Juliana Wetmore Weekly

More on Juliana!

Recent News:

2/19/2006

Update

I'm posting 3 pictures. The quality may not be good as I've done some cropping, but you can see how big Juliana is getting. They go in sequence. In the 3rd picture you can see how proud she was for going down the "big girl" slide all by herself. She is so pleased with herself when she does something new.

I know everyone is missing the caringbridge "guestbook" and the camaraderie it provided. We're still working on acquiring a new web site with a more secure comment section. "Building" a web site takes time! Also, I haven't been making "weekly" updates - I've been sick with the first cold I've had in years. First Tami and Kendra were ill with a stomach "grip", but Juliana and I didn't catch that. Then the people at my house came down with colds, and I did get that one. I kept working, but I wore a mask so Juliana wouldn't catch it. Juliana didn't like for me to wear themask. She doesn't like anything new, and the mask probably reminded her of the hospital, but she didn't catch the cold, and now I'm over it too.

I had a question asking if I was in the service, as I use "military time". No. I became conditioned to use it while working in hospitals. Hospitals use military time. I think everyone should use it. Once you learn it, you can't not use it.

Another question - since her eyes are closed in one of the recent pics (on caringbridge) does that mean she doesn't need the plastic wrap anymore? Unfortunately, no. Sometimes she closes her eyes, but not always. It's easy, once she's asleep, to apply the eye ointment, then lay a piece of plastic wrap over her eye (a separate piece for each eye) and secure it with a small piece of tape. She doesn't rub her eyes or bother with it at all. When she wakes up she waits for it to be removed.She'll sit up and wait. This is a good thing, because next month she'll have metal rods in her face and we won't have to worry about her picking at them or messing with them. She has a way of knowing that something is necessary and to leave it alone. She's a very wise little girl.

Several people have requested more details about how I "found" Juliana. Here's the "short" version. I was working in a hospital on a telemetry unit and hating it. Overworked and unappreciated, poor job satisfaction, etc. I had already returned to school to become a Licensed Massage Therapist. That didn't work out very well, although I love massage. (The details of my experiences with massage will be found in the "long" version of my big long story.) Then I went back to school to become a truck driver. I actually did drive a real 18-wheeler, for Werner, for 6 months, all over this country and into Canada, but that didn't work out very well either. (Those details will also be in the "long" version.)

I quit Werner with no idea of what I was going to do. I hired back on with "Traveling Massage" but they had not renewed their ad in the Yellow Pages and I wasn't getting many calls. But I went on one call to a hotel not far from my house. As I was wheeling my massage table into the hotel I ran into a nurse I had worked with many years ago. She was at the hotel for a conference. Ordinarily we never would have run into each other. She told me about the agency she was working for, I went over the next day, and they sent me to Juliana on my 3rd case!. I had never even thought about working with children, never thought about working for an agency, never thought about networking with old acquaintances - but look how it all worked out.

That's all for now.

Jeanne



01/31/2006

Update

As you've probally noticed, the Caringbridge site is temporary closed. Don't worry and be patient. We know you want more infomation about Juliana. I'm posting two pictures today, so you can see how big she's getting. In the family photo, notice how nicely she's posing with her little hands folded in her lap. If you've e-mailed me and not received an answer, please try again. I accidently deleted two e-mails. I don't seem to have any way to retrieve them.

Juliana has recently, in the past month, started to go to sleep at a reasonable time. Now when I get there about 10:15 she's already in bed asleep. Sometimes she's still sleeping when I leave about 0740, but not always. Sometimes she's up ready to play. I can tell if she's starting to wake up, so I go over and take the plastic wrap off of her eyes. She sits up and waves at me, then points to the monitor wires which have to be disconnected. Then she practically bounds out of the bed.

I had an e-mail asking me if this isn't a boring job, since Juliana is asleep most of the time I'm there. You know, I don't mind being bored. I worked in critical care in one hospital for 18 years and on a telemetry unit in another for 4 years. I was really "burned out" with nursing, so I went to school to become a massage therapist. I worked at that for a year (2 jobs), and love giving massage.However, I found that about 10% of the male clients don't understand what a massage consists of ! Next I went to school to become a truck driver. I have a class A CDL and drove an 18 -wheeler all over the country for 6 months. Four winters ago I was driving for Werner in a blizzard in Spokana, WA., with no CB, no cell phone, and no GPS. (And no money!)

There's a long story (next time) about how I got "lucky" and found Juliana. For now I'll just say I'm delighted to be sitting at Juliana's bedside each night with a stack of books and magazines, and Juliana's DVD player.

I'll post again soon with more information. Jeanne



01/17/2006

Journal Entry

I’m posting two pictures today. One was taken just a couple of months ago. When it was taken the tubing in her nose had been recently changed. The other picture was taken on Christmas morning. You can see how far the tubing has worked itself forward. Dr. Wolff has seen pictures, and she’s being scheduled to go in and have the tubing changed. However, it’s very close to the time he wanted to do another jaw “distraction”, so he might do it all together. We’ll let you know when we know.

There have been some questions about Juliana’s meal times. Well, she has a feeding tube called a “MicKey”, which is like a “Tupperware” button in her abdomen. The formula goes into a plastic bag and the tubing just snaps into the button. The bag goes on a pump and the feeding takes approximately an hour. She gets the feedings at scheduled times, twice during the night on my time and twice during the day. The early one usually is given while Tami is doing errands etc., so Juliana is in her car seat or stroller for that one. Sometimes the next one is given as a bolus whish goes in quicker, or sometimes the feeding bag is placed in a back pack for Juliana to wear around. There’s no way to keep her still for an hour feeding, if she’s awake.

When the Wetmore’s actually sit down at the table for a meal Juliana joins in, sometimes actually putting some food in her mouth, then taking it out. She doesn’t have any swallow reflex. She’s quite puzzled as to why people are always putting food into their mouths. She doesn’t see any benefit to it. But she gives it a try once in a while. She also likes to take a capped soda or water bottle and tip it up to her mouth, trying to figure out what that’s all about.

Tami and I were discussing the scene in “The Miracle Worker” where little Patty Duke wrecks havoc at the dinner table, going from plate to plate disrupting the whole meal. Tami said, “That’s Juliana!”!  But no, no, no, it’s not like that. Juliana does like to go around the table, sitting on various people’s laps, but she pays attention to what’s going on and tries to make sense out of it. She tries to get some food on a spoon, etc. Her favorite thing is to have a cup with some ice cubes in it and a spoon.     We don’t know if and when she’ll be able to swallow and eat. They’ve worked with her quite a bit at speech therapy, getting her used to different textures in her mouth. She still resists mouth care and having her mouth touched. She’ll fight having a “toothette” put into her mouth, but if you hand it to her, she’ll do it herself. No matter how noxious the procedure is to her, she wants to do it herself!

Here’s another clarification - about her breathing. The trach isn’t so she can breath, it’s to keep her tongue from blocking off her airway - then she wouldn’t be able to breath! When she has enough surgery there will be more room in her mouth for her tongue. There’s another of those surgeries coming up in a month or so. It’s called a “distraction”. She’ll have pins in her jaw again. We’ll be very happy when they come out. (The long thick blue tubing seen in some of the pictures is just a humidifier.)    This next section isn’t about Juliana, but it is about something I get asked a lot. Kerrie B. posted a question for me on caring bridge - “What is the significiance of your screen name arrowsmithwoman?"   She has no idea what an assignment she placed before me.  First, I’ve had to reread a large portion of a book by the Eastern philosopher Osho titled “Discourse on the Royal Song of Saraha”. Now I’ll try to paraphrase that complex symbolic saga.

It happened a long time ago. There was a young man named Saraha, the youngest and most favored of five brothers. They were raised as scholars in the King’s court. Saraha became famous for his knowledge and the King hoped for a marriage between Saraha and his own daughter. Instead, Saraha shocked everyone, renounced everything, and became a monk. Even worse, he chose a different religion to become a monk in. However, he persevered and over the years regained fame, this time as a follower of and spokesman for his new faith.

But then he had a vision - there was a woman in the marketplace who was to become his real teacher, the marketplace being symbolic for “the thick of life”. So now he renounced his religious teacher saying, “You have done half the work, you have cleaned my slate. Now I’m ready to do the other half”.  He went to the market place and found the woman he had seen in his vision.  She was making an arrow, an arrowsmith woman.  (There’s a lot of symbolism here but I’ll just skip all that.)  He watched this woman raise her bow, with one eye closed and one eye open, aiming at an invisible target, and he had an epiphany. She was not looking to the right or to the left, just in the middle. He suddenly understood the wisdom of “the middle way”, avoiding excess and focusing on the present moment. He goes off with the arrow smith woman, to be blissfully happy.

There’s more, but that’s enough. I read this story about 15 years ago. It wasn’t that I saw myself as the arrowsmith woman. I was “in love” with a man I saw as Saraha, and I wanted him to see me as the arrowsmith woman. He didn’t. So you see, it has nothing to do with the rock band Aerosmith.

I’ve tried to change this screen name to a different one, but have failed to figure out how to do it. I think I have to just close the account and open a new one. So far it’s been more effort than it’s worth. Yahoo already has a nursejeanne and a nursejean. I’m thinking I’ll change to nurse4juliana. I’ll keep you posted.

Jeanne



01/04/2006
Journal Entry
I'm posting two pictures today.

The quality of these pictures are not as good as I'd like, but at least you can see how Juliana's growing and get a "feel" of what she's like.  She looks so cuddley in some of the pictures, you just want to squeeze her!  In the picture labeled "bouncing" she's on her little trampoline, holding onto the safety bars.  The dog, Shelby, is behind her, looking through the sliding glass door.

Last night when I went in, Juliana was already in bed sleeping.  She'd been sleeping since her 6PM feeding.  "Oh", I thought, "She'll be waking up early in the morning".  It was early all right - 0130!  She was awake from one thirty  until four thirty.  Since she was wide awake I got her up for a while and we played, colored, looked at her photo album, read books, and rocked.  When I'd point to her bed she'd point to another book, but finally I put her back in, with her DVD player of course.  She'd watch one "Signing Time" video and when it was over she'd sit up and sign "change".  After 3 or 4 videos she went back to sleep, and was sleeping when I left.  Usually Juliana's awake when I get there (her mom says she waits up for me), we play a while, then she goes to sleep and sleeps all night, not even waking up during her respiratory treatments.

I'm not sure exactly how old Juliana was the first time I realized she was interacting with me in a meaningful way.  She was quite young, only a few months old, and I was getting her dressed.  I had given her trach and mouth care, and she was crying.  I was pulling her shirt on over her head when I realized she was trying to get her arms into the sleaves.  She was upset and crying, but she wanted to help herself get dressed.  That's just how she is now.  She wants to help, no matter if she's upset, or in pain, or crying.  Sometimes when she's asleep her diaper will need changing.  She'll be sound asleep, but she'll raise up her little butt - helping.  It makes me want to just hug her.  Instead of having an attitude of "leave me alone", she tries to help.  What a nice little girl!



12/27/2005
Journal Entry

Here's a quick update to let you know how Juliana liked Christmas morning.  The first thing she saw was the big playhouse.  It's going outdoors, but her dad put it up in the livingroom so she could play in it Christmas morning.  She loves that it has a door she can close.  She always wants doors to be closed!  I'm attaching a picture of it, and also one of her holding a ball.  I chose this picture because it shows clearly that the tubes in her nose are working their way forward.  Tami has taken some digital close-ups to e-mail to Dr. Wolfe to see if he wants to adjust the tubes.  I'll let you know.  So far he's said not to worry about it.  His concern isn't so much what she looks like now but what she will eventually look like.  I was upset before when it seemed like the tubes were twisting and tearing her little nostrils, esp. the left side.  But he's not so concerned about what he knows he can correct when the time comes.  The tubes prevent tissue way inside from growing over and occluding important passage ways.  I've been asked about her inability to breath without the trach.  The reason is her tongue has no place to go and therefore falls backward into her throat, occluding her airway.  When she has further "distractions" to her jaw there will be more room for her tongue and it will lay in place inside her mouth.  Then she probally won't need the trach anymore.    There really isn't a schedule as to how many surgeries she will have, and when.  Dr. Wolfe has a plan, and is in consultation with many more experts.  We just go day by day, enjoying this dear little girl each day.  We know difficult times are coming, but we can't focus on what might happen.  I know every night that I must do things to her that she really doesn't like.  She hates the eye ointment, she doesn't like to be suctioned, etc.  But when we're done with all that she's ready to hug and play.  She just "gets on with it".  She really teaches me how to "stay in the present moment".  When she sees me come in at night she doesn't start dreading the procedures and trying to get away from me.  She's always paying attention to "now".  She's my little guru.

Well, now, about Christmas morning - she doesn't like unwraping presents.  We couldn't get her to unwrap a present.  And she doesn't much like presents either.  She says most of them are silly (her favorite "sign").  She does prefer her old favorites instead of new things.  She got a little trampoline with safety bars which she loves to jump on (picture of that next time).

This was meant to be a short update.  I'm stopping now.  I must go to bed.  This month I've been working (if you can call it that) with Juliana seven nights a week.  The agency doesn't have anyone to cover for me.  They actually don't like me to get this much overtime, so they're not happy about it.  But it's OK with me.

Jeanne



12/21/2005
Journal Entry

Already I’ve fallen behind with my “weekly” updates! Nothing major or different has happened, but I realize many people are interested in everything about Juliana, not just major events. Some people have asked questions regarding Juliana’s hearing ability. She has a hearing aide, which she’s willing to wear most of the time now (she used to pull it off). I just realized that none of the pictures I’ve posted show her wearing it. I’ll get pictures of her with it on for next time. She will eventually have an implanted hearing aide, but, as with all her surgeries, we really don’t have a time frame of when that will happen. Dr. Wolfe keeps track of her,requesting pictures once in a while, and when he thinks she’s ready for the next step he sets it up.

Part of Juliana’s routine is going to Speech Therapy two or three times a week. She’s learning communication skills using sign language and pictures. The therapists also try to desensitize her mouth, with the ultimate goal of teaching her to swallow. She’s had several surgeries on her mouth already, and always has tubes and wires in her nose and mouth. She really resists having her face touched, or letting anyone put anything in her mouth. Lately though, she’s decided she likes her toothbrush, so she gets to brush her teeth whenever she wants to!

The pictures I’m posting today are of Juliana “reading”. The reason I like these pictures are that they “capture” how intensely engrossed she gets in whatever she’s doing. When she’s interested in something you can’t distract her. She’s very smart. She knows all her “Signing Time” DVDs by heart. Sometimes, atbedtime, she’ll “sign” along to a whole song, looking at me like “You sign too”. But I don’t know the whole song like she does. So I sign “smart girl” and that satisfies her. She turns her attention back to what she’s watching and soon she’s asleep.

-Jeanne



Journal Entry
Journal 12-8-05  

I’ve received a few questions which I’ll try to answer. An e-mail from Katie asked about the helmet (mentioned at the end of the documentary), and if it had worked out as planned. Here is a short version of what was a very complicated and difficult time. Juliana had her 2nd jaw displacement done last March.  This was a procedure in which 2 rods were placed horizontally through her jaw. As screws were turned (one turn to each screw twice a day) these rods were to gradually separate, causing her jaw area to lengthen . This was to happen over 3 months time. However, instead of the bottom rod being forced downward, the top rod was being forced upward, putting pressure on her eyes. It didn’t look right to me and I showed it to Tami and Thom. Thom took pictures and e-mailed them to Dr. Wolfe, who arranged for Juliana to be seen right away, in Miami again. The top rod was removed, and she was fitted for the helmet. This is how the helmet was to work - extensions were added to the mouth area of the helmet, which, when she had the helmet on, were connected by elastic bands to both ends of the rod which went through her jaw. This was to put enough tension on the rod to gradually cause some lengthening of her jaw area.

She was to wear the helmet all the time, except for bathing. You have no idea how miserable this was for Juliana. Her head would be wet with sweat most of the time, plus I’m sure the tension on the rod in her face was painful. Yet she just accepted that she had to wear it, and went about being herself, playing and climbing. You would think she’d find some way to make her misery known, to fuss and cry to have the dreadful thing removed, but she just went about her day. That’s what she does - she just “gets on with it” as best as she can. What great “heart“!

As it turned out, she wore the helmet for about 3 weeks. Then Dr. Wolfe determined not only wasn't it working, but it was actually doing some harm.  It was such a relief to have those rods out.  The dear little girl hadn't been able to hug, to put her face near anything or anyone without the danger of jarring the rods!  It took a while for her to trust hugging and cuddling after that experience, but she's a hugger now.

I’m posting a couple old pictures so you can see the jaw “distraction” with the 2 rods in, and then the helmet with 1 rod left in.  These are "old" pictures - she doesn't have any hardware in place now.  I'm also posting a recent pic of Juliana and Tami.  It's not a very good quality picture, unfortunately, because I love the picture.

Juliana's doing fine.  She hasn't paid any attention to the tree in the living room.  That's probally because it's not decorated yet.  When she notices her mom putting things onto it, I'm sure she'll get interested in helping!



11/30/2005
Journal Entry

Here's a question I received: "I hope Juliana is doing well tonight. I think of her at night. You wrote that she doesn't usually go to sleep till midnight, and has 6 different things hooked up to her at night. Does she need that much during the day also? I was wondering what bothers her about going to sleep. Do you think her eyes being covered causes that, or all of these things she is hooked up to?" Gail, Redford, MI Answer: Actually, it's 7 electrical outlets she needs at night. When Juliana gets into bed she wears a monitor belt around her chest, attached with velcro. This alarms if her heart rate or respirations are too high or too low. Also she receives cool mist from tubing attached to a humidifier. These are the only 2 things attached to her throughout the night. She doesn't need them when she's not sleeping. She has a stationary suction machine plugged in beside her bed, and a portable one that gets plugged in at night to recharge. She has a nebulizer machine for respiratory treatments as needed.She has a feeding pump which can run by battery but needs recharging at night. And, very important, the DVD player. That's the 7 machines she needs plugged in at night.

She's always had the monitor belt and the trach mask for humidity. They don't bother her - she expects them to be there. She's very routine oriented and will point to something if I forget to put it on! She doesn't get the plastic wrap over her eyes until after she goes to sleep. She doesn't even know she's got it on.She sleeps all night, once she goes to sleep. She doesn't even wake up during respiratory treatments or suctioning.

The reason she stays up so late is just that she doesn't want to miss anything. There's a song, "Dance hall girl, dance all night" I used to sing to her, and call her "party girl".

When she first learned to stand up in her crib, I would have to lay her back down over and over again. I couldn't just let her walk around in the crib or she'd pull apart her tube feeding. Some nights I'd lay her back down 15 -20 times. As soon as she got her portable DVD player all that stopped. She loves watching her "Signing Time" DVDs, every night, over and over. She goes to bed with the DVD player every night, never tries to get out of the bed, never complains or fusses. Today's picture is of Juliana in bed with her DVD player. She's a wonderful little girl.



11/25/2005
Journal Entry

As we were making our way through the crowd of people at Disney World last month I noticed a little girl’s reaction to Juliana. As she glanced into the stroller, the girl’s face quickly went from puzzlement to sorrow. She looked so sad. I wanted to turn and run after her, to tell her, “Wait, don’t feel so sad. Juliana is a happy little girl”. Juliana doesn’t spend much time feeling sad. She’s just too busy having a good time.

Most nights Juliana is awake when I arrive at her home (about 10:15 PM). Right away I have to do things to her that make her cry. She really doesn’t like to have her face, mouth, or eyes touched, but I must give her mouth care and eye care. She has a lot of oral secretions but her tongue still gets dry because it protrudes from her mouth, so she gets a lubricant on her tongue. Then she gets eye ointments. She usually needs suctioning, and sometimes her trach needs changing. All this makes her cry (you can’t hear a child with a trach cry, but she’s crying). She resists mildly, twisting and turning her head away. Then we’re done. I gather her to me in a hug and she points to “our” big reclining chair. But she doesn’t just point. It’s point, point, point! We sit in the chair and she points at a book, not just a little point but an adamant point. Then she’s engrossed in the book.

She has never held a grudge against me for anything I’ve had to do to her. She’s very forgiving! She doesn’t pout or sulk. Her attitude seems to be, “I’m glad that’s over, lets play”.

It’s been very busy at the Wetmore’s house over Thanksgiving, with lots of family visiting.

Juliana is well and having a ball.


Nemaste, Jeanne



11/20/2005
Pictures and Links

This week, we added a couple of separate pages, to make it easier to stay up to date and in touch. You can now go click on any of the links above (Pictures, News, or About/Contact) and get right to particular information! Our goal is to keep everyone up to date, so we’ll post pictures as we get them!



11/19/2005
Journal entry

On Oct.-- Juliana was admitted to Miami Children's Hospital for a relatively new procedure, the application of BMP (Bone Morphogenic Protein) to certain areas inside her skull.  The purpose was not to make a difference in her appearance now, but as preparation for future surgery.  This substance is to promote bone growth, and it's benefits will be realized further down the line as more facial reconstruction is done.

It was expected that she would have some swelling after this surgery, but we didn't realize how severe it would be.  Juliana's whole head was swollen.  Her eyes were swollen so tight that she couldn't see.  It took two weeks for the swelling to go down enough for her to get her sight back.  It was heartbreaking to see her like that.  I can't imagine what she was thinking - she literally went to sleep and woke up blind!  Yet she would feel our heads and give us a pat on the back, then she'd make the "sign" for "I love you".

She was discharged home before she got her sight back.  I'd come in about her bedtime, and follow our same routine (Juliana loves routine).  I'd sit her on my lap facing me and we'd turn the pages of her books and photo album, just like always, even though she couldn't see.  Then I put her into her bed, and she'd reach to push the buttons on her feeding pump, just like always.  She was comforted because things were where they were susposed to be, and she slept well.

Each day the swelling went down a little bit more.  One night I went in and she turned and looked at me!  If she held her head just right she could see.  I was so happy for her.  Now, she's back to normal, and as Tami said on www2.caringbridge.org/fl/juliana, she hasn't sat still since.

The picture I'm posting today is of Juliana sleeping with her "plastic wrap" mask on.  After she goes to sleep I cover her eyes like this.  She doesn't close her eyes tightly when she sleeps, and this keeps her corneas from drying out.  It doesn't bother her at all - she doesn't even wake up.  Juliana sleeps well all night, even through tube feedings, suctioning, and respiratory treatments.  She's a wonderful little girl.



11/17/2005
Email Juliana!

You can email Juliana Wetmore, care of Nurse Jeanne! Email arrowsmithwoman@yahoo.com Also, we’ll eventually have a message board here, but for now you can post questions to: www2.caringbridge.org/fl/Juliana

And, another picture update for today!



These journal entries were written back in October during a family trip!.


10-6-05

Thurs. night 0630 I’m writing from the desk in room 4231 at the Disney Yacht Club Resort, Orlando Florida. My roommate is Juliana. She’s asleep in the bed next to me, and I’m hoping she doesn’t wake up for a while. I’ve still got a lot of things to do. I’ve got a new camera phone and I haven’t read the directions yet. I want to be able to get some pictures to post and also some video clips. We checked in about 8PM last night, and Juliana went to sleep about 11:30. (Thom, Tami, and Kendra are in the next room.) It took quite a while to get all Juliana’s equipment set up in here. It’s taught me never to travel without a multiple outlet extension. Juliana has 6 necessary pieces of equipment that need plugging in.



10-9-05
Sun. night 11:30

This is our 4th and last night at Disney. It’s been great. At first Juliana was timid and afraid of the Disney characters, turning away and trying to hide. Now she waves at them. She was precious in “It’s A Small World”, waving and pointing during the whole ride, and on the “Magic Teacup” ,waving her arms in the air.

I’m so privileged to be part of this dear little girl’s life. She is so loving and giving. She has such “heart”. She radiates goodwill everywhere and to everyone. She restores my faith in humanity.



10-12-05
Wed. 0400

We attended a “Character Breakfast” on Mon. morning, which is really a brilliant concept. While breakfast is served a cast of Disney “characters” circulate throughout the room, stopping at each table, chatting and posing for pictures with the children. Kendra loved it. Juliana would point and wave, but as soon as a “character” came near she would try to hide. There are times when the fact that she’s non-vocal is a plus! She screams, you just don’t hear her.

Both girls were well behaved on the ride home, staying in their car seats without complaint. There’s a “drop-down’ DVD player that keeps them entertained. Their favorite DVD’s to travel with are Shrek I and II and Monsters, Inc. The car seats have to be separated though, or Juliana pulls her sister’s hair, etc. It’s hard for Juliana to sit still without doing something.

We had a wonderful time at Disney and plan to go back, perhaps in January.



11/14/2005

I'm Juliana's Nurse


I'm Jeanne, Juliana's nurse (and secretary!).  I've been her nurse since she came home from the hospital at 3 weeks old, working at night so she'll be safe while her parents are sleeping.  She has a tracheostomy, requiring suctioning to keep her airway free of secretions.  She doesn't have a swallow reflex, so when her oral secretions build up they must be suctioned.  She receives nebulizer treatments to prevent and relieve airway congestion.  She has a Mic-Key feeding tube and gets two feedings during the night.  She also gets medications through the feeding tube.  Her left eye doesn't blink and her right one seldom does, so she gets frequent applications of eye ointments.  When she's asleep her eyes must be covered with plastic wrap to prevent her corneas from drying out.  She's always resisted going to sleep and is usually awake until almost midnight.  Once she's asleep she sleeps all night, even through the treatments and procedures.  She's usually still asleep when I leave in the morning, but if she does wake up before I go she makes the "sign" for "all done", and is ready for mischief.

This web site for Juliana is under construction.  Please check back for updates.  Also, check www2.caringbridge/fl/juliana.  Thanks, and please continue to be patient.  We know many people are eager to learn more about Juliana.