9/13/02
Here's the latest update from school:

Dear Mike and Gina,
Zach has been absolutely wonderful to work with...he's excited about
being back in school...he greets everyone by name as they enter the
room. We are more structured this year offering "centers" of activities
rather than "free play" when they first arrive at school. This has
worked out so much better and the kids play so well together.

Zach was working at the "Play dough station" , he was rolling out
play dough and using the "hand" cookie cutter to make a hand....after he
was finished and satisfied that it was just right...he says..."Look
Lisa...it's a hand.."....then he throws it on the table and slaps
it---saying..."High Five hand"...then picks it up...and says
"Knuckles"...and precedes to put his knuckle prints on it.......We were
all splitting!! During crafts...I said to him..."Zach, I have an
idea....let's make a school bus!" He looks at me and smiles, and says,
"Sandie, I have an idea too!!" Crafting wasn't one of his favorite
things last year...but, he seems happy to work with us now. He gets
along very well with the other kids...

I didn't see you at the Fairgrounds...otherwise we would have stopped
for a quick "hi"....Our afternoon kiddos are so active...it took all of
us---plus a few extra adult helpers to make sure our kids all had two
adult eyes on them at all times!!! Zach was thrilled when I got to be
his bus partner...and I have to tell you...remembering our bus ride to
and from the fair last year....Zach was telling me all about going to
the Fair and how he was going to see horses..."because I love horses..."
(this is what he said....and then when we get there and I make a special
point to get him to the horse...pick him up...he would have nothing to
do with them!! Hehehe) He loved the petting zoo...we took lots of
pictures...(I washed him with soap and water from top to bottom after we
were finished touching all the animals.) He really laughed when I took
him to see the chicks hatching out of the eggs...and they let us pet
one...and I said to Zach..."Look Zach...it's a chicken nugget!!" He
just laughed and laughed!!!

Zach said all the store names as we drove past them while we were on the
bus....plus words like "Drive thru window" "Exit only"...."Welcome to
McDonalds"...and then suddenly he'd say, "Are we there yet?" I would
tell him not quite yet....and he'd say..."almost there?"

10/12/02
We arrived in California late yesterday afternoon for Zach's yearly check up. We're again staying with our friends the Staffords who we met through our church. We've had a nice time catching up and it's been fun to see Zach and George (whose house we're staying at), they have quite a bond. We went to the W.S.U. vs Stanford game today, tomorrow we go to church with the Staffords and then on Monday the appointments begin.

10/14/02
Zach and I arrived at 8 a.m. and got him registered. We got all the insurance info out of the way and we had a little time before we went to get our blood draw. As usual Zach took me straight to the train set by radiology

.The blood draws at Stanford have always seemed to gone relatively easily and this time was no exception. We were done shortly and back to the train to wait for our 10 a.m. appointment for pulmonary function tests.

Well, I guess you could sum up Zach's PFT's (pulmonary function tests) with "you've got to start somewhere". This was Zach's first time with PFT's and we weren't quite sure what to expect. He's always been too little for them in the past. I'm not sure they got much usable data but I was very proud of Zach and how hard he tried to do his best to do what was asked of him. There is a mouth piece that has one part that goes in his mouth and a cover that goes over his mouth. Kathy, the technician doing the tests, instructed Zach to do different things such as breathing normally, taking as deep a breath as possible and breathing out as far as possible. Zach wasn't real good at this but considering he's only been able to blow out candles for less than a year, I thought he did well. He also did a good job of walking with Kathy for 6 minutes and then repeating the tests when fatigued. Although I'm not sure fatigued is the right word for it since I think Zach has great stamina that would rival most non transplant kids his age.

10/15/02
Today was a day off for us so we took the boys to the beach. Zach has been talking about the beach from the first day we said we were going to California so it was fun to see him and Cole get to play. Zach's pretty afraid of the water after getting wiped out by a wave on our last vacation but he did have a lot of fun making sand castles.

10/16/02
8:30 a.m. We we got to the hospital for Zach's bone density scan.. This was another first for us so we weren't quite sure what to expect. It was a lot like x-ray so Zach new the drill. The only problem is that with x-ray you only have to hold still for a moment, with the bone density scan Zach needed to stay still for a couple of minutes at a time. It took us several tries but Zach did finally hold still long enough to do a reasonable good scan of the hip and the lower spine, two of the places that osteoporosis shows up first. Doing the whole body was out of the question since Zach just couldn't hold still that long. By the way, the reason for this test is because with a lung transplant Zach will always be on the steroid prednisone which causes increased loss of bone density.

9:00 a.m. We took Zach back over to the children's hospital for his echocardiogram and EKG. Both tests we have on a regular basis at home but they were extra thorough this time since they are looking at Zach's aorta closely from his first surgery in Spokane. There is a narrow spot in the aorta that was surgically repaired when Zach was a couple of weeks old. There is a bit of narrowing there so they are trying to decide if they need to use a balloon to expand the spot that was repaired when the do the heart cath. tomorrow.

10:25 We took Zach in to clinic "C" for his annual visit. That's where we get to see the doctors and have our visit. I have to admit it gets harder and harder for me to remember all the new doctors we meet. Dr. Theodore was there but he is in or heading for semi-retirement so we will eventually have new doctors but all the doctors are VERY sharp so we feel like we're in good hands.

10/17/02
6:30 a.m. We arrived at children's hospital admitting and then were sent up to the second floor. We're pretty familiar with heart caths but this will be the first bronchoscopy since shortly after the transplant. Although Zach is too small to take a tissue sample from during the bronchoscopy, they will do a lavage which is just rinsing out the lungs and collecting the fluid to look for cells that show signs of inflammation. Inflammation can mean rejection.

12:00 Everything went as well as can be expected. They had to put pressure on Zach's femoral artery is his groin area for about an hour after the heart cath to get the bleeding to stop. The Dr. who did the heart cath. stopped and talked to me to tell me everything looked great. I was a little disappointed that Dr. Conrad who did the bronchoscopy didn't come and talk to me but I will call her next week to find out what went on. I also was a little upset that they didn't come get me sooner to be with Zach while he was coming off the anastethia but we finally have all the testing done and that's what is important.

10/18/02
We intentionally didn't fly home today because we wanted to give Zach a day to recover. Last night he was still pretty sore and grumpy. This morning he was up early and running around. In fact we had to keep trying to get him not to run around so much because we were worried the bleeding might start again from where the went into the artery in his groin. He's very bruised down there but otherwise he's doing great.

11/19/02
Zach's speech therapy at St. Luke's continues to go well. Right now we are working on that tricky letter "F". But Zach and Mindy (his speech therapist) are making great progress.

1/12/03
Zach's doing well, other than a minor adjustment to his Prograf dosage and a cold there's been nothing remarkable medically for him the last month.

Socially Zach continues to catch up. While he's made tremendous progress we still occasionally have some funny things happen on the way to learning. On Christmas before church I explained to Zach that we had to go to church because it was Jesus' birthday. Well Zach got his important birthdays mixed up and told everyone it was Chucky Cheese's birthday!

This morning we weren't watching Zach and he broke 10 eggs into his cereal bowl and poured a whole bottle of creamer into the coffee pot. He was making breakfast for his dad!

2/13/03
Well this is the big day Zach's been waiting for! Today is Zach's 6th birthday. We plan on spending the day at Chuck E. Cheese's with the family and then on Saturday we'll have another party in Yakima. Zach is Very excited.

Recent medical news is that Zach's therapy has advanced to the group setting from individual speech therapy with Mindy. Zach will take part in a tasting group that will help him and other finicky eaters try new foods. Luckily for us Mindy Zach's speech therapist is involved with that group so her and Zach can continue working together.

Recent financial news includes continuation of help from the state through the division of developmental disabilities for Zach. This help allows us to handle medical expenses without having to worry about cutting back on therapy to do it.

Zach is growing and experiencing life and entertaining us every day. Last week when we weren't watching he used one of the toilets in the bathroom display area at Home Depot. Thankfully it was only #1. We apologized profusely and promptly headed for the registers. A little embarrassing but you can't help but laugh.

2/21/03
Zach recently had his first Dentist appointment with Dr. Andrew Garabedian. (Yes he is the son of Zach's cardiologist). Zach has three cavities and will need fillings on two teeth. The third tooth may need capped, pulled or a root canal! Zach will have to go to the hospital to have this done since he will have to go under general anesthesia. One of the causes may be the high sugar content of all the medications that he takes. Zach still can't swallow pills so everything must be compounded into a syrup. We will have a renewed commitment to brushing twice daily after his medications.

3/30/03
It's been almost 10 days and it looks like Zach has made it through his bouts with bugs. First he had an ear infection and then he progressed to pneumonia. Ten days of Omnicef and the big guy is being himself again (some times that's good and some times not). We've been working a lot on discipline lately. The first two years of his life Zach received almost no discipline since he would faint (literally) whenever he did and after the transplant Gina and I have had a hard time not feeling guilty for all he's been through. Zach's had lot's of time outs lately and he must sit with us at the table until he's excused. Like a lot of parents with kids who have been through a lot we've done a pretty good job of spoiling Zach but we're working hard on "tough love" and hopefully the manners and behaviors will come around before he's too big to tame. Zach and I have been having breakfast lately while Gina and Zach's brother Cole sleep. I enjoy every minute I get to spend with Zach although I'm still adjusting to my role as the bad guy.

Next week we're using the sky miles I've accrued on my credit card from working overtime and going to Disney Land. Both the boys (and their parents) are very excited!

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