Pup sparks recall of baby’s 1st year

It was just a week ago when I first saw a picture of “Champ.” Two-toned black and white coat. Two tiny bottom teeth mere buds in his gum line. His pink nose and top lip split in two, the result of a common birth defect in Boxers and other dogs with “smushed” faces. Champ was born with a cleft lip and palate, and the memories flooded back.

Solo Champ 1Marty and my first child, daughter Moira, was born with a cleft lip and palate. I didn’t know it happened in other species. And yet, why wouldn’t it?

In the two weeks before Moira was born, we learned as much as we could about clefts: how they developed, how they’re corrected, what else was wrong, what we could do.

Whether human or puppy, the head grows in such a fascinating way. The face basically starts at the base of the skull with two mirror-like sections on each side growing up and forward. Each section reflecting the other as it grows, the flesh wraps around the top and sides of the skull before finally coming together at the nose and mouth.

Our septums and that indent in the middle of our top lips? They’re like biological seams, evidence in flesh of our fetal experience. This basic blueprint for the face, as explained to Marty and I, was usually in place before most people even learn they’re pregnant, about midway through the first trimester.

~But clefts can be startling and scary. Startling simply because they look unnatural, a wee little face unfinished. And that’s basically what they are, as cells divide and flesh meets and grows together, a cell gets dropped or lost, leaving the lip or the palate or both, open. All the material is there, but at the very end of the process, it just didn’t come together.

The scary part is in the survival. Kids (and puppies) with clefts have a terrible time eating. Robbed of the ability to suck, nursing is often unsuccessful. Moira was fed with a soft-side bottle that we’d squeeze to the rhythm of her gnawing. I had reams of yellow legal pads documenting her nourishment by the ounce, by the hour. We kept a hospital-grade baby scale handy, measuring her losses and gains.

~I don’t like thinking back on this. It was a heart wrenching time. All I wanted was to comfort and cuddle my child and yet every feeding was choked by the worried thought, “How much would she eat this time?”

At death’s door, Champ is given a chance

~When I met with Champ’s foster mom, Tara Hansen of Miles who is also a vet technician at DeWitt Veterinary Clinic, she exhibited many of the same emotions I did nearly 15 years ago. Almost steely, I could feel her push aside the fear that comes with caring for a child with a cleft and focus on the task at hand, Champ’s survival.

Champ was two days old when he arrived at the vet clinic. Tara has a friend who breeds German Boxers and when his latest litter was born Jan. 18, one had a severe cleft palate. Two days later, unable to nurse, the pup was brought to Tara at the clinic to be euthanized.

Tara is not your average animal lover. She and her family have fostered countless animals in the past, but it’s the Boxer breed of dogs that is her calling. She and her family have two at home, six-month-old Lola and six-year-old Lucy. Just last fall, her eight-year-old Boxer Layla died from cancer of the blood vessels. “Now that she’s gone, I feel like I have to carry on caring for the breed.”

That’s what drove her to ask Champ’s owner if she could try to save him. “I knew the survival rate was low,” she said, “but I had to give it a whirl.”

~A brief attempt was made at bottle feeding Champ, but the cleft in his palate is so wide, the risk of aspiration was too high. “He’s turned blue on me. Several times,” she said.

So began the process of tube feedings every two hours in which Tara passes a feeding tube down Champ’s throat and into his stomach . . . every two hours. That means where ever Tara goes, Champ goes, too.

But it’s not all bad, with a four-year-old son and 11-year-old daughter, Tara’s kids have relished the tiny baby. And the furry kids, how have they reacted? While the older Lucy doesn’t pay much attention, six-month-old Lucy may be a puppy herself, but has taken to mothering Champ like a pro. Even the family’s 15-year-old cat has proved vital, filling in on nap and cuddle duties when Lucy or the kids need a break.

~As she would with any other puppy, Tara started Champ on regular puppy formula, but after the first several days of slow, but steady gains he reached a point in which the formula wasn’t enough, “he was just stuck at 22 ounces. He wasn’t gaining and he wasn’t losing.”

After searching various website dedicated to the care of puppies with clefts, she learned goat’s milk could help boost a pup’s growth. And it has. For the past week, she’s been feeding Champ a half and half mix of puppy formula and goat’s milk. When I met him, Champ’s eyes had just opened and he was learning how to use his legs under that large, heavy head of his, bobbing all around.

While Tara loves to see him doing so well, she admits the feedings are growing increasingly more difficult: Champ can no see the tube coming and wants to fight it and chew on it.

~Monday Tara and Champ head to Ames and the veterinary college at Iowa State University for a surgery consultation in which she hopes a feeding port can be put in Champ’s stomach until he’s healed from the oral surgeries.

Tara was told medical costs could run as high as $3,000 so she set up a Go Fund Me account to collect donations.

Many people have asked Tara if she’s keeping Champ or, more commonly, can they adopt him. More than Champ’s foster mom, Tara sees herself as his protector. While there are many who’d love to adopt him, she has found Champ’s forever home in the arms of a local couple. After he heals from his surgeries, Champ’s new family will train him as a therapy dog for their chiropractic clinic!

Originally published 7 February 2015 in The Observer.

Champ loses battle for life

Last Saturday I told you about Tara Hansen, a veterinary technician at the DeWitt Veterinary Clinic who had taken on the role of foster mom and caregiver for a Boxer puppy born with a cleft lip and palate.

Monday night, sitting on the couch with my husband who was looking at his phone, I heard him groan, “Oh no…”

~Tara & Champ 2Looking at his Facebook feed, he merely turned his phone to me, showing me the following message posted to the Boxer Champ community page:

“It is with a very heavy heart to have to type this update . . . (definitely) not an update I ever thought of writing. Champ passed away in my arms tonight. I fought for him until the very end attempting CPR, but it was too late. His little body couldn’t fight any more.”

Marty was stunned. I was in disbelief. And when I told daughter Moira, she bent her head to hide her tears.

Neither Marty nor Moira had the pleasure of meeting Champ. In fact, most of his fans never got the opportunity to stroke his sweet little cheeks or shake one of his cute, tiny paws. But he had a huge fan club to be sure.

None of us would’ve learned of this sweet little puppy had Tara not answered the call of her heart, a call that whispered, “Give him a chance. Try,” when he was brought to the clinic to be euthanized.

Tara is the quintessential animal lover, truly going to any lengths necessary to help an animal in need. Whether it’s to bottle-feed an abandoned litter of newborn kittens, find a new “forever family” to adopt a homeless dog, or, as she did with Champ, devote herself morning and night to the survival of a struggling animal who needed a shot at life.

I know plenty of people who roll their eyes at those of us who connect with other beings covered in fur (or scales or feathers). They mutter thoughtless things like, “It’s just a dog.” So I’m sure there are a few readers wondering why I give so much attention to animals. Simple, each animal, each creature (yes, even spiders) are a living, breathing being that has purpose. Often times, we’ll never know their purpose.

When I talked with Tara the day after Champ passed, she admitted she wasn’t completely shocked that he died because he was exhibiting a few troubling symptoms indicating he was struggling.

“But at the same time, I was upset. I still am.”

Tara reviewed the symptoms with me, saying that at 7 a.m. Sunday, after Champ’s morning tube feeding, she saw him start to gag and struggle. He was open-mouth breathing and turning white. Taking an infant bulb syringe, she did an emergency suction on Champ and discovered copious amount of mucus had coagulated in the back of his throat.

Hearing this took me back nearly 15 years to Moira’s first five months, before any surgeries started to correct her cleft, when her breathing would rattle when mucus clogged the back of her throat. Marty and I grew quite adept with the bulb syringe. Fortunately for us, that usually relieved Moira’s woes and she’d return to easy breathing.

With Champ, however, Tara could tell things weren’t right and she feared pneumonia could be setting in. After clearing the mucus from Champ’s throat, she then took him to the bathroom and started a hot shower so the steam could enter his lungs and loosen any remaining mucus. While it seemed to help, later that day she gave him a nebulizing treatment for safe measure.

The following morning, Monday Feb. 9, Tara woke to give Champ his breakfast and found him in his kennel. “He wouldn’t stand up and he had blood all over the side of his face.”

After Tara cleaned and then fed him, “he perked right up,” she said.

Once he was stable, she and a friend loaded him in the car and made the three-hour drive to Ames where they met with doctors at Iowa State University’s veterinary college.

Tara explained what had been happening over the last 24-hours and while doctors initially guessed the blood may have been caused by irritation to the throat from the tube feedings or sneezing that may have caused Champ to bite his lip, chest films were taken.

“I was sure he had pneumonia,” Tara said. While the films didn’t indicate pneumonia there were a few small spots doctors couldn’t explain. “I wonder if it was some blood clots,” she said.

While in Ames, doctors mapped out a progression of surgeries and had tabled the idea of a feeding port due to Champ’s fast growth rate. His first surgery was slated for next month.

Returning home, Champ was tired and Monday evening, after a feeding “he fell asleep,” Tara recalled. “Then all of a sudden he woke up and threw his head back.”

Tara immediately suctioned Champ, “I ended up getting a whole bunch of blood out of there.” Then his heart stopped. “I started doing chest compressions and by then he was doing agonal (spastic, labored) breathing.”

Despite her efforts, Champ died.

Having raised nearly $2,000 in donations for Champ’s medical costs, Tara wants all the money returned. Many of her donors, in thanking Tara for her compassion and hard work, wanted her to keep the money as compensation. She refused, “It was something I never wanted to pocket the money from or be paid for.”

Instead, Tara is suggesting donating in Champ’s memory, either to an animal shelter or the “Care for Cleo” fund at the DeWitt Veterinary Clinic, which covers costs associated with helping stray and unwanted animals.

Writing on the Boxer Champ Facebook page Wednesday, Tara wrote that despite the heartbreak of losing Champ, she will continue her work.

“In three short weeks I was able to watch this little guy open his eyes, struggle to take his first steps and see him find his little voice. In three short weeks my heart was wrapped up in his pudgy little Boxer body. I will continue on and do whatever I can for animals, this will not detour me from doing what I feel is right. . .

“. . . If (we) humans could take a few lessons from animals, our world would be a much happier and loving place to be!”

RIP Champ. . .

Originally published 14 February 2015 in The Observer.

The long road of repairing birth ‘marks’

Two weeks ago my 14-year-old daughter, Moira, had surgery. Not relating to anything life-threatening, no surgical response to a scary diagnosis, but surgery nonetheless. It was the third attempt to graft bone into her hard palate.

Having been born with a unilateral cleft lip and palate, Moira’s baby smile was extra wide and the inside of her mouth, a veritable canyon of openness. Aside from the expected eating issues, the cleft was merely cosmetic.

I prefer the term birth “mark” to birth “defect.” Well-meaning people would see her baby self and remark how lovely she’d look after surgery. I’d gently remind them, “she’s lovely now.”

2014-05-16 07.12.21Her recent trip to the OR was one of many surgeries she’s undergone. At six months of age, University of Iowa doctors closed Moira’s lip. At 1-year, her palate. Then there were the holes (fistulas) that popped open in her palate, requiring skin grafts from her hip to close them. Like many other children, Moira also had a couple of sets of ear tubes put in, as well.

Then in 2nd grade, doctors made the first attempt at grafting bone from her left hip into her hard palate. The reasoning behind the graft was to allow Moira as natural a smile as possible. Often times, children born with cleft palates are missing teeth in the area where the face and skull didn’t fully come together. By grafting bone into the open palate, it allows doctors to either move teeth into the area or install implants.

Unfortunately, within the first couple of weeks after this first graft, tiny shards of bone began escaping and by the one-month post-op appointment, doctors confirmed our fear: the graft failed.

In 3rd grade, a second attempt was made. Once again, by the second week of post-op, she began handing us tiny shards of white bone. I felt sick.

Despite the emissions, the otolaryngology team believed some of the graft did take, which put Moira in a holding pattern, of sorts. No more surgeries until after braces.

Last spring the braces went on and after several months of moving teeth, we were informed x-rays showed there remained insufficient bone in the hard palate to continue moving teeth, that enough bone did not survive the 2nd graft five years earlier and she’d need a third.

I felt that old flutter of panic rise in my chest. I wanted to scream and holler that my daughter had to go through this, again and AGAIN! It wasn’t fair. And then the panic passed . . . even Moira would admit she’s got a pretty great life. Her “problems” are cosmetic. She’s a healthy, happy, normal kid!

Not only did Moira’s attitude help fend off the demons of dread, but the doctors working on her were a new team. Rather than go through the otolaryngology department at the University of Iowa, her orthodontist referred her to UI’s dental department where he teaches weekly and is “hands-on” with her team there.

After meeting with this team, I felt a little less scared. Their approach was more aggressive noting Moira would be placed on an antibiotic immediately after surgery, the bone would be harvested from the opposite hip, or as they put it, “a fresh site,” and then warned, “you’ll be coming out here a lot” because of Moira’s history with rejection.

An aggressive approach was music to our ears. I didn’t care if we had to drive daily or stay in a hotel, I loved the idea of these doctors keeping a close eye on her.

There were a host of other issues, minor in comparison, but pressing nonetheless. For instance, Moira plays trumpet, would she be able to continue? How limited would her other activities be?

Her team assured us that after 4-6 weeks of recovery, Moira could likely resume her normal activities. Timing proved key. To minimize any chance of being jostled, bumped or hit, we scheduled surgery as close as possible to the last day of school. May 15 was the best they could. We opted to keep her home for the remaining 10 days of the school calendar, working with her teachers to help her focus on homework and such.

By being at the end of the school year, she would have the summer to recover and be ready to resume her trumpet in August.

Many people have asked how Moira was handling the idea of surgery, “was she nervous?” Undoubtedly, yes, but Moira has two things going for her A) it had been several years since her last surgery so her recall wasn’t as fresh, and B) she’s a little Buddhist! If ever there was a child who lives in the moment, it’s Moira.

But as surgery grew closer, as she attended the pre-op appointment and talked with teachers and friends about the upcoming knife, she admitted her fears. Those fears? Not being able to eat Mike & Ike candy or popcorn. (Oh, the teen mind…)

The day of surgery came with several delays, but eventually she was taken into the OR. When she came out, it was with fabulous news!

Tune in next week to learn what happened and of the amazing things people did to honor Moira (and her fellow human beings)!!!

Originally published 31 May 2014 in The Observer.

Surgery enables ‘pay it forward’ ops

When last I wrote, my 14-year-old daughter was heading into surgery for a third attempt at a bone graft into her hard palate. Having been born with a unilateral cleft lip and palate, surgery is a common occurrence.

While we can talk and act as if this type of corrective surgery is “no big deal,” when you stop the foods and fluids at midnight, gown her up the following day in a pre-op room, the chin will inevitably quiver.

To help bolster our spirits, I intended to put out the typical Facebook plea for prayer, but as we headed west, I was hit with the following idea surely hatched in the heavens:

“We know there’s oodles of positive vibes being rocketed into the Universe for her, but what if those thoughts, vibes and prayers were put into action? If interested, do one nice thing for someone today to show you believe in humanity! While Mo is totally healthy . . . we’d all fee better knowing good deeds are on the rise today.”

As we waited for Moira to be taken for surgery, her operation was delayed from 1:30 to eventually 4 p.m. During those hours, I read Moira Facebook updates from friends and family who were doing good work in her honor.

A friend of my husband’s told us that she and her coworkers were volunteering to serve a community meal.

A previous co-worker of mine said she sent “cute cards to two elderly friends who don’t have much family” and added she was working on a gift quilt for a person preparing for a bone marrow transplant.

Then one of her doctors came in to discuss the previous week’s pre-surgery appointment in which x-rays taken showed Moira’s wisdom teeth had come in.

After getting our consent to remove those teeth the doctor proceeded to explain a possible change to the graft plan: rather than open her hip and shave bone from the pelvis, doctors would attempt to harvest bone from her lower jaw.

Not only would that alleviate the need for a second surgical site, but the doctor added jaw bone was more dense then hip bone.

All three of us were pretty excited at the idea of no hip surgery, but nothing was for certain until she went in, and the waiting to do so dragged on so we regaled Moira with more Facebook well-wishes.

There was the friend who treated his co-workers to an afternoon snack of hot wings; n aunt, who herself has suffered much more than most of us, shared she’d seen a friend of hers that day.

This friend was upset so my aunt told her about Moira. “Her problems seemed little compared to precious Moira and her journey endured so bravely,” my aunt wrote. “It certainly helped cheer up my very sad friend.”

Then the nurses came to take her back to surgery. Now that she’s older, I no longer get to accompany her into the O.R. so we gave hugs, kisses and Hi-5’s and kept smiling and laughing with her until she was out of sight.

Both Marty and I felt very confident in the University of Iowa’s dental team, but admittedly it doesn’t get any easier watching our daughter be wheeled away. In typical Moira fashion, however, we could hear her continuous chitter-chatter with the nurses awhile after the gurney disappeared around a corner.

The surgery was estimated to take up to four hours so we headed off for food and enjoyed reading a few more Facebook messages, one from a teacher friend of mine who wrote of giving a picture book to a student. Given Moira’s book-worm nature, she thought Moira would appreciate a book-sharing act of kindness.

This student who received the book has a younger sibling living in another state who has no books at home. My friend helped her student read the picture book aloud to their sibling via the wonders of technology and a little thing like video chat.

Then a message from a running buddy popped up. She wrote of the “very nice man who sometimes panhandles for bus money.” The morning of Moira’s surgery, this friend found herself at a Davenport Walgreen’s near where this gentleman was “so I grabbed him some fruit, protein, some cash and a note of caring.”

Finally, another friend wrote of having books to return to a local library and was inspired to ask the librarian to choose someone who owed a fine they couldn’t pay.

“She immediately chose a young woman who recently lost her mother, got kicked out of the place they had been living (and) lost her car,” my friend shared. The young woman also tried to go back to school, but couldn’t maintain her studies. She’s also been unable to find a job.

The mammoth fine she was unable to pay? $3.70. The librarian asked my friend to write a note to the young woman: “Good luck and God bless you! In honor of Mo.”

She then added, “Of course, I cried the entire way to my next stop. It’s so sad that $3.70 is insurmountable to someone out there AND I’m grateful you asked us to do this today because it’s easy to forget the value of ‘little’ kindnesses.”

After about three and a half hours, Moira’s surgeon met with us and appeared relaxed and pleased with how events played out. He told us her jaw provided enough bone that he could place pieces into the hard palate, but also mill additional bone into a sort of cement he packed around the graft.

But the even better surprise was learning part of her second bone graft five years ago was not a painful waste of time. Enough bone had “taken” that it saved a few teeth from falling out and actually created a bridge between the edges of the cleft, requiring less bone for this graft!

Even as I sit and write, I’m amazed at how different this bone graft has gone compared to the previous two! Moira feels so good that we have to remind her not to run, not to wrestle, not to pester her brother.

The change is so drastic that I have to believe these wonderful, random acts of kindness played a part. That we are blessed to know such caring people who refuse to harden their hearts.

I don’t know how the idea came to me or from where it originated, but one thing’s for certain, it inspired beautiful people to shine their lights into the lives of others.

May we all live so inspired . . .

Originally published 7 June 2014 in The Observer.