It's only been a few days, but there's much to say. The short of it is that God brought Ruth Truth safely through surgery, and we made it home Saturday evening, November 2nd (despite the Hawkeye football game happening that night).

Ruth's surgery was scheduled for Thursday morning, October 31st, so we drove to Iowa City on Wednesday afternoon. Friends of Lauren's family, Scott and Cathy Tigges, own a condo a short drive from the hospital, and they graciously opened it to us Wednesday and Thursday night. It was a blessing!
 
That first night, our trust in God was tested as I started coming down with cold symptoms. The sniffles hit me out of nowhere. This caused Lauren anxiety because if Ruth became sick, her surgery would be postponed. If Ruth didn't become sick, but I or anyone else did, we wouldn't be able to go in to see her if the surgery still went forward. That would have been the worst case scenario. 

Thankfully, God is gracious. After praying over it together Wednesday night and taking homeopathic medicine (Thanks to Kim Zahari and her sister Kris for teaching us about homeopathics and providing us with them), I woke up the next morning without any of the symptoms I had the night before. All glory to God!

We needed to have Ruth at the hospital by 6:00 AM on Thursday morning, so we were all up early. Even Martha. That was not intended. She was supposed to sleep later and spend the morning with Grandma (Lauren's mom), but those plans did not stand. Instead, we all went in to the hospital with Ruth. In the moment, I was frustrated because our plans fell through, but looking back, it was a sweet thing to have everyone together. 

We checked in, waited an hour, and then they came to take us up to consult with the team that would perform Ruth's procedure. Grandma and Martha stayed behind in the waiting room while Ruth, Lauren, Mima (my mom), and I went with the nurse. We met the team, asked our questions, said goodbye to Ruth, cried when they took her, prayed over her surgery together, and went back to wait. 

The surgery itself went well. There was the possibility for three incisions, the third being for extra help with positioning, but only the two necessary incisions were required. One in her navel (for guiding the placement) and the other at the site of the G-tube. 

Now, for the next six weeks as everything heals, we are to treat Ruth's G-tube like gold. If it comes out in this window, which would take an act of force, we would be required to go to Iowa City immediately and likely to surgery again. But after the channel between Ruth's abdominal wall and stomach is fully formed, we would simply be able to replace her G-tube ourselves if it was accidentally removed.

But the hard part was anesthesia. Because of Ruth's Pierre Robin sequence (PRS), she has a narrow airway, so she gave the anesthesiologists quite a challenge when they intubated her. This meant she needed to be on a ventilator for ~24 hours while we waited for the swelling in her throat to go down. If we moved forward with extubation too quickly, there was a risk that her airway would swell shut. This would require another round of intubation, and that would be extremely difficult. Apparently this is abnormal for this type of procedure, and it meant we needed to stay in the hospital longer than anticipated. 

Seeing Ruth on a breathing tube was one of the harder parts of this for us. The tube meant that her cries were silent, so while we could see her discomfort on her face and in her tears, we could not hear a sound. This meant we needed to watch her diligently so we could do our best to comfort her. 

It was a long night as we tried to determine just how much sedation and pain medicine Ruth needed. There were a couple of times she was awake when the nurse expected her to be sedated, which surprised the nurse. She's a little fighter! Our hope was to limit the medicine she received to only what was necessary for her comfort, but we also needed to make sure that she could rest. We really didn't want to see her become agitated and displace her breathing tube by flailing about. We did end up increasing her medicine once, but after that, Ruth settled down. That night in the PICU, we were thankful to have a wonderful nurse who heard us and had Ruth's best at heart. She came into the room throughout the night to help comfort Ruth.

The following morning, we were able to stop Ruth's sedation and pain medicine and proceed with extubation. The doctors were very pleased with how well this went. She didn't struggle with breathing at all once she was off the ventilator. God gave us many new mercies on that Friday morning!

After she demonstrated she was stable, we were able to move forward with the slow protocol for her feedings with the G-tube. Since she had only been on IV fluids and hadn't eaten for over 24 hours, she was hungry! These feedings went well as we eased her into them. 

However, the issues Ruth had with intubation came back to haunt us. Her throat was so sore that it was causing much of her discomfort. Not only this, but she began accumulating thick mucus that she had trouble clearing—even after we used a hose to suck out what we could. This meant she rattled loudly as she breathed and had trouble sleeping. At its worst, this mucus caused her to cough, gag, and vomit. This kept us in the hospital a few extra hours as the doctors monitored her to see if it was okay for us to bring her home. 

We could have easily stayed another night in the hospital with that going on, but we were ready to come home, so we pushed for that. We were confident we could safely meet all of Ruth's needs, though we knew it would be challenging. And by God's grace, we've made it through these challenges. We've waded through deep waters and even deeper grace.

It's amazing how much the surrounding environment matters for healing. Now, a couple of days into being home, Ruth is doing well. While she has cried more in the past few days than she has in her entire life (so much so that her cry is only a hoarse whisper at the moment), she is coming back to herself. Smirks and smiles are emerging again. Her throat is getting better, her rattling is diminishing, she's handling most of her feeds, and she's able to rest. We're figuring things out all over again. 

We're thankful for all that God has taught Ruth in this. She's learned to cough, and much of her vomiting has been replaced by spitting up—though there's still progress to made here. But if she can keep her airway clear, we're fine with this. Because of her soft palate cleft, these simple functions of the throat are harder for her, so we don't take her progress in these areas for granted. 

We're also thankful for all that God has taught us through this.

Looking back, I realize now that I wasn't as prepared as I thought I was on the day of Ruth's surgery. In response to the reality of my baby daughter having surgery (it's not supposed to be like this), I began to protect myself by hardening my heart. This means I was not nice to be around on Thursday. I was harsh, unkind, stoic, and unloving. I was numb. That afternoon, I confessed this to Lauren and sought reconciliation as the brunt of my sinful heart posture landed on her. I also took this to the Lord in repentance, and I am thankful for the forgiveness I have in Christ.

As for Lauren, she would share that she struggled with a fearful heart, and this overwhelmed and paralyzed her. She so badly wanted God to deliver Ruth from the prospect of surgery, and that didn't happen. In the midst of this pain, disappointment, and grief, she sought to remember the truth of who God is while surrounded by the enemy's lies of who God isn't. 

When we had shared this with Mark Scaffidi, he wisely reminded us that Jesus walked the same path. Christ pleaded with the Father to deliver Him from the cross, and He wasn't. It was rich and profound to remember that we weren't alone in our longing and grief. Our Savior was with us. He went before us.

Seeing all that Ruth had to go through caused both Lauren and I to doubt our decision to proceed with surgery. We wrestled with regret. It felt like we were responsible for all of her pain and discomfort.

Lauren later said that the hardest part for her was that this wasn't a mandatory surgery. It would have been easier to accept if it was necessary, but we know so little about what Ruth's needs, growth, and development look like in coming months. These thoughts and questions caused Lauren to enter a disheartening, downward spiral as she put Martha to bed on the night of the surgery.

It was God who brought Lauren out of this low place as she dedicated herself to prayer. I was at the hospital, but I noticed the change in her texts. Truth, encouragement, and an assurance that only the Lord can provide started to come from her in our conversation. Praise God!

I want to thank Bethany Washington for the prayers and liturgies she shared with Lauren from Every Moment Holy during this. God used these mightily in our hearts, especially Lauren's.

I also want to thank Heidi Brocka for taking Friday afternoon to drive to Iowa City and care for Lauren's heart for several hours in the midst of all of this. (And thank you to Leo Brocka for making this possible!) We were able to make her visit a special surprise for Lauren.

While we were trying to do what was best for Ruth, it didn't feel good in the moment. But as our ENT doctor shared with us months ago, the Lord gave us parental authority over Ruth for a reason. And so we continue to learn to both fear and trust the Lord. 

As Lauren recognized, Ruth's G-tube may be hard and inconvenient for us now, but it will surely be more comfortable and helpful for her long-term. This is what we want.

As I reflected on this, it occurred to me that as Christians, we're often called to hard work now so that we can reap good fruit later. Reaching for the fruit first only brings even harder work upon us later. Our first father and mother, Adam and Eve, can attest to this.

We've had another bout of intense, low days. As Pastor Dann Green shared with me, "This will take you to depths and heights few people journey." He knows. He's journeyed through similar depths and heights himself. I'm hopeful that great days are coming. In fact, they already have.

Yesterday evening, which was Sunday night, the Holy Spirit filled me with the indestructible joy of Christ. This came after a day spent in worship. It started when Mark Bell joined me for an early morning trip to Iowa City and back to pick up Ruth's blood pressure medicine, which we had forgotten the day before. Mark and I enjoyed time together filled with fellowship and prayer. We were back in time for church, and I was happy to take Martha to the second service where we worshipped the Lord in song and Word. That night, our family took a short walk together in the dark and mist, followed with dinner and family worship. By this point, I was bursting with joy! What can I expect? I was doing what God made us to do! Thank you, Jesus, for placing my feet on the heights.

For your joy, after we read 1 Samuel 24 last night, we danced and worshipped to this song: YOUR WAY'S BETTER by Forest Frank