(No Longer) The Sickest Kid in the Cardiac ICU

 A couple days ago Jason overheard one of the doctors giving report to another physician.  As he talked about Annika, he said, "She's probably the sickest kid we have in the CICU right now."  I know Annika likes to be a trendsetter, but this isn't the contest you want to win.

Today, several therapists asked when she is graduating to the regular cardiac floor.  We don't have an answer, but the way things are going, it feels like it could be really soon.

While I'd never wish to repeat the past few days, sinking so low has made the joy of healing indescribably sweet.  For days, Annika didn't feel well enough to peek inside a gift bag.  Heck, she didn't even want to snuggle a stuffed animal.  Without a stuffy, Annie hardly seems like herself.  Yesterday Annika was so depressed that she hardly spoke all day.  When asked a question, she would morosely nod or shake her head in response.  She just looked so sad.  An Annika who doesn't talk, an Annika who doesn't smile, an Annika without any sass--well, that just doesn't feel like our Annika at all.

With the dawning of a new day, Annika turned a delightful leaf this morning.  She is smiling, chatting, playing, teasing--it feels like we have our little girl back again!  And oh, what a beautiful day!

***

Favorite moments:

While depressed for the most of the day, Annika did have three genuine smiles yesterday.  Two were reserved for Talia and Eli.  She was so happy to have her siblings come visit.  She's missed them so much!  The third smile came when Uncle Lance provided music therapy.  She giggled at his song and insisted that Austin sing along as well.

Speaking of therapy, Annika had pet therapy come twice today.  These furry visits make her so happy!  She was equally delighted to have a visit from integrative medicine.  You could see her whole body relax during her fifteen minute massage.  In fact, she fell sound asleep and got a much needed nap afterward.  The very best, however, is music therapy.  I've mentioned that all of the hospital trauma I've experienced has made me kind of numb to most emotion.  It's like I've expanded the emotional scale to such extremes that normal fluctuations just don't hit me the same way that they used to.  Listening to the beautiful chords on the guitar as our therapist sang directly to our little girl--it opened channels of tears that have been welling for weeks.  I don't have words to describe the spirit I felt in that moment as she sang to Annika in her lowest moment.  You could see Annika's little body release the tension and feel peace.  Weak as she was, Annika thanked her for learning "I'm Not That Girl" just for her.  As the therapist went on to sing "Dos Oruguitas" from Encanto, I felt like heaven was speaking directly to us: "Viene Milagros"--miracles are coming.

***
Crepes!  During her depressed day yesterday, Annika told Jason that the only thing she felt like eating was crepes.  She wasn't being obnoxious--she had a craving, and nothing else sounded good.  We live close enough that Jason could have driven home to make some, but it would have taken a big chunk of time, and the crepes would have been cold by the time they arrived back at the hospital.  After a little reflection, I realized that the Ronald McDonald room upstairs had everything we would need: flour, eggs, milk, and butter.  Jason and I headed over to their fully stocked kitchen, and in no time had  savory and sweet crepes ready to go, complete with fried eggs and cheese or nutella, strawberries, and whipped cream.  I feel so grateful to the Ronald McDonald room for making this indulgence possible for Annika! 

Truly, the Ronald McDonald rooms have helped us in so many ways.  Their family friendly spaces have given us a great place to gather and relax with Talia and Eli when they come to the hospital.  We've been grateful for the quiet room when we've wanted to huddle as a family to pray and give blessings.  Twice our social worker has requested a room for us to stay the night in the hospital close to Annika--once on the night of her transplant and again the night after they reopened her bedside.  On both occasions, Jason and I were grateful to be able to sleep so close by.  We are likewise grateful for the access to a washer and dryer so that we can wash Annika's blankets and stuffed animals every day, keeping them clean and safe for the ICU.  Most of all, it has been such a blessing to have meals available here, saving money, time, and above all, stress.

***

Annika went for a walk today!  They were able to discontinue her nitric oxide and high flow nasal cannula, so she got out of bed and walked around the unit with just her IV pole and an oxygen tank.  This girl is so strong!  We were amazed by her speed and grit as she made her way to the full-length windows to peer out at the mountains.  While the foothills were beautiful, she rightfully commented that we need some more snow before Christmas.

Other notable progress: they removed Annika's NG (nasogastric) tube and the two wires sticking out of her chest that were used to pace her heart.  They removed her arterial line (mostly because it got clogged), and she is currently running only three IV medications (at times she has had 12 going all at once.)  They discontinued her NIRS monitoring, and her foley catheter is likewise out.  Tomorrow they plan to remover her IJ (interjugular) central line, and they might be able to remove her chest tube as well if the bleeding is controlled.  (Annika is currently being anti-coagulated because some clots formed in her left shoulder near the spot where they removed her ICD.)  She has a nasal cannula, but it's only providing 1L of oxygen/min, and that's mostly to provide extra support for our heart.   In other words, she looks so much more like the little girl we know!

***

If you talked to Annika today, she likely would have told you about the poop fest she had last night.  After massive doses of both senna and Miralax, she set what might be an all-time record on the unit for the amount of poop.  Uncle Justin is so very proud.  Jason and our unflappable night nurse spent much of the night dealing with Annika's repeated Code Browns.  I'll be honest--I'm kind of glad I missed all the fun.  But gosh, Annika sure felt better after!  Lest you think I missed out on all the fun, Annika did have a massive vomit episode during my day shift.  Let me tell you, cleaning off an ICU child and their thousand lines and tubes and dressings is a LOT of work.  I'm just glad her tummy settled down and we didn't have to do that all day long.

Other than that, today has been a joy.  We've read books, listened to our favorite songs, eaten chocolate, done crafts, given each other back rubs, painted toenails, and basically just enjoyed each other's company.  Annika has been so kind and polite to all of her caregivers--there are so many who are rooting for her!  Each time I go up to the third floor to fetch her a slushie, I run into nurses and techs who ask how Annie is doing and tell me how much they are looking forward to having her there again.  It makes me teary to realize how many people are cheering her along!  It makes me think of how I prayed on the night of her transplant that she would be in the company of angels.  I honestly feel like many of those angels are right here, right now.  I have met so many nurses who commute long distances (Spanish Fork, Orem, Kaysville), just so they can care for these remarkable kids. There may be nursing jobs all over, but there is truly no other place like Primary Children's.

A Thousand Words

The last post was kind of heavy, so I thought I would share this instead, taken this afternoon.  

They say a picture is worth a thousand words.  While there is still plenty of road to travel, our girl is feeling SO much better.  We are extremely grateful for the skilled and compassionate care of her nurses and her medical team.  Many of the nurses remember her and cared for her two years ago.  She's done so much beautiful living since then!  Now we're looking forward to healing and living life fully outside these hospital walls once more.

Fasting for the Long View

10:00 am Monday

I'm sad right now.  Sad and scared.  Yesterday morning all the doctors were raving about what a rockstar Annika has been with surgery and recovery, but today she looks worse.  She is hypertensive so they've had to add a bunch of meds to control her blood pressure.  Her CVP (Central Venous Pressure) jumped from 2 post surgery to 9 yesterday to 17 at the moment.  Her kidney labs (BUN and creatinine) have jumped, and she's stopped diuresing.  There hasn't been any urine output since I got here.  She has opacities in her lower lungs due to atelectasis.  Her skin feels hot and clammy, and you can see her poor chest heaving with every beat.  There is so much jugular venous distension.  Yesterday she ate a little food--today she doesn't even want a drink of water. Unlike yesterday when she was chatty and a little sassy, today she is lethargic, barely opening her eyes.  Today she's basically only woken up long enough to say, "I feel sick."  

If I've learned anything over the years, it's to take Annika at her words.  When it comes to how she feels, she doesn't overdramatize.  If she says that she feels sick, then she is sick.  I'm praying we can figure it out soon.  

Mostly though, I feel terrible guilt for putting her through all this.  There is such remorse for making her suffer.  The truth is that although she gave token consent, the decision was ultimately ours.  We took this hyper, happy kid, pumped her full of toxic meds, and now everything is struggling: her heart, her lungs, her kidneys.  What if we made the wrong choice?  What if her body can't accept this new heart?  The fear is paralyzing because no matter what, there is no going back. 

Today I am fasting for my daughter.  I am fasting for the patience and faith to take the long view.  I am praying for faith to see her playing tag with friends and pickleball with the family.  I am praying for the doctors and nurses so they can practice at their very best as they help her heal.  May they be blessed with inspiration beyond their own.  And may Annie's shared heart be blessed to heal with time, just as I pray for the hearts of her donor family to be healed with time.  Just as Annie's life will never be the same, I know their lives will never be the same.  Annie misses "Fred and George" (her name for her ICD/heart combo); I can't imagine how big the hole in their hearts is from the loss of their loved one.  Even as we all grieve a bit, may we find comfort and peace from on high.  I wish they could have seen Annika's echocardiogram today.  I teared up watching their shared heart beat steadily on.  This beautiful gift continue to give life.  I may be sad, I may be scared, but I am grateful.

7:30 pm Monday

Annika is still so sick.  Watching her chest heave, listening to her dry heave, feeling her pulses bound, seeing her flushed face and swollen fingers--it's all so hard.  For the most part she's hardly spoken all day.  This evening, however, she opened her eyes and said, "Mom, I just want to go home."  My eyes filled with tears.  Me too, baby girl, me too.

As sick as she is, there are still a few signs of spunk.  After she said she wanted to go home, she followed it up with a weak, "Come on Mom, let's go go go!"  Earlier today the nurse wanted her to rate her pain on a scale and she just didn't feel like speaking.  The sweet nurse said, "Come on Annika, you have to say something."  Annika stared her straight in the eyes and finally whispered, "Wolf."  The nurse laughed and said, "I'll take it."

8:30 am Tuesday

Another rough night.  It's hard--we checked into the hospital with a kid who had a sick heart.  Now her kidneys are broken, her entire left lung is filled with fluid, her blood pressures are uncontrolled, and she's super constipated.  Last night she was so uncomfortable--whimpering and crying from severe back pain.  She's grunting with every breath--they call it auto-peeping.  When our lungs are struggling, sometimes we grunt without realizing it to help the air sacks of our lungs inflate and stay inflated.

9:30 am Wednesday

Wow.  I feel like we've been hit by a Mac truck.  Acute kidney injury, pneumothorax, pleural effusion, septic work-up, hyponatremia--this feels like an overly complicated exercise from nursing school.  I never thought we'd have to add MTP (Massive Transfusion Protocol) and an emergency bedside sternotomy to the list.

An hour after I updated this post yesterday, her nurse went to check her chest tube and discovered deep red drainage.  The chest tube output had already been picking up--there had been 60 mL and 40 mL of drainage over the previous couple hours.  This time, however, the drainage kept coming and coming.  300 mL, 400 mL--by the time the team arrived, she'd already drained 600 mL over a matter of minutes and it was still coming.  You can tell how serious a medical emergency is around here by the number of people that arrive.  The cardiothoracic surgeon was called--he was ten minutes away.  The IV team came, emergency blood was ordered, followed by activating the Massive Transfusion Protocol.  They called nurses, techs, X-ray, and even a social worker for Jason and myself.  Annika was intubated at the bedside and we thought she would be rolled into the OR.  Instead, her room was transformed into an operating room.  They placed another IV in her foot and started pushing blood as quickly as they could.  As tears poured down my cheeks and I fought back sobs, Jason stood by Annika's side and told her how much he loved her.  The social worker asked me if there was anything I wanted to say to Annie before they gave her fentanyl, but I was too choked up to do more than whisper.

I can't describe what it's like to say your final good-byes to your child as a team of medical professionals frantically scurry around to get everything set up.  I can't describe what it's like to stand outside the room and watch as a surgeon opens your child's chest.  Mercifully, I am short and didn't see much over the mass of bodies.  What I saw was enough.  Jason saw it all--surgeon's hands inside our daughter all the way up to the wrists.  

What I can say is that I hope this is something you never have to experience.  The pain is excruciating.  I excused myself to the bathroom for a moment so that I could let out the ugly sobs in private.

Tethered to the pain, however, was still gratitude.  Immense gratitude for ALL the people who were there (30?  40?  I wish I had counted), each of them there for only one purpose--to save our child.  And save her they did.

While open heart surgery in your child's hospital room is indeed dramatic, the situation was not quite as dire as I make it sound.  Although Annika did lose a substantial amount of blood, her blood pressure never dropped to a dangerous level.  Her vital signs remained stable.  While there was a lot of blood pooled, they never found an active bleed after opening her up.  We don't quite know what happened or why, but they were able to send the MTP team back.  Before the surgery, the surgeon came to talk to us and ask us to sign consents.  He said, I know this feels like a lot, but it's not a crisis.  Always sassy, I told him that it felt pretty close.  And it did.  

But I know what an actual crisis is.  We've been there.  And thankfully this was not it.

Even though reintubation and a bedside sternotomy was not part of our plan, Annika has actually been doing much better since.  Whether due to the blood products received or getting that liter of fluid out of her chest, Annika's kidneys suddenly kicked back into action.  Hallelujah!  She started peeing a ton.  I never imagined that I would feel so excited by the sight of a giant bag full of urine.  

Her poor body has been so swollen, but she's started to lose that fluid too.  Her unrecognizably puffy fingers now look like her own hands, and her swollen cheeks have gone back to normal.  Her ankles had gotten so swollen that her ID band was tight, but it's loose once more.  Her blood pressures have been better with less medication needed to control it.  Her chest x-ray also looks better, and her electrolyte levels are back in range.  Last night she spiked a fever so they are being very careful about infection, but even the fever had broken by 11pm.

Even though in some ways Annika looks more sick--she now has an NG tube and even more IVs, she also looks better.  We may be headed into post-op recovery round 2, but we are hopeful for smoother waters.

Annie's Shared Heart

On Thursday night, I received an unexpected call from UCHAMP (the cardiology team) at 7:30 pm.  As soon as I saw the Caller ID, I knew what they would say: the team had accepted an offer on a heart for Annika.  

Eventually I might put together a play-by-play from the time we received "the call" through the time of her transplant on Saturday.  In the meantime, I'd like to share some tender moments.  Transplant is an experience so intimate that in a way it feels sacred.  I want to honor it with more than mundane details.

***

Peace.  In many ways, I am an anxious soul.  I tend to be constantly on the move because my mind races and the physical movement calms my jitters.  You'll often find me compulsively straightening my physical space because I can't focus with clutter around me.  The kids will send me out for a walk or run when I get too stir crazy.  As you might imagine, all of the worry about Annika's heart has heightened my anxiety over the past couple years.  It's not out of control, but it's nearly always there as an undercurrent making my heart buzz a little faster in the hopes that hers won't stop.

When the news of Annika's heart arrived, I expected to be a nervous, jittery wreck.  Instead, I felt this overwhelming peace and calm.  While I shed a few tears, I didn't feel sad.  Instead, I felt hopeful.  Even during the eight hours of transplant surgery, the calm remained.  I thought I would spend the hours of transplant nervously pacing every hallway of the hospital like a madwoman.  Instead, I found a chair, curled up with my pillow and blanket, and was still.  I pondered, I meditated, I prayed, I slept.  I experienced the lyrics of the hymn: Peace like a River, it is well with my soul.

This peace--a peace surpassing all logic, a peace so unlike my typical worrying self--this peace enveloped me in what should have been my hardest moment.  I know this peace was a gift from God.  A know it was His reassurance that no matter the outcome, everything would be and was already all right.  Before Annika's surgery, I offered a special family prayer where I felt strongly impressed to tell her that she would be protected and watched over by angels.  I believe angels were watching over me too.

Pain.  Not every moment leading up to the surgery was peaceful.  Just a day before the transplant call came, I experienced something horrific at work.  I can't say much because of HIPAA,  but this was the kind of experience that many Labor and Delivery nurses never encounter during their entire careers, let alone ten weeks into orientation.  We nearly lost a mother. Fortunately our response was timely and appropriate and the patient will likely recover.

The culprit?  Undiagnosed cardiomyopathy.  As terrifying as this experience was, I don't believe it's a coincidence that it happened to me in particular at this particular time.  I could condemn God as cruel for exposing me to all this when He knew it would hit so close to home.  Instead, I am choosing to be grateful that I was able to help save this mother and am thankful for the reminder that cardiomyopathy is not to be trifled with.  While a dreadful experience, it helped reaffirm our decision to proceed with transplant.

Place.  I don't believe that God micro-manages our lives like chess pieces on a board, but I do believe He occasionally orchestrates us to be in the right place at the right time.  During the transplant, Jason left the hospital to go pick up Cafe Rio for lunch.  On his way back, he pulled behind an ambulance traveling without its lights on.  Suddenly, a fire chief scooted around Jason and pulled back in between him and the ambulance.  Obviously the ambulance was being escorted.  Jason watched as the ambulance pulled into the ED at Primary Children's.  As Jason recounted the story, we both felt strongly that this vehicle was carrying our daughter's new heart.  We'd recently received an update that she was in the operating room with her chest open and waiting.  After the surgery, the surgeon confirmed that indeed, this was precisely the time when the heart arrived.  It had been flown in via jet and then transported the rest of the way via ambulance.  What are the chances?  As Brian Blackham would say, 100%.  While a small thing, this tender mercy felt like God letting us know that He is near and very aware.

***

I'm still trying to wrap my mind around the fact that the heart beating in my daughter's chest today was beating in another's yesterday.  Coming up with a title for this post was tricky: I almost said "Annie's New Heart" but whose heart is it really?  We don't know anything about the donor, but we do know that this heart has been with them for years.  It's hard to resolve the cognitive and emotional dissonance.  How is transplant even possible?  I feel simultaneously awed and numb.  I am overwhelmed that any person or any family could and would give so completely of themselves.  My own heart is struggling to contain all the hope for Annika alongside all the sorrow for her donor and their family.   It's like my body and mind have experienced so much emotion that I don't even know how to feel anymore.  Mostly though, I feel gratitude.  I am grateful for the donor and their family.  I feel grateful for the army of surgeons and nurses and doctors and therapists that allow transplant to happen.  I feel ever so grateful that Annika's surgery went smoothly and she is doing so well.  And I am grateful for this beautiful shared heart.

Hermana Wheeler in Espana--Weeks 6-10

For those missing our Brooklyn, here are updates on Hermana Wheeler in Spain from Weeks 6-10.  It's been so fun to re-read her emails.  Love you so much, Buttermilk! 

***

Week 6: Intentar

 Hola amigos!! Como están?

This week was crazy! We were sooo busy, so it went so fast but at the same time it feels like last P-Day was forever ago. I'll try to actually keep it pretty short this time.

Tuesday was the day of sugar. It was my roommate Hermana Turner's birthday, so we ate chocolate for breakfast and then all went to lunch together at this 50s diner close to us, which was SO fun. I had a burger named after Dolly Parton with goat cheese and caramelized onions and we all got milkshakes. Then, we were the guests of honor at a birthday party for a 12 year old member. She was so excited to see us it honestly kind of made my week. After that we had an ice cream date with the Hotties de Madrid (I'm not even kidding, that's our group chat name). They're this group of JA girls that are mostly less active, so we're trying to help them feel more comfortable at church. Anyway, by the end of the day we were definitely feeling the sugar crash.

Wednesday we had zone conference and I honestly learned so much more than I expected!! It was all very teaching skills oriented, which was great for me because with my assignment that's definitely an area where I lack. I could talk about that forever, but I guess I'll just say that there's a really special spirit that comes with having that many missionaries in the same space. I'm so inspired by the sacrifices that every single one of them is making to be here.

Thursday was exchange day! We planned 3 fire lessons but unfortunately all of them fell through. I guess that's good practice for what it's like being a regular missionary anyway. In the evening though we had English class and taught about clothes and colors!! We went to a corner store and bought a bunch of super cheap clothes to play games with and it was hilarious. 10/10 recommend.

Friday we spent basically the entire day doing contacts and setting up lessons for this week, which meant we definitely got a little house crazy. However, the coffee shops here are a great place to study accompanied by super cheap pastries. For dinner we went back to the 50s diner and worked there while drinking green smoothies.

Saturday we spent like 4 hours at a young adult activity that was Mexican themed (although all the posters were in English which kind of cracked me up). I ended up being strong armed into doing karaoke to Shakira since there were only like 12 people there and that's the only Spanish music I really know. Thanks, Dad. ;)

Yesterday was crazy busy but I got to have my first arepas here! We had lunch with this Venezualan family and the arepas were soooo good. Plus, they're just amazing people. After studies we had another meeting with a couple who are getting sealed this month! He brought his less active brother too, so it was a really good chance to get to know some more JA.

I'm discovering that every week on the mission is this combination of spiritual highs with moments where you don't feel equal to the work that's been asked of you. I had so much fun this week and I'm so grateful for everything we were able to accomplish, but I still had a day where I was really struggling to find the energy and motivation to put my best self into it. So, the word for this week is intentar.

Intentar means to try. Now I know Yoda said trying isn't a thing, but to God it is. One thing I've really had to learn to take to heart is that even when we're not at our best, God loves us for trying. I believe he is even more proud of me for trying when everything feels hard than for doing it perfectly when it feels easy. So for now, I'm just trying to be like Jesus, and that's enough.

I hope you are all doing amazing! Sending lots of love and prayers!!

Best,

Hermana Wheeler

P.S. PHOTOS!!!

1. Sugar day part 1: The Diner

2. Hermana Turner being my fav person

3. Sugar day part 2: Cake (I promise the birthday girl was actually happy)

3. Sugar day part 3: Llao llao with the Hotties

4. Zone conference posterity pic! My mother, grandmother, sister, and aunts (My grandma Rothas is dying in a week)

5. The most incredible sweet potato fries of my life

6. Elder Stoehr playing our game at English class

7. The Diner part 2

Week 7:  Ayuno

Hola everyone!!

How's life? As SpanishDict keeps asking me, are you eating enough fruits and vegetables? And as Hermana Eastland (my mission president's wife) keeps reminding us, are you showering every day? Maybe I need to come up with my own general health question: when was the last time you read the Book of Mormon? If it was more than 24 hours --- wait, actually, scratch that. It doesn't matter, reading more of the Book of Mormon is always a good thing. And if you don't know what all the hype is about, try it out!! And email me if you do, I'd love to hear how it goes. 

Now that you've heard my little missionary schpiel (no idea how to spell that) on to the good stuff! Speed round.

Monday: P-Day! Fire Italian pizza at the mall, tried to skip zone P-Day but got called out, got too into secret Hitler, and went to a carnival (fun fact, in Spain they're waaayyy sketchier than in the states).

Tuesday: Went to the temple!!! Oh my gosh, I love the temple so much. I also got my Spanish residency and did a whole ton of doorbell-ringing. Experienced a miracle (found a corner store with refrigerated water when we were parched).

Wednesday: Taught a lesson and had district council with a questionably named "speed dating" activity (don't worry it was actually just speed invitation-extending).

Thursday: Exchanges! All 3 of our lessons happened, I was guided by the spirit, we ate Kebab, taught English class, and I got to sleep in the AC since Hermana Bailey stayed the night in Villalba with Herbst (I think I like parenthesis too much).

Friday: So many contacts and volleyball in Carabanchel. Talked to a Ukranian guy, Sergio, who I think was just really excited to not be speaking in Spanish. Had my first DL call.

Saturday: A million baptisms and didn't end up going to any of them because the person we invited didn't show up so we did passbys instead. Also bought groceries for the first time in at least 2 weeks and got a new blender.

Sunday: Member meal with the sweetest older Spanish woman named Arbolina until I was physically incapable of eating anything else. Had a call with Presidente and we got permission to make an area instagram!

Monday: We're going to Segovia! Look it up. Not there yet though so I'll tell you about it next time.

One of these days I'll stop giving you a play-by-play of my week but oh well, you're stuck with me for now.

Word of the week: ayuno!! Ayuno means fast (no, not like I ran fast, like breakfast). In the Church of Jesus Christ of Latter-day Saints, the first Sunday of every month members go around 24 hours without food. 

Now you're probably thinking, Hermana Wheeler, this week wasn't even fast Sunday! True. However, in my apartment, we are all starting a 40-day fast tonight. Don't worry, it's not a food fast, it's a fast from behaviors that keep the Holy Spirit from being our constant companion. It's inspired by a letter President Robert E. Quinn from the Adelaide, Australia mission wrote to his missionaries some time ago. I don't know if you can find it online, but if you want it, shoot me an email and I'll send it to you.

For me, for the next 40 days I'm working to be more charitable, to myself and others. I want to stop tearing myself down, start eating to feel good, and stop guilting myself when my best efforts seem to fall short. I want to look for ways to serve others, see the best in them, and let them know how their examples bless me. I'm hoping that through my efforts, the Lord will be able to work through me more thoroughly and I'll be prepared to be the best missionary I can be. Is there anything you can give up to God to be closer to Him?

I hope every one of you is finding the sunshine in your life!!

With love,

Hermana Wheeler

Photos!!

1. The Venezuelan family that fed us arepas last week 

2. The Italian pizza (you're welcome Lily)

3. Temple!!!

4. Us and the Ruppes!!

4. We maybe shouldn't have done the Titanic pose here...

6. Carnival Craziness

7. Random Catholic virgin parade

8. Segovia sneak peek ;)

Week 8: Creyendo

Hola amigos!

I hope everything's going well for all of you! This week has been crazy so I'll get right to it. The goal: one sentence per day. Get ready for an English teacher's run-on sentence nightmare.

Monday we had to create a new group photo album for just Segovia because between the aqueduct, castle, and incredible bookstores we had almost 400 photos for the day...

On Tuesday I had interviews with President and Hermana Eastland and officially adopted the Ruppes as my third set of grandparents because on the way home from a ward game night I mentioned I hadn't had empanadas in Spain yet and they made an immediate empanada pit stop.

Wednesday was district council, the sweetest lesson with a less active family in Parla, and more volleyball in Leganés (I don't duck as much now!).

We ran around even more on Thursday with another lesson in Parla and an appointment in Getafe before coming home so by this point I'm considering making the metro station my permanent residence.

Friday was exciting because a lesson we thought would be short ended up being a 2 hour game night and dinner that let out 10 minutes before we had to be home (it was epic though so all good).

I learned on Saturday that God is in the details: a month ago I bought a white skirt even though it was 2 sizes too big because it was 7€ and have been regretting it ever since, but this 72 year old lady was in a pinch and wore it for her baptism.

Sunday I went to church in Villalba for a young adult council meeting and had the most amazing lunch with the senior couple that lives out there, but most importantly I was able to take the sacrament.

I'm realizing my life this week was a little repetitive, so the basic gist of it is that Hermana Herbst and I are doing everything we can to meet and get to know as many less active young adults as we can, and as a result are constantly hopping from city to city. Between this week and last week, we will have visited almost every ward in our stake that is within a 2 hour radius (plus 2 that aren't). It's a lot of work, but I'm so happy and grateful to have the chance to do it.

To wrap up, my word this week is creyendo, and it comes with a book recommendation. Creyendo means believing, and for everyone who hasn't read Believing Christ by Stephen E. Robinson, you should put it at the top of your list. It's been on mine for a couple years and I'm seriously regretting not reading it until now (cue the "I told you so"). There's so much I could write about it, but I'll suffice with saying that it has changed the way I understand the atonement, repentance, and my covenants in a way that has brought me so much joy. You might hear me talk about it more later. ;)

Hope you're all doing amazing!! Thanks for all your messages and prayers.

Love you all!

Hermana Wheeler

Photos 

Hermana Turner being a mother of 4

Not sure how I got to Wyoming from the middle of Spain...

Photoshoots are obligatory with the quad so here's my favorite picture of me and the aqueduct in Segovia (that might be why we had 400 photos)

Goofy yet accurate representation of my feelings about being in Spain

I love books :)

Apparently I'm quite large for a medieval Spanish knight 

The castle!!

Well, that's as many pics as this email will let me add. Guess I need a google photos now.

Week 9: Milagros

Hola todos!! Como estáis? (I'm thinking about learning vosotros - it's like the y'all of Spanish)

Congratulations!! I am here to inform you that you have all officially made it to the end of Hermana Wheeler's play by play, day by day email era. Well, probably not but I'm at least going to do it a little differently today because GUESS WHAT? Today's word of the week is milagros!!

I honestly had to go through all of the emails I've already written to double check I hadn't used this word already because it has been such a big part of every single week of my mission. Milagros means miracles. As a missionary, I've gotten so much better at seeking and expecting little miracles every day. Here are some of the highlights from this week.

Juanjo: My companion Hermana Herbst served in the area where we live when she first moved to Spain a year ago. While she was here, she taught and helped baptize this man named Juan Jose (Juanjo). Shortly after, he stopped coming to church for personal reasons and hasn't really has any contact with missionaries since. That is, until Hermana Herbst reached back out and we were able to have a lesson with him last week!!

Juan Barreda: Juan number two has a similar story. He was taught by Herbst a year ago and baptised, but then he kind of dropped of the face of the earth. Randomly a couple months ago he started showing up in a different ward and somehow was put in contact with our roommates. Turns out, he was robbed and had to change numbers and move. He still reads the Book of Mormon though and we're meeting with him again tonight!

Sara: Sara's yet another one of my companion's recent converts. Herbst did her hair for her wedding, was at her baptism, and is now going to be here when her baby is born any day now. What's awesome though is that even though we just went to the temple, we got special permission from President Eastland to go to her sealing on Saturday!! The spirit there was absolutely incredible and I'm so grateful we got to be there.

Honestly, I could go on and on and on about the miracles I've seen this week. From the thunderstorms that have finally broken the Madrid heat to the conference talks that have brought peace to my sometimes angsty mind, I know God sends us tender mercies to strengthen us every day. All you have to do is look for them.

Sending lots of love,

Hermana Wheeler

Week 10: Obra

Hi friends!! How's it going? I hope life is treating you so well and (at least for those of you in the states) that you are appreciating having easy access to delicacies such as goldfish and Kraft mac and cheese.

I hit 10 weeks as a missionary today!! To be honest, it feels like a mission goes so fast and there are so many things going on that every other day is an anniversary of something, but they're kind of fun to celebrate anyway so who cares. Plus, we are always looking for excuses to buy pastries or chocolate or ice cream so it works out.

Now that I have reached the ripe old missionary age of 70 days, I figured I would offer some sage advice about what I've learned since donning the chapa (bonus Spanish word! We call our nametags chapas).

Here it is: missionary work is really hard. The expectations are so high, you have to be *on* all the time, and even if you do absolutely everything in your power, people still have agency and sometimes things don't turn out the way you wanted. To be honest, Hermana Herbst and I had a little bit of a slump for a few days this week. All our lessons canceled, the activities fell through, and we spent so, so many hours in Google sheets making sure the member lists are accurate. Doing the work was just difficult.

Here's the thing though. When you translate "missionary work" into Spanish, nobody calls it "trabajo misional," even though that's technically correct. It's called "la obra misional." 

Essentially, "la obra" is "the Work," capital W. More than just effort, it implies a mission or significance. It's more related to work as in work of art than in the sense of labor. 

Working as a missionary can be exhausting and frustrating, but I am so happy to get to do it because it's God's work and God's mission. I get the incredible privilege of waking up every day knowing the only thing I have to do is point people to Christ, even if I only succeed in pointing myself. Good day or bad, I get to be a part of the obra that God has planned for me, and the rough moments make the miracles even more miraculous.

I'm so grateful for the opportunity to be where I am right now. I'm so grateful for the sun and the rain and my companion who feeds me out of her treasured stash of Skippy peanut butter when I'm having a meltdown. I'm so grateful for Christ's infinite atonement, and I'm so grateful for all of you for bearing with me while I wax philosophical, this time (and probably a hundred others). You're amazing.

Lots of love,

Hermana Wheeler

Tender Hearted

My heart is pretty tender right now.  Annika and I just attended sacrament meeting on the third floor of Primary Children's.  The meeting wasn't long--less than half an hour--but the spirit was so strong in that little auditorium that the tears flowed.  Annika wanted to sit in the front row, but we moved back because there were so many kids who needed the front row seating, whether because they were in wheelchairs or because they were trailing giant IV poles with multiple lines.  Far from being silent, the sacrament prayers were peppered by the beeping of IV pumps.  Two adorable toddlers with VADs (Ventricular Assist Devices) were there, their cardiac pumps trailing behind them on wheeled carts the size of a rolling suitcase.  These kids are so small that you can see their external Berlin hearts dangling past their knees, kind of like in this picture I found online.  Annika's wait for a heart will be much shorter than the wait for these toddlers, mostly because she is tall enough to accept the heart of a small adult.  Toddler hearts don't become available very often, which is mostly a good thing, but it also means that these sick kids wait in the hospital for many months, sometimes even years.

It's funny, but I never expected to be admitted to the hospital for a heart transplant and feel overwhelmed by how fortunate our circumstances.  Whether talking about the proximity of home, Annika's relative health, or Annika's size, we feel extraordinarily blessed.  It's been special to form some connections with families going through similar challenges.  A few days ago Annika met a beautiful Mom who was listening as Talia and I were playing piano.  The Mom asked Annika about the journey that brought her to Primary Children's, and we learned that their newborn daughter was likewise waiting for a heart.  Yesterday we found out that a donor heart had become available, and the transplant was successful.  When Annika saw this Mom in church today, she ran up to her and gave her the biggest hug.  It was so sweet to witness their special connection and the shared joy.  

There is a lovely meditation room just outside of the cardiac unit featuring a wall of fairy lights and tiny clothespins.  They have little slips of paper for you to pin your hopes and wishes on the wall.  After spending some time meditating and praying in that room, I simply jotted down "The right heart at the right time."   As I pinned it to the wall, I realized that my prayer wasn't just for Annika--it's for every cardiac child waiting anywhere.  

Going back to hospital church, as I sat in that sacred space, I was overwhelmed with this feeling of how much God loves these children.  We are all precious to him, but I believe he he has a special, tender place reserved for these kids who are going through so much.  Tribulation softens hearts, and these tender hearts have been molded to draw close to Him.

Hospital Life

Here's an update that I started on Friday.  I'll get a more current one later, but the general theme is the same.  Despite a couple of nasty migraines, we are doing well and just hanging out waiting for a heart.

***

Well, it's been 90 hours since we checked into the hospital, but who's counting?  I feel a little stir crazy, and I've been able to spend time outside every day, including working two 12 hour-shifts at a different hospital and sleeping at home twice.  I can only imagine how Annika must feel.  Primary Children's is doing an amazing job making it feel as fun as possible, but it's still hard.  She wishes she could go home.  Me too, girl, me too.

In the meantime, here's a photo journey of some of the better parts

Checking in.  While most of her stuffies had to stay at home, she brought both of her dragons to keep her company. 

She handled her initial blood draw like a champ.  In fact, she did so well with them that she opted for a daily poke instead of getting IV access where the tube has to stay in all the time.

One of her first priorities was to make a how-to video for drawing a tiger.  She had me record it so she can start a Youtube channel.  I'll let you know if we get it edited and published so you can check it out.

Jason took this picture as he came up after work.

Talia joined as well after her orchestra concert.

We headed upstairs to play some Christmas carols.  I love that they have a piano available!  Yesterday I brought Annika's piano books up and she even practiced a bit.

Playing along with her imaginary violin.

Goofing off as we say goodbye.

Here's Annika sending a transmission from her CardioMems the next day.  Shortly before Thanksgiving they inserted this tiny sensor (the size of a paperclip) that lives in her pulmonary artery.  When she lies on this giant "pillow," she can send a remote transmissions of the pressure readings, kind of like a tire gauge.

All done!

Hanging with Eli.

As for Talia, our tired Senior chose to take a nap on the floor.  (This room was pretty small, so places to stretch out were limited.)

Bedtime.  We told the cardiology team that quality sleep was a high priority for us, so they are letting Annika skip her 4am vitals, plus phlebotomy is supposed to do blood draws after she wakes up.  (I had to gently remind them of this when they came in at 5:30 this morning.)

In general, Annika's liked the hospital food okay.  Each morning she orders an omelet with spinach, onion, mushrooms, cheese, and bacon.  It smells amazing and she devours it all without sharing a bite.  For this lunch she got fettucini alfredo with shrimp.  I think she liked it, but not enough to order it again.  Personally, I just like listening to her call and give her menu preferences.  It was scary at first, but she's getting more comfortable picking up the phone and dialing.  #lifeskills

These first days were filled with a LOT of Minecraft.  So much that we may have had to go through a period of detox because she was becoming super dysregulated and wasn't able to switch gears when providers came into the room.  I may or may not have taken the X-Box controller home from the hospital and brought it home for three days until she earned it back.  It was a bold move, but I think it was a good choice.  The following days were so much more creative and positive.  Now she can have Minecraft for an hour a day again, but has to "earn" her play time by doing some other things first, like practicing 15 minutes of piano and going for a walk.

We didn't love our first room because it was so tiny, but we still did our best to decorate by putting up these amazing garlands that NomiAnn made and sent.

Hunting for the Elf on the Shelf.  That Elf's been up to mischief for sure!

Out for a hospital stroll with Mom.

Someone made these adorable crocheted plushies.  Annika adopted a snowman to give to Violet for her third birthday.

Nose to nose with a gnome in the gift shop.

Enjoying the cute little plush snowflake given to her by her friends Ilse and Ehrhardt.

Upgrade!  Since Annika may be here for a while, they were able to move us into some larger accommodations.  Hooray!  It feels SO much roomier and accommodates guests much better.  Thanks to Callie for helping us transfer over.

Other fun moments--hanging with our new bishop, Eric Buell.  It's pretty awesome when your bishop happens to be a pediatric anesthesiologist.  

Pet therapy!  Annika was so excited to have Guiness come visit.  I was at work and didnt' see, but apparently Guiness is massive and great for cuddling.

Jason, Annika, and some of the care team made the most beautiful snowflakes!  I love how they make the room feel.

With Minecraft on hold, Annika got super creative and started making dozens of unique birds that each have their own name and personality.  Apparently the Firebirds battle the Waterwings, so I have to be careful to separate them when they get stored away.  For a long while they have taking over the couch (that's where the nest is), but I finally had to insist on getting my bed back.

Last but not least, mailing a letter to Santa.

Hope it makes it to the North Pole, even (or especially) from Primary Children's.