Saturday, 16 September 2017

Something Just Like This


... But she said, "Where d'you wanna go? How much you wanna risk?

I'm not looking for somebody with some superhuman gifts.
Some superhero, Some fairytale bliss,
Just someone I can turn to, Somebody I can kiss.
I want something just like this."

I've spoke before about how much songs can ignite a light in my soul and relief in my mind. I've written in my chapter (in the Dear Stress book) how some songs can help push out the clutter and worry in your mind.

This song is our 2017. It's my daughter not looking for some super hero, with super human gifts...but instead her mom, this summer and something just like this. She's happy and I'm taking risks.

In my last blog post (from May 4th) I touched a lot on my Mental Health, my complex PTSD, how it has affected myself and others, compassion and trying to support others in a similar situation. This post will focus more on Bella. My last post came after we spent the previous 3 months in hospital (Jan 25th - March 22nd) for an unexpected, very life threatening, bowel blockage and recovery. This post, right now, comes after Bella's second summer, at home, and  most enjoyable, pain-free summer of her life yet!

I've been reading books of old, the legends and the myths.
Achilles and his gold, Hercules and his gifts.
Spiderman's control and Batman with his fists...
And clearly I don't see myself upon that list.

But she said, " Where d'you wanna go? How much you wanna risk?

I'm not looking for somebody with some superhuman gifts.


If there's one word in which I could describe my daughter after all she has been through and put up with yet came out excited about life! ... it would be: Adaptable.
She does NOT need someone with super human gifts, she's clearly superhuman herself. And I have finally been able to put away the constant fear and worry that she needs me as that superhero...she doesn't.

Bella has adapted to and overcomes every hell she faces, big or small.

This quality in her, in her spirit, this profound gift from God is what makes me consider that it is not just the prayer, support from family and friends, my mental health nurse and doctors that have helped me overcome the anxiety of what may come next...no, it has been my daughter and how she fiercely adapts to every hardship thrown her way and comes out smiling every. single. time.  I don't fear what may come next anymore.


Bella's Best Summer Yet

 I have been saying this a lot but the main reason I have not blogged in 5 months is because we have been physically, mentally and emotionally enjoying a pain-free summer and quite simply just taking it all in, in a carefree manor.

Oh, I want something just like this

Doo-doo-doo, doo-doo-doo
Doo-doo-doo, doo-doo
Doo-doo-doo, doo-doo-doo
Oh, I want something just like this

Here is a month to month summary of some great accomplishments from Bella's 2017 summer:

May: * Bella fought off a line infection and got to keep her cvc Broviak line. (This is the line that prevents her from getting poked for blood or IV meds. It saves her in so many ways, she needs it for her TPN or if she ever gets dehydrated and needs replacement fluids...however, it restricts her from so much as well, like swimming and safely going to a childcare facility.

June: *Maintaining weight and tolerating large decreases of TPN requirements. *Still loving her vanilla flavoured formula even though its the ONLY oral food source she is allowed. *Maturely understanding that she can not remove herself from her bed in the mornings that her IV line running from her chest, is hooked up to the towering IV pole that could risk her line pulling itself out of her chest.. ya that made it hard to sleep for A LOT of nights.

July: * Bella enjoyed her first overnight stay with Grandma Heather and Grandpa Buck where they managed all her ostomy care, line protection and food restrictions.

August: * Bella accomplished a full month off of TPN (The nutrients she receives through IV lines when her bowels need rest.)  * After 6 months of not being allowed to eat at all, we were given the go ahead to let Bella try liquid/soft solids!! Her first choice: Tomato Soup, followed by Gravy.

September: * Celebrating not having to travel to Calgary, AB since May!




I think what I have been celebrating the most is her consistency of feeling so so good. Since her bowel surgery back in January Bella did not have one episode of distention or bloat, not one. Her bowels have been happy all summer.  And also her resilience when it comes to adapting to when shes allowed to eat/drink and when she's not. This girl kept a sane mind at the age of 3 even though she had to go from months of not being allowed ANYTHING in her mouth, to seldom sucking a water dipped sponge to only 1 juice box (250mL) size of her formula a day (24hours) to 3 boxes a day to now 1/2 cups of soup and small amounts of liquid solids. Can you even imagine that 9 month process for yourself?



Who Is She?

Bella is still the girl who lights up a stranger's life walking through a mall, still the warrior who has survived all odds against her and still the little warrior princess you never saw coming.

It's funny how I used to get so bent out of shape when we would walk in public and everyone, yes I'm talking every person that walked by her stopped and stared with amazement, curiosity and wonder. I'd cringe because I knew what was coming after the stare, it was the question "How old is she?!" or the comment, "She's too little to be walking!"  I knew they were blown away by this child who looked like a super-genius-one-year-old but I've come to realise its more than that. People are drawn to her light and not solely because of how she seems from the outside but I think now because of what they unknowingly see on the inside of this bright sole that lights up their day.

Bella smiles, talks to and converses with everyone she meets. She'll hug and kiss a friend she just met. She still gets excited about bananas in the grocery store even though she knows she can't eat them! She's a light and I'm so happy she shines in so many peoples lives.

I still have strangers cry instantly when they come to realise the 14 mountains I have tattooed on my arm and back count the surgeries my little light has had. And as they look away from my tattoo and into her eyes their tears disappear as they question, "But she's so happy!?"
 ... I know.

She is a strength that you never knew you had.  When I think about all she has been through, I know that I myself can get through anything. Bella is the warrior who has battled confinement with poise. She is the soldier that tells me she is hungry every minute of the day yet understands when her tummy requires a break and simply replies, "Okay mommy." It's inspiring that she carries on with this happiness in life that pure strangers are recognising out of the blue, and in some ways that comforts me, and I know... she's getting through this all okay.


Where Are We At Now?

Currently we are in "delay mode" and I'm not sure if I should be relieved that Bella hasn't had to endure her 15th surgery yet or upset because her GI team is taking too long to figure out more important information about her unknown bowel disease that in my opinion, could save her more pain in the future.
It's mid September and back when we reviewed "Best Case Scenario" with her specialist team and surgical team back in March before we left Calgary, they had told me that if Bella can come off of TPN for at least one month by the end of the summer, they could plan for more bowel tests and her mapping surgery come September. This was quite important to me because #1 We do not know what extremely rare bowel disease she has and the Mapping surgery involves biopsying her entire remaining small bowel (she has no colon left due to Hirschprungs). These important biopsies could possibly tell us what her bowel is doing, how it functions, what it needs to function properly and what could harm its function so we could avoid those things. #2 This surgery could take away her ileostomy pouch and if things looked well enough she could start Kindergarten without the hassle of a pouch, which would be a lot for her size and current ability.

So after we had worked so so hard and Bella surpassed all expectations by coming off TPN for one month by the end of August, I was disappointment her hard work felt like it was all for nothing as her GI team told me they did NOT expect her to get that far that fast and that nothing, not one test had been booked for her bowels in which surgery requires results of before planning the huge surgery. I was quite upset, and my upset was very clear to her team. We worked our asses off for more "wait and see"?! ... no thank you.

So I composed myself and called them back with everything I needed to say, written down in front of me so I wouldn't forget what was important for them to truly understand and how we could move forward with Bella's exceptional progress, with time on our side instead of against us. The conversation went way better and we gained a much clearer understanding of where I was coming from, what Bella needs and what her specialists team could do.

They needed to understand that I am not pushing for a surgery, I'm not wanting my child to endure more tests and trials in a hospital that are not comfortable.  No, they needed to see that I need to know, (with their expertise to guide me)  when it IS appropriate to push her and when it is not. They have proof now that Bella will overcome any mountain thrown her way with the odds stacked against her, and yes many of those mountains have been conquered through miracles but many of those mountains have been conquered by her pure strength and hard work...with mommy pushing her at the right time and knowing what she can and can't handle.

As a team (medical personal + parent) we reviewed what tests would be appropriate for Bella, given her progress, given what we know and don't know about how her bowels choose to function when given formula vs solids. We discussed what next steps would be best for Bella when thinking about her future and time lines and when the heck I can get back to work! This all matters when it comes to planning the up and coming motility tests and major surgery our little warrior must go through. I mean she is going to turn 5 soon, that doesn't get delayed. I want her to be able to start kindergarten with the least amount of medical issues as possible.

We leave for Calgary on Tuesday.


What's Next?

In the next 2-3 weeks Bella's GI team and Immunology team have 6 major tests lined up for Bella. We also have meetings planned with her Surgery team. These tests will involve procedures that Bella will have to put up with as an outpatient, but they will still take time and may not be comfortable for her. Please pray for her to tolerate these upcoming tests, that they involve no pain and she gains comfort throughout. And also please pray that her team of specialists gain all the information they need from these tests so that not many are needed.

Her Immune System

Yep, there's been a lot of bowel talk from birth and lately her immune system talk has been put on the back burner...but we have some worries here.  Bella's bone marrow transplant happened March 25th 2015. That was the day her new immune system was to grow and learn and come to protect her, because she was born without one.  So here we are, almost 3 years post BMT and that hasn't happened yet. Her Tcells came in 100% and thats been huge! They are the virus killers. But in order to have a fully functioning Immune System, you have to have Bcells and Tcells working together.  Bella still does not have any Bcells, and it's a constant hell swirling in the back of my mind.

Bella has been getting her "Immune Protection" (IVIG)  infusion monthly still. This is where she is hooked up to IV lines for roughly 4-6 hours once a month to receive this monthly booster that protects her just like when you and I have vaccine and immunisation shots. Problem is her Immune system is not creating Bcells or the Memory Bcells to learn from this IVIG infusion and so the protection wears off by the end of the month and she becomes very vulnerable again. Her IGG levels (the number that shows if she is making Bcells) is supposed to remain above 5 and consistently  hers haven't even got above 3. Well... last month they dived down to .3. Quite, quite upsetting and scary. And her team is unsure as to why this is happening, especially when a while ago her blood work was actually showing small signs of Bcell recovery.

Please pray for Bella's Bcells to come in, and work with her Tcells to give her a fully functioning immune system and give her the ultimate chance of protection so she does not need to live a life of fear of deadly infection or monthly infusions.

In Calgary next week her Immunology team will do specialised blood tests for Bella's immune system that can not be done in Saskatchewan. Please continue to pray for Bella's doctor's and specialists to fully understand what is happening here.

I've been reading books of old, The legends and the myths.
The testaments they told, The moon and its eclipse.
And Superman unrolls, A suit before he lifts... But I'm not the kind of person that it fits.



Just something I can turn to.
Somebody I can miss.
I want something just like this.
I want something just like this."

Oh, I want something just like this
Doo-doo-doo, doo-doo-doo
Doo-doo-doo, doo-doo
Doo-doo-doo, doo-doo-doo
Oh, I want something just like this
Doo-doo-doo, doo-doo-doo
Doo-doo-doo, doo-doo
Doo-doo-doo, doo-doo-doo 


                     ~ "Something Just Like This" By The Chainsmokers ft. Coldplay









Thursday, 4 May 2017

I Draw My Own Child's Blood Now



It's A Need

I've found a growth in my want to help more people understand the mind set and thought process of a person who suffers. As I learn to advocate more for our mental health community, I see this need rising. Its not a need to make you all feel my pain. Its a need to help others switch perspective, even just for a moment, to help another get through a struggle. Its a need for more compassion in this world. And like a recent and quite relevant phrase flying around our facebook and Youtube pages right now, "We need to help each other." ~ Jimmy Kimmel.

I Draw My Own Child's Blood Now

I need that phrase to strike you and change your perspective, for even just a moment. Think about a little one you know, may be your own child, grandchild, niece or nephew and if they are not a medically complex child with a cvc, how do you think you are going to get blood from them? Pretty gruesome to think about, right? Pretty horrific to imagine cutting them open with a sharp object, poking them while they are awake... over and over, day after day. This imagery is what enters my mind every single time I lift my daughter's shirt and expose her cvc. This visual image of her being cut open for 13 surgeries and 7 cvc lines is right in front of my face when I have to draw the Ethanol out of her line and the bright red blood fills the syringe in my hands. Because it still did take, cutting her open with a sharp object and hundreds of pokes in all of her limbs to acquire this central line in her chest that I draw blood from every. single. day.

This is the mind of someone with PTSD, This is the thought process I battle every day of my life. It is gruesome, it is my reality, it is also Bella's reality...and until we face that reality we can not heal and until more understand from our perspective, we can't heal as fast.


The Battle Between Heart & Mind

With the rarity of our past 3 1/2 years since Bella arrived into this world, healing is something I need to work on every day. The hopes of a known fix are long long gone and to really, truly be happy and ok I need to work on healing every day and know that facing the reality of how my daughter's life will be, will help me suffer less. The little things have always been HUGE to me. I mean I don't even take breath for granted anymore! Sometimes I'm literally just sitting quietly and it springs in my mind to thank God for my ability to breathe...most times it brings me to tears if no one is around. I've always been quite sensitive, reading into things too much. And now, now?! ...can you imagine what I'm like now? One word (well two words), "Closet Basket-Case." I say 'closet' because you can't just run around 24 hours a day like that, exposing all that emotion to everyone around you, besides... Oprah did enough of that for us in the 90's, we've had our dose of emotion.

 So my heart and mind battle now, like never before, and now I am learning to understand the TRUE levels of my emotions. Sort of like someone saying the word 'literally,' literally before every sentence they say. Or like if you over exaggerated everything and believed it. So I'm learning...stay with me now, I AM LEARNING.  It's not easy but when a person has on going Complex PTSD, not typical PTSD it's a whole new ball game when trying to end the battles between your own heart and mind while trying to stay happy and sane. If I could help you understand in another way; I often take things quite differently now, while needing a much higher level of reassurance and empathy. Now, many may think, "Gaww Kyla...it's been 3 years, get over it." But that is so damaging and actually makes it even more difficult for the person who is already trying so much not to annoy others, while fighting through their struggles. And I'm no different than a person who maybe only had one incident that scarred them and now they suffer. Just because our rare life of struggle is on going doesn't just mean it automatically gets easier just like someone who has only suffered once. I think if the scarring or mental struggles are ongoing, that only means the battle gets worse and the sensitivity heightens and people like me become worse by trying to bottle even more in, because waaaay back when, when things first went bad all the love and compassion was poured out to them then...and people are tired. They grow tired of always having to lift you up time and time again. So then you begin to feel like a burden, constantly. And you always feel like you annoy people and that BECAUSE your struggles are ongoing...you're even more of a burden. So all of this builds up to the point that even when someome simply uses a ever so slightly different tone with you, you actually feel like they are shouting to the world, "What an idiot you are!" and have become.

So if just for a moment, you can grasp the battle between my heart and mind and switch your perspective for a quick sec, please know it helps me through this, it helps me heal and in turn helps Lyle and Bella as well.

Me Trying  Other's Perspective

So... I think I've come to realise what 'Autopilot' really means. And many many people are on Autopilot. Man, a lot of you run on Autopilot...do y'all realise?  I think I see this as extremely evident because I'm running on "Fully/Boarder-line Too Aware."  This of course being me working on my sensitivity levels.  But I think I need to note this, get it out there because I think 'Autopilot' can be quite desensitising for others. Let me explain...   Let's bring this convo back to my good 'ol rant about when people ask me, or say, " How are you?" (My most hated question. It really grinds my gears.) A lot of people ask this question because they are on Autopilot. They don't even realise the words rolling off their tongue cause that's what autopilot is. So fine, I get it and I'll speak your language with the same 'ol, " I'm good thanks" reply. Until.... Until I am SO NOT GOOD that I don't care how rude or annoyed I sound, I will give you my 'Too Aware' response and tell you how it really is, or to shove that question you know where because you're on autopilot and its a stupid question. Ugh, It's fine... I'm trying not to bark at people so much anymore but I think that will come in waves depending on how well Bella is feeling that week or what curve-ball is thrown at us next.


Where Have We Come From in Two Months?

So ya, it's been 2 months since my last blog post. It's been since March 22nd 2017 since we got home with Bella from our 4th Long Term Hospital Stay...637 Days in Hospital total. It's been since Jan. 25th 2017 (3 months) since Bella has not been allowed to eat. But her bowel function has improved and progressed and now she is allowed more than one juice box in a 24 hour period. Now she is able to drink half strength formula and her bowels are tolerating it and doing very well with the increased volume she is allowed to drink! Bella is truly thriving right now. I know that may not be apparent since sometimes when I write or speak I focus on the very real fact that our worst nightmare came true: Bella needed another surgery, a bowel surgery and all the horrific unknowns around it. The nightmare was basically her entire first year in hospital, happening all over again. But since Bella has moved her largest mountain yet, she is at her best. She is growing, thriving, very active and supremely happy. 


 Lyle and I completed our classroom teaching and training for administering Bella's IV TPN at home, back in March before we brought Bella home. We once again upgraded our medical parental knowledge and developed more skills to help our baby girl enjoy home life once again. But this time it has come with even more sacrifice for Lyle and I and to be honest it's an exhausting, heavy load this go around.  But hey, these are the cards we're dealt right, and we are going to roll with it. I'm looking forward to all the 'little things' that my hubby does to keep my chin up with a smile on my face. My gosh, I have an amazing man. No we may not ever get out on a trip together for over 24 hours away from Bella...but for now he does an amazing job at helping me look at the bright side. We can be home, Bella is alive, Bella is thriving (in the most medically micromanaged way possible) but thriving! And he sees this and he sets up little at home wine night picnics for me. He gets ready to take charge with Bella when my brain has shut down for the day due to stress, he's there. Quite simply he is there and I'm a blessed wife. So shout-out to all the single moms out there. Your strength and ability to do any of this medical mom life alone, blows my mind.

From Immunity Jail to Ostomy Jail to IV Jail

Well for starters, Bella is not really out of Immune System Jail given the fact we have not been given the go ahead as of yet to stop her monthly IVIG (immune booster) and start vaccinations and immunisations... like we were almost, pretty much promised could happen this month...it's not, and I'm waiting for a phone call from Bella's Primary Immunologist for clarity on this next week. I'll touch more on her Immune System updates in a bit. So for now it's like she still has an ankle bracelet on with a jail warden following her around 24/7.  And now, her ileostomy pouch is just as restricting most days and it makes me so angry that she just went from one medical condition restricting her freedom, to another. In the past week or so the ability to keep Bella's ostomy pouch on and secure has improved...but just in the last week. The struggles we have had with this dam pouch, 6 changes in one day, every day, the expense of that and the fact it keeps Bella restricted for hours and hours has brought me to tears. I literally broke down in tears for all of Easter Sunday because the pouch changes kept Bella from playing with her cousins, for over 6 hours of the day... it was horrible. Oh and this doesn't include the hours shes attached to an IV pole for her TPN.  I never thought there could be a more restricting environment for a child to grow up in besides the 200+ days we spent on isolation inside a hospital room. But there is! Turns out, shit CAN get worse. ** large eye roll.  The hundreds of days on isolation pale in comparison to a highly active 3 year old being tied down by a leaking stool pouch inches away from the cvc line that goes directly into her heart, connected from a towering IV pole over her tiny body being tangled through the connected lines.

I am going to face this reality to heal from it. I will find a way to make this reality a happy experience in Bella's life instead of a burden. 

I am going back and forth through every ordeal like a never ending ping pong match, but hey many things are still very fresh so it'll take time, but I'll get there. I will get to the point where I'll initially see less of the negative and more of the positive. I'll learn to enjoy the moment, be in the moment because I have NO other choice. When I panic and anxiety takes me way too far back in the past, or worry and stress fire me way too far in to the future...the anger and fear is unreal and I become paralysed, I can't function. But when I can ground myself quicker, see whats really happening today, just today, just this hour and realise something is NOT has bad as the past made it out to be, or the future thinks it could be...no, its now and its okay and its doable.  I can also breathe slower in the moment and pray. Like I mentioned earlier, I am able to not take so much for granted now and just in the moment be thankful. Instead of screaming at the pouch for restricting my daughter for the tenth time that day, I can teach her it's name, help Bella care for the medical appliance she needs on her body because they help her live. We come up with cute names for them and I can make funny songs about them instead of crying about the life she could have if she never needed them. I'm learning.



What It's All Like For Bella

I'm in awe of how well this girl adapts to what I know most adults couldn't. She's so smart, so in tune, aware and keen. I mean she'd gone from starting her life breast feeding for 3 short days to an ng hose down her throat, to being told she's not allowed to eat or drink, to getting over severe oral aversion and being allowed to eat and drink whatever she wants! To once again, nothing...not a drop. And she handles it. She handles it. I'm not sure I can even explain her strength in words, but my goodness its astounding.

My sweet girl wakes up every morning in her big girl bed, happy and shouting, "Mom... I'm Awake!"  She knows shes connected to the IV pole and if she dare jump out of bed that thing would come towering down. And that's no joke, in fact it's the reason I can't sleep most nights. Unless I bolt it to the wall, if that thing falls it could rip the IV line out of her chest and God, I can't even go there. So I'm just going to be calm in the fact that at the young age of three Bella 'get's this' very very well.

So I hop out of bed and, well sorry, let me rephrase...I peel myself out of bed and head into her bedroom where she's usually sitting up after a great sleep. And right there in that moment I need to take a breath and put on a face. Bella is so smart, even if the look on my face changes..she can see and feel the fear, or anger and sadness in my eyes. Even a simple sigh from my breath can send her in to crying a waterfall of tears because she sees in that moment I am upset about something.  Ya I'm not kidding you, this is EVERY morning. And it is every morning because of that relentless devil ostomy pouch that is helping me learn to be calm in the moment (I say that while gritting my teeth) and not shoot my fear and anxiety through the roof the instant I see that it has leaked all through her pyjamas.

In that moment of jumping into a happy morning song vs bursting into tears wondering if any stool from the pouch has touch her cvc line... Bella buys my facade and can enjoy her first ten minutes of waking up instead of crying because I am crying. It's tiring and it still wears on me heavily throughout the day. When she first wakes up and wants to play or asks for a drink of milk and I can't even let her move until shes clean or I've had a chance to disconnect her IV lines. It's so hard when she just says, " Mommy I wanna go play." and I have to tell her no so that I can fix her pouch or tend to her connected IV lines first. It's just hard. I don't want her to have to have this life! It breaks my heart in half every single morning.

Looking Ahead

I cried to my Mental Health nurse today as I broke down about the fear that drops by in my mind at least once a day. I thought the possibilities of anymore nightmares related to Bella's bowels were over when it came true on January 26th 2017. But they arn't. There's another nightmare I battle every day. I try not to let it take up any of my time but sometimes it lingers and my gut turns into a huge knot. And it's this: The possibility of Bella needing a bowel transplant.
This fierce little girl beat all odds by surviving Septic shock twice before her BMT for SCID. And that BMT saved her life! And then Hemalytic Anemia came along and she beat that (not to mention the 13 surgeries she also conquered) and now after 2 years post transplant we wait for the chance to achieve the ultimate goal of being safe which is to be immunised and vaccinated. She is still fighting so hard to get to that point that the thought of a bowel transplant ripping that all away breaks me into a spiralling fear. She would be on immune suppressants for the rest of her life never achieving that ultimate goal of full immunity protection.

Thankfully the progress her bowels are making and maintaining keep that nightmare from entering my mind too often. And I continue to pray every day our brave Bella will never require a bowel transplant.


Currently Bella's GI doctors help keep us focused on the relevant progress and where that takes Bella in the near future. Bella is on her way to eventually coming off of TPN (IV nutrition) fully and solely thriving and growing from just the specialised formula she is currently drinking at half strength with water. In a nut shell we will get Bella off IVs and onto a milkshake only diet.  We don't need to look past that right now because just that goal alone may take a few more months. So we don't know if Bella will ever be able to eat solid food again, we arn't sure if they'll be able to reverse her ileostomy yet. We do know that once Bella's bowels show they can handle full strength formula, then we are closer to having her come off of TPN and then we also start discussing her next surgeries. This will include discussing time lines around when and if we trial solids or when to do her mapping surgery. The surgery where they biopsy her entire small bowel. We will then also discuss when may be an appropriate time to try the surgery where they reverse her ostomy and she goes back to going poo like most of us do.

For now Bella remains on IV from 7pm-7am, only allowed to drink and lick a sucker here and there. I have morphed into somewhat of a fasting closet eater. This is how I get through the day until shes in bed and then I can prepare a supper once and a while for Lyle and I to eat after Bella is sleeping. It's still bittersweet to see her request and almost beg for foods. Half of me falls apart having to constantly tell my child I can not allow her food, but I am also hanging on to hope that one day she can eat again and she hasn't given up on that want and desire to eat. We are trying find ways to support her through it, I mean it's going to happen..she is going to see people eat or run into moments where she catches someone eating something she herself, used to love to eat. I mean I embedded the love of food into her mind. That was my doing. We worked so hard to overcome that oral aversion. I worked tirelessly to make her fall in love with healthy foods, and want them. Now I have to ignore that while she still remembers the taste and smell of ALL her favourite foods? How do I not ruin this child's mind?! It's an eff'd up game but I am doing the best I can and thankful for how smart and aware Bella is.

Immune System Update

It has been 2 years since transplant, 2 years since her BMT! And Bella has still not had the chance to be fully immunised and vaccinated. We still rely on the mercy of others vaccinating and immunising their children so that Bella is not exposed to viruses and diseases that could kill her but not a child that has a fully working and protected immune system. I typical SCID patient that has been cured by a BMT would have completed their vaccs/immunisations by now. Bella has not because her BCells and in particular her Memory Bcells have not come in yet. When you don't have Bcells to work with your Tcells, you don't have a working immune system. So we wait and we wait some more. Problem is that back in March her Immunologist was quite confident that Bella showed signs of proper Bcell function coming back. But a recent phone call from her nurse stated otherwise. So I am waiting for clarity on this and a phone call next week to clear it all up. For now it looks like Bella will continue to require IVIG monthly to give her the protection that her immune system can't yet.
                                                      March 25th 2017, Bella's 2nd Lifeday
Exciting Side Note!
Since it is over 2 years post BMT we are now allowed to contact Bella's bone marrow donor! YAY!!!!  Remember all those amazing letters you all wrote to her, we have saved them all! We also have that necklace ready for her and so so SO many stories! Can you imagine her reaction after she gets a chance to catch up on my blog!? I doubt many Bone Marrow donors get to read about the 2 years they missed out on, just because I don't think a lot of recipients or recipient\s parents blog. crazy to think about! So soon, Lyle and I are going to take time to email her, send her photos, etc. I will not share her information until I know what she is comfortable with...cause I mean, the Bella Brave nation is kind of massive. ha ha. So stay tuned for updates on this through our Facebook Page: Isabella's Mustard Seed.
                                                         
Other TidBits

I need many friends near and far to know how thankful I am for you and all you have done for Bella, Lyle and I, ever since she was born in 2013. Often, memories pop into my mind about something someone has done for us and I just feel overwhelmed with wonder if I have thank'd them enough or at all! Our life has been on high-speed medical light-year travel from day one in hospital and if I have ever missed a comment you made or question you asked or gesture you gave, please please know I am so very thankful. So many things, gifts, prayers, letters,messages that people have given to me or Bella over the years pop in my head daily. I reminisce about so many of them and I get sad that for many I haven't had time to reply. Often in the worst most exhausting moments in hospital so many people have reached out and helped us A LOT..and its during those times Lyle and I are exhausted by fear, unknown and medical demands that by the time we realise how we can do more than just verbally say, "Thank You, " it's been months. So I just hope that all you amazing, loving caring people in our lives truly understand how you help us immensely and that you truly lift us up through this life for our daughter. Thank You.


























Saturday, 4 March 2017

Summary 2013-2017 > Keep Up


This is my life now, it has purpose and I won't forget that.
This is his life, he carries me through but he needs carrying too.
This is HER life, she's moving mountains... keep up.

A side note before I get going with the 3 year summary. This is my therapy. Writing is my way of releasing some stress from myself. You may have heard bits and pieces of our story from the Facebook page, or snapchat updates, or my Facebook page... but I often try to make sure my blog writing is different. The writing in my blog post are of course way more detailed, and the the words/thoughts I just need to get out there. 
Thank you for listening, thank you for reading and thank you for caring about our story.

March 4th 2017 - Day 620 in Hospital

Since Isabella (#BellaBrave) was born (Dec. 6th 2013), I've counted the days spent in hospital. I never had my blog running until after she turned 1 year old. So that whole first year in hospital wasn't well documented, but with all the chaos that has become our medical life... in the time span of 3 years and 3 months thus far, we have had roughly a glorious 10 months in our home.

Jan. 25th 2017 we entered back into living the hospital life with Bella, once again.

It is quite difficult to keep up with our years in hospital and all the reasons why. #1 For people who try to fathom it for the first time it seems just flat out "Not Real." How can that many things go wrong, time after time with no break?! #2 The reasons Bella needed highly professional care, specialists all over the world to slowly discover 6 rare diagnosis, like perfectly timed blows in a boxing match.... "Round 1: left hook, Round 2: right hook, Round 3: Uppercut, Round 4: Jab Round 5: Cross Punch, Round 6: Bolo Punch..." I'm just waiting for the KO like its expected now. And #3 the countless times we have been told we are going home and don't, they think she's fixed and she's not, 'catching a break' is proven to be a flat out myth to me now.

Here's a Medical Summary of Bella's Hospital Life from Birth:

Pregnancy: A wonderful, easy pregnancy where I never got sick and we knew nothing of what was yet to come.
Born: December 6th 2013 in Swift Current, SK hospital
3 days old: Air ambulance to Saskatoon hospital for 1st bowel surgery dealing with Hirschprungs Disease affecting her colon/Got her first ostomy pouch.
Jan 28 2014: 2nd major bowel surgery taking down scar tissue thinking it was the blockage.
April 9th 2014: 3rd major bowel surgery to take more of her colon thinking more of it was affected by Hirschprungs.
April 10th 2014 (Bella is 4m old): First Septic Shock episode nearly taking her life. Most likely due to major bowel surgery with no immune system (unknown SCID at this time)
June 2014: transferred to Alberta Children's Hospital in Calgary
July 2014: 4th Major Bowel Surgery that took her whole colon but also took away her ostomy so she went back to pooping normally.
Bella still had oral aversion at this time due to the ng tube still placed down her nose and throat to feed her formula.
September 8th 2014: a brief and very stressful  few weeks at home still unaware Bella had no immune system.
October 2014: Admitted back to RUH in Saskatoon for lung infection, needing Oxygen.
November 2014: transferred back to ACH in Calgary because Saskatoon could not clear her infection.

November 20th 2014: Bellas biopsy of an enlarged lymph node from her armpit showing she had no immune system, absolutely no Tcell or Bcells and thus diagnosed with a rare unknown form of SCID.
- This happened a week before Bella would have received her 1y live vaccine that would have killed her because she had no immune system to build antibodies from the vaccines. Hence why I advocate for Newborn SCID screening to happen in all provinces. Genetics began to make connections between how Bella has CHH, HD and SCID.

> We remained in ACH Calgary, AB and prepared for her BMT to cure her of SCID < Strict ISOlation protocol began for Bella.

March 20th 2015: After about 6 days of chemo an infection in Bella's cvc sent her in to Sepsis and they removed her cvc 2 days before her BMT was due.
March 25th 2015: Bella's BMT
May 2015: We moved from strict Isolation in hospital to strict isolation at RMH across the street.
- we would walk across the street every other day to have her BMT team examine her at ACH
- Bella is 1 1/2 years old at this time and just learning to eat solid foods and went from ng - Gtube use.
October 2015: It is discovered that Bella may have contracted a severe MAC bug prior to BMT that survived chemo and BMT, so now she is treated with a year long dose of 3 antibiotics and only allowed Distilled Water.
November 2015: Bellas has her first Hemalytic Anemia Attack (a rare complication post BMT) Her case required a med called Retuximab to fix the Anemia but it required wiping out all her Bcells. This turned out to be a need of a year long dose of steroids. Steroids kept her Immune Suppressed for an entire year. 

December 1st 2015: At 2 years old Bella took her first steps and learned to walk.
December 13th 2015: We went home. Monitored weekly with bloodwork by Swift Current doctors and travelling to Calgary monthly to see her doctors there.
April 2016: Admitted in ACH Calgary for second Hemalytic Attack, receiving more blood transfusions and longer need of steroids.
June 8th 2016: We went back home.

- Many motility bowel distension issues began and got worse. Bella is now eating solids and more stress is on her bowel to move food through. Bowel issues still unknown. Much blame was put on the use of steroids and antibiotics and diet. Many restrictions and medications were laid out and trialed.
-We still make monthly trips to Calgary.
December 6th 2016: Bella's first birthday celebrated at home, she turned 3 years old.

January 25th 2017: Bella's rushed from Swift Current hospital to ACH in Calgary for emergency Bowel surgery.
January 26th 2017: Bella's 5th major bowel surgery. Her 13th surgery since birth. (She's had other surgeries for cvc lines and biopsies, etc) This was also her first surgery with a working immune system and her not being immune suppressed from steroids.
February 21st 2017: Bella's team of primary specialists (11 people) meet with Lyle and I to discuss the rarity of their finds from Bella's recent bowel surgery and what the plan is moving forward.
March 1st 2017: We continue to remain admitted in ACH waiting for Bella's bowels to begin working, they haven't yet, so we continue to drain built up fluid from her stomach.

> It has been 36 days that Bella has NOT been allowed to eat and it remains that way until her bowels start to work. And even then, she'll only be allowed small sips of clear fluids. <

I can't watch anyone's child eat. I can't walk through the cafeteria any more at the chance I may catch a glimpse of the ability some other child has to pick up what ever they desire and see the simple choice of nutrients be chewed with ease and swallowed with no effort and glide down their throat to be processed by their working bowels which have never been touched by the hands of a surgeon, have never been been cut wide open on an operating table, cut apart and put back in. I can't describe the pain that wells up inside me right now when I see how easy it is for other children to be nourished without torture and pain. I just can't.

I sit here and day after day and I train (with Lyle and our Home PN nurse) to run the TPN through IV, through my child's veins to keep her alive and I wonder what it would be like to sit down for supper as a family again.

I can no longer eat in front of her any longer. Once again (Just like all of 2014) She can't eat, I can't eat.

How Did This Come To Be?

I can tell you first off, what makes it harder to believe that all of this could happen to one little girl before she even turns 3 years old, is that it has not been at the hand of humans. This is strictly a hand full of bad cards that was dealt from birth. I know this because her Amazing team of specialists from ACH have worked tirelessly, night and day to understand the whys and hows with me.

So What Do We Know?

We know from highly specialised Genetic Testing Bella was born with mutated genes that caused the damage: CHH, SCID & HD.
We know that the MAC bug was a bug that normal immune systems can get rid of but Bella caught this from the environment somehow before she had a working immune system.
We know the Hemalytic Anemia can be a complication post BMT, they have seen this happen to other patients. Its rare but it happens and its fixed.

We DON'T KNOW how or why this new bowel blockage formed, or the time it took to form. From here we make guesses with the information we have. And in a later section I'll explain how the surgeons explained why they believe this blockage piece took time to form and why it was appearing as "normal bowel" in the previous 4 bowel surgeries.

Leading up to the 5th Bowel Surgery on Jan. 26th 2017
Bella began struggling with bloat distension and motility issues since June 2016. From there they worsened. So many factors were always at play when asking, "Why is this happening to Bella?" We began to blame a lot of her bowel issues on her history of HD (Hirschprungs Disease) but it just never made sense that with antibiotics and no colon that she was severely severely constipated and needing more and more laxatives to poop. We also blamed steroids for a while as well.  Her doctors tried many meds thinking this was a chronic motility issue that would eventually be sorted out with the right med. But in actuality a 5cm section of her bowel was narrowing and becoming what would eventually be a full on blockage that they cut out on Jan. 26th 2017.

The Details Around The Surgery Itself
The day the Ambulance delivered Bella to ACH her surgeon wanted her in the OR stat! Thank God they recognised her worsening symptoms before she went down hill fast and possibly went through septic shock due to a perforated bowel.  Instead they had Lyle and I sign the papers for a "Emergency Exploratory Bowel Surgery" and we walked our baby girl to the OR for the 13th time. But hey! First surgery with a working Immune System and not on Immune Suppressant drugs! Bright side to everything right?! (If only you could see my face right now as I type this...)

When you go through this much medical trauma in this amount of time, as parents, you do become desensitised. Its why I may look at you like you have 3 heads when you tell me your poor child had to stay in the hospital for one night while they had the mild flu, or if you complain to me about. anything. at. all.

So we kept positive remembering things like the fact Bella has never had issues with anaesthetics, she's not immune suppressed, we know her surgeon so so well and he knows Bella, we are in a world renowned children's hospital, and Bella is one tough cookie. But entering hour 3 into surgery we get a phone cal from the surgeon's clerk...

I don't care what sort of positive things you tell yourself to distract yourself during the wait of your child's surgery... it is the most gut wrenching wait you'll ever have to go through. And then to get a phone call in the middle of the surgery, well it just drops your heart into your stomach and your stomach is a blender, shredding your heart until you hear the words, "She's doing great."

So she was doing great but since this was exploratory surgery and they didn't know what they were about to discover or what they even knew they needed to discover meant that they needed to tell Lyle and I the surgery would be another few hours.
Our surgeon came to speak with us promptly after the surgery to best explain what he (and the other gallery of surgeons in the room) also saw. And I quote, "It was WEIRD and ODD." What the fuck (sorry mom) else would we expect right? We have a huge family of prayer groups diligently praying for Bella, we have been seeking and searching for concrete answers for SO SO long and still we receive the worst of all... "We have never seen this before and no one else in the world has either."

We were left with this:
Bella's team of surgeons went through every piece of her small bowel, from her stomach, inch by inch all the way to the end which would be her bum. They cut scar tissue away but did not see any bands "choking" the intestine. That would be an 'easy' answer and why would we ever deserve that, right?!  As our surgeon meticulously searched along her bowel for answers he became worried that nothing would be found and then IT appeared. Near the end (bottom third) of her small bowel the diameter of her bowel went from as wide as the bottom of your coffee mug to the width of a pencil. The Blockage was evident and then cut out. It was roughly 5cm in length.

This narrowing blockage formed in her small bowel. Hirschprungs Disease is a Large Bowel (colon) disease...so what was this? How did it form? It explains a bit of why it was not seen in the 4 previous surgeries... you don't look anywhere else for HD, its only a colon disease. So what was this narrowing in Bella's small bowel?

The surgeon told us the extent of the trauma done to her bowels from the distension. 4 Litres (an entire milk jug) was drained from her tiny torso. The bowels were trying so hard for so long to push what ever food and drink was thrown at them, through an entire bottom third of her bowel in order for her to poop. Her bowel needed rest and so the ileostomy was built. This is where they bring the upper end of her small bowel to the surface of her abdomen skin and cover it with a pouch. This allows her upper small bowel much needed rest. Her bottom third and rectum remain inside her body for rest, healing and not being used.

6 hours later we met our baby girl, intubated in the PICU.




Even though she was on the 'Loopy Meds' she looked at me like, "Get this effing tube out of my effing throat NOW mom!"

As I looked over her body my eyes welled up as I realized what her tiny bodied endured. The cuts through the scar tissue through her abdomen, the deep purple bruises on her arms from the Art line and IV line that pierced her skin, the new ostomy pouch attached to her, exposed a small bowel stoma on her right side, sitting so close to her trusty Gtube button on her left. Looking and realising I can't see her skin, I just can't see any of her precious, porcelain skin. She was covered in the patches, pouches, buttons, tubes and lines that she required to survive this whole ordeal.

Finally I came across her soft exposed thigh, to gently rub, in hopes my touch there comforted her in some way while I kissed the tiny patch of skin on her forehead.

The Team Meeting 
Feb. 21st, 2017
This is the information we received with ALL Bella's specialists present (11 people). This team was made up of Bella's primary doctors: Immunology, Hematology, BMT, GI, CHIRP, Surgery and the Pathologist. Bella's team in total currently sits at 43 people. So the 11 top specialists on her case attended this meeting. This also included the surgeon who conducted her 4th bowel surgery. Basically, we had everyone there that we needed to get the clearest picture of what is actually going on and what we need to know.

We didn't think Bella's conditions and issues could get any more rare, and now we were about to hear the rarest of them ALL...

80% of HD (Hirschpurngs Disease - dead cells of the colon) stops at the junction of the colon. 5-10% of HD kids it goes up from there a little more. Less than 5% of HD kids have it affect their entire colon (Large bowel)... this was Bella by the time of her 4th bowel surgery. That was her full colectomy surgery, colon gone. And now to the Odd, Weird, Rarest part no one has seen before and some doctors refuse to believe exists: Skipped Lesion Hypoganglionosis.  So it may be possible that abnormal cells ( like a form of secondary HD) skip'd up into her small bowel. Unheard of, never seen before, some choose not to believe it exists. Thankfully none of those people are Bella's doctors and everyone in ACH wants to know exactly what THIS is.

The team is not sure how or when this section of blockage formed. Once the Pathologist could tell us about the slides and cells she meticulously inspected, she found that the cells from the biopsy were abnormal. So not only did they look funny, (not like normal cells) they were also sporadic and not in their 'right spots' for normal bowel function to occur. So how did these eff'd up cells get to this spot in Bells'a small bowel, why did they form here and how did they form here?  We don't know that yet.

We then discussed how this section was not seen in her previous bowel surgeries.  First of all doctors don't look for HD in the small bowel, its not supposed to be there. Then comes the weird and odd part of this section of rare... Bella seems to have a longer Transition Zone (from bad cells to good cells in the colon) than typical HD patients have.  Roughly 10 years ago it was noted in HD documents that a typical transition zone was about 3cm long. Then more recently a New Jersey HD specialist changed that to 10cm long. So when surgeons are looking at the bad HD cells and deciding where to cut the bowel so that all the bad cells are taken out, they would go roughly 10cm up from the bad cell section.  Bella's was longer than that. So she was never Typical HD even in the first place and then to have a longer than normal transition zone complicated things further. So through all her bowel surgeries the doctors never wanted to take too much of her bowel and then also followed the most typical guidelines for cutting out HD affected colon.

So they understand now that the bowel 'appeared' normal in the previous surgeries and they also technically didn't need to look there (her small bowel) after her first surgery when she was diagnosed with HD.

Between her 4th and 5th bowel surgery there was a 2 year gap. This is where we start guessing as to how and why the recent blockage section formed. We are still asking at this point "Are all her cells in her bowel 'abnormal' or just this last section they took out? In order to find that out her surgeons have to do a future surgery where they MAP Bella's entire bowel from her stomach to the bottom of her small bowel. This would be an extensive surgery where they biopsy a chunk of her bowel every 5-10cm. So we aren't there yet, that will be down the road. For now, we guess, and try to get her bowels to work.

Bella's surgery was so extensive on Jan. 26th that she couldn't walk for 9 days after.

- The Valentines card we wrote for all of the other children as inpatient on Unit One for Valentines Day. - 

Guesses on how the recent blockage formed:
Bella's whole team believe a lot masked what struggles her bowels were really under-going during that 2 year gap. They recognised that the majority of those 2 years Bella was on IV fluids through transplant, NPO with oral aversion so her feeds were a very broken down formula or TPN IV, so no solids. Bella didn't really start eating solids until later in the 2 year gap and when that was going on she was also on many many medications including lots if antibiotics. So for a while her gut was under very little pressure and everything was just liquid form flushing through.
     Then she began eating solids and taking steroids and becoming bloated and distended and from there the pressure on her gut to process increased. Possibly, after this something could of triggered her bowels to reach their breaking point and they shut down thus showing us a full on bowel blockage that was quite evident.

So perhaps those abnormal cells were there from birth and as the pressure on her bowels to process increased, the narrowing began on one end, and the distension on the other. Her doctors still do not know for sure, but this is there best guess at this point. We will not know FOR SURE what is going on until they get that chance to map and biopsy her entire remaining bowel.

So Now What?
Lyle and I left that meeting quite deflated and discouraged. We never received answers and no 'for sures' and there was even discussion around the Bowel Failure Team being involved and what scenarios led to the need of a full bowel transplant for Bella. (Worst Case Scenario) And at the date of  this meeting it had been nearly 4 weeks since surgery and also still NO movement from her bowels, no bowel function at all. This meant stressing procedures that needed to be done on our fragile 3 year old daughter. The older she is now for these most traumatic situations, is showing the harmful effects of stress on her mind as well. She is fully awake and aware when they need to dilate her stoma, or when we need to drain her entire stomach contents from her Gtube button because her bowels are not working. It has been somewhat of a horror movie 5 inches from her own eyes.

In the last month my daughter has been the most aware for the harshest procedures. She has remembered for a long time and they can't tell me anymore, "Don't worry mom, she's a baby, she won't remember."  No, now I have to stare in to her tear-soaked eyes with mine and pray she forgives me for holding her down as she screams, "Mommy no!"

We were also left with what we have usually received from Bella's doctors...HOPE. There is hope that her bowels wake up and start working just like they had before, she comes off TPN iv and is allowed to eat again. There is hope that the rest of her bowel functions beautifully with the support of an ileostomy pouch and that in the future she could hydrate herself enough for us to remove the CVC line in her chest. Speaking of which, thank GOD for the life line known as Mr. Rigatoni (her Broviak cvc). We were just looking forward to taking him out because the Hemalytic Anemia was gone and we only needed to see her BMT/Immune/Hematology team once every 3 months! We were almost at a 3month break point... but thank God we still had her cvc line and didn't take him out early. Mr.Rigatoni has saved Bella a ton of pokes.

Daily
Daily we wait for her bowels to wake up. Daily Bella is connected to IV lines that feed her veins all the nutrients (TPN for 22 hours) her body needs when she can not eat. Daily we try to keep our heads above water as we strive to keep her comfortable, thankful, aware and learning. The doctors stream through her door like a revolving sushi train. As soon as I swallow one's ideas, orders and concerns, the next one comes by.

For a while I could see the stress of all of this rearing its ugly head in my daughter's mind. She felt her entire world was out of control and not one person was going to get away with one thing, not even a "hello."  It broke my heart to tell people that saying, "Hi" to Bella stressed her out, so shut your mouth and walk by without speaking, thank you. This was my Brave girl who loved 20 doctors in her room and hated being home alone with mom. Now, I had our nurse telling me not to worry, this is the way a 3 year old should react to hospital.  Which part of me believed but part of me also knew this wasn't "3 year old behaviour" this was my baby girl not herself and stressed out.  I mean no one could even compliment her.  If she did not initiate the convo, then no, you are not allowed to engage. She needed complete control of her world as she healed and this is how she started to gain it.

Things have brightened in her world this week and I'm getting glimpses of my happy girl coming back. But I mean she started with the tiring job of dealing with the distension that she put up with for so long, with a smile on her face! Then she went through a extensive surgery at an age where she is very much aware of her surroundings. And after that, being told she can not eat, no snack, no food, no drink.

Say you have a 3 year old right now... could you call them from the other room right now and tell them,
  "No hunny, I'm not giving you supper tonight. In fact, Mommy is not allowed to let you have a drink before bed and I won't be giving you breakfast in the morning. Actually, hunny... Mommy won't be feeding you for another month."
The pain in my chest still lingers since the first week after surgery where Bella sobbed because I had to say no to a snack for her. It lingers because now she has given up, she's "put up," she's fine with it now. And the chest pain continues to linger because the PTSD from her entire first 8 months of life when the NG tube down her nose and throat caused an oral aversion and I wasn't allowed to feed my baby girl a bottle. And that aversion continued to the point in time when I WAS allowed to feed her a bottle and she wouldn't accept it because she had given up, she had put up and she was fine with it...over it. So the fear from those months when she was forced to "put up with' it all for so long that she just gave up on trying. God, I pray for my brave girl's chance at eating again. Please.

My Mental Health
This paragraph may not be long because really my only question is: "When you are receiving support from your Mental Health nurse for PTSD from a year of exactly what your worst nightmare is, that you have already lived through (Bowel Hell)... and your PTSD nightmare becomes real life AGAIN (Bowel Hell Take 2)... Do you spontaneously combust?

I feel like I have strived ruthlessly to prevent prevent prevent; pain, mistakes, hardships on my daughter. Why has it all just blown up in my face. I begged my doctors to figure things out quickly and they tried tirelessly to never see me beg them again because they are amazing. Yet issue after issue arose for Bella and I still feel like I'm tied up, beaten and gagged while my daughter suffers. I need this suffering to stop for her. I need her quality of life to never have the word 'pain' enter it ever again. If only..if only.

I miss my dog so effing much it hurts.
I miss my 2 cats a lot. I miss the way they bring my heart rate down.
I miss the way that Sajak (my male kitty) thinks he's human.
I just want to hold my dog the more I think about my cats.
Dammit all I miss them!!!!
I hate this!

If One. More. Person. asks me, "How are you?"  I'll blow up.
STOP ASKING THIS TO PARENTS IN HOSPITAL WITH THEIR CHILDREN!
Gaaaaawwwwww

How are you? Honestly... come one people!? Really?
  "Oh, I'm fucking fabulous! Holding my double shot latte, with my new outfit, driving my car to my job, in the town I live in, which is also the same place I live and see my dog and cats daily, while my healthy child goes to daycare and my non-stressed husband picks her up after his daily job which allows me "self care" time to work out at my fab gym before showering and going for wine with all my girlfriends at the local pub downtown."  Just. effing. fabulous.

I get that this is just the common phrase that rolls off your tongue and that it takes a little more brain function to try and think of ANYTHING ELSE to ask...but please try. For my mental health sake, please try.

How Is Bella Lately?
Today is March 4th, so even though it has been exactly one month and 5 days since she has been allowed to eat she is 'putting up.'  Bella's GI docs have allowed her a max of 200ml per day of clear fluids, because her bowels are supposed to be allowed to fully rest. This 200ml of clear fluids is for comfort for her in the safest way possible. Its less than a juice box a day that we have to drain from her stomach 2-3 times in a day anyway, while we wait for the day that her stomach is empty, which means her bowels have started to move stomach contents through!  While we wait Bella has been doing well with her options of juice, popsicles or suckers. She has not puked at all and has been relatively comfortable other than the soreness from irritation at her Gtube button site. The strain from the stomach drain tube has irritated the button site and has made it quite painful for Bella even when we touch it.

Slowly as we coach her in to regaining control of her current environment she's becoming a bit more friendly little by little. Slowly I see her "happy girl self" coming back and lighting up every hallway she walks down in that Children's Hospital. She is a girl of routine. Here she feels control and comfort in knowing what will come next. It has even got to the point of a surprise blessing for Lyle and I. Shortly after her surgery, roughly 2 weeks after, Bella told us flat out to leave her room. This was her bedroom now (hospital room) and she demanded her quiet, alone time. Even though I was a bit taken back by this request...I could see her craving for peace very clearly. So a couple times in the day it started with, "Mommy, go sit down." Quite a harsh demand but I respected it. I was standing at her crib-side too long and she needed a break from 'nurse-mom.'  But then it escalated to, "Mommy, Daddy leave."  And Lyle and I sort of stood there in shock. So we contemplated leaving her hospital room to actually sleep at the Ronald McDonald House, free from lights and loud alarms over night. Bella was telling us to go!

I double checked if I was hearing her right and asked, "Hunny, should I leave?" and Bella would respond, "Yes mommy, mommy...coat and boots. Put on your coat and boots and go." And as I picked my jaw up off the floor I turned down her lights, plugged in her toe probe monitor for the nurse, gave her a kiss goodnight and walked towards the door. As I closed the door I'd say, "Ok hunny, Mommies going to leave  now (as I triple check that she was still ok with this) is that ok?"
And she responds, "Yes, night mommy." These little bits of her showing how brave and grown up she is, melts me.


What if her Bowels don't wake up?
We have been given a time period from her GI specialist for her bowels to wake up and work. It was confusing because after surgery they said hopefully they would begin working in about 2 weeks. Then once they realised what they were actually dealing with they switched that time line to 2 months. So given what they know in regards to Bella's case her doctors are telling us they will not start to worry about her bowels not working until April. Given the trauma her bowels went through right before and during surgery, her doctors don't expect them to start waking up and working before April. So if they do before then, great, bonus.
If April comes along, then her bowel's rest period is over and they will try putting them to work. This means throwing every motility med at them until they do work. Bowel transplant will only be considered after every possible motility med has been tried, even the ones they need special approval for.  So currently today we are still holding on to hope that Bella's Bowels will wake up on their own and begin to work on their own with-out any medication support.... its possible.

Currently Lyle and I are also back in school taking Home TPN Training. This in a nut shell is us being taught how to administer nutrients through IV for Bella at home. It may be a while before Bella can eat again, so she needs TPN through her cvc line to stay alive, to get all the nutrients she needs to gain weight.  So yeah, we have gone from managing just dressing changes of her cvc line site, Gtube (stomach button) use, to now ileostomy maintenance and full on IV hook ups, lines, pumps, beeping pumps, flushing her line, checking blood return, running fluids through her IV, etc.... at HOME. We won't be done training for another week and even then, we don't take Bella home until we feel comfortable and confident enough to administer TPN IV at home.

    Me as Nurse-Mom just hit a whole new level. 

You may have thought I had enough to carry around for Bella due  to her Gtube and cvc line and regular toddler needs... now I have a full on hospital room that I'll need to adjust to hauling around. We are getting the IV Home TPN training in hopes that we can bring Bella home once our training is done and care for her in the comfort of our own home,  & wait for her bowels to wake up there. Thats a blessing.  $15 000 is what it costs per child, per month for a parent to be able to administer TPN through IV at home. Thank GOD we live in Canada and it costs nothing for us to do this for our daughter. Thank GOD. So I am going to bite my tongue a bit harder and remember not to complain when I relearn how to function out of hospital, and competently tend to my daughter's medical needs at home. 

Thank You Is Not Enough

Without question our friends, family, hometowns, friends of friends, extended family have support us in spectacular ways and Lyle and I can not thank you all enough. To stick by our sides, for our daughter through this unusually long endeavour has meant the world to us. We feel your love when we are alone in our RMH room, we feel your support when Bella is in her hospital room, we know you have our backs all the way through, thank you from every inch of our hearts. To all the friends that I can't always reply back to right away, please know I will get there. Days can become overwhelming and I'm trying so hard to keep up with the Thank Yous that even that can become overwhelming at times. So please know, when I have time, when I finally get home with Bella... we want to thank you so so much.

Thank you to everyone supporting me with my book sales. I hope I can physically get to my shipment soon and be able to set up my own book signing event for you all to pick it up from me in person.

Thank you to my thoughtful, selfless, amazing co-workers, the Chinook School division, Central School, Hodgeville School, Ecole Centennial  and All Saints Catholic school for all your loving support.

Thank You From Inside Out Creative Studio for the keychain & magnet fundraiser for Bella.
Thank You to my loving friend Becky Warnke for the GoFundMe page and the BellaBrave online auction fundraiser.
Thank you to our community for the auction support and everyone for the support through the GoFundMe page.
Thank you to my friends Carissa, Stephanie, Alana, Jess, Alanna, Melissa, Jenna and Brooke for all the hard work you have done to bring a smile to Bella's face.
Thank you to my Medical Mom friends in Calgary who have made breaks in the day possible for me. I cherish you SO much.
Thank you to my mom and dad and Lyle's mom and dad who have been the foundation of the abundance of family support in our lives for Bella.

A Thousand Thank Yous to all of our friends near and far. Please keep the prayers for our Brave Girl going, she's not done moving mountains yet. Keep Up!