From: Kraig Warnemuende <ad6075@wayne.edu>

Date: Sat Jan 18, 2003 6:10:52 PM America/Detroit

To: Kraig Warnemuende <ad6075@wayne.edu>

Subject: 01/18/02 Update from Kraig, Loren and Keren

Dear Friends and Family,

Nothing like the holidays for falling off the face of the earth!!! We trust all of you had a marvelous Christmas and New Year and are looking forward to this year to come.

The past month has been a busy one for us, full of family and adventures.

We were thrilled to have all of Kraig's family here in MI with us for Christmas. His folks were able to come home from Mali for three weeks, and so a big prayer of ours was answered in that they got to meet Keren. Not only that, though, we also had Kraig's brother Kevin, his wife Mandie, and our 8 1/2 month old niece Abby up from Oklahoma, and Kraig's sister Kat and her husband Ryan who have now headed off to Arizona to settle in for Ryan's basic training with the army. To add to the craziness of a houseful of people and to the general excitement, Kraig's brother Kris got engaged to our good friend Katrina over the holidays! So now we get to look ahead to a summer wedding and another excuse for us all to get together.

How did Keren make out with the crowd and the busyness? She seemed to cope with it pretty well, though we did have a few stresses that made things a little hairy. As we've mentioned in the past, eating has been one of our big issues with Keren, and the week or so before Christmas, she was getting continually worse with it--fighting the bottle tooth and nail, and not eating as much as she should. We finally took her to the doctor the day after Christmas and he diagnosed her with acid reflux (that's when the acid in the stomach flows back into the esophagus due to an immature valve between stomach and throat). The good news was there was an immediate treatment we could start which usually has quick results. Within a day it was making a difference for Keren, but then two days later she got her first cold! Figures! On top of that, Kraig and I came down with a 24 hour flu bug at the same time.... But we all made it through. Keren got really congested and we had to keep her on the oxygen cannula for two days to make sure she got enough air. That was a small blessing in disguise in that we already had the oxygen machine for her feedings. God was good once again and the cold didn't settle into her chest and become something worse. It did, however, limit food intake once more. Since then, we've been working to push the amounts up again, but she's still only taking her minimum requirement, if that, and each bottle takes an hour. She tends to be very sleepy a lot of the time, and sometimes won't wake up for her bottle (no matter what wake-up techniques we use :) ). Makes for long days, but when she's not fighting it, it's not such an emotional chore.

We've got a long list of doctor appointments set up for this month and beginning of February. We've met with a pediatric surgeon to talk about the what-ifs of a stomach feeding tube. Basically, Keren wouldn't need one as long as she continues to gain weight and doesn't develop worse reflux or chronic respiratory problems. So far she's still gaining weight, though she only gained two ounces during the two weeks of the cold. As of last Monday she was 9 lbs, 9 oz. The doctor set up for us an upper gastro-intestinal and swallow study which will help us know how the reflux is behaving. We'll also finally be seeing a pediatric ENT (ear, nose, throat) specialist, who will hopefully provide us with some answers as to why Keren always seems to have some obstruction to her breathing through her nose (is it really just congestion?). It would be nice if we had definite answers to questions, but we realize that this may never be the case! Amazing how multi-faceted the human being is!

Despite colds, reflux, breathing and eating issues, Keren seems to be thriving. She's growing so much and developing in many ways. Last Friday, we had her first official "class" with her physical therapist, Francie. Francie showed us a number of stimulation activities we could do with sight, sound, touch, etc. We are also working with Keren on stretching the muscles in her hand. Keren's really tracking things, and when she's not sleepy, she's very alert and interactive. She's begun to make some little commenting type noises (the great "goo!"), and she's begun to smile!!!! Unfortunately, the smile came after Grandma Warnemuende (Sharon) and most of the family had left (January 5 to be exact), but since then she's showed it off to Kraig and me, Kris, Grandpa Warnemuende (Larry), and my mom. It's becoming more of a regular feature :) . Talk about a look that lights up her whole face--it's adorable!!! She's a lot more active too, and is just beginning to sortof reach out toward toys. Still a little random, but getting there.

We're continually learning new things about her and about ourselves. We've gotten involved with an email support group for families with kids who have trisomy 18, 13 and other odd trisomies. That's been an incredible help already (we've been able to get a lot of helpful information based on their experiences), though sometimes it gives us a glimpse of the possible future which can be scary. Kids with T18 don't seem to develop very much cognitively, and verbal skills are at a minimum. I find, though, that all is well if I don't think about stuff like that and focus on the successes of today. "Do not worry about tomorrow, for tomorrow has enough worries of its own," as Jesus says. And I know also that he gives us the strength we need for today. When we eventually get to tomorrow, we'll be able to handle whatever comes, 'cause then that necessary strength will be given. And besides, this is Keren we're talking about! Not a statistic!

So that's where we're at as we begin 2003. We'll do better at keeping you posted again now that the holidays are over and life is returning to something of routine. We hope to hear from all of you again, too! Your prayer is still greatly appreciated, and helps give us that daily strength.

Much love,

Kraig, Loren and Keren

PS--I've included two Christmas pictures below--hope you're able to access them (they're jpeg files)! The first is Keren on Christmas day and the second is Keren with her cousin Abby.