Tuesday, May 10, 2011

Yet Still I Rise

Anyone familiar with Yolanda Adam's "Yet Still I Rise" would agree it is a very appropriate song for such a time as this. If you've never heard it before, take a minute to Google or YouTube it...Yet Still I Rise..never to give up, never to give in, against all odds!

Yesterday was not the best day of information. Mireya had a few areas of petechiae on her mouth and she began complaining that her stomach hurt late in the evening last night. I took her in to the Pediatrician's office for a CBC (capilliary blood draw). The counts across the board are low. Her platelet count is down from 71k to 16k. When we were in the hospital last week, they wouldn't consider allowing us to be discharged unless the count was higher than 16k, so I mentally prepared myself to have to be re-admitted. Instead we were given some 'high level' criteria to keep an eye on that would require us to go back.

Mireya's white blood cell count is low, so it is imperative that we guard her as best we can from infection. Fever is one of the first indicators of possible infection, so any sign of a fever is definitely on the 'return' list where they would administer antibiotics intravenously. Any additional petechiae, bruising or bleeding would also necessitate us immediately going to the hospital. If the counts are lower, another transfusion would be given. We will be at the Hemoc office first thing Friday morning to get the complete findings from the biopsy report. In the meantime I need to place our Princess in a padded room with a helmet and straight jacket because her activity level needs to be zero. We are doing our best to minimize her activity, but she's an active 4-year old that just doesn't get it. Overall she appears to feel well, but we have noticed she is slowing down some. The pediatrician did share some snipets of information she received while speaking to the Doctors at Hemoc. Everyone is trying to get an understanding of what the underlying issue is, but we are going to wait for the full report before we get too anxious or amped about a word here or there.

The bible tells us 'Be anxious for nothing, but in everything by prayer and supplication with thanksgiving let your request be made know to God'. God knows it all and he is in control of it all. He is whispering in my ear Psalms 46:10, Be Still And Know I am God.

Monday, May 9, 2011

Order My Steps Lord

It feels so good to home and sleeping in my bed...yes the same home I've been trying sell and move out of for the last year, but nothing felt better than turning on my street and pulling into my driveway. It was a serious exhale moment of 'Home Sweet Home'. I had a wonderful Mother's Day full of sweet surprises and surrounded by the ones I love. When I woke up this morning, 'LIFE' was calling for me. We all know it stops for no one regardless of circumstance. So I'm trying to get back on track and I'm instantly reminded of how full my plate was before any of this happened. I will spend most of the day realigning my to do list and wrapping my arms around graduation invites, finalizing celebration plans, dance recital rehearsal, college paperwork, camp forms....and the list goes on and on. Did I volunteer to do a Senior Day collage by next week? Help! I'm also working on responding to all the wonderful messages we've received. I've been thinking about how great it would be to somehow compile and bind them all together. It would be really special to look back at this time and have a memento of how 'a village' comes together and the awesome example of God's love through the thoughts and actions of others.

Mireya is doing great today. The bruising is starting to fade and her appetite has increased. She is so happy to be home with her brother and sister, playing with her friends, and changing her outfit one million times a day. I tell ya kids don't miss a beat. We are doing well also. Friday can't get here soon enough, and we are continuing to believe for the best!

Saturday, May 7, 2011

The Power of Prayer

Today started out as another puzzling day. Mireya's counts were down across the board. The results of the bone marrow biopsy won't be in until early next week. Where do we go from here? If these counts don't increase we will remain here until next week. The decision was made to give Mireya a platelet transfusion. The process would take about 30 minutes to administer and then after several hours her counts would be retested. A platelet transfusion will typically boost platelet counts to 50k or greater. These results usually last for 5-7 days on their own. At 20k, we can at least go home while the biopsy results are being compiled and a treatment plan is established. The transfusion was given this afternoon and they projected we would have the results around 7pm. This is the first day that Mireya really began to voice that she didn't want to be at the hospital any longer and that she was going home. The nurses didn't come in until about 7pm to get the blood samples. They were having some challenges getting blood flow through the hep lock. So they had to try to draw from another location. After two failed attempts and tears of pain, we had to ask them to just 'pause' for a little while and try again later. Insert 'pause' as a nice way to say stop now before I go off. Trust me, it was a very tense moment and a rough scene. Mireya has done such a great job with all the daily poking and prodding without incident and we just didn't want her to suddenly have a complex. The good news is the counts came back at 71K. Praise God! We packed that room up in what felt like 10 seconds flat, threw up the deuces and rolled out. I received the BEST Mother's Day gift ever...my girl is home and we found out from preliminary scans of the biopsy there is no cancer or malignancy. Thank you Lord!!

Thanks again for the calls, the meals, the princess packs, cards, balloons, your time, your prayers...everything. We have some follow-up appointments next week to help us determine precisely what this is. It has the classic signs of ITP, but could also be another condition called Aplastic Amenia. So we still wait, but from the comfort of our home, with confidence that Mireya's health is increasing and with faith that it will continue to do so. We'll share more as we know more.

The Sincerity & Compassion of Others

Everybody needs somebody. Thankfully Quentin and I have each other and we know God is always with us, but the outpouring of love we've received over this week has been tremendous. It has been an extension of God's love for us through others. We are so grateful for our families, church family, friends, friends of friends, kind words, and deeds....the list goes on.

We often find ourselves looking for ways to bless others in need. It has been an incredible feeling to have the things that we need be provided or coordinated for us. Prayers are going up all over the nation right now on our behalf. How incredible is that. We're thankful that through social media, text messaging and a up and coming blog (shameless plug) that we've been able to share our story and keep everyone updated and in the loop. It's hard to just exist and manage your life from a hospital room. I think of the many families for whom this has just become routine or the norm. I've seen a lot in these few short days and while we are fighting our own battle here, I've been in prayer for many of the other children and families I see. I imagine this gets old and your life sort of stays in flux.

Balancing your real life, along with everything you are suddenly hit with when something unexpected like this happens, requires coordination, visitation, nutrition and seriously 'real' sleep has to be factored in there somewhere. Coordination of who has to be where and when. Some things we just have to sideline until this is over and we can slide back into our regular routines. But we're trying to keep it as routine as it can be given the circumstances. Visitation really has to be handled delicately. We love that so many people want to come and spend time with us while we are here. It's great to have support in that way. The most important thing is ensuring Reya gets the rest she needs and is not overwhelmed in the process. Nutrition, well we all have to be fed. I love that friends have stopped by to bring us meals. It's safe to say that it's day five and I'm no longer excited by Subway, Chik-Fil-A or the Cafeteria. I mean I could learn a thing or two from Jared and maybe come out of this pounds lighter, but I really don't want another sub from Subway. Everyone loves Chik-Fil-A, but that too has lost it's appeal and I really want to still like going to Chik-Fil-A when I leave here. The cafeteria has some good options, but I've really been overwhelmed every time I go in there. It has this 'Regulars' feel and flow to it and I feel like a complete foreigner. Sort of like the first time you ever went to Starbucks to order that drink and you heard everyone before you hollering out Grande, Venti, Soy, no whip blah, blah, blah and then it's your turn and your are clueless. Sleep deprivation goes with the territory. I think I could go to sleep today and wake up next week. I'm so tired, but my mind has been so occupied it's been difficult for me to have quality rest, but when this is over, sleep is definitely on the top of my list.

'Thank You' to everyone who asked what can I do?, what do you need? and those who stopped by to sit and entertain the children so we could just have time to take care of things. We know no one is holding it against us, but forgive us if you've sent a message, text or took a moment to phone us and you have not personally received a response. At this point keeping up with all the love, care and concern would require a lot but I will get around to it myself because I appreciate that you cared enough to do so. Words can't really express our gratitude and how touched we've been as a result of your kindness.

Friday, May 6, 2011

Strength Don't Fail Me Now

'Feet Don't Fail Me Now' is a part of the lyrics to 'One Nation Under the Groove' by The Funkadelic's, but for me it's taking everything I have to roll with Elton John's 'I'm Still Standing'. Mireya had her bone marrow biopsy this afternoon. The procedure itself took about an hour or so including the anesthesia and recovery time. Reya is a super trooper! This kid has just rolled with the punches. Her levels will be rechecked in the morning. There is a possibility if the numbers increase we can go home until the complete report is compiled, which could take up to 5 days. I'm tired, I'm dazed and I just want to go home. Even though my physical and emotional strength is waning, my faith in God to see us through never will.

I arrived at this hospital with preconceived notions based on negative press and stories I've heard over the years. Surprisingly, their Hematology and Oncology Department (referred to as Hemoc) is one of the best in the area. They also have a really awesome Pet Program. Reya was visited this week by Emma, a sweet and lovable Jack Russell who just wanted to cuddle up next to her and have a afternoon nap. He had a busy day visiting all the little patients on the floor. The second day Chip came by to say 'hello' and play a tune for Mireya on his piano. It was so adorable. His owner, recognizing Reya was all about "Princesses", shared a photo of Chip in a costume contest dressed as Tinkerbell. She got a real kick out of that. The preschool/elementary school teacher on staff stopped by to introduce herself and invite Mireya to come and join other preschool age kids for a variety of fun this week. Everything from making Mother's Day cards, arts, writing, singing songs and playing the guitar. The playroom is decked out with tons of fun toys, games and books to include a fully equipped kitchen center. We've been in there everyday and I've about had my fill of tea, plastic veggies and wooden cookies...yum! The hospital's Child Life Program is quite impressive too. Yesterday they brought coloring books, crayons, bubbles, sidewalk chalks and videos for Reya, Jalen and Makinley to enjoy. Today they brought spin wheels, Legos, Princess Puzzles and Princess Coloring pages for the kids to have and the biggest hit of the night was the Window Markers. Imagine Jalen's face when he arrived to see a 200-pc Lego box waiting just for him and there wasn't a free space left on either window after we were all done coloring, writing and scribbling.

We also spent time this week out on the Child Life Play Deck. How cool is it to go outside of these four walls to run around and get fresh air, surrounded by flowers and greenery. The kids enjoyed using the sidewalk chalk, swinging on the swing and blowing bubbles off the rooftop. The view from there is very tranquil and peaceful. The children have also enjoyed watching the helicopter flying in overhead. For them it is really cool, for me I imagine the tragedy of someone having to be medevaced to the hospital for care. I have witnessed this at least five times this week. The Child Life Center is located on this floor. It brought tears to my eyes to see all the things they house there for kids to enjoy through out their stay here, to include clothing for all ages. We purge toys and clothing items several times throughout the year and I will definitely be making donations to this program in the future. This has been a very positive hospital experience for us. There are volunteers that have stopped by the room each day to sit or play with Mireya to allow me to run errands or just to have a break. I mean young adults truly excited about brightening a child's day and putting a smile on their face. They also have a Grandparent Volunteer program of more mature adults that enjoy coming to sit, read, hold and play with the babies. This has been quite an ordeal, and even with all these great things to keep our time and minds otherwise occupied, we wait, we hope, and we continue to pray for answers and that our sweet girl will be well soon.

The Counts are In

It was a long night. I had trouble getting to sleep and once I finally did Reya jumped me. She left her big spacious bed to come cramp up the situation on my not as comfortable pull out chair. Good thing she is not as big as a minute. I on the other hand had to overindulge my abs and core to hang on the edge of the bed. All for the comfort of the Princess. The headaches and stomach aches returned overnight, but she was able for the most part to sleep through the pain. Early morning rounds felt like they would never get here. Our normally upbeat Pediatric Physician came in missing a few of his beats. The report was not favorable, all of Reya's counts went down. So this afternoon we will be having a bone marrow biopsy done. My sails are fighting to stay up. Our faith in God continues to carry us. We take the bad (or unknown) with the good and keep pressing, knowing that it ALL matters to God.

Looks like I will be fasting with Mireya today. I sure wish they had told me she couldn't eat or drink after a certain hour. Her appetite has been hit or miss, but I would have given her a few extra things I know she would have gobbled down before the clock struck midnight. So now I'm hiding the stash of 'this and that' I have in the room...out of sight, out of mind (as my stomach grumbles). God is so awesome! She has yet to ask for anything to eat or drink, instead she just woke up wanting to put on her princess garb and play with her new 'Dora's Royal Adventure' block set.

We are scheduled for the biopsy at 1pm this afternoon. She will have to be put to sleep for this procedure. The Dr. will have to take a small bone chip sample as well as draw some of her bone marrow by needle from back of her hip. She barely has a hip...yikes. No stitches required, a little Tylenol for the pain and I'm sure if they put a Princess Band-Aid on the spot, she'll barely feel the projected 'moderate' pain associated with it. Funny how a band-aid can instantly cure an ouchie (coupled with a 'let Mommy/Daddy kiss it').

From there test and reports will be done and prayerfully we will be closer to unveiling the cause of all of this. Should the platelet count increase we can go home until all the results from this procedure are completed. It usually take about 5 days. If her counts don't increase we'll remain here until a treatment plan can be initiated. Continuing to pray and believing for the greatest report in the end. More to come.....

Wednesday, May 4, 2011

ITP

I wish I could say this stands for 'I'm Traveling Purposefully' or 'I Train People' (for all those who know about my love for Training). ITP stands for Immune Thrombocytopenic Purpura, a mouthful of words that has landed us in the hospital for a few nights. Throughout the course of a week Mireya developed some markings on her neck that looked like her skin had been scraped against something. Her story was that she had gotten tangled on the steps and injured herself on the handrail. Not to far fetched or unbelievable, so we went with that scenario without to many questions. The next morning another set of the same markings appeared and then the next day another. I searched her bed thinking perhaps there was a spring in her mattress that was causing the problem. I looked through her bedding and combed over the mattress and didn't find anything out of the ordinary. Within a few more days she had light bruising on her legs and arms. Her level of play doesn't constitute excessive bruising. Remember she is the Princess of the crew, she sashays and glistens. Over the course of the weekend she complained about dizziness, headaches and stomach aches. Her appetite diminished and she just wanted to lay around. By Sunday evening I was really concerned because several more bruises appeared and we couldn't figure out why? My husband did some research online and found a few things it could be, all of which needed immediate attention.

I had a difficult time sleeping that night. I decided to get up and do some research online too. Within about 15 minutes I was in tears from information overload and all the possibilities of what this could be. I went in Mireya's room scooped her up out of bed, wrapped her up tight in my arms and finally managed to go to sleep. When we woke up Monday morning I called the Dr.'s office and was given an appointment time within two hours. When we arrived I gave them all the pertinent information which resulted in a finger stick and a platelet count of 7. The normal range for blood platelets is 150k-300k+. We were immediately sent to the Hematology & Oncology Department at MCV for further tests and admission. The test results came back with platelet counts a little higher than 7, but considerably lower than 150k. Her hemoglobin and white blood cell counts were a little low, but not of major concern.

ITP is a blood disorder in which the immune system destroys platelets. Platelets are necessary for normal blood clotting. In children this disease may follow a viral infection. We all know we've had a few of those run through our household over the past several weeks. One of the risks with low platelet counts is risk for excessive bleeding, especially head bleeds that can prove to be fatal if not detected. So activity levels in children with low platelet counts needs to be restricted. Reya is not the heavy hitter in over-exertion, but she is a normal 4-year old child who is constantly on the move. One of the initial treatments that has proven effective in cases where the body does not produce enough antibodies is a IVIg infusion. The process take 4-10 hours to complete and once it is given, you have to wait 12-14 hours before testing the blood for increased platelet counts. The common side effects are flu-like symptoms. Vital signs are checked every 15 minutes initially, then every 30 minutes up to 1 hour. If the body shows signs of fever, or increased blood pressure the process of administering the infusion is slowed down. Reya had no problems in receiving this treatment. The Dr. did some additional testing to eliminate other key factors. We were told if the counts when up at all, she could go home.

Unfortunately the news was not favorable. Her counts had in fact gone down several thousand. We were told the draws would be done again within 12 hours, resulting in us staying another night. The news in the morning didn't get us any closer to being released, because the counts remained the same. My prospective told me it's not better, and it's not worse, what next? The Attending Physician recommended a second infusion. That was completed about 3pm. So they will do draws at about 3am and then we should have results when the Dr. does his morning rounds. It is not known why patients develop ITP. It occurs in about 1 in 200,000 people. None of the tests or results have provided the medical team with concrete evidence or direction as to why this is happening. My prayer is that platelet count will increase, but also for revelation throughout this process. I pray the Lord will lead, guide and direct the decisions and the orders of the Physicians. That they will be able to routinely determine the origin of this issue. If routine tasks and measures don't produce answers, I pray the Lord will equip them with the awareness and necessary means to figure this out. We are so thankful for the prayers and petitions going up across the world to the Lord on our behalf. Heaven is listening! Thank you for the calls, texts and emails of love and support. We are standing on the word of God, trusting that all things are working together for the good and that in the end we will receive a good report. Stay tuned....