When the smooth ride hits a bump…

T+191

So just when I allowed our family some breathing space, just when I figured we were getting to a place, 6 months post transplant, where we could relax just a little, things changed. I should know how this goes by now!

On Wednesday Herb woke up early and behaved the same as every morning. He didn’t eat much breakfast but seemed fine. He began to complain of a headache and said he felt sick. I gave him some calpol after checking first that he didn’t have a fever, he didn’t. He was sick but said afterwards that he felt good. He spent the day on the sofa playing games as usual on his ipad but we decided not to go to The Hub as he wasn’t quite right.
By 5pm it became apparent that he was definitely under the weather. After many battles with many thermometers, the Braun ear thermometer, a forehead scanner and the GOS faithful tempadot , all of which gave varying temperatures from 36.5 (normal) to 39.4 (definitely NOT normal), we called the JR switchboard with a heavy heart knowing that we were off to hospital for a minimum of 48 hours. Everyone was very sad.

It took some sorting out on the part of one of our lovely community nurses , Laura, to get Herb admitted. First of all he still needs a cubicle, not easy during November. We feared we may get sent to the Horton where he’s not known but thankfully a cubicle on Bellhouse Drayson was found, number 25. I know I should be thankful but cubicle 25 is where Herbie spent his 5th birthday and I dread being there!

Herbie was sick a few times before we set off to the hospital and when we arrived in the car park ( but that was possibly due to Dan’s inability to decide on a parking space!)
He walked into room 25, lay on the bed and just got hotter. Rebecca , the nurse who looked after him on his 5th birthday, looked after him until handover. She asked if we would prefer another free cubicle, number 16, she understood!

Cultures were taken and Pip/TAZ started , iv fluids put up and calpol administered. Dan left to return to the other three children and I settled down for the night. Dr Mannesh reassured me by saying he thought it was likely to be viral and that he didn’t look as bad as he had on previous admissions.

Thursday arrived but sadly no improvement. He felt sick much of the day and complained that his head hurt. He slept, was sick a few times and didn’t eat or drink. The iv fluids stayed up. Victoria (his outreach teacher) came to play a game with him and he brightened on her arrival.

I spent a lot of time thinking during Thursday and Friday. It was all a bit too much like déjà vu. This time last year we were in and out of the JR as Christmas started popping up all around us. I didn’t want to be here again. I had promised all of my children and Dan, a different December , a happier, non hospitalised one.
Friday I had hoped would be the day we were discharged but it was clear from early on that this would not happen. I noticed that odd blotches were appearing over his body, they were not raised or spot like, so I hoped it was just a viral rash.
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He spent the morning laying on my bed watching a Christmas film on the ipad.

Watching a Christmas film
Watching a Christmas film

Amikacin was restarted and the steroids went back up…it all seemed like a backward step and I felt quite disheartened and flat for the first time in a long time.
Andy, the music man, came and asked if he would like to play the instruments , something he loves to do. His reply… “No thank you”.
Victoria came in to cook croissants and he seemed willing at first. When she realised she had forgotten her scales she stepped out to get them. I made a move to get my long awaited cup of tea “don’t go mummy” came a small voice. How could I go after that?
Victoria returned and cooking began but it was clear that Herbie just didn’t feel up to it. Victoria helped him out.

Making croissants with Victoria
Making croissants with Victoria

Making croissants with Victoria
Victoria took the dough off to prove and Herbie fell asleep. He slept for about 4 hours.
Dan arrived and he finally woke up. He seemed brighter straight away and I noticed that he was sitting up properly. Dan took over hospital duty and I returned home , slightly hopeful that we might be close to turning a corner.

Saturday morning came and not unlike our GOS days I waited for the text from Dan containing the news. How was he? Was he afebrile? Did he still have iv fluids? Had he been sick?
Here is our exchange!
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Followed by…

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I couldn’t wait to go and see for myself. When I arrived at the hospital it really was brilliant to see him looking so much better.

By Sunday at 1pm he was discharged home.
It was a rocky couple of days but cultures were negative and it looks likely that it was just a nasty virus.
I feel like I need a huge stash of cotton wool to wrap him up in until Christmas! For now he is home , for that I’m grateful!

Half a year ago…

T+183

6 MONTHS POST TRANSPLANT

I must warn you that I am about to share some photos that you may find difficult to view. I started this blog when we knew Herbie needed an imminent bone marrow transplant but there had been many many difficult times before then. I’m not trying to shock you, this blog was always meant to be a positive and truthful account of our experiences but  in order to celebrate where we are today it’s important to realise how far we have travelled.

A year ago  our happy 4 year old had spent the day lethargic and with a fever.  He wasn’t able to go to school on the  following day…that’s where this BMT journey began.  We had also had other tough times with our boy, meningitis, lung problems and horrible lumps that needed surgery on his neck.

 

Reasons why we celebrate 6 months post transplant
Reasons why we celebrate 6 months post transplant

So today I reflect once again on the tough times that my youngest boy has gone through , since this time last year alone he has endured a lung biopsy and lung wash, 3 surgeries on his neck, insertion of a peg, insertion of a PICC line and then of a double lumen Hickman line. He’s had daily iv’s since December, he’s had more blood tests than I can count, he’s had skin biopsies , numerous X-rays , CT scans, lung function tests, ultra sounds and taken a mountain of drugs.
I know many children endure the same and worse but when you live through it with your own precious child it engulfs you.

However today’s post is actually meant to be a celebration! 6 months ago today that moment happened, Rufus gave his bone marrow to his brother and Herbie, fresh from chemotherapy, began the journey of the reconstruction of his immune system. Yes it’s been a roller coaster ride, yes there have been times when I’ve thought “when will this settle down” “when will we get home” “when will these meds stop” but here we are, still standing, still positive and still moving on.
Herbie found out this week that he is going to be Angel Gabriel in his school nativity! Dr Waseem says he can go back to school full time in the new year and visit before then. We are understandably nervous knowing what a breeding ground for bugs schools are at this time of the year. So he will be in the play if all is well but if it’s too risky they will record him and project him on a screen. I am so grateful to the teachers in Rufus and Herbie’s classes for making this possible. The inclusion has been wonderful.

In other news we are now weaned off of MMF which is great, one immunosuppressant down. On Wednesday, if their is no sign of GVHD returning, we can reduce the steroid (another immune suppressant ) too. Only by 2ml per dose but we are happy that the wean is slow and safe.
Herbie has had a good week. The steroids make him eat loads and he drinks his 1600ml required daily almost exclusively in chocolate milk and orange juice making his calorie intake rather impressive!

Eating bacon butties with Papa after the hub visit this week.& on Children In Need Day (hence the ears!!!)
Eating bacon butties with Papa after the hub visit this week.& on Children In Need Day (hence the ears!!!)

Bloods continue to make comforting reading

HB 14.3
WCC 10.9
Platelets 167
Neutrophils 9.37
Lymphocytes 0.22

Engraftment 100%
Cd4 220

We will keep on to the next appointment in December which will involve more tests and scans but hopefully good news and stopping of the iv!
Thank you to everyone near and far for every little bit of support so far, it means so much to us all xxxxx

Rockets, sparklers and miles of smiles…

T+176

Since we first heard that Herbie was definitely having a Bone Marrow Transplant earlier this year we have worked very hard to stay positive and focused, not just for our own sanity but for Herbie and our other children.  I can’t tell you how often we have been commended by friends, family, nurses, consultants and total strangers for our positive outlook and our strength.  It’s always very lovely & flattering to hear this but I often think ‘what is the alternative?’ And ‘wouldn’t any parent do the same?’

So here we are , 175 days since Rufus donated his cells. It’s often hard to remember our time in Great Ormond Street in much detail,  perhaps we are already pushing it back to allow new and happier memories.  Some days  actual transplant time seems miles away then suddenly something transports you back there in a second.  That was the case this week.

On Wednesday we went back to GOS for Herbie’s outpatient appointment & Lily came too as Waseem wanted to see her as it had been almost a year since her last appointment. Herbie was thrilled that his big sister was coming.  The mood in the car was happy and positive. We talked about the imminent future, Christmas, birthdays etc with a different , more hopeful tone.  I won’t deny that last Christmas was pretty rubbish despite my efforts to keep the spirit alive,  even me, the Christmas queen, lost the Christmas sparkle. The birthday celebrations got cancelled, the family get togethers only saw some of us and this year we have plans to turn what Herbie & I refer to as last years Hard Candy Christmas (there’s some Dolly Parton for everyone right?’) into something a little more soft and squidgy!

We arrived early and walked from our usual parking space , past Russell Square tube station down  to the hustle and bustle of GOS.

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We were met by Hiral and Charlie,  from the BBC crew,  who wanted more footage , especially of Lily,  for the series. Once we arrived in Safari it was the usual drill. Herbie was called in for  weight, height etc whilst Lily went off to film with Hiral & Dan. His BP was rather high but he was so excitable that Waseem wasn’t overly concerned.

As I had been checking in I felt a hand on my arm and it was Vicki, Jack’s mum , who we seem to bump into every appointment now. Looking at the gorgeous Jack it’s hard to believe that I started reading their blog almost a year ago  and  what has happened to us all in that time. It’s funny how people you hardly know seem like old friends, bone marrow transplants do give you a bond with those you share the journey with.

We went into see Waseem.  He looked genuinely pleased to see Lily & Herbie looking so well. It was agreed that Herbie would restart the wean of MMF that was stopped months ago and if that went to plan in two weeks we would drop the steroid (prednisolone ) by another 2ml per dose. The steroid creams were to be used every other day  & in December we would repeat scans etc  and hopefully stop the Micafungin iv. We were more than happy with that plan. Herbie asked again about returning to school and Waseem said he thought he could do a few hours here and there , hopefully be in the Nativity, with a view to proper reintegration in the new year.

Lily  looked well and he was pleased that there had been improvement in her  lung function. He said that for now the BMT was on hold. Music to our ears!  He was very pleased to hear that she did PE had managed no days sick from school, was off on an adventure weekend and had  played a gig on Saturday!

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Both children needed blood taken, for Herbie this is easy using his Hickman but Lily had peripheral bloods taken using a little numbing spray.  Hiral and Charlie were filming  this with a new member of the crew!

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Before we left for home Herbie and I had another job to do.   We returned to Level 5 to Robin and a Fox Wards with cards and magazines for two BMT buddies.

Our BMT buddy Milan,  who  came into transplant about 2 weeks before we did in April this year, is still in his same room in Fox and has been now for nearly 7 months.  I’m sure you will read this and be touched by the thought of this, a young boy, the same age as  Ru, being stuck in isolation and unable to go home post transplant. I can assure you that once you have been in their for ten weeks you feel nothing but admiration and love for these people. His wonderful parents, juggling work, hospital and another child whilst maintaining  positive outlooks and  determination.  We know how tough that is for ten weeks let alone 7 months.  It was great to hug his mum and catch up, although we couldn’t obviously go to see Milan himself. I just wanted his family to know that we think of them.

Just to prove how special they are, they gave Herbie a gift too! Still thinking of others!  Herbie was thrilled when we got to Robin to see Rehka through the window, he shouted at her and suddenly she burst through the door to see him, closely followed by Ella, another of his favourites. It was wonderful to catch up with them and we all had hugs.

Yay! Catching up with  Rehka & Ella
Yay! Catching up with Rehka & Ella

Herbie gave them the card and magazine for Jacob who had his transplant in May like Herbie but has recently returned to GOS following a bout of illness.  We didn’t want to disturb him or his mum as we know things are a bit tough right now but I was thrilled to bump into Lucy, his mum , on the way to the lifts and catch up. Another strong family, juggling work, two other children and being away from home.

Finally, after goodbyes , promises to return to say hi again soon and messages of  support,  we left. Herbie was thrilled with his gift but I knew we were both thrilled about having the luxury of leaving to go home…being back there brought it all back.

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We travelled home and got back in time to run indoors for coats etc for Guy Fawkes /Bonfire night celebrations. I quickly opened the post and was emotional to find this letter confirming guest entry for us all to Camp Bestival 2015!

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Then it was off to Dans parents house for the family fireworks and. Herbie’s first family get together since March. He was thrilled and so were his cousins and friends.

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So after a fun packed day we move forward into the next phase of recovery. Weaning off of more meds,  gradually visiting school and hopefully an immune system that works properly.

our thoughts are still with our BMT friends, Milan, Jacob, Jack  and Erin and their families who are having tougher times.

It just shows how fragile each stage of this process is…

 

Bloods…

HB 15

WCC 9.12

Platelets 166

Neutrophils 8.30

lymphocytes 0.18

 

Oh and if you are feeling a little bah humbug about people getting festive a little early think again, they may have reasons for it that you have no idea about.  Everyone deserves to decide when they want to start feeling Christmassy whether it’s November 1st or Dec 24th. X

Pumpkins, carousels and a little magic!

T+168

We are almost at 6 months post transplant. Just 2 weeks to go. It’s quite amazing that time has gone so quickly! Herbie is also only 33 days away from his 200 days post transplant milestone. So where are we now?

Well this week has been half term. Initially Herbie was disappointed to learn that his outreach teachers wouldn’t be visiting and that we wouldn’t be going to The Hub.
On Thursday he spent an hour at the hub investigating flight and parachutes with Christine.
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Term ended on another brilliant high for him with his teacher, Victoria, taking his finished story about tomato soup into his class at school so that they could hear it. Even more special, Victoria recorded it on the iPad and sent it to us to watch. Herbie was thrilled!
These special times have helped Herbie to feel part of a class that he hasn’t regularly attended for almost a year!

Having the other three home has been lovely but also highlighted our situation at times. Monday was Herbie’s immunoglobulin replacement therapy day and so Dan took him to allow me to take the others out.
Tuesday it was Lily’s turn to go to the JR! Her three month outpatient appointment with the ID team was very positive which was brilliant but another holiday day given up to the hospital.
Finally we had some hospital free days as Wednesday arrived. The problem is that with a community nurse visit at midday, lots of oral meds etc and children enjoying lie ins it’s hard to get out anywhere!

Herbie has remained well since my last blog post. He continues to look rather cushingoid in appearance due to the steroids but we know from Lily that as the steroids reduce his face will become less round and puffy. He has a lot more energy although his ipad and minecraft do take up quite a lot of his day, making him sofa based! His bloods remain quite good with high HB and platelets within range. Lymphocytes are attempting to increase but his immunosuppression will always stop them climbing too high.
Interestingly a wart that he had on the side of his foot prior to transplant, that disappeared after chemo,has recently returned and is huge! We were advised by GOS that this is just due to his immature immune system and not to treat it but I think we will show them on Wednesday as Herbie wants us to treat it.

On the Wednesday of half term the Fab Four headed around to grandma and grandpas to make a guy for the bonfire night celebrations on November 5th. They enjoyed creating the 2014 Guy and Herbie particularly enjoyed the change of scenery! Drinks and chocolate cake for refreshment and a few videos about The Gunpowder Plot (As Herb was intrigued by it all) and then we headed home.

Making guy
Making guy
Watching an informative Bonfire night film.
Watching an informative Bonfire night film.
Guy 2014
Guy 2014

The following day we decided to bite the bullet and take Herbie to the Hallowe’en Howl at Millets Farm. It’s pretty much all outside and we couldn’t go until later when the iv’s were finished anyway so we hoped it would quieter.
We had a lovely time and Herbie loved the freedom.

Pumpkin patch
Pumpkin patch

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He was very excited to get a free ride on the carousel too!
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It was funny how Herbie worried about seeing other children, at one point a child coughed and even though Herb was no where near them he said “let’s go, I think it’s a bit dangerous here!’
His hair continues to come back. Photos always make it seem patchy but you get the idea!
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Hallowe’en 2014 kicked off with a small mummy wondering around the house around 7 am! Herb was so excited that he was ‘up & at ’em’ early. The pumpkins were carved and then with the girls at a birthday party we headed off in the car to ‘trick or treat’ a couple of family and friends.
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Herbie loved it! He also got to see his cousins Otis & Felix, Charlie , Jude, Esta, Issy & Martha which he loved!
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Armed with a bucket of sweeties we headed home and an exhausted but happy little mummy settled down to sleep (and I don’t mean me!!)
Today Herbie got to see two of his cousins, Harry & Lola , and he was in his element! He’s missed getting together with his cousins.

So we still feel we are floating on the millpond. Things are calm for us right now. We had a small reduction of the ciclosporin as his levels were high and we have stopped the potassium supplements (although it’s possible we may need them again in the future).
Our thoughts tonight go out to fellow BMT friends who have been experiencing rougher waters. May their ponds become calm soon.

Signing off until next Wednesday! We go to GOS for an outpatients appointment with Waseem. Lily is coming too.

Bloods this week (for anyone still remotely interested!)

HB 13.9
WCC 9.5
Neutrophils 8.36
Lymphocytes 0.38
Platelets 156