CT Scan Update

Dear Friends and Family,

We have been so blessed by all of your prayers, texts, e-mails.  Thank you for your love and concern for our family and our boy.

Asher was a great little patient through his CT scan.  He didn't even need an IV line, so he was happy to avoid another poke. 

The initial feedback that we received from the radiologist was that the images of the lungs had not changed much since his previous scan last October.  We still wait official word from his pulmonologist, once she has been able to compare them closely, which may demonstrate some growth (since he has grown, and his oxygen needs haven't changed).  We will also wait to hear from the cardiologist and hopefully an anesthesiologist to further discuss the risks of sedation should we decide to attempt a heart catheterization.  

The long and the short of it:  at first glance it doesn't look like the best we had hoped for - substantially improved lung tissue, we may not be any closer to knowing Asher's tolerance for invasive surgery, but we wait with hope for more detailed results from pulmonology.

We will update further if there are any changes or big decisions to make.

He did so well during the scan, though, and I even got to ride with him through the machine, holding his little arms above his head as we sang, "Had a Little Rooster."  

After our long day of appointments, play dates for Noah and Ethan, and dinner with friends, I found the Bible verse for today on my kitchen counter:

"The steadfast love of the Lord never ceases,

his mercies never come to an end;

they are new every morning;

great is your faithfulness."

Lamentations 3:22-23

This verse comforted our family last Fall as we first faced all the unknowns, and it comforts us still.

With much love,

Laura and Michael

Asher Summer Update

Dear Friends and Family,

We realize it has been too long since our last update.  Indeed, we have been very busy with moving into our new home, settling in, and enjoying the new summer schedule with everyone at home.

The new house has been a tremendous blessing - allowing everyone a little more space.  We did a lot of construction on the front end, our families and friends all helped to turn it into a beautiful home. There will always be projects, but most of the big ones are done and we feel so welcomed into our new neighborhood.  Asher in particular likes the back deck, where he can look out into the woods and hear the birds! 

Through it all, our little champ has been growing well (now 14 lbs 13 oz!) and he has had very few of his hypoxic spells (when he goes blue and unresponsive for a brief period of time - terrifying).  While those will always remain a concern, we're grateful that they are more rare now.  He is sitting up, babbling a ton, smiling occasionally, taking oral feedings of cow's milk, yogurt, and water, and using a sippy cup!  At his most recent speech therapist appointment, he did so well that he will now start getting part of his nutritional feeding orally, and reduce the amount through his NG tube. These are all sweet answers to prayer. 

His last clinic visit in May was generally good, but his cardiologist is leading us to ask when and if we might want to explore Asher's need for heart surgery.  The first step in determining whether or not he can handle surgery will be repeating the CT scan of his heart and lungs to see if his lungs have grown at all since the last one he had in October - the one that revealed the underdevelopment of lung tissue.  If they have grown, that is very good, although not necessarily a direct indication of his ability to withstand sedation (being intubated).  If he is intubated (for any number of needed surgeries - heart catheterization, eye alignment, repair of the holes in his heart), there is a high chance that his lungs would not be strong enough to take over again after being extubated.  So while he is doing extremely well, better than anyone expected, this has reminded us that there could be some very difficult decisions in the future. 

At this point, we are prepared to schedule the CT scan, perhaps in August once he is a year old. (!)  Beyond that, we covet your prayers.  There may be some sense of urgency, as some children with heart disorders require surgery before two years of age.  Over time, the high pressures in the vessels cause damage.  With Asher, we don't know what that window is. We have an appointment on Friday, where we will discuss a lot of these concerns, and maybe leave with a better timeline. 

Here are some ways you can pray:

Praises:

- For all the ways he has grown and developed!  We are eager to celebrate his first birthday on August 12th!

- For all the support that we are receiving at home - Physical Therapy, Occupational Therapy, Speech (Oral) Therapy, and personal helpers 4 days a week for 6 hours a day!

- For his new portable oxygen concentrator that allows us the ability to travel longer distances in the car without needing all those tanks.

- For his new leg/foot braces that he wears for 6 hrs a day - they prevent his from developing muscle contractures in his feet and will give him the best chance at walking one day

- That all of these supports are covered by insurance!

Please Pray:

 - For stamina in parenting and finding time to rejuvenate both personally and as a couple.

 - For opportunities to make memories as a family this summer - it's really hard not being able to travel as we usually like to do, but it also means that Asher is still with us - and in that we rejoice.  We are spending one week away at a family camp (Shrinemont) with Michael's family, where we are renting a home that is handicap accessible.  Please pray that this vacation will be as restorative as it can be and that he will remain stable throughout our time there.

 - For wisdom and peace - as these big decisions in his care loom.

Also, just before we moved, a new friend gave us the gift of creating a short video to give folks a better picture of who Asher is and what his special needs are.  He is starting a non-profit called Help Healing Productions that is designed to create videos at no cost to the families, telling each child's story and bringing awareness and support for the child's and family's needs.  Asher's is linked below, and it is beautiful.  At the end, there is a link to the gofundme account that was created by a dear friend of ours back in October.  We want to be entirely forthright in saying that Asher's current financial needs have been met, much of it covered by our primary insurance or Medicaid, and so much generously given by many of you.  Any funds raised at this point are being put aside for future potential needs (equipment not covered by insurance, etc.)  Again, thank you for your great kindness to us.  So much love has been poured out.

Here is the link:

https://www.facebook.com/helphealingproductions/videos/vb.373604142812629/426228037550239/?type=2&theater

"For you, O God, have tested us;

you have tried us as silver is tried;

you have brought us into the net; 

you have laid a crushing burden on our backs;

you let men ride over our heads; 

we went through fire and through water;

yet you have brought us out to a place of abundance."

Psalm 66:10-12

We are seeing God's abundance as He provides daily for our needs, and our daily needs are all we can handle.  When people ask us how we are doing, we often answer "one day at a time."  We try not to worry about the future (though I do, even as I write this), because it might very well crush us.  We will never understand why this has all happened in our family, but we can trust that through it all God is good.  While it may not make sense, we see His goodness more clearly because of Asher.

With love and gratitude,

Michael, Laura, Noah, Ethan, and Asher

This Week

March 26, 2015

Dear Friends,

This week has been extremely full.  We were discharged yesterday from UVA Hospital after two days there, specifically monitoring Asher for 24 hours to rule out seizures.  It had been suggested by one of his doctors that the recent episodes he had been having sounded slightly like seizures.  This past weekend he had five episodes, so we decided to monitor him just in case there was new information that could help us know how to best treat him.

The video/EEG monitoring came back almost completely negative for seizures.  While we can't be 100% certain because he didn't have one while in the hospital, his tracings didn't appear prone for seizure activity and for a little guy with so much going on, they actually looked "quite good" for a baby his age.  That was a relief and an encouragement.  The episodes are, then, most likely caused by that change in pulmonary blood pressures, as we had thought before.  We can do some things to help him avoid having them, but it sounds like they may not go away, given his anatomy.

We are all happy to have him (and Mommy) back at home with us.  He was back to his cooing, happy little self by the evening.

To add to the fun, we may or may not have treated someone in our home for lice (for the 3rd time in a month and a half), and Michael's school chorus performed at the Paramount on Tuesday.  

We also closed on our new home yesterday!  Our Dads are here to help with lots of house projects before we move in on April 25th.  Meal help was graciously started back up to help us in these nutty weeks - just let us know if you are interested in helping in this way or any other practical moving way and we will happily find you something to do. (c:

Thank you for your persistent prayer!  Asher's sweet little life is joy amidst the chaos. 

Much love,

Michael, Laura, Noah, Ethan and Asher

7 Months

Dear Family and Friends,

Greetings as the hope of Spring beckons us outside again.  We are happy to have made it through the cold, dark days of winter with Asher, now 7 months old!  The rest of us have suffered colds and viruses, but this little guy has avoided all of them with the help of his vaccines and breast milk. 

Overall, there has been little change in his status.  He has continued to grow (almost 12 lbs), but has slowed down slightly, so we are adjusting for that nutritionally to help him keep the pace.  He has improved his ability to track visually and is really quite interactive, which we all love!  His smiles and mimicking coos bring us deep joy.  He is making very slow progress, orally, but is learning to allow a pacifier into his mouth without gagging.  We have been experimenting with whole foods like apples in his mouth, just for tasting - very entertaining.  The presence of the NG tube remains irritating, but he tolerates it far better than anyone of us would.  At this point, there is still no timeline regarding placement of a "G tube" (one that would go directly into his belly, instead of through his nose).  Any surgeries are still a ways off, unless his lung tissue demonstrates maturation, indicating his ability to handle sedation.

We are thankful to have all the hired helpers that we need at this time. Each one is a friend whom we already knew and who loves Asher and our family!  We are so grateful to each of them and to so many who also volunteer their time to help me run errands, work, attend church, give us date nights, or help me during Michael's rehearsal nights with all the boys.

In the last couple weeks, Asher has had a handful of episodes where he turned quite pale or blue.  It coincides with bowel movements and indicates that the blood flow through the holes in his heart has briefly reversed, due to the increased intrathoracic pressure as he bears down.  The only things we can do in these moments are to increase his oxygen level and comfort him until he can recover.  The episode lasts only a few minutes, though it feels like an eternity, and the recovery, 15 minutes or so.  It is in these moments, that we hold him extra close and are reminded of his and all of our fragility.  Each breath is labored for him and seemingly, so close to a downward spiral where we could lose him.  We haven't felt this worried in a while, and it's a tough wake-up call.  

Tonight, Ethan, Asher, and I were reading a book about baby Moses.  When we read about his mother placing him in a basket in the river, I mentioned that she must have been scared for her baby son.  Ethan then said, "Yeah, because he could've died.  Mommy, could Asher die?"  I had to respond honestly.  He covered his face with his hand, but I could still see his out-turned bottom lip.  This is a reality that none of us want to face.  Truly, none of us know when our last breath will be, but we have hope in a God who does.  He has sustained us thus far and will sustain us still as we continually face uncertainty.  

The coming six weeks hold a lot of change for our family.  We are under contract on a new home, still in town, that will better meet our needs.  As crazy as it sounds to move at a time like this, we have seen God's kindness in the whole process. Our current home sold in no time, and so many details have worked out in extraordinary ways. We are very excited about this new place, but we will dearly miss our neighbors on Chisholm Place.  They have been like family to us. I'm pretty sure we will witness a miracle as we again need to rely on our family, our church, and our community during this transition.  If you are local and want to help with the move, just let us know.  We close on our new home on March 25th and have until the end of April to move in (end goal is April 25).  

Let us know if you would like our new address.

Again, we are so grateful to be coming into this season of Easter with eternal hope in the Risen Lord, who sustains our every breath!

With Love and Gratitude,

Michael, Laura, Noah, Ethan, and Asher

Asher's First Nap in his new bedroom! (We were just walking through)

Discovering his feeding tube

A New Year's Post and Update

Dear Friends,

2015.  Wow.  Two months ago we doubted that we would even have Asher with us for Thanksgiving, and now we are rejoicing that we could celebrate Christmas and the New Year with him too.  As we stare down the foggy road ahead, all we know is that our feet are grounded and a path has been laid before us.  Many of you are the sign posts giving us hope and encouraging us as we travel, slowly.

The Advent and Christmas season was a blessing to all of us.  We made special efforts to bring Asher with us to our church's "Lessons in Carols" and Christmas Eve services.  Both were a rich encouragement to us and so many were happy to see this little boy who they have been praying for.  Holding Asher (by the wall with his oxygen tank, away from all the little flaming candles!) we sang "Hark the Herald Angels Sing" and the third verse had never sounded more hopeful: 

Hail the heav'n-born Prince of Peace!

Hail the Sun of Righteousness!

Light and life to all he brings

Ris'n with healing in His wings

Mild He lays His glory by

Born that man no more may die

Born to raise the sons of earth

Born to give them second birth

Hark! The herald angels sing,

"Glory to the newborn King!"

I found myself unable to sing, and instead weeping as I considered the beauty of these words.

The week of Christmas we had a fun visit from my sister and nieces and then went to Arlington the day after Christmas to be with Michael's family.  It was so good to be with cousins and the rest of the family there.  Like Thanksgiving, it was stressful to travel, but completely worth it for the memories and the traditions.

Ice Skating with the cousins on Christmas Eve

How is Asher?

Asher gets time with Aunt Cindy

Honestly, he's doing as well as he possibly can be.  He will be five months old this monday and weighs about 10 1/2 pounds.  That's 50% more than he weighed when we left the hospital! His recent clinic visits have been helpful as they continue to monitor his status, adjusting medications as needed to keep up with his weight gain.  His last visits were with his cardiologist, a speech therapist, and two friends here who are a developmental pediatrician and nutritionist.  We also have a speech therapist and occupational therapist who are coming to the house regularly.  You might wonder why he needs a speech therapist.  Asher hasn't taken any food orally since the beginning of November and he's essentially lost his reflex to suck.  A speech therapist will help us with regaining and building his oral skills.  Since his visit last week, he has already shown improvement as we practice with him at home now.  Yesterday, while his speech therapist was with us at home, he smiled SEVEN times!  It was such a gift, since he does that so rarely. All milestones will be reached late, but we celebrate every one. Lately he has been reaching out to grab things with his hands, and he always loves music.  Next week we will see a pediatric ophthalmologist to see if he has any insight into his vision needs.  His lovely nurse still visits us twice a week or so. Lots of doctors, lots of appointments, but we never thought we'd get to this point, so we're thankful. He is one tough kid.

We are currently seeking out a better, longer-term system for Asher's caregivers and are beginning a search for the right team of folks who will be with us at home so that we can continue with our normal jobs and family life.  He qualifies for the Virginia Medicaid waiver for the disabled, so we are able to actually hire these helpers.  Please pray for this process, as it feels pretty daunting right now. After four months of receiving amazing meals from you all, we're back to cooking, something we really enjoy when we have the time. 

This is still a few months away, but eventually if he keeps growing, we will talk about taking another CT scan of his lungs, and discuss possibilities for future procedures.   For now, we'll keep taking it a day at a time, trying to find a new rhythm in this new year.

Your prayers are still appreciated and deeply felt. God is good. Pray for rest, which is pretty hard to come by, and for patience with each other and the boys. Pray for Asher to grow and be able to take food by mouth again. 

Thanks for reading this long update, and we pray that your 2015 is full of grace and peace. 

With much love,

Laura and Michael

Asher's First Christmas Party

 

"Quick, Maggie!  Pull the tubes while their not looking!"

Family Time, Clinic Visit

Since our last update, we have had some wonderful time with both sides of our family.  My parents came up for a great weekend of celebrating Mom's birthday, and we had a big Thanksgiving in Arlington with Michael's family.  It was good realize that we CAN leave town (Asher's first trip!), though it's certainly not easy.  There is no running from all of the extra work and gear that goes into caring for our precious boy.  We just bring it along.  He did great in the car, and we made some beautiful memories all together. That, we are learning, is most important right now.  His NG tube fell out soon after our arrival, but we were thankfully able to put it back in ourselves.


On Friday  Asher had an appointment with his cardiologist and pulmonologist.  He also got another echocardiogram (an ultrasound of the his heart) which was about the same as his last one.  His doctors were pleased with his growth and progress.  He weighs 9 lbs 5.6 ozs!  He is not on the typical growth curve, but he has his own little growth curve, on which he's moving along just fine.  We will be starting a new medication to see if it can reduce his pulmonary hypertension at all.  He is scheduled for another follow-up visit with his doctors in two weeks.

Meanwhile, we are all preparing our hearts for the coming of Christ during this time of Advent.  Honestly, it's a challenge to be hopeful these days as we long for our boy to be healed, but we do  trust that God is doing amazing things in all of this - even if we cannot understand it at all right now.

Ollie, our Christmas mouse (see below) has made his return to our home.  He loves to help the boys count down the days by giving them little tasks or creating some fun activities for them to do.  This year we are seeing more clearly how important all these seasonal traditions are.  And it would be so much more challenging if we did not have all the help we do - grocery and errand runners, meal providers, and babysitters.  Thank you again for all our your prayers and support - for being Jesus' very hands and feet to us!!

Asher Update: It's been 4 weeks since we left the hospital

Dear Family and Friends,

We are well overdue for an update on Asher and our family, but to some extent it is a case of "no news is good news".  You all have been so incredibly kind in caring for us through this storm.  The waves keep coming, but through you we remain afloat.

We are slowly and timidly working out a new normal, but friends, it is hard. Medically, there is good news, in that Asher remains stable at home.  Last Friday he had a follow-up appointment with his cardiologist and pulmonologist who were both pleased with his continued stability.  He really is a little fighter, and has surprised everyone. He's learning to use his hands more, and lifting up his head when on his tummy, but still doesn't smile or hold a gaze very often. This week he has had a cold, with a cough and congestion, but he seems to be weathering it well. His nights are a little more restless with his cough, and we pray he can fight it off.  He continues to put on weight  - up to 8lb 10oz - a good sign that he is using his calories to grow and not just to breathe.  He is still on oxygen and receives all of his feedings through his nasogastric (ng) tube. That tube is of constant concern, as he has managed to pull it out several times, and it is decidedly NOT fun when it goes back in.   

A rare moment without tubes after he pulled out his
feeding tube last Sunday

As far as what life looks like for us right now, we are getting used to navigating the house with cords and tubes and noisy machines (his oxygen concentrator sounds like a snoring dishwasher, but it has become our white noise machine!) following him wherever he goes.  It certainly makes us thankful for our small one-floor home. He doesn't leave the house much, especially not in this cold weather, but we had been trying to get outside for walks using one of the smaller oxygen tanks.  He's still getting Laura's milk through his ng tube every three hours, but it is fortified in order to give him the extra calories he needs to grow.  A wonderful nurse comes to see him two or three times a week.  Laura is getting out of the house for errands, bible study, school events, etc, with the army of helpers that have come to our aid.  She has even been able to go in to work a handful of hours a week.  Michael has been back teaching for a few weeks, and while he loves his job, it is tiring, especially with the extra emotional weight we are carrying.  

We continue to receive meals four times a week or more and are SO grateful!  Grocery shopping, childcare, holding Asher, and errand running, among many other thoughtful acts of service, have absolutely sustained us.  If you are interested in helping in these or other ways, please contact Tim Jones at tim.jones@trinitycville.com or email us directly at thesalvatierras@gmail.com.  We do love visitors, just text or call beforehand to make sure we're there. 

It is still incredibly difficult not knowing how long we will be on this most-challenging road, and we are grateful for a Steadfast God who is loving us through so many dear family, friends and even strangers.  Our plan remains - to enjoy each day that we have with him.  He has given us and so many others an aching reminder of the preciousness of life and the hope that we can bear in it.  But it is exhausting. Some days we feel we are closer to normal, others we are still overwhelmed and fragile. We have talked to Noah and Ethan more about the possibilities and uncertainty of Asher's condition and they always pray that he would get better.  We're glad that they have grown more accustomed to all of his gear and remain devoted and affectionate big brothers. 

Please feel free to share this as needed. Please pray for Asher to keep growing as much as he can. Pray for much grace and patience with each other and with our boys. Pray for blessing upon those who have served our family. Pray that we would find rest and hope in Christ.

With much love,

Michael, Laura, Noah, Ethan, and Asher

Our Asher - Past E-mail updates

November 2, 2014

Dear Friends,

We have been home for a week.  Asher is thankfully doing about as well as he was when we left the hospital. He has been stable here, comfortable, growing, and finding his way into the rhythms of our life at home. He was baptized last Saturday in a beautiful service put together by our church, Trinity Presbyterian, and our friends. We now have a home nurse coming three days a week, house calls from some of our doctors, and a host of generous friends and family visiting.

The big news is that the latest round of genetic tests found the almost certain overall cause of Asher's many problems. They discovered a particular microdeletion in one of his chromosomes, called 15q26 (it's rare enough to not be named after anyone yet).  There are very few identified cases of this deletion, but those in the medical literature match his symptoms well. His situation seems to be particularly severe, as not all children with this condition have such underdeveloped lungs. For those less severe cases, there are varied outcomes, a wide range of physical and cognitive delays that can be expected.  But Asher's lungs are still the primary concern. This does not change anything about his prognosis or our immediate plan for his care; there is no "cure" for a syndrome like this. Yet somehow there is a bit of comfort in understanding what is behind everything, and potentially being able to connect with others in the same situation.

The most difficult thing is learning to tread the line between going back to normal and being ready for the worst. How does so much uncertainty fit into routine?  Michael has tentatively gone back to work, and the boys have kept up their schedules, but of course it is not the same. Our emotions seem to roll in waves, from grief to gratitude.  When other distractions fade away, we are still left scared and weary. We will never be able to say all the thank you's that are deserved. You all are amazing - you remind us that God is still good, and that He has not abandoned us. 

With much love,

Michael, Laura, Noah, Ethan, and Asher

 

October 24, 2014

Friends,

Short update with two items:

1. We arrived home this afternoon. All the care and equipment needed to replicate a hospital room at our house is pretty overwhelming, but it is so good to be back here, with the boys and our whole family. 

2  For those of you who are local, we are having a special baptism service for Asher tomorrow, Saturday October 25, at 2pm.  It will be at Meade Park behind our house, and all are welcome. 

Thanks,

Michael

October 23, 2014

Dear Friends,

So much has happened in the last five days, and I will try to summarize.  In the last update, we were on the way to the PICU, trying to watch closely and understand why Asher was having such labored breathing. He returned to the regular pediatric floor a day later, and has undergone test after test. We have learned a lot, but still have no true answers. While we initially thought that the heart was his great problem, it turns out that the real issue is underdeveloped lungs. A CT scan showed images unlike anything that any of the doctors here have seen. There are so many brilliant people here talking together and trying to figure out what's going on with our boy. They are contacting experts from around the country to get further opinions, but there are no definitive answers - Asher is just unique.
In the meantime, he is stable, getting nourishment and medicine through a feeding tube, and additional oxygen.  We don't know what has caused this abnormal lung development, and the doctors don't have a way to treat it.  What we can do is manage his current condition, help him to grow, pray and hope for the best - for the lung tissue to grow as he does, and surround him with love.
We can do all of that from home, so we are planning to leave the hospital tomorrow. He will still have oxygen, an oxygen monitor and feeding tube at home.  We truly do not know how many days, weeks, months, or more that we have with our son, but God does, and he holds Asher in his hands. We want to make the most of every day, and try to find a new kind of normal at home.
We have not talked to the boys yet about all the possible outcomes for Asher, but they know that he is very sick, and not getting better. I know they will be happy to have him and us home.
Our days here have been filled with so many sweet visitors, prayers, songs, and tears. The amount of love that has surrounded us here has been beyond words.
We'll try to give more updates as we see how things go.
Thank you for everything.
Love,
Michael, Laura, Noah, Ethan and Asher

October 18, 2014

 Friends,
 Thank you for all your prayers and support. We wish we could give some happy news, but we're reeling once again. We brought Asher in to the cardiologist yesterday , because his breathing had been more labored. They did several tests and determined that there was much more going on than we initially thought. There's a lot that we don't know yet, but he was admitted to the hospital last night, and they are keeping a close eye on him for the weekend. We have a great team of doctors and nurses at UVA caring for him, and they are working together to figure out what is causing his breathing difficulty, and what is best for our sweet boy at this point. All the unknown is pretty scary, but we're trying to hope and trust and lean on the Lord and each other. Even as I write this, they're preparing to move him to the Pediatric ICU for more support and monitoring.

Prayers, friends.

 Michael and Laura

Asher's Last Picture before being admitted to the hospital and having tubes on his sweet cheeks

 September 29, 2014

 Dear Family and Friends, 
Thank you so much for all your prayers and love over these last 12 days. We had been waiting until today's appointment to send out an update, and thankfully there is good news! The cardiologist was amazed at Asher's growth and progress in every way. He has gained 10oz in that time, tipping the scales at 5 lb 13 oz, and everything, from his pulse rate to respiration to oxygen saturation, has dramatically improved. We know so many of you have been praying for this, and we can say that God has been gracious, and our boy is growing. What this means is that, incredibly, we are not talking about a timeline for surgery yet. It is still nearly sure that this will need to happen, but every ounce that Asher gains makes him better prepared for it. The doctor told us that if things had stayed as they were at the initial visit, it would be a matter of weeks before the surgery, and now we are talking in months. Incredibly, there is still even the slight chance that he could develop so well that we avoid surgery and wait on the holes in his heart to close on their own. But that is unlikely, and we will wait and see. It all depends on his growth. Everything depends on his continued weight gain and physical development. To this end, we will continue with the rigorous feeding plan that has helped him grow thus far.
 We are honestly pretty exhausted from the time it takes, and all of the meals, visitors, and child care have been and will continue to be a huge help. As long as he continues to gain weight, our next appointment will not be for another month. We cannot thank you enough for all the ways that you have come to immediately and creatively care for us these last couple weeks. Really, you all are incredible. These days have been some of the hardest we have known, and still we have felt such a sense of the Lord's presence, through all of your kindness and generosity. Everything, every word of encouragement and act of love has been meaningful, and often brought us to tears. Please continue to pray for Asher's development, and pray that he would avoid any sickness, even a cold, that could take precious energy away from growing.
 Grace and peace, Michael, Laura, Noah, Ethan, and Asher



 September 19, 2014 

 Dear Family and Friends,
 Please pray with us for our baby boy, Asher. After his one month check-up on Monday when he had not gained much weight, his doctor discovered a heart murmur and sent us to the UVA pediatric cardiology specialists. At our appointment Wednesday, they discovered that Asher has two holes in his heart; one in the wall between the two atrial chambers and one between the two ventricular chambers ("ASD" and "VSD"). This is making his heart work a lot harder to pump oxygenated blood to the rest of his body in an efficient way, thus he is not gaining the weight that he should. The only way for those holes to be fixed is with open-heart surgery. Once his weight is to an appropriate (for him) level, we'll discuss surgery further, but it is likely to happen sooner rather than later since it is inhibiting his ability to grow. To get to that point, Laura is working extra hard at getting him the calories he needs. We are beyond overwhelmed with this news. We are grateful to be here in Charlottesville with such an incredible pediatric medical team, who are so perfectly trained and gifted by God to deal with Asher's condition. Our Savior is beautifully reminding us of His love for us and our family as we receive so much love, care, and support from our family and local community in this scary time and in the weeks ahead. Still, we ache for the healing of our sweet son. There is so much that we don't know. We know that the surgery is considered pretty straight forward, but even that being true - it is open-heart, with all the potential complications that could entail, and it is OUR baby. We are in total shock. Please know that if you respond to this e-mail or reach out to us in some way - it is so welcome and deeply appreciated, but we may not reply at all, or maybe not right away. We are incredibly grateful for all the ways you have already helped us welcome Asher to our family. He is a most treasured gift to us and such a poignant reminder of how deeply God loves us, just because we're His. Please feel free to pass this along to anyone that you think would want to know and pray for us. It's easier to not have to explain everything over and over again, but just be allowed to cry and grieve the loss of the ideal situation that all parents desire - a perfectly healthy child. In this we still hope, because God is present, and in control of every detail of Asher's and our lives. He is already at work in this situation and we have every hope that a year and a half from now, Asher will be running after his big brothers and getting into all their lego creations. We will try to keep updates coming as best we can. We don't even know what we need at this moment, besides prayer, meals, and help with Noah and Ethan. Michael's mother is here with us this weekend. Thank you for your love and care!

Warmly,

Michael, Laura, Noah, Ethan, and Asher


 August 12, 2014

 Dear family and friends,
It is with great rejoicing that we announce the birth of Asher George Salvatierra! He arrived by the grace of God at 12:02am, weighing in at a small but mighty 4 lbs 10 oz. Both he and Laura are healthy and feeling great. Noah and Ethan are completely crazy about their new brother! We are eager for you all to meet Asher (means "happy"), and visitors are welcome at Martha Jefferson hospital tomorrow in the later afternoon. We can't thank you enough for your prayers and support as we gear up for life as a family of five!

Spring Break in Arizona!

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Highlights from a Month of Celebrating

December is a month of anticipation.  Our boys have loved our nightly advent readings, songs, candles, and getting to place one more character from the Nativity scene up on the advent calendar.  Indeed, they are excited about Christmas and when asked they will likely say they are most excited about the presents they are convinced are coming their way.  Well, we've got some work to do in shaping their desires and attitudes towards Christmas, but at least they're honest?
This month began with Michael gone most evenings as he prepared for our church's "Lessons and Carols" weekend (the 8th and 9th).  This is the second year that he has had the honor of directing the performance and it did not disappoint.  He works closely with our Worship director and his administrative assistant, and I am so grateful for how the three of them work together - since this is a second job for Michael, he couldn't do this without them.  This is also the second year that Noah has been able to participate in the event, as a member of the Children's Choir.  The whole evening drew us in and pointed us towards the beauty of Salvation through the birth of Jesus, born as a lamb, in a humble stable.  At one point, I just melted into a puddle as I sat in the front row with Noah, Ethan, and my Grandma as the choir began singing Lauridsen's "O Magnum Mysterium" which sung in Latin means:

O great mystery
and wondrous sacrament,
that animals should see the newborn Lord
lying in their manger.

Blessed is the Virgin whose womb was worthy
to bear the Lord Jesus Christ. Alleluia!

And as the choir began, I could see both my son, Ethan, and his Daddy begin to direct the piece together.  I just couldn't keep it in.

My Grandma Erickson (who is 90!) flew from Minnesota to Raleigh where my parents picked her up and brought her to Charlottesville just so she could come see Lessons and Carols.  The boys LOVED spending time with their Great-Grandma.  Noah said, "She's so fun!"  After she arrived, the boys quickly took her on a tour of our little home and ten minutes later I wondered where they had gone.  I found them all in Noah's room where he was pulling out his "snap circuits" to show her, and she was just giggling with delight.  She also taught us all a little Norwegian:

My parents and Michael's parents were both in town that same weekend!  It was wonderful to have everybody here at the same time and very gracious of our neighbor to let some of them stay in her home.

This past week also brought lots of celebrating as Noah gave his first piano recital performance of "Away in a Manger" at Grace Church in Keswick.  He did such a great job!!  He is thoroughly enjoying his lessons with Lenora Conway.  She is so patient and challenges Noah's musical mind.

On Tuesday evening, Michael's Third and Fourth Grade Choruses gave their concert which was diverse in tradition and song.  They did a wonderful job, performing for their supportive parents who packed the auditorium and gave them a standing ovation!  Michael is incredibly blessed to have such a supportive base of parents at his school.  The Fourth Grade chorus closed the program with "Dona Nobis Pacem" or "Give Us Peace" and Michael introduced the piece with a quote from  Leonard Bernstein in response to last weeks' tragedy in Connecticut. 

"This will be our reply to violence: to make music more intensely, more beautifully, and more devotedly than ever before."

This was so well received, one parent passed a recording of the performance along to a local public radio station who aired it, along with the sentiment, the following evening!

Ethan also had a chance to perform this week in his first preschool Christmas program.  Michael and Noah even took off from school a little bit to be there.  Ethan smiled widely from ear to ear to see his family watching him, this time.  His teachers are so sweet to have the children sing songs and recite poems that point them to Jesus.  We are grateful to have such a delightful preschool in our church.  Here is Ethan afterwards with his good friend, Katherine.  If you want to see some short clips from their program, here is the link.

Today, we have three days left before Christmas, our Christmas cards are yet to go out, but we eagerly await the coming of the baby King!  It is good to stop in the middle of this busy season and be grateful.