Life with Two because One is the Loneliest Number

"One is the loneliest number that you'll ever find" or so goes the tune.  Life has changed a lot since May 13, 2014.  Luke has already brought immense joy to our lives, including big brother Landon's.  Landon is already eager to show his brother new stuff all the time.  Plus, Landon isn't the lonely one always clamoring for Mommy or Daddy's attention anymore.  Sure there are moments of jealousy, like "Daddy stop holding baby", but things are going well in the newly expanded Walenga household.  Luke has been a much easier baby for obvious reasons, but for also less obvious reasons.  He already goes eight hours at night.  

With that said, I wanted to take this time to try and put into words the deepest satisfaction I have for being a parent. I've been feeling these emotions more and more ever since Luke came.  There is nothing in our lives  more significant (besides our faith) than our relationships with our children.  

I definitely have more "helicopter parent" tendencies than I would have imagined I'd possess before kids.  I think it stems from a few things related to Landon's heart journey, but I want to control so much of what he does because "I know what's best".  

Let's face the facts.  I can't be there for every scraped knee (I hope he gets a few playing hard), nor can I be there when he faces a difficult situation at school or on the playground (amazingly those have already begun which I didn't anticipate).  What I can do is help him build his self-esteem and self-confidence.  This will enable him to fend off negativity in a world full of it.  "In this life we will have trouble, but take heart for I have overcome it."  I noticed the other day, maybe more so than any other time, that when I lavish praise on Landon and push him with repeated encouragement and praise he responds like a champion.  Just like my dad did with me.  Thanks dad if you're reading this.      

This is what God tries to do with us in our lives.  How will we respond if we're not listening on a daily basis?  I'd say it's pretty hard to respond to anything without hearing it.  Am I engaging with God enough so that I can lavish his grace and peace upon my children and my wife?  The answer unfortunately is a resounding no.  

Am I trying harder than I have in a long time?  Yes.  Because this is the area of my life I refuse to fail in.  You can have my job and all my possessions, but you can't take my faith and connection to my family.    

A New Year, A New Walenga

Sorry it's been a while since we've posted.  But with Landon, no news is usually good news.  Landon had another follow up appointment just before the New Year that went great.  His anxiety from the hospital has pretty much gone away at home but at the doctors office doing an xray and echo are always a big challenge since it is nearly impossible to keep him calm and still, which are both very important for those tests.  His xray should that his lungs were clear and the doctor finally OKd him going back to a normal diet from his low fat diet.  We celebrated with donuts on the way home from the doctors office and a big brunch on New Years Day (where Landon ate 2+ pieces of bacon).  He did really well with the low fat diet but it certainly makes things easier on us to not have to count his fat grams every day.

The doctor also approved him to do an overnight pulse ox study which means he would sleep without oxygen at home one night and have his saturations continually monitored throughout that night.  Then the doctor would review the results of the pulse oximeter and let us know if it was ok to pull him off Oxygen completely.  It took a while to actually get the equipment to do the study but as of this week we got the official OK from the doctor to take him off oxygen for good.  Add on the fact that we had a few of his medications cut and his life is pretty much back to normal!  He went back to daycare this week and has loved getting to play with his buddies who I know he missed while he was away for a few months. 

Developmentally he seems to have continued moving forward and not had any delays as a result of the surgery which is a huge blessing.  A lot of kids experience delays and we will take him to the pediatrician soon to make sure he doesn't need any therapies but based on what we've observed he seems to be on par with where he should be.  There is no getting around that fact that he is a 2 year old, so he has gotten very picky about certain things (the blue cup, not the red cup and these pants, not those pants) but it seems to be very normal for his age.  He and I have both had a cold for a few weeks that we can't seem to shake but it's bound to happen at some point in the winter and it hasn't been severe for either one of us. 

We spent Christmas day at home just the 3 of us, which was a nice lazy day other than me doing some cooking and baking and Christmas night my family came in town.  We had my parents, my older sister Jenny and my younger sister Brittany with her husband Josh come out and stay for about a week.  We are very grateful that they could come out since we were not quite ready to travel with Landon yet.  Landon soaked up all the attention as he always does and had a blast playing with his aunts and  uncle and his new toys. 

In other news, we are expecting Baby Boy #2 in May!  We found out a few weeks ago that we are having another boy and are so excited that Landon will have a little brother to play with and cause trouble with!  I am 23 weeks along now and had a fetal echo this week to check this baby's heart.  We already had the big ultrasound at 19 weeks to check everything and the heart looked good then but with Landon's heart defect they wanted to take another look.  Landon's cardiologist, Dr Brames performed the echo and said that everything looks great and he doesn't think I need to have another one!  So all signs point to a healthy baby so far which is very exciting and a big relief!   

We want to thank you again for asking about Landon (especially when we have been slow to update) and for your prayers, meals, cards, etc.  We are so grateful for every act of kindness that our friends, family and even total strangers have offered to us.  Happy New Year!

Excellent Follow-up Appointment

Landon's follow up today went well.  Xray was a battle as always and he was pretty upset for this one, but the xray is much better than last week's!  It's much more clear which shows the fluid starting to dissipate.

 

His saturations have been really good lately too (93 or so on room air and 96 or so on oxygen) so the Dr said we can take him off oxygen during the day although we'll still put him on it at night.  It will make his playtime much more fun though!  No more distance restrictions or tripping over the cord.

 

We are sticking to the low fat diet for a few more weeks and expect he will be taken off of that at his next appt (Dec 30) as long as the xray then still looks good.  So we'll have to make sure to have a Thanksgiving/Christmas meal on New Years Day as long as we get the go ahead.  He also had one dose of one of his twice a day meds (enalopril) removed so we are slowly starting to come off the medicine.

 

Great report and he did really good (aside from the xray) but this time was minimal bothering since no labs/ekg/echo. 

 

The PLE test still has not come back (it is taking forever) but Dr B said he would be shocked if that's positive considering how well Landon is doing.  The other stool sample test we did for a bowel infection came back negative. 

 

He's making great strides (literally and figuratively!) and we are so glad to see where he is now as compared to a week ago. 

Good Followup Appt

Landon was upset quite a bit yesterday and it had us concerned that it might be a sign that fluid was accumulating again but when we took his oxygen saturations last night they were normal so we weren't sure what news we would get at Landon's followup appointment today.

His appointment was with his primary cardiologist here in the Springs.  It was a rough morning with him because we were rushing to try to get out the door on time (not to mention the fact that it was below zero outside when we left the house).  He also had xrays, bloodwork and an echocardiagram in addition to all the waiting time so it was a rough few hours for  our poor little guy.  We got a good report though - his xrays are about the same as when he was discharged which isn't what we had hoped for but at least it's not any worse.  His labs and echo looked good so we are happy with that news.  We didn't make any changes to his meds, low fat diet or oxygen based on the visit today.  We'll go back for another followup in a week.  Hopefully xrays will show some improvement by then and we can start to wean some medication or oxygen or go back to a normal diet. 

We are so grateful to be home and today Landon seemed to be in a little bit better mood than yesterday once we got home.  His cardiologist said it would probably take a few weeks before he gets back to his normal self in terms of feeling safe again and not being so anxious about constantly being poked and prodded.  We're hoping he will feel more emotionally secure a little bit each day and are very happy with the progress he has already made. 

Discharge attempt #2

Got discharged this afternoon and just got home. Here are a few pics of Landon on the way out of the hospital. We have a follow up appointment on Thursday. Will post more details later.

We are glad to be home!!

No change = good news?

Xray continues to show very little change today and since the existing fluid does not seem to be bothering Landon or affecting his vitals, they may send us home today with a follow up and xray in just a few days.

The medical team still needs to discuss with the surgical team and Landons primary cardiologist so we will see if they all agree that discharge is the best decision right now.

Not Much Change

Landon got to sleep in a little bit this morning which was nice.  Gary went to work today but his mom will be here the rest of this week so I'm glad to still have some help with him gone.  The xray today again didn't seem to show a significant difference but his lung's were expanded on yesterday's xray and contracted on today's so that can make a big difference in comparing the two.  As many as xrays as I have seen, they still seem very subjective to me.  Those and echos are something I don't think I'll master interpreting. 

Anyway, so they decided to increase Landon's dosage of his diuretic medication to help him pee off some of that extra fluid but that's the only step they are taking now.  They were also planning to talk to the surgical team and Landon's primary cardiologist in Colorado Springs today but I haven't heard any feedback on that yet.  His IV was removed since it was not working very well which is bittersweet because at least he has his right hand and arm back but if they decide he needs any other IV medication he'll have to get another one.  We're praying that he doesn't.

He decided a nap wasn't going to happen today so we did a lot of walking around this afternoon and it was a relief to give him a little bit longer leash and not have to hover over him.  I still have to follow him with the oxygen tank but since he has the IV out I don't have to worry about him falling and landing on his hands and messing that up.  And having the chest tube out makes that a lot easier too.  He doesn't spend much time in bed during the days anymore! He spends a lot of time in the wagon in his room and out on walks or wagon rides. 

So it still sounds like it will be at least a few more days before we can go home.  I think they wanted to see how this increased lasix dose might help the fluid dissipate and see he ends up.  So tomorrow's xray will be a big one but it feels like that every day.  Continued prayers for improved xrays are what we need right now!

Good News from X-Ray

The morning started at 6:15 when we were all woken up to Landon having to get blood drawn from his finger for labwork.  Not a fun thing to wake up to, especially for Landon! 

Landon's xray this morning was about the same as yesterday which we are told is a good thing.  It means that at least the accumulation isn't increasing so there is no need for a chest tube right now.  Hopepfully over the next few days his body will reabsorb some of that fluid so his xray will get more and more clear each day.  If this happens we could go home in the next few days.  If it stays the same it sounds like it would still be likely we could go home this week as long as Landon doesn't have any symptoms that indicate it is causing problems and the surgical team is ok with it. 

He hasn't been eating very well since his procedures this last week but he's also still on a 10g of fat per day diet so it's not like he gets to eat whatever he wants.  I'm sure the repeat meals are only so appealing after 2 weeks.  He's always been a pretty good eater but I can't blame him for not being super excited about food with so many bland options.  He also has the IV in his right hand so it's more difficult for him to feed himself.  We hear that the IV is probably on it's way out since it's not being used (which is causing it to dry up even though it's flushed about every 4 hours) so hopefully he won't need another one after this one comes out. 

We're not counting on leaving any particular day just yet, just hoping Landon continues to make progress in the right direction so we could maybe go home this week.

If you've been following the blog since surgery, you may remember me talking about meeting Kaden's parents (I mis-spelled his name with a "C" before) and asking for prayers for him.  I got a chance to talk to his mom this morning and he's doing very well! He has a long way to go but considering he wasn't given much of a chance after his surgery he has done great.  They are on the same floor we are and might even get to go home this week!  Praise God for sustaining this tiny baby (born at 34 weeks with a heart defect!) and giving him the strength he needs each day!

Landon's an all star

Gary here.  Has Landon been grouchy and irritable?  Yes, but I'd say he has handled all of this like a champ.  Let's just review all he has been through to this point. 

We started this journey November 4th and tomorrow the calendar turns to December.

Nearly 20 trips to get x-rays, which he hates and I don't blame him. 

About 8-10 doses of medicine everyday. 

5 or 6 IVs (I've lost count).  Many failed IV sites too that have left cuts and bruises.

Pokes and prodding every 4 hours at a minimum, even while he sleeps.  Blood pressure readings aren't fun for toddlers.

5 chest tubes.  Excruciating, yet he was basically running today with the chest tube in.  Running better when it came out for sure.

The large incision on his chest, which is looking great by the way.

The very annoying and irritating oxygen tube shoved up his nose.

A total of six procedures where he has been under sedation over the last three and a half weeks.

He is on a low fat diet so he can't eat many of the things he loves, including his milk.

There have been so many times where he has asked to be held and I couldn't hold him the way he wanted because of the chest tubes.  Frustrating for all of us.

I cherished today with no chest tube.  I tried to hold him as much as possible knowing that freedom could be stripped tomorrow.  I think my shoulder hurts from all the holding.  The second x-ray today he didn't cry at all.  A huge blessing and break. 

Landon is a hero.  A fighter.  A winner.  Brilliant.  You should hear him speak.  See him do puzzles on our tablet.  A charmer with his personality.

Praise God for his spirit and the testimony that is being written.  An incredible story he will forget since he's so young but which will always be a part of who he is.  So very proud.  One day at a time.

An Encouraging Day

The pulled the chest tube today around noon and sent Landon down for another xray right after (which he didn't mind at all since he was on some strong pain meds).  After that the day improved.  Landon did a lot of walking around when we went on our normal wagon ride around the hospital where we saw the new Christmas tree! It held his attention for about 5 seconds before he said "ball machine?" He also took a 4 hour nap which was much needed after last night. 

 

We got him a much needed bath (which he hates in the hospital since all we can really do is a sponge bath but he always feels better afterwards) and did lots of wagon rides around the unit with daddy.  We are hoping and praying that the xray tomorrow shows improvement over today's and we can continue to move forward without the chest tube.

 

 

Daddy and Landon playing puzzles on the tablet after bathtime (we gave him a few minutes of a break from oxygen after bathtime).  I swear he was happy, just focused.

 

 

The beautiful Christmas tree they just put up in the lobby of the hospital

Bad News/ Good News

Sorry for the delay in posting!  Here's on update on the last few days:

The rest of Thanksgiving was a little bit rough.  Landon got his new IV before we moved up to the CPCU but it took 3 tries and a long time to get it, which is never fun.  So we were all pretty much spent the rest of the afternoon.  They put everything but battle armor around it though to make sure we can keep it for as long as possible so hopefully it will stay good for a while.   They also gave him some albumin and immunglobulin by IV so that took several hours to run and we couldn't really go anywhere.

We had a nice dinner for Thanksgiving that was prepared by a church for the Ronald McDonald house.  It was a bit non-traditional since we were trading out to eat in the hospital lounge so somone could stay with Landon but it hit the spot.  I'm determined to make a nice Thanksgiving-esque meal once we get home and Landon is no longer on a low-fat diet.  It might not happen until Christmas but we'll make it happen!

Pretty much since Thursday afternoon Landon's chest drainage has slowed almost to a complete hault.  Yesterday his chest xray showed that fluid was accumulating so it seemed there was fluid that wasn't draining through his chest tube for some reason.  It is particularly important that it drains at this point because if there is fluid in his chest then it prevents the pleuorodesis from really doing its job of adhering the lining of the lung to the chest wall.  They tried a few things yesterday to try to get the fluid moving and pull out any blockages that may be in the tube but they were not effective. 

Yesterday was pretty frustrating for us and both Gary and I were feeling defeated.  Having been here for almost 2 weeks since being readmitted it felt like we're back at square one.  Landon has been more irritable and while we still see his "normal" self some he has a very short fuse right now with the medical staff.  We knew that last night would be a tough night for him to sleep very well since the fluid accumulation can be uncomfortable.  We were given the option of giving him some Ativan (an anti anxiety med) just to help him relax and sleep well so we decided to try it and unfortunately it had the opposite effect of making him wide awake.  So after getting it at 8pm he was up until 1130 which was frustrating for us.  He slept in a little bit today and had an xray a little bit later so at least he wasn't up super early. 
_______________________________________________________________________

Update:

We just had rounds and found out that his xray today actually looks better than yesterday's.  Since his chest tube is still draining almost nothing and is pretty worthless at this point, they are going to pull it out but wait on putting in a new one.  Hopefully his xray tomorrow looks better than today's which would be a sign that his body is reaborbin the fluid and that the fluid that is being produced is either going down in quantity or at least not accumulating in the chest.

This is great news since this morning we were planning on him probably having to get a new chest tube again.  We will still have to wait and see though how things go tomorrow before we can think about going home anytime soon.  Even if the xray looks good tomorrow they will keep him a few more days to make sure he doesn't reaccumulate.

Please pray that his body will reabsorb the fluid and that Landon would continue to take steps in the right direction.

Much to be thankful for

Landon did great overnight - they weaned off his IV drips completely and continued to mostly sleep and wake up intermittently until about 3:30am and then was up!  At that point he had slept for a LONG time and he was off the drugs that were keeping him so tired so we weren't surprised.  He watched some movies and was very much back to his normal self this morning.  We feared today would be another day of pain for him so we are grateful to see our happy little boy especially when he's only on Tylenol now for pain.

They pulled the IV out of his hand last night since it dried up and this morning the other one he had in his foot came out.  I think it wasn't taped down well enough or something which is a bummer because he had only that that one a few days.  We had hoped we could put off getting another one and see if he needs it because he's off his IV meds but they decided in rounds that they want to give him a few things by IV so he will have to get another one shortly.  He really is starting to run out of places to try so we are praying they can get it quick!  Once they get the IV started, we will move back up to the CPCU.  He had an xray this morning (a portable one so he didn't have to go downstairs for it - it's still not fun but not the kind he really hates) and his surgeon said it looked normal for post-pleurodesis so we take that as good news. His fluid drainage is really down which is mostly good but we don't want it to dry up too quickly or it could mean the chest tube isn't working. 

A church is providing meals for the families in the Ronald McDonald house and is even going to deliver some to the hospital so we will get a nice meal without even having to leave.  We have so much to be grateful for on Thanksgiving but we also want to rememeber that the Bible says to "give thanks in all circumstances".  We should pause and be grateful for the ways we have been blessed each and every day.  It is not our preference to be in the hospital today but we are thankful there are many doctors and nurses here to willingly care for Landon when they would probably rather be home with their families as well.  Landon is right where he needs to be and for that we are very thankful. 

Sleeping it Off

Landon is still sleeping quite a bit - he will occassionally wake up and say a few words or be upset for a few minutes but he has mostly been sleeping since we got back here several hours ago.  He is still on some strong drugs for pain relief and to help relax him and those will be slowly weaned overnight as he allows. 

He spit out his airway support just a few minutes after my last post (which was fine) and he's been doing good without it.  He's been drinking some water and a few sips of juice but we're not ready to move on from that quite yet.  We will be trying to walk the fine line of getting him to not be so "drug sleepy" and still keeping him in as little pain as possible. 

He's done great today but we certainly hate seeing him uncomortable or in pain.  I try not to dwell on the pokes and prods he's endured but he has a lot of bruises and scabs now from IVs (and many attemps), chest tubes, central line, etc.  and even as some of them fade it is little reminders of the champ he has been.  It will be such a blessing once we can hug him and pick him up without having to worry about IVs or his chest tube.

Please pray that as he becomes more awake he will be comfortable. 

Procedure compete

The procedure is done and we are with Landon. He is sleeping and has a support in his airway since he is on some heavy pain meds right now. The rest of the day will be about pain management. We won't know how effective it was for at least a few days  hopefully by the weekend we'll see a little bit of a difference as far as the fluid goes.

He has a new chest tube which is draining well and once they pull the airway support we hope he will be able to start drinking some clear liquids and hopefully move on to solids later tonight or tomorrow . We will be in the cardiac icu overnight and as long as his pain needs to be aggressively managed.

Moving forward with pleurodesis

Landon had very little output overnight but his xray this morning did show fluid again so they are performing the pleurodesis right now and also giving him a new chest tube that will drain better.

Please pray that this would be effective in eliminating the fluid accumulation in his chest and that his pain would be managed well today since it can be very uncomfortable from what we've heard. He will be on some iv pain meds so we hope that will help him be comfortable.

Next Step

We talked to the surgeon late yesterday afternoon after I posted and he said we would watch the fluid today and move forward with pleurodesis, the next step of treatment of the pleural effusion, tomorrow.  It is a procedure (again, under anesthesia) in which they put a chemical in the chest cavity for a period of time and then drain it out.  It essentially irritates the outside of the lung and causes it to adhere to the chest cavity to eliminate the space in which the fluid can build up.  Since the fluid cannot accumulate in the chest cavity, it is reabsorbed by the rest of the body.

Landon's fluid was still significant last night and this morning but since this afternoon it slowed to almost a complete hault.  We have seen several clots come through the chest tube over the last several days so we don't know if it is a clot that is preventing drainage, kinks in the tiny chest tube, or if it really could be clearing up.  His drainage overnight tonight and xray in the morning will tell us a lot.  Our assumption is that if he has minimal overnight drainage and the xray tomorrow looks clear, then we might hold off on the pleurodesis.  But if their is either a lot of drainage overnight OR a chest xray that shows fluid building up, we will likely move forward with it late tomorrow morning and also have a new chest tube put in place that will drain better while he is under anesthesia. 

We would love if the fluid just went away on it's own and no other interventions were required.  Please pray for clarity in how to move forward in the morning. 

Cath Complete

They completed the Cath around 12:30 and we went back to see Landon shortly after.  He was upset and somewhat out of it for a while, which we have learned is normal for his post-anesthesia self but it's still not very pleasant.  After a little while of recovering in the pre/post unit on the 3rd floor they sent him back up to his room on the 9th floor. 

He napped for a little bit and woke up and wanted to watch "balloon movie" (Up) so we are relaxing and watching that for now while he eats a snack (his first food of the day).  He had to lay flat for 4 hours after the Cath and luckily we are almost done with that so hopefully we can get him up soon and let him go explore a little bit.

The Cath itself went well - everything heart function wise looks good.  They did say he threw up andd aspirated a little bit but not enough that they felt it was a concern.  We will continue to watch him closely but if it was going to be a problem we think he would have started showing signs by now.  He had a few collateral vessels that they put tiny coils in to help cut them off and keep them from getting any bigger but the doctor who did the Cath did not necessarily think that was a major cause of the fluid.  So in the long term, the Cath provided very good news about Landon's heart function but as far as the fluid goes, it doesn't sound like it provided a quick solution.  As far as we know we will have to continue to wait and hope it subsides.  There is one other treatment option that we know of but we will see how things go for a few days before moving forward with that.  Again, we know that time will eventually solve the problem, it's just a matter of how much time.

Thanks again for your prayers today.  Despite the fact that it is not the quick solution we hoped for it is still good news for Landon's long-term health.

Cath Update

Landon had a decent morning (he was up and happy at 5:15 for some reason so it started early!) and is still in Cath.  His xray this morning showed a moderate amount of fluid around his right lung but it seemed like he had a decent amount of drainage this morning before his Cath so we hope it will continue to drain as it should. 

So he's been back there for 3 hours now and we're not sure how long it will be.  They are going to coil some collateral (extra) vessels but did not feel that ballooning any vessels was necessary based on the size of his pulmonary arteries.  It took a while for them to get the lines in him, so it's taking a little longer than we planned on, but that's nothing new.

One more day of calm

We had somewhat of a quiet day again today, which was great considering tomorrow will definitely be crazy with xray early in the morning and Cath at 9am.

We made it to the playroom this morning, watched some movies and had our typical ball machine/fish tank tour in the late afternoon.  The output from Landon's drainage tube has been significantly higher the last day or two so we are hopeful that during Cath tomorrow they can find and treat the cause(s) of the fluid.  Whether or not the Cath is an effective method of managing the continued perfusion, we are assured that with time it will eventually go back to normal, it's just a matter of how much time (for some post-fontan patients it takes weeks). 

Please pray for the Cath at 9am and that it will provide the insight the doctors need to effectively treat Landon and hopefully get him home soon.

More of the same. . .

The past few days with Landon have been a little more mellow and it's been nice to see him more comfortable instead of anxious all the time.  He's because much less skeptical of the doctors and nurses and will even willingly get his blood pressure taken if he can hold mommy or daddy's hand.  We've learned a lot of what he will and won't allow and what just makes him more comfortable (ie Gary holding the stethoscope to put it on his chest while the dr listens) and continue to explore the hospital a few times a day to get him out of the room and let him see some of the fun things. 

He had an xray yesterday which looked good and got a "day off" from xray today.  The drainage from his chest tube has not slowed to where we need it to so it looks like they will move forward with Cardiac Cath on Monday.  If it dropped down to where they could remove the chest tube we could maybe avoid the cath but he is putting out 3-4 times that amount so we don't anticipate this will be an option. 

In the Cath, they will get a better look at the inner workings of his heart than they can on an echocardiagram and can possibly do a few procedures that could help with the fluid that keeps building up.  The surgery created a whole new blood flow for his body which he is still getting used to but there could be some changes from the last time they did the Cath 3 weeks ago like extra vessels that have formed or narrowing of vessels that the surgery was performed on.  After Cath we'll have to wait a few days to see how his body responds and if the fluid slows. If it does we'll have the chest tube removed and hopefully go home a few days later if he doesn't reaccumulate fluid, but if not we'll have to move on to the next step of what they can do. 

The good news is that the fluid that is building up in his lungs continues to drain but we need it to slow down a lot more before we can take another step towards going home.

We are not thrilled to still be in the hospital but relieved that Landon has gotten a little more used to this routine and environment which lowers the daily stress for all of us.  Gary and I are still staying in Landon's room at night and Gary's mom is still at the Ronald McDonald house.  Luckily this means comfortable accommodations for all of us at a low (or free) cost. 

Thank you for your continued prayers.  We are still in "wait and see" mode as far as when the drainage will slow down and hope that the cath will provide some clarity in terms of information and possibly treatment.