Thursday, March 20, 2008

Dr. Seuss dress up day at school


Jake was a star-bellied sneeetch. His friend Lucas was Thing 2. The green hair is not a medication side effect.

Back to Legoland




We got to do a very quick make up trip to Legoland after dialysis on the last full day in San Diego. Jake got to meet the Master Builder, tour the workshop, and make a Lego model of himself which went into the permanent display. Look closely at the model in Jake's hand.

Day 2 - DisneyLand?




We left the hotel so Jake could go for his special planned day at LegoLand. We we arrived, we were informed that the park was closed for the day because it was raining. Jake was despondent, so we decided to drive up to DisneyLand. He calmed when we hit the Lego store at Downtown Disney (which had better stuff than at LegoLand). He got picked to pull the sword out of the stone, and he was very excited after that.

Day 1 at Legoland




We landed in San Diego, and went to Rady Children's Hospital the first full day for his scheduled dialysis. It turned out his catheter was cracked, so that meant general anesthesia and surgery, and an overnight stay at the hospital. When he woke up, we decided to skip the San Diego Zoo and do an extra day at LegoLand (which was a good thing, as you'll later see).

Make A Wish travel to California







The trip was pretty impressive - limo to the hotel, cockpit trip (as soon as they cleared him off the terrorist list), special rental car reception and an incredible hotel room with bay and ocean views.

Trip to Sebring



We went to Sebring so Jake could pull the winning raffle ticket. The event was the national Porsche Owners Club get together, and Jake got to ride in the pace car around the track.

3/20 Update - Make a Wish and other things

We've been pretty busy. Jake had his Make A Wish trip to Legoland in San Diego, with a side trip to DisneyLand. We had another trip to Sebring Florida so Jake could pull the winning entry in a Make A Wish Raffle for a special edition Porsche Cayman. He's currently on the kidney transplant waiting list, and we still go to dialysis three times a week. The next few entries will be some of the pictures from our trips ...

Friday, January 11, 2008

1/11 - My work goodbye

I sent this today:


A heartfelt and sorrowful goodbye (with the obligatory top ten list)





Today is my last day at Akerman. It has been an incredible privilege to learn from and work with my colleagues here for the past 12 years. Having previously worked at Skadden Arps and Greenberg Traurig, I can state with confidence that this is the finest firm that I have ever seen.



So why am I leaving? Male menopause. My wife won't let me buy a Camaro, so starting a new firm is apparently the only way to recapture my quickly-fading youth. Actually, the real reason is probably no more logical. As many of you know, last year was a very tough year for my family, due to my son's ongoing illness. My friends at Akerman have been the lighthouse that helped us weather the storm. That said, my subconscious appears to be driving me, like a spawning salmon, to separate from everything in the "past" so I can approach a different future (healthwise) for my family. Can you see why I only earned a B- in Psychology 101?



Once my subconscious began driving me (without a GPS) towards unspecified "change", I developed my one sentence business plan – "Do something in which Akerman remains a friend." I have never had any desire to go to another large firm, because Akerman does it better. So I came up with the plan for a small litigation boutique, in which I am joining Scott Cosgrove and James Sammataro. That allows us to continue to work with our Akerman friends, call upon their vast expertise, and do the kinds of things that Akerman can't do because of client conflicts.



So where does that leave us? Akerman is the dominant firm in Florida. And Miami. Period. A quick look at the phone list reveals the caliber of our people, from the most senior partners to the most junior staff. There's nobody smarter, and nobody more skilled. Period. To top it off, our "jerk quotient" is so low that an unbiased observer wouldn't believe its actually a law firm. Think about it.



While nobody can touch me with regard to pop culture knowledge from 1980 to 1990 (yes, I've thrown down the gauntlet), the rest of the litigation practice will march on without even a hiccup. In the face of the continuing recessionary pressures, there is no firm better situated to thrive. On the other hand, if you have questions about "Pretty in Pink" or the Psychedelic Furs, you probably need to call me.



Yada. Yada. Yada. What would my email be without a top ten list? So here it is, the top 10 reasons why I'm leaving:



10. The firm won't let me try to fix the copiers when they jam, so I wanted the opportunity to do it for myself.



9. There's a glass ceiling – I will never, ever, ever, be able to beat Steve Roddenberry at Brickbreaker on the Blackberry. I give up.



8. "I forget what 8 was for."



7. I really, really want to go back to Word Perfect.



6. Management said that if I walked around the office in spandex bicycle clothing one more time, I was in trouble. It's so comfy against skin, and one thing led to another, and the rest is history.



5. I can now buy a Keg-erator for beer room.



4. I can't get over the fear every time I step into the new elevators.



3. Work was getting in the way of my blog (which is still going, if anybody's interested).



2. The firm was pressuring me to update my web bio picture, which was taken 3 years ago during the brief 2 week period after I lost weight and before I lost my hair. No dice.



1. People were getting suspicious about the collection of Porsche headlights in my office.



As you can see, there's still a writer's strike. . .



If you need me, Scott or James for any reason (Hart Scott advice, L.A. Law trivia, teaching your child how to ride a bike), we'll be 40 yards to the east in One Biscayne Tower. Our phone number is 305-377-1666.

Thursday, January 10, 2008

January 10, 2008 Report


Big news. Jake is scheduled for a Make-A-Wish trip during President's Day weekend to Legoland in San Diego. We fly out after dialysis on Friday, spend Saturday and Sunday at Legoland, do dialysis in San Diego on Monday, and fly back on Tuesday. A whole weekend where it won't be safe to walk around in bare feet. He's very excited, and we are of course grateful to Make-A-Wish. I'm going to miss the annual 24 Hours of Sebring endurance bicycle race, but it's clearly worth it.

We're moving forward with getting him on the Kidney Transplant list at University of Miami Hospital. It looks like he'll go on the list in April. From there, it could take a week or it could take a year.

In other news, I left my job and I'm starting a small "boutique" law firm with 2 friends. See www.SCS-legal.com for details. It's kind of a mid-life crisis thing. I'll post my goodbye email to Akerman tomorrow.

Tuesday, December 25, 2007

December 25 (Picture from Halloween)


I fixed the #%#$^&! digital camera. This is from Halloween.

Sunday, December 23, 2007

December 23 update

We're doing dialysis today (Sunday). We normally do Monday/Wednesday/Friday, but for the next two weeks we're doing Wednesday/Friday/Sunday. This gives the dialysis staff Christmas Eve and New Year's Eve off. Everybody came in very early, so there's still some weekend left when we finish.

Yesterday, we participated in a ceremony at our synagogue to give him (i.e., add) a new Hebrew name - Chaim ("life"). He's now Yaakov Chaim Avraham Silverman. This is apparently an orthodox/Lubavitcher tradition, but we went with the flow. He didn't even participate in the process. Dad was part of the minion, the prayer was recited at the Torah, and presto. The scary part was Dad having to recite the Hebrew prayers that are looong forgotten. Reading Hebrew with my 41 year old eyes is out of the question, so it's a memory thing. Jake was out playing with the other kids while all this was taking place, and Mommy was behind the lace curtain (the sexes are separated at the shul during services, much to her displeasure). It was nice, because the synagogue building had a serious fire last week and services were held in somebody's house. The house had a big front yard, it was a beautiful day (70 and sunny), and Jake had a fabulous time playing with the other children. I had suggested adding Shaquille as his new name, but nobody seconded the motion.

He had a flu/cold for a few weeks, but he's mostly recovered. He still has that little kid chest cough that comes from not knowing how to blow his nose or cough up, but there's no more fever. Kidney function is unchanged. The docs seem to feel that the lack of improvement in creatinine levels means that transplant is the proper course. That would still hold to a schedule where we "go on the list" in March or so.

We're staying home for the holidays. After the new year, Jake and Mommy will go to Jacksonville for a few days (with one day of dialysis in Jacksonville).

Wednesday, November 21, 2007

November 21 Update

It's been a long while since the last update. I can explain a few weeks of the delay, but the last 15 days were was laziness. The explainable part was that his blood chemistry results started improving - so much so that there was talk of taking him off dialysis if his 24 hour kidney function test results hit 20%.

In order to do the 24 hour test, you have to collect urine in a jug (which is kept on ice in a cooler) for a 24 hour period. Since we can't hang around school with a jug and a cooler, the test is normally done on a weekend. Each weekend following the last update, there was some collection mishap which required that we start the process over again the next week. One weekend he forgot about the collection process and went to the bathroom without the jug. One weekend he had a jug-less playdate. One weekend the cap fell off the jug and it spilled out in the driveway on the way to dialysis. We ended up completing the test three weeks ago, and his kidney function numbers came out at 10%. That's an increase from the 7% we saw in August/September, but it's short the 20% we'd need to cease dialysis. He's scheduled for another 24 hour test in late December.

The evening human growth hormone injections are going a little better. We give it to him an hour after he falls asleep. Mommy gives the shot and Daddy holds him down as necessary. He cries when he gets the shot, but generally goes back to sleep fairly quickly.

He still likes school. We're going to start some reading tutoring after the holidays, but he's very advanced in math. At home we've been reading the Star Wars books at night, and playing the new Lego Stars Wars Complete Saga for Wii.

Mommy has been very busy helping her brother close out her grandmother's probate estate and helping Daddy with some other projects. Daddy's been working and bike riding (triathlon season is over). Mommy's family is in for the Thanksgiving holiday, so Jake has time to play with his cousins.

Monday, October 8, 2007

October 8 Update

The little pischer discovered that if he "doesn't feel good", he doesn't have to go to school. His Grandma came to town for a visit last week, so he decided he didn't feel good. He stayed home from school that day and got to play with Grandma. In the next few days, he got a little cold, which he's attempted to milk so he can stay home from school. Now he's just fakin' it every morning. I'm starting to threaten him that he's going to have to repeat first grade if he misses more school. Since he does have occassional bouts of nausea as a result of his condition, it's hard to tell when he's crying wolf.

As soon as we complete parent training (which is a story by itself), he starts daily Human Growth Hormone injections at home. I'm sure it will be an ordeal at first, but hopefully he'll get used to it. He's now used to his yucky Sunday Kaexolate dose and his bandage changes at dialysis, so it will be a matter of time.

Monday, October 1, 2007

October 1 Report

Jake's still doing well in school. He's very good in math, and is progressing well in reading. The only part of the homework where he gives us grief is that he doesn't have the patience to color the pictures after he's filled in the answers to the narrative questions. We cut him some slack on that (for now).

It's been over a month since he vomited ("Does your tummy hurt? Mommy, you know I don't throw up anymore"). The new bandage-changing procedure is working well, and he says he doesn't mind going to dialysis. One of the other kids in the unit (with a different form of HUS) had her kidneys resume functioning, and he was stoic but disappointed ("I hoped that hers and mine would come back at the same time").

We received a second opinion pathology report from Columbia University Hospital, and they are very pessimistic. They don't think that his kidneys are coming back. We'll have another 24 hour urine analysis next weekend, and we'll see what that brings.

Friday, September 21, 2007

September 21 Report - Pre Yom Kippur

Jake had a pretty good week. Mommy had to go out of town on Wednesday afternoon, so we had some quality Daddy-Son bonding time. We did some homework, rode our bikes, and played a lot of an improvised game involving Legos. He's also into the Super Mario Brothers Super Show, a DVD set of mixed live action and cartoon shows from the late 1980's. I'd never seen it before. "Captain" Lou Albano (the wrestling manager) played Mario, which is kind of cool. When we go to the playground, he likes to pretend we're playing a real-life Super Mario Brothers level. Our next purchase is the "Legend of Zelda" DVD box, which contains another cartoon series from the 1980's that was heavily cross-marketed on the Super Mario show.

No big changes on the health front. We're waiting for final insurance approval to begin Human Growth Hormone treatment, because he's stopped growing since beginning dialysis. The doc says that you can "catch up" missed growth as long as HGH is provided before transplant.

No big post-yom kippur plans.

Saturday, September 15, 2007

September 15 Update - More of the same, but . . .

More of the same is generally a good thing. This was our most recent message from school:


Dear Mom and Dad,

The bad news is that Ivy League colleges are expensive, so start saving! The good news is that Jacob will no doubt be applying to some of them in a few years! He scored another 100%, this time on our Chapter One Math test. I am so proud of him, to say the least, and I see his academic progress as exponential! I thought you might enjoy knowing this before the weekend!!Love to all the Silvermans..... Have a great weekend!


Jake had a CAT scan of the kidneys on Friday. This was his first scan that used contrast (which is more radioactive) to show blood flow, so we can't really compare it with the prior non-contrast scans. There's a section of healthy kidney tissue which receives blood flow, but there are large parts of the kidneys which don't appear to receive blood flow. There are risks and side effects associated with the contrast CAT scan, and we don't expect to do another one for a while. If there is improvement, it will be revealed when they do chemical tests of his urine (which is collected over a 24 hour period). That was the test which reflected 7% kidney function as of last month. They will do that test every 90 days or so.

Friday, September 14, 2007

September 14 - Happy New Year


Happy Rosh Hashanah! Jake went to childrens' services at the shul, and later in the day we went to the Rabbi's house for an awesome dinner. Unfortunately, Jake didn't accept my advice to take a nap some time during the day, and conked out at around 10:30, costing me a second helping of stuffed cabbage.

He's still enjoying school. He felt fairly well this week. He's got the same school year runny nose and sniffles as the other kids, but that doesn't seem to impose additional kidney-based fears.

We're sitting at Friday dialysis, trying to obtain some star coins on Super Mario Brothers on the Nintendo DS. We're going to work on his "home-fun" reading assignments, too.

Friday, September 7, 2007

September 7 - A report from school

We received this email today from his teacher:


Sent: Friday, September 07, 2007 9:45 AM
Subject: Perfecto!!!!!!!!

Dear Mom and Dad,
Jacob got one of the few PERFECT spelling papers on our test this morning. I am so proud of how well he is doing! I would never know that he missed part of school last year! He is not average; He is above-average at least, but I suspect that he will be at the top of the class by the end of the year. I am not saying this lightly!! He is so smart and "with-it"!! Have a great weekend!!xoxo

We're ecstatic. I though the only words he knew were "start", "save", "load game", "new game", "attack", "defense", and "game over".


P.S. - He recently decided that I'm "jumbo." I told him he'll be jumbo when he grows up.

Monday, September 3, 2007

September 3 - Status Report

We're at Monday morning dialysis (no Labor Day here). He's doing great. In his words, "I don't just like school, I love it." He's right in the middle of the class for reading and near the top for math. He has no interest in organized sports, but he and I go bike riding (he's a two wheelin' guy) a few times a week. In other words, he's about right where he was (or was going to be) both in school and athletically.

His primary hobby right now is New Super Mario Brothers for Nintendo DS. I'm his hero because I can finish the few levels that he has problems with (although there are other levels that he can finish but I can't).

I am reminded of how much he's improved. When we left the hospital, he couldn't walk, and was wearing his "hospital pants". Now he's an emergent reader, a Nintendo wiz, and a bike rider.

No big changes in kidney function. They will do another kidney function test mid-October, and we'll find out how he's doing. Meanwhile, his blood chemistry levels are stable, his appetite is good, and blood pressure is in check. The transplant paperwork process is ongoing, but we don't expect to go through with it until late summer 2008.

Sunday, August 19, 2007

OK, so it's been a while . . .

Sorry for the long layoff. The ghostwriter's union was on strike . . .

He's excited for the first day of first grade tomorrow. He'll go to school full time, but leave at around 1:00p.m. on Monday, Wednesday and Friday so he can go to dialysis. He can do some schoolwork at the hospital, although it's more likely he'll play Nintendo DS and watch TV.

He's doing OK. He's off the Depakote (seizure medicine), which has helped his tummy. As a result, he's vomiting much less.

He's generally in good spirits, but he can get a little cranky at times. Some of that is due to the fact that he gets worn out a little faster than normal, and some of it is due to the fact that we have get him used to hearing "no" on occasion. We presume that they won't be able to indulge him at school like we were during the summer, so it will be a bit of a culture shock for him. He likes the teacher and knows most of the kids in his class, so we're hopeful. As a general matter, he's pretty good in familiar settings (play dates, etc.), but has more trouble with groups of unfamiliar people (birthday parties, etc.).

He recently had a kidney function test (which samples 24 hours worth of urine collection). His kidneys are currently working at 7% of normal capacity. We don't know whether that's improving (this was the first full test since he left the hospital), but if he can get to 15% he can live without dialysis or a transplant. I wouldn't say that the medical staff is optimistic about a recovery, but it's enough of a possibility that they've slowed down the preparations for a transplant. Right now the transplant schedule is deferred until at least next summer.

I'm out of town all week for a trial (my karma-impaired opposition wouldn't agree to a continuance). Jen's holding down the fort alone, so I'm sure she'd appreciate some help - at least until Wednesday, when my Mom comes to town.

Since we're pretty busy on medical issues, all out-of-town athletic travel(duathlons, triathlons, etc.) for the fall has been cancelled. If anyody wants my spot for IronMan Florida, let me know.