Sunday, July 6, 2014

Holding Pattern

We saw the immunologist and really liked him. He was calming and although Anna wouldn't have anything to do with him at first, she was laughing with him by the end of the appointment. He ordered a bunch more labs. Some of them were repeats. They showed a lower IgA, continued neutropenia (low neutrophils which are a type of white blood cell) and that she does have immunity to measles. She still did not show immunity to tetanus, haemophilus influenzae, or strep pneumoniae. The process is to re-immunize her with DTaP and Pneumovax (which we did that day) and then wait 4 weeks and have the titers redrawn. We have about 10 more days before the redraw. Those results will determine where we go from here. It will either mean prophylactic antibiotics every other day (or 3X a week) if the vaccines take or IVIG once every 3 weeks or SCIG every week (our choice) if the vaccines don't take. The IVIG and SCIG are immunoglobulins that are either given IV or SC (subcutaneous).  They are the part of the blood that contains the antibodies that she's missing (if the vaccines don't take).  The IgA cannot be replaced because it's half life is so short but protecting for the other things will help her to stay well anyway.   So we are in a holding pattern again. So far she has been off of antibiotics for 2 weeks again and things have been ok. I pray this streak continues!

Thursday, June 19, 2014

Tour of Manhattan- Selfie Style


Times Square


Radio City Music Hall


The Subway


On the Subway


Grand Central Station


Random store where we wasted time after being evacuated from Penn Station


Tavern on the Green


Central Park


Fountain in Central Park

The other important place we went was the 9/11 Memorial but a selfie there just wouldn't be right so I'll leave you these instead. 




What an experience. It's a trip I will never forget!











Wednesday, June 4, 2014

Baseline

Thankfully about 2 weeks into the antibiotics the cough that seemed it would never go away finally began to subside but was quickly followed by a GI bug that I can only really describe as looking like something out of the Exorcist. It was one that landed Anna in the ER for a night. Some IV fluids and phenergan and we were luckily able to go home about 6 hours later. I thought it would never go away. 5 days were horrible and on the 6 th day the symptoms improved. Then on the 7th day Gabe didn't want to be left out so then he began the exercise in exorcism as well. 13 days total I cleaned vomit and wiped butts. Enough!!  Looking back on the last year it seems like Anna just can't catch a break. She catches something, gets over it only to catch something else. She's having a harder and harder time returning to baseline. I assumed it is probably due to poor nutrition but thought I'd check with Dr Goff just to be sure. He wanted to explore other avenues before chalking it all up to malnourishment. Off to the lab we went, again, for what seemed like the 5000th time this year. Anna just sticks her arm out. She never even flinches or cries anymore. That is a huge blessing but one that shouldn't be- this shouldn't be routine for her. Anyway, a few days later I got a call from Dr Goff and he said her IgA levels are very low. IgA (from my understanding) is a surface type immunity that lines mucous membranes (gut, lungs, etc).  Her labs also showed that she has not built any immunity to the vaccines she has received.   So he referred her on to an immunologist. I do not want another specialist or another diagnosis for her but I am thankful for some explanation as to why I can't keep her well. I was beginning to take it as a personal failure. I kept her out of school the last 3 weeks. 2 of the weeks for the virus (it lasted 1 week but took her another whole week to recover) and the other week because knowing what I know now I did not want to send her back to school to catch another illness. We meet the new Dr this month and I'm interested to see what can be done. Anna continues to take it all in stride. She is making gains everyday and is now typing things like "Frozen" into the iPad so she can watch videos on YouTube. Words cannot describe how it feels in my heart to see her not just making it but really succeeding in ways I thought might not ever be possible. She is a little miracle.  During the midst of the GI bug from hell we were dealt another gut punch. We live in one school district and have our kids transferred to another. We received a letter from the district we were transferred into that they would not be renewing the kids transfer for next year. To say I was livid is an understatement. I spoke with the superintendent hoping somehow he would change his mind but he didn't. He would not even reconsider. But then he said a few things that made me realize that maybe that district wasn't where my kids should be anyway. He informed me that even though Carly was an A/B student and passed all portions of her STAAR test that he didn't really care about that. All he cared about was her absences. She had a couple more than he liked so he cut her. This is the exact opposite of what I was told last year. I was told that as long as the child made good grades, passed the STAAR test, and wasn't a behavior problem that they would not be denied year to year. Guess I should've gotten that in writing. He didn't even address Anna's absences but that's a whole other ball game. Carly is not happy about starting over and about having to start wearing a uniform to school but she's adjusting to the idea. She does know a few kids in her grade and for that she and I are both thankful. And to the other stupid district- you're not too bright. You get extra money for my kids because one has dyslexia and the other has a host of educational and medical problems. Way to go if this is all about funding. One thing I have learned over the years is that God protects me and my family. He makes moves that seem illogical at the time but he sees the whole picture which we cannot. So I am trusting him that this is what is right because he remains faithful. Carly is growing up so fast it is unreal. I know many parents don't want their kids to grow up and I don't want it to go too quickly but I'm so excited to see the person she becomes. She is so beautiful inside and out. She is so intelligent and has such wit. She has become such a helper at home and strives to make things a little easier in the ways that she can. Gabe is still every bit of 3. He's so adorable but such a terror too. He is a momma's boy and I can't say that I'm upset by that. Everywhere we go I get told how handsome he is. I still look at him sometimes and can't believe he's mine.  I'm currently on a plane headed to see my sister in New York. Oh how I have missed her. The last time I saw her was in November at my grandfather's funeral. The visits are never long enough. She bought me a ticket to see her for my birthday. There couldn't have been a better gift. I think I left Anna once when she was an infant for 3 days. Other than that I have not been away from her for more than 24 hours in her 6 years on earth. I've been away from the other 2 when I have been in the hospital with Anna so they are a little more accustomed to it. I know they will all be fine because they have an awesome daddy who will make sure of it. I wouldn't change anything in my life but to take a break from the incredible load of responsibility is something I will treasure. 

Monday, May 12, 2014

Momma Knows Best

So we saw the new GI. While in the patient room for the Dr to come in the song "God of Angel Armies" played over the radio in his office. I knew at that very moment that we were exactly where we were supposed to be. Then he came in and  I got to thank him for his wisdom at the beginning of this journey which was something I had always wanted to do but was somewhat afraid and didn't know how. He was kind and humble about it. The GI gave us a few suggestions about medication timing but otherwise said his recommendations would depend on the findings of a Pulmonologist. He referred her to one that he said he works together with a lot. I had no idea what that really meant but went with his suggestion since I didn't know anyone else and since this GI had gained my trust and respect. I got her an appointment with the Pulmonologist for a few weeks after the GI. He was thorough. He was thinking maybe the problem originated with a sinus infection that wasn't clearing up. He sent Anna for sinus X-rays in the middle of the visit. They came back clear. So then the craziest thing happened- the pulm called the GI. This is unheard of among any specialists we have met with up to this point. It is always left for me to relay information and messages and although I am an RN I am also a mom and also not a Dr. This should not be left up to me. So the new Drs decided the best thing would be to do a bronchoscopy and EGD, get this, at the same time. They said they wanted to minimize anesthesia and cost. Crazy town. So last Friday she had the procedures.
Both went well and were fairly routine. She was discharged a couple of hours later. The ride home was uneventful as were the next few hours. Then she spiked a 104 temp and began relentless vomiting. It was the sickest I have seen her Ain a very long time and it scared me. I called the Dr back and he placed her back on antibiotics and said she had probably aspirated again. He really didn't want to start anything until the cultures were back but with that fever he said he didn't feel safe waiting. He said there was a lot of "pus in her lungs."  Ewwww.  So today the cultures came back and she is growing 3 bugs. For the medical types the bacteria are streptococcus pneumoniae, haemophilus influenzae, and moraxella catarrhalis. He referred to her condition as being chronic bronchitis. She will be on antibiotics for 3 weeks. We will talk to the GI later this week and meet with the Pulmonologist on the 30th to all formulate a plan. I'm pretty sure the fundo will be the plan because it looks as if this is all aspiration related. I can't help but wonder how long this has been going on and feeling a bit annoyed that when I've reported symptoms they were brushed off.  The moral of the story always has been and always will be that momma knows best. Most of all I'm thankful for a new team who is listening and working together for the best outcome. That seems to be a rarity these days.  Technically I'd like to put a double space here but every time I do blogger messes up my formatting. So consider this a double space. For the second year in a row Carly participated in The Dirty Scurry. It's a youth mud run and she participates with her friends from Sibshops at Cooks. I am so proud of her not only for running the race but also for always stopping to help others along the way. She did amazing and I think it gives her a great sense of accomplishment when she makes it through.  Because she is there with SibShops she is a VIP which is nice because she deserves to be the special one sometimes too. 



 Even Gabe got in on the fun. After the race there are a lot of family friendly activities. 


One last pic that I'm currently loving...except for the fact that they are growing up so quick. 



Sunday, April 13, 2014

Coming Full Circle

After staying frustrated with our current GIs office for quite awhile now, they officially pushed me over the edge last week. I love the Dr. I do. He is great. That's the problem though. He is so good that he has too many patients. He can't keep up. When I call to make an appointment the soonest available is 2 months away. I could understand if we were new pt's but we aren't. We have been there for almost 6 years. So the solution (according to the office) is to handle as much as possible over the phone. I'd be fine with that if I could actually talk to (or even email) the doctor.  But I can't. It's not an option. I have to leave a voicemail for the nurse or medical assistant who will then relay the message (inaccurately) to the Dr.  Then the medical assistant or nurse of the day will call me back with an answer which makes no sense because the Dr didn't get the correct original message. So I get pissed and tell them the right message again which they relay wrong again... This has gone on for as long as I can stand. I don't want my daughter to be a patient in a practice that is this busy. It's not safe and it's not fair to her.  So we are now coming full circle. If you know Anna's story you know the whole thing began in a GIs office. We went to find out why she wasn't gaining weight and were told by that GI that we needed to get her to a neurologist because she had much bigger problems than weight gain going on. We never went back. We ended up trying to keep all of Anna's MDs in the Cook's system. But now we are going back. I trust this guy. He clearly knew what he was talking about even back then. I don't remember him or what he looked like or what the office looked like. I think I've blocked all of that out. I would be lying if I said I am not scared to go.  I'm afraid it will bring back memories that are so incredibly painful that I don't want to remember. But we must go and we must do this. Anna needs someone to listen and pay attention.  She deserves it. So I'm putting my emotions aside and taking her tomorrow to where she needs to be. Please say a prayer for all of us- for her, for me, and for the Dr. We need answers. 

Wednesday, April 9, 2014

1-10 and Letters Too

Lamictal is the med we have dreamed of!  Anna has had only 2 seizures since beginning on it and they were short and mild.  It has taken from the end of January until today to get to the full dose but we are finally there. Anna has made more progress at school since the med change than I have seen in a very long time. She is counting without problems. She is remembering letters. She is recognizing numbers. She can enter "3-0-0" on the microwave all by herself and that is huge. One of my goals for her this year was to recognize numbers so that she could cook herself some popcorn or something like that with minimal assistance. Look at the last post at her spelling test. Now look at this:

Unbelievable!  I can't even believe it is the same kid. I cant explain how good this feels for me so I know it must be so amazing for her too.  I swear there is a genius in there just dying to come out. But of course with every positive we are usually certain there will be something not so positive to accompany it. Anna has been on antibiotics twice within the past 2 1/2 weeks. She will spike a high fever and wake up with a junky cough. She had a CXR which confirms she has been aspirating. I truly believe it is happening at night and not with eating and drinking. She had a swallow study back in January that was mostly normal and the choking she had been doing has mostly resolved. We continue to use small diameter straws with all liquids to help her. I hear her do this weird swallowing thing at night and I have been pretty sure it has to do with reflux. Years ago she was scheduled to have a fundoplication which we ended up canceling and avoiding with pyloric dilation. It seemed that the delayed gastric emptying was causing things to back up which was actually the problem. Once that was fixed things improved. Well the pyloric dilation is still in effect but now there is reflux and aspiration again. We may be looking at surgery again. I hate more than anything in the world to put her through it. It breaks my heart. But lung damage is serious and I have to look at the big picture. To say I am frustrated with the GIs office would be an understatement but that's a whole other post. Suffice it to say it would be nice to communicate directly with a doctor and not through staff who can't seem to relay a message accurately.  There will be more to come on this whole issue. For now we continue the augmentin and hope for the best. Thinking about putting her through another procedure makes me want to vomit.  Excuse me while I head to the toilet. 


Friday, March 7, 2014

I Don't Care

This is the second spelling test Anna has taken this year. It looks very similar to the first one. The only discernible letters on it are the "A" and "N" at the top. The first test broke my heart. The other kids were all writing letters and words and are spelling and reading. But guess what happened this time?  I don't care. You want to know why I don't care?  Because in the beginning this is how Anna's hands were:

This was her at 7 months. Her hands stayed in tight fists with thumbs in and she wore splints in hopes that someday she would relax her hands and pull her thumbs out. Guess what, she did.  Now she can hold a pencil.  Why else don't I care?  Because at the beginning of this year she could not write her name and she did not know any letters. She did not follow along with the class. But now?  She did and she does. She followed along and tried to write the words. And in my book that is huge.  If it's not huge to you well guess what- I don't care about that either.