Kendall, also known as Miss K, was born on June 2, 2011 via repeat C-Section with no planned complications. When she was first born at 12:38pm the pediatric attending physician was there, as he is there for all high risk deliveries as well as all planned C-Sections. When he first tried to clear her throat with suction, he realized he was unable to pass the suction past a certain point. He attempted to repeat this multiple times and then informed us he was going to take an x-ray to make sure everything was ok. While in the nursery, they also noticed she had no anal opening. It was at this time he began to look for other symptoms of the VACTERL Association. This is an acronym that stands for V- Vertebrae (any vertebrae or spinal issues) / A-anus / C-cardiac / T-Trachea /E-esophagus / R-renal / L-limbs. Babies with this diagnosis have 3 or more of these components. This happens to less than 1% of all babies born and is unknown as to why it occurs. It is not genentic. Kendall has all of the components with the exception of “L”. It was while she was in the nursery that he noticed she also had what they thought was a heart murmur and started her on medication (PGE) to keep her PDA open (a bypass that is found from the heart to the lungs while in utero that naturally closes on its own shortly after birth). They intubated her and she was transferred to Shands by that evening. It was 2 days later that I was able to be discharged from the hospital to join her at the hospital we would call home for 6 weeks. When she got there they performed multiple tests. In the end they found she had a (V)- Wedge shaped L4 vertebrae,( A)-a low imperforated anus *no opening to her bottom*, (C)-Tetralogy of Fallot with Pulmonary Atresia, (T)(E ) trachea-esophageal fistula with esophageal atresia *her stomach was not attached to her esophagus* (R) Renal- hydronephrosis of the right kidney with a duplicated collection system and stage II kidney reflux. There were going to be 3 surgical procedures needed to correct her initial problems. They repaired her esophagus and her anus when she was 5 days old. I got to hold her for the first time the day before her first surgery. They waited for her to heal slightly and learn how to swallow and eat. She was 14 days old the first time she took any food by mouth. They did her heart surgery on June 27th. They performed her first open heart surgery at 26 days old. Her heart defect included…. a ventricular septal defect in her lower heart chambers, the vein and the valve that carries the blood from the lower right side of the heart to the lungs to oxygenate it was grossly insufficient (pulmonary atresia). They closed the VSD and placed a gore-tex tube to replace her artery with a cadaver valve inside of it. They left her chest essentially open and didn't close her chest for 3 days. They did this because of her size and to allow swelling without complications. They had told us they would do a chest closure on her 3-5 days after her surgery, she only had 3 days due to how well she was doing. She continued to progess and we went home about 2 weeks later. Because of how small she was and how small the valve they placed was, it has severe regurgitation and is no longer functioning. She is in a holding pattern at age 2.5 as we continue to buy time and allow her to grow some until her next repair. She will outgrow this as she grows and will have to have these both replaced multiple times. When she stops growing, she will still have to have the valve replaced as it weakens/leaks every 10-15 yrs. They won’t tell us how many surgeries she will need, only that there will be multiple ones. Her next surgery is expected within the next 3-5 years. In addition to the above issues, she also has intermediate bronchial stenosis with bronchomalacia and tracheomalacia. This basically means she has a stricture in her right lung going into her lower two lobes. The other part of this means she has floppy airways and sounds croupy. This was found upon her second admission in March when they performed a Bronchoscopy to see what was going on with her respiratory issues. We have been in the OR for numerous procedures since since she was born. She has had her esophagas dilated twice and two Bronchoscopies in addition to her surgeries. She has quiet the medical team including Cardiology, Pulmonary, Pediatric surgery, GI, Nephrology, Immunology, ENT, and a Chiropractor in addition to her pediatrician. Over the first 2.5 years of her life, she has had as many as 60-75 appointments a year as well as multiple extended stay admissions.