Friday 16 October 2015

Treehouse and Chill • Daily Diaries

Thursday Oct. 15th 2015 
(1 week ago)
I think I've come up with a better way to blog that I am goin to try so it's not so overwhelming when I have a bunch of updates pile up on me and then things get crazy with Bella's hospital life. So I'm going to try daily diary type writing on here, save the draft, and come back to working on this post when I have time in the evenings. This may be an easier way of posting in Bella's blog maybe once per week. I also have found some moments that I should of shared, are missed when I don't write about them right away. 

A Side Issue - Bella's Right Wrist
This has been on the back burner since Bella's BMT back in March but her wrist doctors have been on the sidelines still supporting Bella with improving her range and use of her right arm/wrist/hand/fingers. 
Back Story: In my whomb Bella's right arm was very squished and stuck in the same position for a while. So bad so that they couldn't even measure it properly through an MRI when I was 7months pregnant. And when she was born her thumb was flush with her wrist, it was that bent. So the doctors know there may be some sort of nerve damage she has there and it has affected her use of this wrist/hand.  
Since birth Bella has had to have a few different braces/splints on her wrist to help stretch it out and give her more range of motion and use. She uses it as best she can and definitely doesn't ignore it even though she can't use it as well as her left hand. Whats affected most is her grip. She also has limited extension from her elbow being so tight from it being so tucked and squished for so long. 
The doctors are not sure how this nerve damaged happened or even exactly where and what the damage currently is. They need to figure this out before deciding if a surgery will fix it. 

So what now?
Bella had a nerve conduction test on Tueaday that was not pleasant. They had to send pinching electrode shocks about 20 times through her right arm. She was pretty strong and handled the first couple , but cried through the rest of them. They still are unsure as to what exact nerve is damaged and how. But they need to know and do more tests to figure out what nerve to fix. If its the nerve, the nerve connection to muscle or just the muscle causing this issue? If a tendon transfer surgery fixes this they need to know what tendon to transfer so they don't transfer a weak one. 
Bella's use has also improved so this makes them wonder if surgery should happen now or later. The next test to help in this decision would involve them putting tiny needles into Bella's arm to test the nerve to muscle connection. Knowing Bella has a surgery coming up on Nov. 4th they may try to do this test then, while she's under so it doesn't cause her pain. They may also do an MRI at this time to help understand her nerve damage better and then be able to really decide if a Tendon Transfer surgery is the fix, or if Bella will just regain full use over time. 

The 9th Surgery Decisions: 
This 9th surgery for Bella is meant to be a "happy" one because it's a step closer to home. But now with the recent hemolytic anemia issue, I'm not sure if this surgery will be postponed or not. We have 3 weeks to decide. Changing Bella's Broviak lumins (the iv lines dangling from her chest) to an Ivad port (button under her skin) before going home to Swift Current was supposed to happen because #1 she should only be requiring blood work once every 2 weeks at most before we go home and #2 because the port is less risk of infection. Well... Our recent hospital admissions have meant DAILY blood work. So that is a step backwards in terms of Bella getting this Ivad port. I haven't spoke with the docs about this yet, but I'm praying this all smooths itself out this week. 
I'm hoping the surgery still happens because Bella is also supposed to get the much "easier to use" Gtube Mickey button for her belly. Genetics is also chiming in to get a skin sample because Bella's original blood before her BMT (to use for genetic testing) is in Winnipeg and there is just a tiny bit left. And from her BMT, her blood and blood type have changed to the donors. Lastly is that the wrist doctors need those 2 tests done for her wrist while she is under anesthetic. 

A better afternoon
By the end of the day Bella was showing me a glimpse of being back to herself. She was walking with the pushcart at lot and just loving it, giving me snuggles and we even had a mini dancing session. 
Friday Morning:
Things took a turn again and her hgb started the day at 81. Basically her cut off point to need a transfusion. So this is telling us that the steroids we tried for the past week are not doing their job. We can wait and hope that maybe this is a slight dip and she'll come back up by the time they check it again Saturday morning. But by the afternoon Bella still had no energy, quite upset and looked more pale. 

Friday Night @ 2 am:
I'm up right now because of a major flaw in this medical system and I'm more than pissed about it. To add to this I had to deal with a power trip, young resident doctor you obviously didn't get the right communication from Bella's day team of doctors. I have been through this way too many times and I'm sick of the lack of communication, and preventative measures/ plans that get thrown out the window when you leave decisions to power trip snot nosed residents at 2 am.

 Sick of it! 

Let's call her Dr. Peabrain. 

Bella's blood pressures have been high for the last week. We know this because of the steroids she's on. They were on a high trend yesterday so we made a plan with Bella's day docs to set perameters so we are not kept up all night with 500 fricken blood pressure tests on Bella's arm and waking her up for the oral med under the tounge. 

So here we go, 2am Dr.Peabrain has to fight with me in the hallway because I'm not going to let her do another fricken bp, that wakes Bella up, for nothing, when we just did one 15min ago!!! 
And you know what Dr. Peabrain does...threatens me with Brain Bleed theories! Are you effing kidding me??!!

#1 You do NOT threaten a mom ( or any parent for that matter) who has sat at their child's beside day after day, watching anxiously while doctors at times seem to solve problems like she's a science experiment. You don't NOT threaten a parent when what they need 99.9% of the time is REASSURANCE of a proper med dose, or plan. 

#2. Don't be a fricken Dr. Peabrain.

She completely denounced the plan I had made with the day doctors about Bella's night time blood pressures and when I questioned her plan, she went on a condescending power trip of threats like I wasn't taking my daughers blood pressure health seriously and proceeded to threaten me with Brain Bleed theory.

I just wanted to be reassured that her change of plan (though it was different from the trusted day team doctors plan) was safe for my daughter. 

Dr. Peabrain did not do that. She did the opposite in a real bad way. She threatended an already exhausted, worried mom with outrageous theories causing her (me) to staying awake longer, unrested, stressed, more worried and doubtful.

I am happy I am able to finally communicate this hidden flaw in our medical system and I need to find Dr.Peabrain and explain this to her so she doesn't do it to another mom or dad... and I will. 
But if you are a nurse or doctor out there reading this right now, please take it to heart and help prevent scenarios like this for other moms and dads. Please stop the production of Dr. Peabrains in this world. 

Saturday Oct. 17th
This day is Treehouse and chill. 

Bella is exhausted. Too tired to even utter "momma" and crying a lot from being so uncomfortable. I had an amazing, experienced nurse let me cry on her shoulder this morning as she reassured me Bella's going to be ok, in all the right ways today. 
Bella's hgb fell to 69. Waaaaay to low again. She's got her 4th blood transfusion (in one week), running right now. 
Bella has been very uncomfortable. Her energy very low due to HGb of 69, her tummy is very distended and she is backed up because of the anemia and steroids. She crying in waves and agony because of the steroid and the aches it is causing in her tiny body. The doctors will be in soon to discuss next steps for treating the Hemalytic Anemia. And hopefully after the blood transfusion, stool softener, Tylenol and nap, she'll wake up feeling much better. For now, it's Treehouse cartoons and chill time.

New Plan / New Med
We are starting the medicine Retuxamab today to fix Bella's hemolytic anemia. The doctors are very confident this will be the fix. Problem is they had to get permission to use it and to qualify to use it they had to try the course of steroid meds first. It's also like a $10 000 med. Bella will be given 4 doses, 1 per week. Retuxmab is good because it means we can start taking Bella off the horrible steroid (Predisone) that causes her so much hurt, anxiety and just makes her a completely different kid. The crappy part is that Retuxmab must be given via iv over 7 hours! I'm calling it Bella's "high maintainance med." ha ha. It's technically a chemo med so there are many precautions and procedures with giving Ratuxabab, although it does not cause any chemo type effects at all, so thats good. And already within the first hour it brought down Bella's rediculously high blood pressures she's been having. So that's really good as well. 
The rest of this day turned out wonderful and I am so happy Bella's doctors are quite confident with this medicine fixing the hemolytic anemia issue. If all goes well and Bella's hgb stabilized and continues to stay around 100, we could be discharged and able to be back at the Ronald McDonald house later this week.

Tuesday, Oct. 20th
Even though we are still in hospital things have been going pretty well since Saturday. Bella's hgb has held steady with and few dips, but only to come right back up without needing any blood transfusions since starting the new Retux. Med. I'm getting her out of the hospital on daily passes and those have been going good as well. Her hgb is hovering around 80-85, but she's also getting 2 blood draws a day and the draw for her cross match was quite large (10mL). Once she has a couple more steady days, then the doctors will start to wean off the steroid med and we'll hopefully be discharged. Our days in hospital look mainly like this:
Wake up around 7/7:30am
Nurse does vitals at 8am 
I get Bella's meds and breakfast going
Watch cartoons, wait for Doctor 
Doctors assesses Bella
Between 10am-12pm I wait to go to Rounds (daily meeting with Bella's medical care team)
Get Bella's 11am feed/snacks going
Bella naps 11:30am- 1:30pm
Take Bella on pass to RMH 2-6pm
Back to hospital room for assessment and bloodwork. Nurse assessment.
Meds/bath/get ready for bed.
8pm, New nurse and his/her assessment
Sleep another night in hospital

There's a lot more to a typical day then that, but that's the gist. 

Wednesday Morning
Amazing, Thoughtful Friends Brighten My World.
Right now I am typing this blog post with so much ease! My friend Bradie suprised me with a bluetooth keyboard that works with my phone and iPad! How did I not realize these existed before?!  This may get a bit dangerous (evil laugh**) as its going to make it a LOT easier to write more, which would mean longer blog posts. My kind husband has informed me they are already a tad long to read. ha ha. Either way I'm sure I have some followers out there that look forward to my weekly novels about Bella's progress. 
Selfie while using the Bluetooth keyboard for this blog post. 

Thursday, Oct. 22nd 2015
This week has turned out to be a lot better for Bella, she's feeling really good even though we are still admitted in hospital. We have been taking daily passes to go out for walks and hang out at RMH. Her hgb has been down in the morning and back up in the evening as they are drawing blood from her and checking twice daily. After the 4th day of this "up and down" hgb level buisness, they are more confident that she is actually steadily above 80 and that there may be some lab errors with the early morning draws. We'll chat at rounds today, but hopefully they will go back to checking just once daily now. I also am anxious about them accessing her line so much as that poses more risk for infection. And less blood work is a step closer to home, so lets get back on that train. 
Me:
Well, I've been feeling a lot better and less down. I've managed to shove the setbacks Bella has had, to the back of my mind and try to take things one day at a time lately. I know once we are discharged, and back to just weekly clinic visits, "going home planning" will kick back into gear. So far its looking like we could be discharged by Monday. Bella has her 2nd dose of Retux med (that takes 7 hours to infuse) this Saturday. They most likely want to keep us inpatient for that. So, next week we'll hopefully be back to our normal routine at the Ronald House. And my mom is coming to visit too! 
The doctors are happy with how well the new med is working and getting rid of the Hemolytic Anemia issue. Bella's immunologist is very confident after the second dose of Retux, that we'll see her hgb levels stablize even better at a higher more normal level. 

Mommy Break
Thanks to my hubby's wonderful sisters I had a much needed Mommy break last weekend and was able to relax and have fun at his sister's Stella and Dot party while Lyle stayed with Bella. It was such a wonderful much needed night out.  Thank you so much, Jo and Melissa. 

What A Gift!
Keep Calm and be Bella Brave

A wonderful coulple I know at the house (RMH) have a sweet daughter also named Isabella. Their cousin had these amazing shirts/sweaters made for their Isabella for the Rock the House Run back in September that read "Bella Strong." As a gift she made two for Lyle and I! (Lyle's  Tshirt is back and white) She even added details that I absolutely love like: Bella Brave, the mountains picture, She Has Moved Mountains and #BellaBrave.  
Thank you so much Catherine, we love them!
Today, RMH had some pretty amazing guests stop by to spend time with all the families. I was so happy I was able to take Bella on pass from the hospital to meet all these amazing guys, The Calgary Flames! 
Tonight I am going to bed happy. Happy Bella is feeling so good, happy her medications are working, happy she is happy...life is actually pretty good in this momment. I can take a deep breath and smile tonight before I rest my head. 

...I could be working on more YouTube videos...sheesh I've gotten behind on my Hospital Mom Hacks videos. I have about 4 ideas ready right now, just haven't got around to posting them on my channel yet. I still receive comments from parents that my videos have helped, and I tell ya, what a good feeling to have...knowing I've helped someone in that way. I have even recently seen that I have gained a few more subscribers to my YouTube channel as well. So I'm happy my videos continue to support hospital parents in need. 

Thank you again for following my blog for Bella, it means a lot to me. Just knowing many of you take the time to read whats becoming my weekly novels...truly means a lot. Thank you.

Not sure how many of you know this about me, but I love memes...I find them hilarious. If I'm having the worst day, a meme always, always makes me laugh. I created this one just in time for flu season. Get your flu shots people! Not everyone has a fully functioning immune system. Remember, Bella was born without one and we are going to make sure her new one has every possible chance to grow without harm. 














Wednesday 14 October 2015

Onward • Day +203 Post BMT


It's been:
•536 days in hospital and counting
•203 days since Bella's Bone Marrow Transplant
•481 days in RMH in Calgary
•Exactly 1 year since Bella caught a glimpse of home in Swift Current for that 1 month. 

I've been broken.
Put back together, 
Smashed 
Put back together
Bulldozed
Put back together... Onward. 
It's been a torturous week back in hospital with Bella so why don't I start with happier news from the glorious 2 weeks and 5 days we were discharged for. (Sept. 18th- Oct 7th)

During these couple weeks everything was so smooth. I even caught myself saying it has been our best weeks yet. Bella had been feeling wonderful and developing in so many fun, toddler type ways. Because of her daddy, Bella started doing amazing with her walking with her push cart. I was a bit nervous with letting her just go. But with Lyles coaching, she's a pro now. I posted a video on her Facebook page "Isabellas Mustard Seed."
We also received a card from Bella's bone marrow donor! This was so so exciting. We sent Bella's donor a card and letter back in April. So to receive a card back, 6 months later shows you just how strict of a process One Match uses. We have quite a few guesses on where Bella's donor is from based on her wording in the card/letter. I would love to create a fun guessing pool contest on Bella's Facebook page at a later time. So keep an eye out for that fun to come.
During these relaxed, easy going weeks at RMH with Bella, I also found time to give our RMH room a much needed purge clean. I actually stuffed 7 large boxes full of stuff that we no longer needed in our room, and got it out. That felt good. 

I think I was riding the high of all Bella's doctors making a to-do list for us going home to Swift Current. I was so excited that it looked like we could be home before Novemeber. 
Not anymore.
Bella's physical skills are developing so well even though she is mainly in a small space/room. I've tried to make our little space into a mini jungle gym for her. She is so close now to walking all on her own. One of her favourite activities is trying on all her hats. It's so cute. I have them all hanging on 3m hooks on a wall and she loves picking them off the wall and putting them on and taking them off. Her absolute fave is still her pink/orange and purple toque. Thank you again Jack and Alyssa. And thank you for the de-stress moments that my adult color book brings me, Carissa. 
Things were going so so well. In the 3 weeks we started those 3 antibiotics for that rare MAC bug, Bella's nodes fully shrunk and went away! It is a great sign that those medications worked so fast. We'll be hopefully discussing this soon with Bella's doctors. But we are all dealing with the worse issue right now, trying to solve the Hemolytic Anemia. Which I'll get to explaining in a moment.  But if the 3 antibiotics worked so fast already, maybe she won't need to be on them for an entire year. I'll be discussing this with Bella's docs at a later time. It's good they are working though, for that MAC bug issue. 
We also started weaning Bella's harshest BMT med, Cyclosporin. This was a big step post transplant, that has now also been put on hold due to the new issue. I was quite exited about getting Bella off this cyclo med, and being able to see her new immune system fully working on its own! But the weaning has been put on hold as well until this Hemolytic Anemia issue is solved. This is really upsetting for me because we saw a timeline in our minds, we had it, so close. Coming off this med meant seeing Bella come off other medications sooner, we'd see her immune system competent, we'd be able to test it and give her normal immunizations, and we had a time frame of this all happening, when starting the Cyclo med wean. That is now all on hold and postponed. It's discouraging because this all ties in to a time line of when I get to be home with her and not worry about her immune system before I have to go back to work. It feels like walls closing in on me.

So October 7th came along and I fell apart, A lot, fell apart. And Bella was readmitted back in hospital on unit 1. 
Our different, yet big room. So far Bella has stayed in 4 different rooms on Unit 1.

Although these white boards could be fun to alter as parents (as I have) I think they are so great for the kids staying here, as well as the nurses. I remember having papers taped to the nurses station wall with notes and reminders... These new boards solve a lot of that. 

Since Oct. 7th
This is where I have been broken again. What this new issue has meant in terms of suffering and agony this week, is feeling like a torture chamber that I've been locked in, forced to watch my daughter suffer while I suffocate. 

You know, I cherish the connections and ability to talk with other parents in similar circumstances on Facebook. And I can tell ya, if it wasn't for the chance to hear from them, talk with them, I'm not sure how else I could catch a breath. In such rare circumstances that Bella has had to face, it's a miracle that I have found other parents who get it. And hearing from them means so much to me. Recently I read a post from a mom whose little guy is only about 30 days ahead of Bella from a BMT, he also is fighting SCID. And his mom wrote a post that literally took my breath away because it is exactly how I am feeling.
This is her post, this is what I feel:

Rare #6
Seriously, the wind was knocked out of me after the MAC bug issue, heck the friggen SCID diagnosis!!! And now autoimmune Hemolytic Anemia! Yes I'm shouting again! Ugh...
So one, there's the Hirschprungs Disease diagnosis that took Bella's colon. Two is the SCID, that almost killed her. Three is the still ongoing diagnosis by genetics about the underlying genetic diagnosis of CHH which they are currently 95% sure of. Four is the chance that all 3 of those are connected or not. If they are all seperate issues then that makes Bella's condition even more rare. Five is the MAC bug and now six, autoimmune hemolytic anemia. There's also technically a seven. Ya I know, I've strained my eyes rolling them at this because it's so friggen ridiculous. I find myself wanting to punch the wall regularly when I hear the word "rare." Anyways, Bella's right arm/wrist nerve damage that they are also still working on. I have more updates on this as well. 

Bella's docs have said that the Hemalytic Anemia in an immune deficiency patient's case like Bella's, post BMT is an uncommon phenomenon. There are not a lot of reports out there to tell our doctors this is how you fix it. So based on what has been tried and the variants of other cases similarities, Bella's docs have a list of things to try first, second, third... Based on how Bella's system responds.  

Hemolytic Anemia
What Bella's immunologists think is going on is that her immune system has created antibodies against her own red blood cells. This causes her immune system to attack her red blood cells which causes hemolysis, breaking of the red blood cell membrane. This causes her to have low hemoglobin (Hgb). This issue came out of no where on Oct. 7th and we've been dealing with it since. They think it could also mean something good though... If that makes sense. This could all be because her immune system is coming in with her B cells ahead of her Tcells. It's good because she's still 100% donor cells, and her counts are stable and are increasing. It's just that her Bcells are acting stupid and they came in faster than the Tcells. So the Teaching Tcells haven't caught up enough yet to tell them what to do and work properly. 

The Fix...The Torture. 
Because they don't see this particular case a lot, it's tricky to know exactly what will solve this. With low HGb you get extremely tired and lethargic. Bella's work of breathing and fever alerted me to bring her in on Oct 7th at 2am. (The episode where I was awake for a total of 48hours.) Her HGb at that time was 67. Waaaaay below what it should be. She should be well above 100. Her low limit for a blood transfusion is 80.  So they gave her blood and that brought it up , but just for a short time. We need her HGb to stabilize above 100. 

The doctors first step of action was to use a steroid med called Predisone. Bella was on this back in April for other reasons. The mention of this steroid brought me to tears. This med changes your child and it's heartbreaking to watch. 
For the past week I've had to watch my little girl cry anxiously, with frustration and pain. She doesn't know what she wants and this med makes her angry, anxious, frustrated, irritated and can also give them bad dreams. After the first dose she would rage a lot and cry momma repeatedly and anxiously while I scrambled to figure out what would calm her. Then she turned to a quiet "poker face." She's either upset or just not happy, zoned out. I feel as though her character has been stripped and she isn't smiling or giggling. I'm broken with this. It's torture to see her so hurting and not know why.  I'm feeling helpless while trying to sooth her. She wants so bad for me to hold her, asks to be held and then pushes away. 
My happy baby girl is not herself right now because of this med and I'm constantly in tears because it is so bad. 

In 5 days Bella has needed 3 blood transfusions. These of course to keep her HGb up after it dropped. Low HGb also makes you very upset, lethargic, uneasy. The first dose of steroid wasn't enough. Bella has now been on the highest iv dose of steroid called Methapred, since Monday. After a straight faced "zombie" couple of days, Bella had another "rage/anxious" cry episode with tonight's dose of steroid. I just held her, swayed her a bit and after about an hour she fell asleep in my arms. I just broke down in tears and asked God for peace, rest and joy. We were both a puddle by the end of an hour. Bella in my arms and my tears on the floor. 

I'm a bit discouraged after Bella's HGb today has dropped a bit again. I'll be talking  with her doctors tomorw to see what the plan is. They'll know what to do, I trust that. We were hoping so bad the steroid would be the fix. Stabilize her HGb, stop the hemolytic anemia, then wean the steroid off and things would be back to normal. Tomorrow I pray her HGb is up and we can start weaning the steroid off. But we'll see, her doctors may want to give it more time at this high dose, or try something else. Either way I'm just praying her HGb stabilizes and this blood issue is ended soon. 

At this point in the blog post I went to sleep and now its Thursday morning and we have good news:

Thursday, Oct. 15th 2015
Happy Birthday Grandma Cheryl Thomson!
Bella's HGb is up today from 88-93! This is good response from Bella's system. She's also done the large iv dose of Methapred steroid. She still remains on the steroid Predisone at a lower dose and we watch and hope her HGb continues  to stabilize. The doctors want to watch this closely over the weekend and hopefully no other steps are needed. We are hoping the steroid was enough to support her system and now she can start to maintain a good HGb level on her own. This level needs to be above 100 and they do another check tomorw. Hopefully this is it and we just start weaning her off the steroid. The doctors do have a back up plan if this isn't resolved by Monday. 
Thank you again to all of our friends, family and people we haven't even met yet! The Fall Photoshoot for Bella was a beautiful blessing that I thank a wonderful group of ladies in Swift Current for. The photo suprise brought me happy tears to see this love from people Bella hasn't even met yet. The timing of this brought me such relief as well, thank you. 
Thank you to my fellow BMT medical momma Michelle here in Calgary. Your "pick me up" gifts always have perfect timing and help me so so much. 

And a big Thank you to all of those who have messaged me lately. Your words and letters you have sent give me such grace and peace, it's like a breath of fresh air when I read them. Some of you I don't even know or haven't seen in years and you write to me with such care and love, it means so much. I keep all of the messages and re read them at times when I am really really down and discouraged. 

Bella's Facebook Pages app is now working again so you can message me on there, or on my Facebook at Kyla C. Thomson or on this blog as well. I've had a few friends have troubles sending us gifts as the RMH postal code was incorrect under our contacts section for a while. It should be T3B 2R6. 

I've piled a lot into this overdue blog post so I'll come back to Bella's wrist surgery updates and Nov. 4th surgery updates at a later time in the next post. For now we are concentrating on solving the Hemoltyic Anemia, praying she stabilizes her own HGb level and happy that her new immune system is still 100% donor and still growing stronger each day. 

Thank you again for following along with us through this blog and Bella's Facebook page. Just knowing we have the love and support of friends, family and strangers following and understanding means so much to me. Even when someone sends me a simple note letting me know they follow and care, it gives me extra love and endurance to carry on with this life and help keep my daughter strong.