just being with her in general).

Elijah getting himself to sleep.  We've been sharing the extra bed in the room as we both seem to sleep better next to each other.

Settling In

We did make it home at 6:30 Tuesday evening.  I was so happy to see Shayna and she us.  She was pretty excited to see Elijah too.  After many Ima hugs, she wanted to hold the baby.

We're settling into our new roles and Shayna isn't having too many issues.  She's a little whinier than usual but that's about it.  She likes to look at, sing to, and hold Elijah.  Elijah eats and sleeps well.  I occasionally get 3+ hours of sleep in a row, but he also decides that he's going to be awake during the night at times.  He's a mellow fellow and is finally starting to relax fully after his NICU experience.  (When we first brought him home, he'd cry for every diaper changed and when his feet we touched and got real jumpy with loud beeping things.)  Nahum does Shayna's mornings, evenings, and nights and she's switched easily to depending on him.  I miss her so treasure my times with her more than ever.

I'm recovering much faster than I did with Shayna.  I'm down to only an afternoon nap as of yesterday with added activity.  I took Shayna (and Elijah) to gymnastics yesterday (see pics below) and today Becca drove us all to the park near our house (don't think I'll be up for a real walk until next week but the weather was just too beautiful too pass up).

That's all my brain is up for just yet.

Please Welcome Elijah Yaakov

We are proud to introduce Elijah Yaakov Arav to the world.  He was born on February 6th, 2011 at 10:55pm after 44hrs of all labor.  At birth, he weighed 9lb 9oz, was 22" tall, and had a head circumference of 14.5".  Yaakov was Nahum's paternal grandfather and we just like the name Elijah.  To me, it has always had a strong yet peaceful feel and that was how he felt.

Labor began around 2am Saturday but it was just a long first stage so I was able to sleep most of the nights.  The birthing waves would wake me but not enough to keep me from getting back to sleep most of the time.    On Saturday, Shayna and I visited the VT duck pond to feed the ducks then to Aba's office to visit him.  On Sunday, things started to get a little more intense but Becca was there to help with Shayna.  I made Nahum come home at 3pm and our doula Cindy came at 3:30.  Things seemed to gear down for a little bit as the company made me feel more relaxed.  I was able to make everyone pizza for dinner but by the time it went into the oven I knew I wouldn't be eating it.  We went for one last walk while the pizza cooled.  During birthing waves, we would all stop while I sang through them with Shayna and sometimes Nahum's accompaniment as well.  We told Shayna we were singing the baby out and she was eager to help.  When the singing wasn't enough, I hopped in our wonderful bathtub about 6pm maybe for a couple hours.  That's when things got started to get amazing as I allowed my body to move into whatever position seemed natural as the waves stepped up in intensity.  This is also when I lost total track of time.  I'd guess it was a 2hr bath before the back labor really kicked in and needed both Cindy and Nahum's support to get through each wave.  At 8:30, I knew we needed to go to the hospital but was so terrified of the car ride that it took another 1/2hr to get out the door.  Cindy sat in back with me to help me through as pushiness was now added to the list of sensations.  We arrived about 9:20pm to be greeted by Kris the midwife on call.  Cindy and Kris walk/danced me to my room where I was pronounced to be about 7-8cm.  That news really helped me make myself relax through the waves on hand and knees at first then assume positions that proved increased intensity, like squatting.  At some point, my body just started pushing on it's own during some wakes.  Nahum climbed behind me so I could lean into him during rest periods.  In the end, I had to lean back into him to widen my base to open my pelvis for my fat baby.  At 10:55pm, Kris had me reach down and pull him onto my belly.  He cried as soon as he was out.  He was he a slippery guy with wrinkled, peely elephant skin and he was beautiful.  It was a wonderful, natural, normal birth followed by 5 minutes of normal post-birth bonding.

As he was a bit grunty, the nurses asked for him to try to help him clear his lungs a little better.  5-10 minutes of this didn't help, so the pediatrician took him to the nursery where he was hooked up to a heart rate monitor.  A newborns hr should be around 150 (as it was throughout deliver).  Elijah's was over 300 and not coming down.  They did manage to bring it to normal after 20-30 minutes with specific physical stimulations but the order for transfer to the NICU in Roanoke had already come down from the neonatologist.  The hospital we were at doesn't have the machines for the tests that needed to be done (EKG and Echo) so he needed to be transferred to make sure there were no abnormalities that caused the excessive heart rate.

As he was stable, they were not planning to do the tests until Monday morning so Nahum made it down to see both of those.  I was discharged from my hospital at 10am.  Becca and Shayna picked me up. (It's the same place we do Shayna's labs so we did those before we left.  She was an angel as usual and didn't shed a tear or fuss.  We've got her trained labs are "little poke" and shots are "big poke" so she says to Erin, "big poke, no. shots big poke.  little poke."  Then she gives her cheerful, "all done labs."  She even knows where they keep the stickers so walked over to the drawer, opened it herself, and picked out a sticker to help her through the draw.)  I got to Elijah about 11am when Nahum told me all had tests had been preliminarily declared good.  He especially enjoyed seeing the Echo as the technician did took "beautiful" ultrasound images of a working heart.

We finally got approval to pull his stomach tube and nurse at 2pm.  He latched like a pro and nursed for almost an hour then slept for 3&1/2hrs.  Nahum was with me when he nursed and that was the time we needed to name him.  Peaceful, normal family time.

Later on, all results were officially declared "beautiful" by the cardiologist and there have been no other episodes.  The most common reason is just for something like this is just the baby adjusting to the sudden change in his condition (inside vs. outside) and so far that's what it looks like in our case.  We are expecting to be discharged late this afternoon and hope to be home by 6pm.  We will have to monitor his heart rate 3x a day for the next 3 months just to make sure it doesn't take off again and make a follow up appointment with the cardiologist in 3 weeks so she can check him also.

Feb 6 about 5pm.  Playing on our last walk before Elijah's arrival.

Our last picture of a family of 3.

Shayna LOVES pizza!

Hello baby! 

Just before the NICU nurses take him down to Roanoke they let me hold him.

Feb 8: Elijah with his proud Aba.

Just Waiting on SJ

We are now just waiting on SJ.  SJ hit 40 weeks last Saturday and has been feeling like all elbows and knees for the last week.  We had a little birthing wave action Thursday and Saturday but both petered out after some sleep.  I think he wants out and my money is on he's bigger than Shayna was (8#13oz).  As long as he's thriving, we have until Feb 19 before the doctors would want to force him out.

In the mean time, Shayna went for some drama of her own.  Luckily, she has recovered from all illnesses but her liver numbers jumped with last Tuesday's monthly lab draw.  Nothing astronomical, but enough to startle Pittsburgh and send us back to check the Liver Function numbers (LFTs) again on Friday.  They were slightly higher than Tuesday so we did it again today.  Today's jumping numbers were lower than last Tuesday's so we did a little happy dance and agreed to check them again next Monday.  They think it might have been due to her having been sick.  Now that she's recovering, so should the numbers.  On the bright side, her EBV blood load was down to the lowest it's been in the last 10 months.  This is even better as we dropped on anti-viral dose (daily instead of 2x a day) at the end of November.  It's not a medicine that is good for the body overall so everyone would like to have her off sooner rather than later.

Nahum continues to work hard all the time and has also picked up a lot of Shayna's evening routine as I've gotten slower and slower over the last 2-3 weeks.  All three of us are overly ready to meet SJ and I to begin the recovery from pregnancy so I can get back to feeling normal.

Jan 23: Shayna had a playdate with Hannah.  This is one of the calm moments in the storm as Hannah ran Shayna ragged with lots of running, jumping, ball-pit-rocking, and tickling.  Thank goodness Becca was here to chase them.

Jan 25: Everyone loves Shayna, including Becca's girlfriend Heather.  On her day off she wanted to come over to play with Shayna since she hadn't seen her since the beginning of December.  Like any parent, I enjoyed hearing all the ooo'ing and ahh'ing over her many developing skills as I worked in the office.  Shayna likes to roll on the ball these days and touch the floor.  For a little more excitement, I usually just hold her feet.  She gets a kick out of the instability.

Jan 29: 40 weeks of SJ.  To compare, here's 40 weeks 4 days of Shayna.