whirlwind week...

October 27, 2010 

It has been a week since we weren’t sure about the future of our baby girl.  She has come a long way from then and has continued to be the little miracle baby.  This week has been a blur to us, but throughout each part, we can feel the presence of our mighty God.  We have had many times of sorrow and grief and just waiting for the next moment.  That is when He has sent us friends to hug us and love on us and sent family to comfort us and to help us sit through the long hours of waiting.  We have felt the many hundreds and thousands of prayers sent up for our dear lil’ Jo.  We are still unsure of the future, but God has preserved this little ladies life and I am sure He has been rejoicing by the amount of intercession that is being done on her behalf and on our behalf.  Thank you!

So how is Josie doing?  She is one tough cookie!  We posted on the wall that she was able to get her breathing tube out on Monday and was given a little air cannon that fit in her nose for extra oxygen.  Then on Tuesday they stopped the oxygen because she was doing everything on her own.  They decided to stop the oxygen in the midst of the Tornado warnings – it helped to not have one more thing to worry about as she was being moved back and forth from her room to the hallway.  Oh, what chaos! 

On Tuesday they removed her arterial line, an IV line and her catheter (too much information? – she’ll be so embarrassed later on in life when she reads these!).  She still has her central line in her right shoulder area and will continue to have this line for medicine administration.  They started her feeding tube feeds on Thursday or Friday night (time runs together when you are at the hospital) and she is up to full feeds and handling them well.  Many of you knew she had severe reflux problems at home and starting her feeds up made us a little nervous that she would begin to reflux again.  So far that has not been the case – Praise God! 

Today was a busy morning – the doctors and therapist all seemed to come in a steady stream.  They included: Neurosurgeon and his PA, Neurologist, Physical Therapist, Occupational Therapist, Speech Therapist and then to top it all off, she ended up having an EEG.  She was a tuckered out little girl!  The best part of those visits was the Speech Therapist – she started messing with Josie’s mouth – of which she didn’t like one bit at first.  Then she calmed down and actually seemed to enjoy being messed with for once.  The last thing the Speech Therapist did was to try a pacifier AND JOSIE TOOK IT!  We were so amazed!  We haven’t been able to give her a pacifier since August because her gag reflex had become highly sensitive.  I have now given it to her several times today and she keeps taking it – amazing!

As I write this, Josie just had another seizure – not sure if it was the busy day or the nurse was given the go ahead to turn her more on her right side (the side where the tumor is) than she has been and if that jump started something in her brain.  Not sure we’ll know the answer to that one, but it is what it is – poor kiddo!  Not an easy thing to watch.

Josie’s case goes to the tumor board on Friday and from there we will hopefully find out more of what is to come.  We know that they cannot do anything until she is more healed and that is at least another week away (usually 2 weeks post-op).  This tumor is aggressive, so they can’t leave it alone for too long, but she has to be stronger before any other procedure. 

We are feeling the weariness of this week – we are both tired.  Pray for Josie, pray for us, pray for our girls, who are being shuffled around a bit. 

Blessings and good night,

Darcia & Marc

Post-Surgery Update

October 23, 2010  Post-Surgery Update (this will be a long post and somewhat detailed, so if you get queasy, it may be hard to read)

It’s hard to know where to begin – we have lots of information that we would like to share.

Let’s start with the day before her surgery.  Josie was in the hospital the day prior for a procedure called embolization.  Embolization is a process by which they take a micro fiber catheter and feed it to the specific artery that they want to “block” the blood flow.  The doctor that did the procedure was able to find a large artery that was feeding the tumor and was able to block it off.  Basically, this was a successful procedure.  The hope was that when Josie went to surgery, there would be less bleeding because this artery was blocked.

The day of surgery:  Josie went to an MRI first thing prior to surgery.  This was to help them during the surgery so they could tell from the images where they were and what was tumor and what was brain.  Later we were informed that the tumor had doubled in size since the last MRI, which was a little less than 4 weeks ago.  This made the tumor the same size again as when they first found it right after birth.  It is an extremely aggressive tumor.

Everything was going well during Josie’s surgery; every update seemed to be a fairly positive report.  One of the last updates, they said that she had a little bleeding, but they had gotten it under control and were continuing.  Then we were told that she was out of surgery – that she was fine and to wait in a little conference room for the doctor.  We thought it was odd that we got a conference room when most people were told right in the waiting room how things went for whomever they were waiting for.   But since they told us that she was fine, we did not anticipate what the doctor came in to tell us.  He sat down and looked weary and then told us that things did not go so well.  Josie started bleeding, they would get it under control and then she would start bleeding from somewhere else, they would get that one under control, but then she started bleeding from places they weren’t even touching.  She received 3 volumes of blood and then her body stopped coagulating (wouldn’t clot).  She was in serious condition.  They ended up leaving some cotton balls soaked with a clotting medicine inside and then closed up her head.  We were obviously devastated.  In fact the doctor was even shaken by the way things turned out since they had gone so well for the first 4 hours. 

They took Josie up to the PICU, where they worked for 1.5-2 hours trying to stabilize her, of which they were able to do.  Praise God.

Thursday morning:  Josie had another CT scan and then we talked with the doctor.  He was surprised that she was holding her own – said he thought maybe she was stronger than he gave her credit for.  The CT scan didn’t show any worse than right after surgery.  Josie even opened her eyes and looked at the doctor.  Earlier, she had moved her legs enough to kick her little blanket off.  The rest of the day she was pretty quiet – which is a good thing.

Thursday night:  Josie started having seizures again – not to be unexpected due to her trauma.  They are currently still trying to get these under control with meds. 

Friday morning:  Josie went for another MRI – this is for post-operative imaging.  During the MRI, the neurosurgeon came by to talk to Marc and me.  The news was quite sickening.  The part of the tumor that had grown back was checked by pathology and the new tissue is malignant.  The type of tumor she had at first, an astrocytoma can have multiple cell mutations in it.  When pathology checked it the first time, there were not indicators of malignant cells, but the part that was left in her brain from the first surgery must have either had those cells in it or they mutated since, which is a possibility.  

The first steps are to get Josie better from surgery, which at this point, she seems to be doing okay, although this morning they found that she has a urinary tract infection from her catheter.  They are on it though and are giving her antibiotics.  Stopping the seizures is another step they need to get under control. 

Next step…the doctors (neurosurgeon and the oncologist) are creating a plan for her.  At this point, they are planning on a new chemotherapy drug – used in infants.  Then they will develop a further plan from that stage. 

So…we wait and we pray.  This will be a long haul for our sweet baby Josie.  Not sure of the future, but glad that she is resting peacefully here in the hospital and also in the loving arms of Jesus.  My emotions have been pretty raw, but for the most part Marc and I are working through this moment by moment.  The girls (Reese & Eliza) are doing well; they are at Nana & Papa’s this weekend and having a great time I am sure.  Pray for them as they are going to get shuffled around a bit for a while. 

Thank you to all who have been and continue to pray for Josie – she needs it.  Thank you to all of our family and dear friends that have surrounded us – we need it.

Blessings,

Marc & Darcia

Next Surgery Date

September 30, 2010  Next Surgery

We received the call yesterday for Josie’s surgery date.  She will be going in to the hospital on October 19 for a procedure called embolization.  This procedure will be done to block the veins that are running to the tumor so that when they do the operation the hope is that she will not bleed like she did during the first surgery.  The actual surgery will take place the following day on October 20^th.  The same doctor will be performing the surgery and we are more than confident in his abilities.

We are now in the process of figuring out how everything will work during that timeframe for the rest of the family since the girls are both now in school.  My mom is coming to help some of the time and we will work out the rest of the logistics as we know more. 

We continue to covet your prayers…we know God is at work in this beautiful little lady!

Blessings,

Darcia & Marc

Tumor is growing...

September 24, 2010  growing…

It is with a heavy heart that I post an update for Josie.  This past Thursday, Josie had another MRI to check on the remaining portion of her tumor.  Unfortunately, her doctor told us that it is growing once again.  L  We were quite shocked to say the least.  My thoughts going into this check-up were that the tumor was either the same as the last time or my hope was that it would be smaller and going away.  I quickly remembered the nauseas feeling I had when we were first told that she had a brain tumor right after her birth, because I was once again feeling nauseated.  We were shown the images of her tumor and the doctor compared the before pictures and the after pictures.  I couldn’t believe what he was saying, yet I knew he was telling us the truth. 

Because the tumor is growing, Josie will be going in for her 3^rd brain surgery (her biopsy was an actual surgery) in 2-3 weeks from this post.  A date has not been set as our doctor wants to have the other pediatric brain surgeon in Josie’s surgery with him and that doctor is not back until next week to make the appointment. 

The doctor took Josie’s case to the “Tumor Board”, which is held every Friday.  This Tumor Board is made up of 30-40 doctors/PA’s and other specialists that make decisions on tough cases within the hospital.  They all agreed that this is the route that needs to be taken for Josie’s tumor. 

As for our other concern, her feeding tube, it has now become a lesser inconvenience in light of what she is up against.  She is still having reflux multiple times a day (went through 4 outfits today) and sometimes it really hurts her and other times, we don’t even realize she has something coming out of her mouth.  We did have an ultrasound of her stomach and everything is in working order according to that screening.  The doctor (neurodevelopment) has started Josie on a new medicine, but it doesn’t seem to be helping…yet.  

The one thing that we must do is to keep Josie healthy.  She has to be “sick free” in order to have the surgery.  We will now need to keep Josie home as much as possible.  This will be difficult, especially with kids in school now and germs are everywhere.  We have noticed that she is pulling at one ear and that is a concern as to whether or not she has an ear infection.  I will be calling her pediatrician on Monday if it continues. 

Tonight I am struggling with letting my baby go through this whole ordeal again, yet knowing that she must undergo it for healing to take place.  There is that fear of the unknown and what will happen during this surgery.  As I was praying over her tonight while I rocked her to sleep, I had to fight the urge to grasp at the situation and try and control it (which I can’t very well do anyway), or open my hands and give it to God.  I think a few of my fingers were pretty reluctant to let go.  My heart is still sad and grieving, but my heart and Josie are in a safer place – God’s hand.

Please pray with us as this rollercoaster starts up all over again.

Blessings,

Marc & Darcia

New Doctor

9/2/10 New Doctor

Amazing - it is September - in some ways life has zoomed by and in other ways, it feels like we have had the longest summer ever. Somehow things don't balance out though!

It has been quite some time since we last updated everyone on Josie and I have promised to write today - despite a cranky baby this morning. :)

Just a clarification and a little bit of surprise, the rash on her head ended up not being what I thought it was in the last posting. The doctor called (a week after I should have received the results) and said "by the way, the rash actually was a staff infection - good thing we put her on the antibiotics." The only problem - we hadn't started her on the antibiotics because we had made the decision to not give her the medicine if she didn't really need it and we assumed we would hear back from the doctors office as soon as the results were back - not a week later. I talked to them about that "slip" and they were extremely apologetic and were going to look into the situation. So, we did end up giving her the antibiotics and her infection has now cleared up and gone away.

The last few weeks since the MRI posting have been relatively quiet, mostly doctor appointments and a couple of unexpected feeding tube checks. The first tube check happened because Josie got a hold of her tube and pulled it out about an inch and a half and the second tube check happened because her feet got stuck on the medicine port portion of her tube and pulled it out again about the same amount, so with that one we weren't worried about taking her in for a check, until we noticed medicine in her spit-up the next morning, so in we went AGAIN. You know it's bad when the radiology tech knows you by name and laughs when he sees you come through the door. Each time she was checked, the tube was still placed in the intestine, not as far as it had been initially, but doing what it is supposed to be doing. I always feel like the over-anxious parent after these visits, but the radiologist tech assures me each time that I did the right thing by bringing her in.

Needless to say, the feeding tube has been the most frustrating thing with Josie. Not just the fact that it can easily be pulled out and that she has tape plastered to her face all the time, but it is an inconvenience to carry the pack around too. The main frustration though is that Josie has really bad reflux which could possibly be a side effect of the tube, although we have been told by several doctors and specialist that it probably isn't. A lot of babies have reflux, but in Josie's case, her feeding tube bypasses her stomach and goes right into her intestine, so she has nothing but saliva and stomach acid that comes out when she refluxes. (hopefully that is not too detailed for some of you)

We had been trying her on a pacifier and the bottle throughout the day in order to get her used to sucking. She started sucking really well on the pacifier (never on the bottle), but inevitably about 10 minutes later, she would gag and reflux because she swallowed to much spit while sucking on the pacifier. We still thought it was progress, but then last weekend, she started gagging almost immediately when we would put the pacifier in her mouth. We have been told by the doctor to stop trying with the pacifier and bottle for the time being so that she does not develop an even worse aversion to them and until the reflux issue is solved. As the saying goes, "1 step forward, 2 steps back".

We met with a new doctor yesterday - she is a neuro-development doctor. One of her specialties is working with the feeding process - she will now be the doctor heading up the management and direction of the feeding tube as well as her reflux/gagging issues. YEAH! We are so thankful - this has been one of those things that had been dropped as to who would manage her feeding issues, so a real answer to our prayers. This doctor will also follow all of the other developmental areas too for Josie - another praise!

The doctor is quite concerned about the reflux issue and wants to resolve that before we do anything else. She has ordered an ultrasound of Josie's stomach and esophagus to start the process for determining why she has it so bad. I am waiting for the call today to schedule a time for the ultrasound. Once we find out what needs to happen and start the process (whatever it may be), then we can start up on the sucking and swallowing process. The doctor also started us on a new formula for Josie that is partially broken down already since she is missing that digestion process by her tube going directly to her intestine. This change could also help with her reflux – not sure how that happens, but the doctor said it could calm it down. I must say – formula is already not a pleasant thing to smell, but this new formula smells disgusting – don’t know how babies handle that stuff! If it does the trick though, we are all for it!

Finally, some basic stats of what Josie is doing and how she is growing – she is now officially a 10 pounder and filling out beautifully – little rolls and everything. She is now smiling and cooing quite often. She has a beautiful smile (biased I’m sure!). As far as her development, there has been some concern that her left side might be affected since her tumor was on her right side and actually replaced some of her brain on that side, but so far she is moving all limbs equally and both eyes track together all the time. In fact we were very excited the other day because she grabbed one of the toy butterflies on her bouncy seat with her left hand and she was holding on pretty tightly. It was a great assurance that the left arm/hand is working just as well as the right. She truly is a miracle baby!

We continue to be on our knees for our little Josie and know that God has great things for her. She has already taught us so much about ourselves and about the great God that we serve in the past 8 weeks. We could not and would not be in the place that we are without trust in the almighty One as well as the through the great support of people that He has brought alongside us.

I have already seen such miracles in Josie and look forward to seeing more and more!

Blessings,
Marc & Darcia

MRI Update

8/19/10 MRI Update

On Monday Josie had her MRI - all went well. They ended up sedating her which meant she needed an IV and a breathing tube. I was taken a little off-guard when they said she would need a breathing tube. They wanted to safeguard her airway while under sedation and also the fact that she would be far away in the tube if something did happen. We were fine with that scenario once it was explained, but also concerned because the last time she had the breathing tube removed, she had "strider", which is what makes her voice sound scratchy. She did just fine though and only had a little scratchiness right after it came out and then it cleared up.

The appointment with the Neurosurgeon went very well. The MRI showed that Josie's brain which was squished over to the left by the tumor was now back to the center. Very good sign! As for the tumor growth, the doctor did not believe it to be growing. The tumor did look different, but he said it is probably folding in on itself because he took the center out in the first surgery. He was very pleased with her progress and how well she is healing. YEAH! Josie has another MRI in one month. Not sure if this will be a monthly process, but the doctor would like to watch this tumor carefully and if possible, get her to 6 months old before the next surgery. We are very pleased with this report.

As for other updates, we are in the process of getting another specialist involved in Josie's care. No one was really "in-charge" of her feeding tube, so now we will be meeting with a GI doctor or specialist that will direct what happens with her feedings and reflux issues. To this point, these 2 things have been the items that have caused us the most concern, so we are glad to have someone stepping in to help Josie.

The rash has pretty much dried up and our conclusion is that she has normal baby "cradle cap" and due to the steroids in her system, they flared up into the rash instead of showing up as just dry scaly scalp. That is not an official prognosis, but it seems to fit with everything that we have been told.

It has been really nice the last couple of days - we are actually home without any appointments - maybe this is a a glimpse at the "new" normal.

Blessings to all...
Darcia & Marc

MRI scheduled

8/15/10 MRI

We have had a pretty "normal" week of doctor appointments and life at home. We had one unexpected trip to the Pediatric clinic on Thursday (which she had an appointment for Friday already and we went to that one too!). Josie broke out in a rash all over her little head the day after she got her new feeding tube. We watched it and let the doctor office know about it early in the week, but then the rash started getting worse and sores started popping up under the tape holding her feeding tube. The tape was right by her eyes, so her eyes also got infected. On Wednesday afternoon we called again and they wanted us to bring her right in Thursday morning. They tested for bacterial and viral infections and so far nothing has been confirmed about what the rash is on her head. After 2 baths, the spots have somewhat cleared up and dried, but her little head looks pretty yucky.

Tomorrow (Monday, August 16) we take Josie in for an MRI. This will be her 1 month image following her brain surgery. This will be a long appointment - approximately 1pm-5pm. Josie will be put under with general anesthesia because she has to hold absolutely still for the scan.

Keep us in prayer - we will meet with her neuro-surgeon on Tuesday to go over the results.

We have been so well supported by everyone - thank you for all the help, we have needed it and appreciate it more than you'll ever know.

Blessings,
Darcia & Marc