Chapter 1

With eyes closed and my back to the thin strips of light fighting their way through the slabs of cardboard in our windows (we truly are cave dwellers), I lay motionless, feeling the exhaustion of the up every two hour routine, when the bedroom door cracked open and Ryan came creeping into the room. (He is almost always up before me and is kind enough to take Pierscen out of the room with him to allow me some much needed rest).

"Can I go to the rec center?" I asked him as he made his way to the bedside. Exhausted as I was, going to the rec center has been very limited since having Pierscen and I treasure any chance I get to go exercise.

"Yeah sure, honey," he responded, climbing up on the bed through the darkness to kneel beside me. There was a moment of silence as I made no attempt to move. "Soooo.." he began, an edge of excitement in his drawn out opening, "It looks like we are moving to Wyoming."

I don't ever recall a surge of energy quite like the one that coursed through my body at that moment. I shot up in bed, my heart thudding rapidly. "What?!? WHAT?!?" I exclaimed as I clawed his shirt, pulling him forward into a rough embrace.

He giggled, his arms wrapping around me, pulling me close. "I got the job!!!"

"Okay, okay," I laughed, "now would be the time to be a girl and tell me everything! When did this happen? When did you find out?"

"About 5 minutes ago. I told myself I was going to let you sleep, but I couldn't wait. I was too excited."

"You would have been in so much trouble if you waited!" Needless to say, I did not go to the rec center that morning. Instead, we spent the morning talking, planning, and looking up information on Casper, Wyoming.

* * *

It all started two weeks before when Ryan was contacted by the Natrona-Casper Health Dept to interview for the Environmental Health Scientist job. Ryan originally responded to the email by thanking them for the opportunity as asking if it would be possible to interview over the phone. He would have preferred to interview in person, but his co-worker had just gone out on medical leave and he was covering almost all her shifts in addition to his own. We waited for a few days, but heard no response. So Ryan decided to call. Apparently they didn't get his email. The manager told Ryan that 8 people were being interviewed, and that of the 8, only 3 were currently certified (Ryan being one of them). Technically if hired, you have 2 years to become certified, but if you are already certified, obviously that gives you a big leg up. He told Ryan flat out that it was basically between him and 2 other guys. That gave Ryan all the motivation he needed to get work off and drive out for an interview in person. He wanted them to know he was serious and that he wanted it badly enough that he would make it work to get out there. Thankfully, Ryan's co-workers pulled together to cover his Thursday shift (March 8th) so he could make it.

He left around 6 am to ensure that we would make it on time for his 2 pm interview. He arrived with plenty of time to spare and called me as he was rolling into town to tell me what sorts of stores they had.

"They have a Wal-mart," he began.

I laughed, "Oh good. I'll live." I don't love Wal-mart, but I always told Ryan that if we were going to move somewhere small(er) I at least needed a grocery store and a gas station. Ryan would happily live in a town of 5 people (or less). So if there is a Wal-mart, I know I am going to be just fine.

He drove around for a while, dictating the stores he was seeing as well as the general feel. He eventually stopped for some food at good old Burger King before heading to his interview. I didn't hear from him until after 4 pm, and even that was just a missed call as I was teaching piano. When I arrived at my in-laws to pick up Pierscen, Ryan's mom was on the phone talking to him. Unfortunately moments later he hit a dead zone in the cell coverage and the call ended.

The interview lasted 2 hours! He has four separate interviews. He met with the Environmental Health Director, the other Environmental Health Scientists, the Health Dept director, and then back to the first guy. I don't think they do that for every candidate... Ryan called back about an hour later. He said even though the interview was 2 hours, he has never had a more relaxed interview before. He felt really good about it. He said it was down to him and one other guy. But the other guy had 10 years experience... As soon as I heard that I felt a little discouraged because for pretty much every job we have interviewed for it has come down to Ry and one other person, and the other person ends up having more experience or education and wins. However, this other guy would be moving from far away and his wife did NOT want to move. So I felt that was to our advantage because I have no issue moving. And even though 10 years experience is nice, sometimes having the newby is better because you can train them how you want them.

We spent the weekend trying not to get our hopes up, but any time we sat down to the computer, we found ourselves looking things up on Google or Bing, searching real estate, stores, gyms, the library, rec center, etc. We finally told ourselves that we needed to stop so we wouldn't get ourselves too worked up over it and be super disappointed if we didn't get it.

Amidst the anticipation though, we also understood that if Ryan got the job, it would require him moving out there on his own, and me and the boys following a few months later. I still have the insurance and with Pierscen's surgery not scheduled until June 4th, there was no way we could move out with him. The prospect of being without him for all that time did not seem appealing, but getting the job would be worth it. We did toy with the idea of moving out with him since he should have insurance starting about a month after he gets hired, but that would mean moving mid April, and then I would have to turn around and come back with Pierscen on my own at the end of April for two of my brothers' weddings, then drive back, then back again for the surgery, and then back. It's a seven hour drive if you don't stop. And making that trip with a 3-month-old that likes to eat every few hours by myself that many times? No thanks. The post-op appointments would be hard enough at 4-6 weeks, 3 months, 6 months, and yearly. So no, the only real option would be to stay here until the surgery is over.

When I asked Ryan when he would know about the job, he was told, "Sometime next week." Ugh. However, the call came Monday morning - much earlier than we thought was likely.

We are stoked! It really feels like we are starting life. Even though we have already entered a different phase of life with Pierscen being born, it's not quite the same. We have been living in the same basement apt for almost 6 years. We have been working the same jobs for almost that whole time too. Not much has changed since we got hitched in July of 2006. Don't get me wrong - life has been really good to us, but it's still just been the same day in and day out for a long time. This opportunity is the beginning of Ryan's career. It's a chance to get out on our own.

I am both excited and nervous about the move. We have always been fairly independent when it comes to family even though both families are a 5-7 minute drive from our home. But the knowledge that they are that close and that we can stop by any time has been a real comfort. It has been wonderful. I have never been anywhere where we know no one - where I don't have any friends yet. Thank goodness for the Church. I know that will be a real sense of security for me. Hopefully, if we manage our finances, I won't have to work when we get out there and I can be mom. I am really excited about it. But it does mean that I won't have co-workers to interact with for friendships and adult time. Again - I am thankful for the Church! And boy... coming from Utah... what a different experience that will be! There are six wards in Casper, and I think a couple of branches. Only three church buildings. That alone is pretty different from here where there is another chapel every couple of blocks. The stake is 200 miles long in one direction. 200!!!

It wasn't until this last week that we finally found a place to live. Having Dodger has certainly complicated the matter as most places don't allow pets. His dad had a contact in Casper and we called to see if they might have any good options for us, but the cheapest they had was $1300 a month to rent a house and that's a little much for us. If we are going to pay that much, I would rather it be towards a house payment of our own! But we finally secured a little 1-bedroom, 1-bath apt. We could have had a 2-bedroom, but we opted for the 1-bedroom so we can save up a little. We only signed a 6 month contract so we can extend if we want, or find something new. We just needed to have something! I think it will be easier to find something different once we are out there if we want vs trying to do everything from 400 miles away.

The last little bit has been really crazy with trying to pack things up and decide what stays and what goes. Ryan is taking the Highlander and just whatever can fit in it. I did my best to go around and pack up half of what I think he will need - like dishes, cooking stuff, towels, etc. As he was packing up his clothes Thursday night, he said, "It's too bad we aren't yelling at each other and throwing stuff."

"Yes, it is 'too bad,'" I replied.

"Uh... I could have picked a better choice of words," he laughed. It was a strange scene though watching him clear out all his belongings - but there was certainly no name calling or anger there.

His birthday is Sunday and this will be the second birthday in three years that I haven't been with him on his birthday. (The first was when I drove my sister-in-law's sister across the country to her new job.) I bought him a bunch of snacks to keep him awake on the drive, some gift cards to buy groceries and whatever else he needs, and some random things like a shower curtain and can opener.

His last day of work was last night. He got home around 11 pm, and was up around 5 am. He gave me a hug and kiss and kissed Pierscen goodbye just before 6 am. It hasn't hit yet, but I am sure it won't take long. He is hoping to get there around 1 pm and check in, sign the paper work, get settled a bit and go shopping. He starts work on Monday.

It is all so surreal. I still can't actually comprehend moving anywhere. It just doesn't seem possible. But I also couldn't imagine having a baby - and well - that little giggling boy is certainly a reality now. :) We were not planning on seeing each other at all over the next two months. In fact, we are just praying that he will be able to come out for the surgery. But Ryan's parents really want to go visit him and make sure that we get to see each other before then, so I know they are planning at least one, maybe two trips out there in the next two months. I am very grateful for that!

We are so excited for this next phase - chapter one - of our new life. No doubt it will be a little crazy getting there, but we are excited, and so thankful for the opportunity. We are going to miss our family more than we can say, but we know this is where we are supposed to be.

Beware The Purple People Eater

My name is Pierscen and I am a
Purple People Eater!!!

Rrrrroar!!!

I want my food right when I wake up.
If not... I am angry!!!

And I might eat someone!!!

Don't keep me waiting long...

Or I might be forced to eat my fist!!!

At last! Life can go on! :)

But as a warning... when the purple comes back...
Beware!!!

Alright... so the truth of it is that this is the doing of Gentian Violet. It is used to treat thrush, but Baby P never had it. I went to the lactation clinic because I was hurting after I fed him, not during, and the consultant thought I might have a yeast infection even though he didn't have thrush and I didn't have any other symptoms. Unfortunately, the treatment is the same. The stuff is dark, dark, dark purple and stains pretty much instantly. You dip a q-tip in it, and then let the baby suck on it while it coats their mouth. Then you do the same to your nipples. They suggest doing it at night to minimize the risk of staining all your clothes.

Well, we did our first treatment on a Friday night. All night I did my best to wipe his mouth after each feeding, but I didn't know if I would do any good. In the morning, I had quite the shock when I looked in the bassinet and saw Baby P coated in purple from cheek to cheek. It was hilarious, and yet mortifying. I knew it would come off eventually - but holy cow! That first picture I snapped to send to Necia to prove just how purple he was when I called her asking what I could do to help it fade. He wasn't actually crying. He was getting ready to sneeze. I had planned on taking P with me to piano that morning, but after seeing that he was a total grape, I opted to leave him home with Ryan. Ryan had a couple people over in the living room when it was time to go. I slipped quietly into P's nursery and put him in the crib and turned on the mobile without Ryan seeing him and then left for piano. Not long after I had been at my lesson, I got a picture message of P from Ryan with the caption, "What did you do to my son?!"

Hahahaha. We learned that alcohol can help remove it, so we used a tiny bit of rubbing alcohol on his cheeks to at least tame it down. It fades pretty quickly with each feeding - that is until night time when you start the process all over again. By Monday, the purple was now just a faint blue/gray like in the last picture. I walked over to my parents to have my mom drive me down to the hospital to pick up the car from Ryan. My mom took P up to my dad, set him down in the carrier and said, "Here's your boy!"

Dad responded, "What do I feed him?"

"Nothing. We will be back in ten minutes. Just watch him."

When we got back, I walked into the room where my dad was. Pierscen was in his arms. Dad turned to look at me, his eyes and face drawn in a serious line. "Okay," he began, "as soon as you left, he filled his pants and then started crying. I looked in the carrier and all I see is this blue face. I thought 'Oh my gosh, the kid is choking to death.' What is this?!" he demanded, now with a bit of a twinkle and a smile pulling at the corner of his mouth as he pointed to P's face.

"Oh dad, I am so sorry! That would be Gentian Violet. I didn't even think about it." I explained what it was and why his face was purple. I felt so bad, but it was so funny! I can only imagine my poor dad pulling him out of his car seat in a panic and then finding that he was completely fine - but purple none the less. And to give him credit, when it fades to that color, it really does look like he is struggling to breathe. Here my dad is, thinking P is dying, and in reality, we are the ones giving him a heart attack. Sorry dad!!!

We have now done the treatment twice with no improvement on my end. Oh well. It was worth a shot.

And That's Why They Make the Big Bucks

We had Pierscen's plastic and neurosurgeon appointments about a week and a half ago. Both appointments were at Primary's with the first one starting at 9 am. I was nervous about trying to get up there in commuter traffic and possible bad weather, but thankfully we experienced neither and made it to Primary's by 8:30. My mother-in-law was good enough to come with me again as Ryan had to work a double for his co-worker.


I had never been to Primary's before. It wasn't what I excepted - but that's not a bad thing. I always envisioned it being set off on it's own - kind of a beacon on a hill. But it's not. It is very much tucked in among lots of other buildings. So much so that I almost missed it. I mean - the signs were all there - but I still kept looking for the building I had imagined. (I blame the picture on the website. It's a great shot, but it does make it look like it is all alone with nothing around it. Very deceiving. AND - the entrance is on the "side" of the building. Well, obviously it's actually the front, but the building faces perpendicular to the street so it looks like the side. The front faces the parking structure, so there is no recognizable feature from the picture visible from the street.) But I must say, probably like every other person who first visits Primary's - the inside is amazing. From the moment you walk through the door you can tell it's all about the children. Their motto - "The Child First and Always" is perfect. Every wall and room is painted and themed. It was a very inviting place. It put me at ease - and I am the adult! I can't help but wonder how much better it would make people feel if we did the same thing for all hospitals - one room painted with mountains and bears, another painted with seagulls and boat docks. I think children and adults alike would fair far better with distractions like that.


Luckily for us, there were no appointments before us (or they weren't there) so they just took us straight back. (Of course we still ended up sitting in the room for a while... but that's the unwritten rule when going to see the doctor.) When the doctor came in (this was the plastic surgeon) he immediately almost seemed... what's the word... surprised? He looked at Pierscen, then back at his chart. Up at Pierscen, then back at his chart. All while making some little chit chat conversation. "How old is he now?" I knew right away this was the question that was drawing the confusion. "10 weeks," I replied. He kind of grunted and looked at his papers. My impression of this was that he must be confused why we were meeting again so soon. I had wondered that myself when the scheduler called with the appointment. I thought he would want this appointment closer to surgery, but what do I know? He proceeded to measure and feel his head. He looked at his chart and more to himself said, "So he is scheduled for surgery May 3rd. That puts him at..."

"4 months and 1 week," I supplied.

"4 months? Ooo... that is really too young. We like them to be closer to 6 months. Why was it scheduled this early? Did you ask them to schedule it that early for a reason?"

"No," I stated. "That's just the date they gave me when they called."

"My girl scheduled that?"

"Yes."

He grunted again with clear disapproval.


Ellen chimed in, "She said it had something to do with your schedule and the neurosurgeon's schedule and that being the best time for the surgery."

"We do surgery together all the time. It shouldn't be difficult to find another time. I would feel far more comfortable if we were to push it back a month."

I felt my stomach drop. Honestly, I shouldn't have been surprised. I shouldn't have been upset. During our initial visit with the doctor when Mr. P was only 2 weeks old, he told us the surgery would be around 6 months. So when they called and said May 3rd - making him barely 4 months, I was surprised, but thrilled. So to hear that he wanted to move it back - again, it wasn't surprising, but it was deflating none the less. But I didn't respond yet.

"How is he doing with his weight? What percentile is he?" he asked.

"He's in the 30's. He was 11 1/2 pounds at 2 month appointment last week."


Again, a bit of a grunt in response. (I promise the doctor is not a cave man. I think just several elements of this appointment came as a surprise to him and this was his way of digesting the information.) "We really like to see them closer to 15+ pounds when we do this surgery. Although we do this surgery all the time, this is still a very substantial surgery. We find that they do far better if they have more reserves. They will loose a decent amount of blood, and the more they weigh, the more reserves they have, and the easier it is on them. So again, for that reason, I would like to move it back a month."

I still did not respond. I wasn't going to argue. I wasn't going to say no. But I still felt like there was a frog clinging on for dear life in my throat, and I couldn't bring a smile to my face to say, "Okay." Silly. I know. Especially because the surgeon would NEVER want to push it back if it wasn't for the safety and well being of the child. So why my stubborn silence? I don't know. Instead I asked him about how they were going to fix his eye. This was something Ryan specifically asked me to ask about.


The doctor then explained that a baby's bones are still pliable. Not super soft, but certainly more mold-able than their adult counterparts. The eye socket is made up of lots of smaller sutures, like the plates of the skull. They bend the eye socket to make it smaller, but in so doing, they may break some of the sutures. If done too soon, they may not heal correctly. Strangely enough - this process is also better if done around 6 months. Again... we need to push it back. I also asked about his nose. The doctor said he was surprised that I noticed it since most mothers don't. The misalignment is pretty slight - but it is there. He said they don't actually have to do anything with it. As soon as they fix the forehead, the nose will actually fix itself. That's kind of nice.

I also asked him about what they would do if he developed a flat spot. (Our pediatrician had said that it was pretty much inevitable that he would develop one - as it was part of the craniosynostosis with him favoring one side - looking to the right. This seemed really strange to me, so I thought I would bring it up.) Our doctor seemed surprised, and confused by this telling. He said flat spots had nothing to do with craniosynostosis and immediately reached out for Pierscen to feel his head and see if he was developing one - which at least so far, he is not. He said that yes - if he developed one, it would definitely impact the surgery. They wouldn't be able to operate! Reason being, if they did the surgery, and then went ahead and put him in a helmet for the flat spot, that it would put too much pressure on the front part of the skull and undo everything they had just done. So they would have to push off surgery. Great! That's just what I wanted to hear. We were super awesome about tummy time in the beginning, but have been really bad lately. You better believe I am a tummy time enthusiast now! That and I carry him around more - but I don't want that to be a habit either. I just don't want him to get a flat spot!


It was so nice to finally have an explanation for why 6 months was the goal. Even in the initial meeting he never told us why 6 months was the magical marker. But it all made perfect sense. And any loving mother would never want to go against all of that just for the sake of doing it early. But I still cried a little when I finally nodded "consent" to moving it back. Like I had an option! Haha. However, the whole time I kept thinking - "He knows that moving it back a month only puts him at 5 months, right?" I varied between wanting to ask him if he was sure one month was far enough, and not wanting to say anything because I don't want it pushed back any farther than necessary. But I figure - he is a smart man. He is a plastic surgeon after all. I am sure he is well aware that only makes him 5 months. Besides, this surgery is usually done anywhere between 4-8 months. So 5 months and 1 week should be just fine. The new date for surgery is June 4th.

We headed back out to the waiting room to wait for our neurosurgeon apt at 10:15. Luckily for us they took us back almost as soon as we got back in the waiting room - much earlier than our 10:15 apt. Unfortunately, most of the time we saved by being called back early was lost in waiting in the room instead. Typical. Haha.


The attending physician came in first. At least that's what I think he said he was. Is that the same thing as the resident? I think so... Anyway, Pierscen had fallen asleep, but woke up as we handed him over to be examined. Thankfully he was a wonderful little guy and didn't fuss. The doctor felt his head and looked him over from several different angels. "Oh yeah. This guy has classic Right Coronal Stynosis." And it's true. I remember when we first met with the plastic surgeon and he showed us pictures of his type of stynosis I thought the same thing. "Left forehead bulge - check. Right forehead recessed - check. Right eye socket elongated - check. Nose tweaked - check." We talked with him for a few minutes while waiting for our surgeon to come in. I remembered reading from some other blogs that often the child will have to have a transfusion, and that the doctors recommended family members go and get matched for blood type to see if they could donate. So I asked our doc about it. He said he wasn't sure about that, and that we could ask the neurosurgeon when he came in, but that the likelihood of him needing a transfusion was pretty low - like 20-25%.


Shortly thereafter our neurosurgeon came in and introduced himself. I liked him immediately. Just very kind and personable. Up to this point I really didn't know what the neurosurgeons job was. Ever since we were told by the neurosurgeon office that it was actually plastics that was doing it I have been kind of confused. So I was really looking forward to meeting with him.

He started off by explaining what craniosynostosis was and then said, "Now you could do nothing about it, but I wouldn't recommend that." He went on to explain that many moms research the condition and see that it can cause "retardation" if the brain is not allowed to grow correctly. He explained that this isn't what we usually think in those terms and though it us rare, it is more like they are a total regular human being that didn't quite reach their potential... meaning that instead of being handicapped like we imagine, you would never know the difference except that maybe otherwise they could have been a genius. I heard him ask the other doc about the CT scan we had done the day after he was born and ask if the brain looked okay. The other doc answered in the affirmative. So I asked if any of that could change and if we would need a more up to date CT scan. He said no, that in fact, P's skull was compensating beautifully (although that's what gives him the lopsided look) and that that wasn't a concern. He said that as a matter of fact, from now until the surgery, the more "unusual" he looks, the better because that means that the rest of his skull is compensating. But that "unusual" look is also the prime reason to operate. Cosmetic? Yes. But much more important than just looks.


Now the risks. Is there a chance of stroke or something like that? Unfortunately yes. But the odds are so miniscule it's not worth stressing over. "Something like 1 in 1000" was his example. I had to keep myself from laughing. The odds of P having this condition are 1 in 2000. Those aren't very good odds!!! I didn't say anything because I knew those numbers were a figure of speech and that it really wasn't that likely. In any other situation 1 in 1000 would sound like a huge impossibility. I am not stressed about that at all. I honestly just found it humorous.

Now for the crazy part: How it's all done. The plastic surgeon makes the incision and peels back the skin. Then the neurosurgeon begins to cut into the skull. There is a leathery layer that separates the brain from the skull and in infants this layer clings rather tightly to the skull. The neurosurgeon may need to cut into this layer a tiny bit in order to help separate them, but he will sew it back together and the brain should never really be exposed. Then he will remove the front 2/3 of the skull. This, he explained, is really the most dangerous part. Once the skull is removed he will come out and give us a half-time report, if you will. You know, working in the medical field, I love this kind of stuff. It is so incredibly amazing. It takes a lot to make me queasy. And even though I find this stuff in particular absolutely incredible, visualizing my son like that... with most of his skull removed... my stomach definitely did a back flip. I am still not worried about the surgery - but just that picture was about enough to make me want to reach out and steady myself. And I was sitting down! It's just that it's my boy. My perfect, blue eyed, blonde hair, infectious smile, little boy.


Anyway, from there the plastic surgeon takes over and begins the process of remolding the bones. This is what takes up most of the time, and almost all of this is done on the table. I don't know what I imagine before this. I don't know how I thought they could remold it if the skull was still attached, but I hadn't thought of it that way. Pretty interesting. Then, once everything is shaped they way they want it, the put it back on and reconnect everything with the dissolvable plates and screws. On average they say it takes about six hours. Hospital stay is 3-5 days. He just has to be eating, pooping, and off meds. Post op care is pretty minimal. Just restrictions on giving him a bath. That is still insane to me. But I am so grateful kids bounce back so quickly.


I asked the neurosurgeon about the transfusion issue in relation to whether we should be asking family to go get tested for possible matches. He answer was surprising to me. He said that they are actually moving away from direct relation transfusions for a couple of different reason. He said there is a study that shows that it's actually better not to use a direct relative. The findings were so surprising to the medical world (and to myself) that they had to do the study again. The results were the same. The main two reasons they are moving away from relative donation is because 1. They were finding that standards were being compromised. For instance, mom might match 16/19 things they look for and a stranger might match 19/19, but they would say, "But it's mom. It must be better." 2. Direct relatives are not as honest on the questionnaires. They found that most people were more likely to be completely forthcoming if it is for a stranger than if it is for a relative because they don't want to lower their chance of being able to donate to a family member. So with that in mind, it totally made sense why they are saying no to family donations. Of course they still encourage family to donate to help the general blood bank, but just not for the family member themselves.


Lastly, I mentioned that they had moved his surgery back a month and that he would now be 5 months. I was kind of trying to ask if that was late enough, but he responded that as a neurosurgeon they never want to do the surgery before 5 months because it is such a major ordeal. He said the chance of transfusion is more like 80%. Slight difference than 20-25% but I didn't say anything. He reiterated what the plastic surgeon said - which was basically to beef him up. There isn't a whole lot I can do about that. He is 2.5 months. I can't feed him solids yet. So I guess we just pray that he puts on enough weight. They won't not operate because of that or anything, but it would certainly help!


My mother-in-law and I both left feeling really good about things. It finally made more sense why they wanted to wait and it was wonderful to get more of the big picture. I did call the plastic surgeon again the other day to see if we needed another apt before surgery and to learn about post op apts. No pre-surgery apt needed. But post op... wow. 4-6 weeks, 3 months, 6 months, and then yearly. I guess we will be seeing a lot more of the surgeon in the future!

And as a final note, all of these pictures were taken the day of the appointment. I started off with my camera phone and moved to the real camera. By the end, P wasn't being as smiley as he was to begin with, and instead insisted on looking to the right like he usually does. This time, however, I tried to follow his gaze.


Can you see what he is looking at? It's the picture of Christ with the children. There in no doubt in my mind that he knows who He is. And I am so thankful to know that He will be watching over my little boy through this whole process.