update & visit from Caid

Ginger writes:

“Ian continues to improve, although he is still on the ventilator. He is off dopamine (blood pressure support) and they removed his Foley catheter. He was fairly alert for about an hour when I came in. The nurse told us to ask him to move his foot, and he did it and also blinked when we asked that of him too!”

Caid came to spend some time with his little brother, along with Grammy Wren and Joey

Caid came to spend some time with his little brother, along with Grammy Wren and Joey

I asked how Caid was doing with all of this, and Ginger responded simply:

“After he visited with Ian, he just wanted to hold Henry in a big hug, and I talked to him a little, but he didn’t say much. I thought it was pretty amazing that a seven year old’s reaction is pretty much the same as an adult’s – a new appreciation for things previously taken for granted.”

~cnp

some recent pictures…

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Ginger: Caid wrapping up homework. I will never again underestimate the power of having a dry erase board, it makes spelling practice fun! 

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Ginger: Ian at CHOC waiting for torture, err, I mean, three vaccines and two blood draws.

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~

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Ginger: We come to the park for the sticks and dirt

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colleen: Henry gets a balancing helping hand from great-grandpa Floyd!

a few pictures to brighten your day…

i’d like to start off with the greatest family portrait in the history of the universe…

Family Christmas Photo 2012!

Family Christmas Photo 2012! Thanks Adrea Scheidler, Photography

Caid’s letter to santa on Christmas Eve…

Ginger's caption: "Caid's letter with cookies, milk and a dragon: To Santa Santa, I want you to see this dragon I hope you like it. And I have cookies Love Caid No Bad guys aloud!"

Ginger’s caption: “Caid’s letter with cookies, milk and a dragon: To Santa Santa, I want you to see this dragon I hope you like it. And I have cookies Love Caid No Bad guys aloud!”

Henry being adorable…

Ginger's caption: "Henry went under here and then said 'So cute'!"

Ginger’s caption: “Henry went under here and then said ‘So cute’!”

and finally, a little video i took the evening the family got home from their Christmas visit to AZ…

The twins are unfortunately still experiencing a lot of illness. Ginger will update on all of that soon, but the family could really use prayers for healing. Thank you! Hope everyone had a wonderful new year! ~~cnp

Day +81… new update!

happy, happy to be feeling good!

Ian is continuing to do well after his stay in the hospital a few weeks ago. Thank you all so much, as always, for the love and prayers that brought Ian through.

Ginger writes:

Yesterday we had our weekly checkup/visit at CHOC. Chimerism was tested again, it was 88% last week, and 89% the week before that, so they will continue to watch it.

The good news is that the doctor discontinued more of his medications including Actigall, Fluconazole, and the weekly GCSF injection! (mean mommy had to do that one and it made both Ian and I feel super sad). Now he is only left with two antibiotics, Bactrim on the weekends and Keflex, which is not related to HLH or the BMT.

We also graduated to bi-weekly trips to CHOC!

A few other pictures:

the yogurt facial.

Caid’s first day of first grade!

Most people have noticed how dark Ian’s hair is growing in…it’s a side effect of one of his meds…and it’s not just on his head! We’ve taken to referring to him as a little werewolf. I wish you could get a good look at his sideburns…i’ll try to get a picture of that. ~cnp

Day +57… quick hello, and a few pictures

Ian receives his weekly dressing change from now-expert nurse “Mama” Ginger.

dressing change for the broviac…all done!

Ian is doing very well, his chimerism numbers fell slightly again as of his last appointment, but the doctors aren’t too worried.

As you’ve all probably guessed, things have been extremely busy around here…including, but not limited to, doctor visits, Caid’s summer activities, a kitty who has adopted the family (and Caid has christened “GreyGrey”), and lots of Baby Einstein.

lots of love for Baby Einstein around here.

feeding GreyGrey…because Ginger can’t stand to see a kitty go hungry. unfortunately, Caid is very allergic, and of course, Ian can’t be around animals…so if anyone’s looking for a sweet kitty let us know!

Ginger will update soon. Just wanted everyone to know things are continuing well, and in spite of the daily challenges, we feel extremely blessed. Keep those prayers going, and thank you again for all the love and graciousness you’ve shown… ~~cnp

Day +31…much joy, much need

the first morning home…he got a few bites down before he decided he was “all done”

Ian has been home for a few days now, and it has been very sweet and very challenging.

As Ginger basically put it…in the hospital, once he was a couple weeks out of transplant, he appeared better than all the other kids undergoing BMT…but once he came home, with no nurses, no doctors, and faced with wild brothers and a semi-normal schedule, the fact that he is still a very sick baby became very obvious!

breakfast with the brothers

He is not eating well, and his first doctor’s appt since he came home is tomorrow, where they’ll check on his weight and other areas of his health since he was discharged…so it would be great if he didn’t lose weight…for many reasons.

wild Henry in Caid’s bathrobe

One of the other challenges is the world of difference between him and his brothers right now. He has always been a little more low-key than them in general, but now he’s also weak and sick, and has spent the last 6 weeks hooked to IVs in a single hospital room while his twin brother got to play and run and develop!

It’s not as bad as it was when Ian came home from Phoenix earlier this year, but it makes the day difficult with all 3 little boys in the house, and one of them is immune-compromised, delayed behind his twin, and can’t even go outside! You could keep a second-to-second eye on them and even then Ian will be bumped around at least a little bit…and it doesn’t take much to upset him. He would rather just play with a nice, calm grown-up or watch Baby Einstein!

Baby Einstein…now *this* is Ian’s kind of hang-out

As a result Caid has been uncharacteristically grumpy and contrary the past couple of days…even with some summer activities and two people here. He gets cramped and bored…and it makes for long days and exhausting evenings.

There are many sweet things, of course, such as (when he is not grumpy or over tired) seeing how much Caid cares for Ian. He hugs and kisses him and likes to help give him his medicine at night…which is great because Ian isn’t taking his medicine well and seems to take it better from his big brother than from mom!

helping give Ian his medicine

So, i suppose just prayers and encouragements for these 3 things:

1. That Ian would eat more and swallow his medicine so he will get better and not have to go back to the hospital.

2. That Caid could be more helpful to his mom and that somehow the dynamic with the brothers could improve.

3. Perseverance and grace for Joey and Ginger, and wisdom for those of us helping them.

Also, i would like to mention that tomorrow is Gwennie’s 4th birthday. I am grateful she is in alive God’s perfect care, and that i have a perspective and appreciation of the precious life and children that i otherwise might not have. But here we are in this imperfect world, wrestling with grief and the ache of missing her life and her brightness. i still wake up and it doesn’t seem real. And as much as i still grieve, i think how much more her mom and dad still feel the indescribable loss. So however you feel led to think and pray for these things…i know that no effort is without impact.

Anyway, there i went, on and on!

Thank you all so so much ~~cnp

Day +19…

boo.

Ginger writes:

Ian’s ANC dropped again today down to 608. They gave him a dose of the GCSF to try to boost it back up. The plan is to give him the GCSF three times a week, depending on how the counts look. Hopefully soon his numbers will come up and stay up on their own.

Otherwise, it was a good news day with some big steps forward! First, his pain medication was discontinued, and Ian didn’t mind. They switched his cyclosporine to an oral medication (it was previously IV) and also discontinued his IV fluids during the day. He also no longer needs to be on the continuous monitor for heartrate, respiratory rate and oxygen.

All this means they think he is doing well and these are steps to get him closer to discharge.

Free of tubes and IVs!

In the meantime, during the day he no longer has to be tethered to the IV pole! They still will be giving him fluids for 12 hours overnight and run all his IV medications during that time. He still continues to get more bruises all over, and they gave him more platelets today.

It seems that turning off the IV fluids was a great move (I believe Joey had a hunch about this) because I was able to get Ian to take a couple ounces of water today and a couple ounces of milk tonight.

Caid happy to see his little brother

Today was Caid’s first day of summer break and he came down to see Ian when I switched out with Joey. Ian was extremely happy to see him and gave Caid several hugs and kisses. Everytime I show Caid a picture of Ian that Joey has sent me, he says how much he misses Ian.

Thank you all for your prayers for us!

Day +15, playroom time, and lots of monitoring

Ginger writes:

Ian’s ANC counts have been dropping the last couple of days, yesterday the count was 1539, today it is 910. That is not unusual, there is a drug they give (GCSF – which stands for granulocyte colony-stimulating factor) in the beginning to help engraftment, but they have not been giving it for several days, so it is not unexpected to have the numbers drop.

Bruises and no hair, but still cute!

Private playroom appointment!

The day went by so much faster since we were able to go to the playroom and we are (kinda) eating meals. The oncology playroom has a specially scheduled time during the day that is for the BMT patients only.

This morning I asked for him to receive the anti nausea medication in hopes that it would help with his intake. Ian did well on his lunch today, but not really with his other meals, and I still cannot get him to drink anything. He hasn’t been drinking from a sippy cup or a bottle for several days now. He is scheduled to have a feeding evaluation on Monday, and we may have to do an NG tube (tube placed through his nostril down into his stomach) if we don’t make some improvement. Please pray that he will start drinking, we would like to avoid the NG tube. Right now, he is of course getting IV fluids.

His blood pressure still is an issue, he is on three different medications, multiple times a day to control it. As they taper the cyclosporine and steroids (he is on a lot of steroids right now – 5 mg twice a day, that is 10 mgs a day; before when he was home, he was getting 4 mg per day and we thought that was bad!) it should get better. They can taper the steroids and cyclosporine if he does not have signs of graft vs. host.

Joey and Caid will be coming down tomorrow to visit for a while, Colleen will be babysitting Henry!

Joey took Henry to Caids school yesterday, and the little guy had to run over and give his big brother this hug.

Day +3

3 days out of transplant, and Ian is doing well all things considered. He is obviously feeling sick and nauseated (continuing to get most of his nourishment through IV), but he is a happy, precious little man!

might as well play with them!

Joey’s picture of little napping feet.

Ginger wrote tonight:

“Ian is doing fine, they are watching him closely. He has several things they are monitoring right now, among them a mild rash, which at this point is probably from medications, since it is still too early for graft vs. host. He also has had high blood pressure for a few days, probably also due to medications that he is taking, so they started a medication today to treat the hypertension. Tonight he slept well for about a half hour and then awoke seemingly in pain since it was hard to console him, and he was acting tired at the same time, so they gave him some pain medication to help. Otherwise he was happy and active during the day, and very bored being stuck in the room unable to leave. All in all, a very good problem to have. Caid returned to school today, we are so proud of him.”

When i (colleen) got to the house this evening, i heard Caid greet me from the dinner table (he knows the sound of my keys, he says). The very first thing he did as i came around the corner to the dining room was ask if i wanted to see where he had his surgery…to which i gave an enthusiastic “yeah i do!”. He turned around, pulled up his shirt, and let me look at the base of his back where he was still bandaged. You know how sometimes you just want to engulf a child in your affection and pride you have for them? Well that was one of those times.

Joey then regaled Caid with the story of his amazing, abundant bone marrow, and how the doctors were to amazed and glad to have been able to get so much from one little boy. “In fact,” Joey said, “the doctor said he decided to take a little bit extra, just in case they needed more for Ian later. And they froze it.” Caid raised his eyebrows and grinned in surprise. “Whoa!” he said, “that’s cool.”

He finished his vegetables and had a piece of carrot cake, brought to the family home-made and warm from our good friend Celena (thank you!). Then played chase and batted the balloon with Henry until it was bedtime.

Kissing the baby brother, fresh from the bath.

More updates as they come. As Ginger said in her last post, please be praying for Ian in these very crucial days and weeks ahead…thank you all! ~~cnp

Transplant Day +1

what a kid.

Ginger writes:

Caid is doing really well. His pain is very minimal and he is happy, just a little pale. They checked his hemoglobin and hematocrit before discharge and they were good numbers, so he did not need any transfusions, thankfully!

Ian is doing well too, he is on IV nutrition now since he has basically not eaten in a few days, but that is very common with bone marrow transplant. The next few weeks he is the most vunerable, since his blood counts will continue to drop and‎…it takes time for Caid’s stem cells to start working.

Transplant Day +1!

Ian will be most vunerable to infections, bleeding, mucositis, veno-occlusive disease and other complications in this time. Then once engraftment starts happening, which is Caid’s cells starting to work, they will be watching him for graft vs host disease, which is Caid’s immune system attacking Ian’s body/cells of all kinds because it recognizes Ian’s cells as foreign. This complication is minimized because they are siblings, and because they are both young.

Please continue to pray for Ian, because the next few weeks are really the most dangerous for him.