August. Seems it was here one day and gone the next. I will try to hit the highlights here...

First week of August found Nathaniel in same day surgery again for another diagnostic bronchoscopy. His trachea development is stagnant. Still just a pin hole opening through the stenosis and webbing. The doctors were not able to find a cause for aspirating. His trachea did grow in length and we were able to size up from a 3.5 neo tracheotomy tube to a 3.5 pediatric tracheotomy tube. A difference of six millimeters in length.

Unfortunately by the following weekend, Nathaniel was experiencing significant bleeding from his trach stoma and we needed to return to the hospital early Sunday morning. I know I say this often, but I am very thankful for St. Louis Children's Hospital and the care they offer Nathaniel. ENT residents, who had been in Nathaniel's bronchoscopy days before, came down to the emergency room and with the head of the ENT department on the phone, we decided to change back the 3.5 neo sized trach tube. Nathaniel had an area of irritation and bleeding between the short and longer tubes. We will try again another day.

Homeschool started the following Monday. Josiah is a sophomore in high school. I will put together a blog post someday on what we are studying. He has mentioned a number of times that he likes his courses this year. Especially Science. We burn things.

Around the time we started school, I discontinued using therapy services through the Missouri First Steps program, and Nathaniel settled into PS Kids for private occupational, speech, and physical therapy. Someday maybe I will write about the reasons for that transition. Or maybe I should just write my Congressman instead. For now, I will state I am simply amazed at the quality difference and the rapid changes I see in Nathaniel. He finds the most creative ways to practice standing on his tip-toes and climbing! These photos should depict clearly why I have no time to write blog posts anymore!

FYI - for almost live postings of adorable Nathaniel mischief, connect with me on Instagram. User name kimmrankin. Nathaniel's personal hashtag is #natemakes8. I am such a 21st century mom. My baby has a hashtag. No more 90's parenting going on here, folks!

Right before Peter and Benjamin started college, we had a wonderful weekend visit from some old friends, Bill and Gale. Old is not reflective of their age; old as in the longevity of our friendship. Bill stood up in our wedding as Rich's best man. We have been blessed for decades by our friendship with these two. They encourage us in the Lord. They laugh with us. Cry with us. Have fun with us. Walk next to us through life. Gale and I enjoyed a long walk in our neighborhood Friday morning. There are some hills along the route and she willingly took over pushing Nathaniel's medical stroller for a bit. It was such a tangible example of her friendship: two women walking side by side and one saying, "Here. Let me carry that weight for awhile for you." I pray I am that sort of friend in return. We continue to add to our Staycation '14 photo collection by searching out the 250 St. Louis Birthday Cakes. Bill and Gale joined in our search and posed with us for a few; our time with them was truly a Staycation.

As August came to a close, Rich and I enjoyed our own mini vacations. I spent four days in Louisiana visiting our daughter, Bailee and her husband, Jeremy. It was a wonderful break for me. Only the first night did I wake repeatedly hearing Nathaniel's alarms in my head and jump out of bed groping to find my way out of the unfamiliar bedroom and back to Nathaniel. Observing Bailee at work as program director of a Volunteers of America Lighthouse site was very enjoyable. Bailee spends her days in a little brick building at the front of some housing authority apartments. She cares deeply for the kids of that neighborhood, working hard to ensure they have food, counseling, homework help, and a little bit of wonderment and joy in their daily life. The day I visited she was short four staff members. Bailee only has four staff members on her team. Do the math. As I watched her cope with a lack of help, I felt again a deep sadness about the Michael Brown shooting incident in Ferguson and the systemic disadvantages African Americans still face in our society. It is so easy for all of us to have opinions on these matters. It is so much harder to show up daily and be the difference in a young life.

A few days after I returned, Rich flew off to Montana to enjoy four days with our son, Andrew. He spent one morning riding around the ranch with Andrew's boss while Andrew finished up his irrigation responsibilities for the day. It is good for a dad to hear his son praised for a whole morning! Andrew showed Rich around local towns and they enjoyed a day trip to Glacier National Park. Our Andrew bought a motorcycle last spring, and recently hit a deer with his bike while going seventy miles per hour. The motorcycle was totaled. Andrew lived. There were multiple times while Rich was with Andrew that I gave thanks to God that Andrew came through that accident.  So wonderful that he was able to share his new home and the work he loves with his Dad. Our trips were refreshing. Our August and our hearts full.