Baby

BABY!!

We have waited to post our news that we are expecting another baby for a couple reasons;  One, it has taken us a bit of time to get through the shock factor.  Two, we wanted to wait until we passed the first trimester and knew the baby's gender.  So here it is:  We are having a little BOY--due August 18th.

Many of our friends and family have had asked about the probability of this baby having SCID, etc.

Of course we are nervous, but even more so we are thankful and excited.  Gender does not matter, regardless it is a 75% chance the baby will not have SCID.  It is also a 25% chance the baby could be a possible match for Alice if ever the need arises.  Of course it would only matter if the baby is healthy as far as being able to donate.  We plan to save the cord blood no matter what.

We met with a Maternal Fetal Medicine specialist and discussed all our options with testing the baby before birth.  This can be done through the amniotic fluid, but should be done before 23 weeks or after 37 weeks because of the risk of triggering labor.  We chose to wait until the baby was considered full term at 37 weeks and even more likely will wait until after he is born, which is of course the safest route.  If we do not know the baby's health status at the time of delivery, we will deliver at the University of Utah and baby will go into isolation until preliminary results are available...approx. 2 days for results.

We hope and pray that this little one will be healthy, of course.

I was telling a friend the other day that I remember praying "before children days" that when I do have children--that they would just be smart kids....hmmm!  Why not healthy-didn't cross my mind.  Anyway it's silly sometimes how we view our futures before they unfold.

We appreciate all the love and support we have received in regards to this new step in our lives.  We know it is a big thing, and we are thankful that it feels right.

Lisy

**Alice has already named the Baby---he will be called "Kipper Snacks".  It has taken her a little while to accept the fact that Kipper Snacks will be his fun playful name...we haven't yet decided on a 'real' name.

The Tooth Fairy and a Tiny Buckle Fracture

Lost Tooth, May 17 (Saturday)

WOW!  This is one proud girl, she lost her first tooth.  She was so excited that she wanted to call everybody she knew to tell them of her lost tooth.  It won't be long before a second one comes out.  Alice carefully placed it under her pillow, and unfortunately the tooth fairy forgot about her tooth, but she managed to come later in the day while Alice was busy playing.

Clinic, May 19 (Monday)

Tyler had taken Alice to clinic today for the normal routine check, she received an infusion of Pentamidine (preventative antibiotic) which she receives monthly.  All went well and her counts are great.  She will not return for two weeks, we anticipate the next visit to shed more light on her hemolysis situation.  A few days after clinic the NP called and informed us that Alice no longer requires Amlodipine (blood pressure med).  The is another step closer to where we want to be.  So, currently she is only taking 6 oral medications and zero regular IV infusions.  It's hard to believe things have become more simple.  When I think of where she was a couple months ago it makes my stomach churn, and I find it hard to imagine the amount of work it was....phew, so glad we are past that!

Counts:

ANC 3200

Hemoglobin 12.4

Platelets 143

Buckle Fracture, May 20 (Tuesday)

Just a regular day jumping on the trampoline, nothing outrageous but somehow Alice landed funny on her leg after leaping over a small stream of water that was dripping from the trampoline mat.  When she came in she was crying as if something was wrong, but she quickly calmed down and took a nap.  We thought nothing of it. Once she woke from her nap she continued to complain of the pain.  She did not want to walk on her leg, we iced it and elevated it for the evening and decided that if it still hurts by morning we would take her in.  Tyler and I spent the night taking turns gently rubbing and icing her leg, pain killers didn't seem to help.  Finally by 6 a.m. she was spent and we took her to the American Fork E.R.  They took some x-rays and stated that she had a very small buckle fracture on her Tibia (left).

For the next three days she wore a temporary cast for support.  She watched plenty of movies with her leg iced and elevated.  We saw the Orthopedic doctor on Friday, they could hardly see anything on the x-ray.  Because of her fragile condition, the doctor decided to hard cast it, better safe than sorry.  Likely she will be transferred to a boot by our next visit and will only need to wear that for a short period of time.

Waiting in the E.R. for the x-ray results

A nice new wrap

Home with baby carrots and a movie

This is a picture of the computer screen...it's hard to see but there is very little evidence of a broken bone.  The supposed fracture is mid calf on her left Tibia.

Just above the knee
I wanted to take a picture of this, it's very interesting.  The lines on Alice's bones, near the joints or growth plates look like tree rings, this is called facial growth arrest.  As explained to me by the Orthopedic doctor, when the body experiences great trauma it stops growing and uses all it's energy to survive.  Each line or ring indicates a time when Alice's body was experiencing great difficulty and wasn't growing.  Sadly, it is also considered lost growth, the bones will not make up for that lost growth.  She is very short for her age, and this is partly why.  Another side effect of chronic illness/transplant.

Her ankle.

Off with the temporary.

New pink hard cast with a walking shoe.

Talent Show, May 22 (Thursday)

Natalie begged to be in the school talent show.  We actually made the sign up deadline, the last day of course, but we made it.  I was totally impressed with myself that I actually made a deadline of any sort.  Natalie chose to do some of her favorite magic tricks for the talent show.  She practiced hard and did a fantastic job.  She didn't seem nervous at all.  We are realizing that she has a passion for acting.  Maybe it's time to enroll her in a play or something.  I won't post the video of the talent show because it's too shaky, Evie was all over my lap while I was trying to film.  Also Matthew's class did a dance, it was so cute and Matthew did great.

So Cute!

Little magician in training.

Keeping up with Matthew and Blair

Matthew has been working hard to become a better baseball player.  His coach has given him some great opportunities to pitch,  and Matthew is becoming more confident at the plate.  Tyler truly enjoys his time playing ball with Matthew, and Blair when he feels like joining them.

On deck ready to bat.

Blair asks me at least 15 times a day to play chess with him....in fact anyone who walks through the door is invited to play chess with Blair.  He loves it, and is becoming quite the player.  He has yet to beat me though.  It won't be long and he will be the president of the Chess club, we need to find a club first. :)

Blair and Tanner in a heated chess game.

Evie at the dentist.  Alice was concerned for her so she grabbed Evie's hand to provide her some comfort.

Memorial Day

Grandpa and Grandma Duncan (Lisy's Grandparents)

Bunkers came from Colorado, they have three little boys buried just across the lane from Grandma and Grandpa Duncan.  (Lisy's nephew's)

Sending boats down the creek by Grandmother's house.

Evie is determined to never look at the camera.  Those who know Evie know that she doesn't give in easily.

Blair, Landon, Kymball, Matthew

Injured Pals...Aunt JessIKA.

Alike?

Switching Blood Types?

I wondered after the last time that I posted, if I may be eating my words.  I mentioned that things were seemingly quiet around here and I was feeling lost and directionless.  It didn't take long, we decided to spice it up, and keep things crazy.  I've included plenty of pictures of our adventures and will give a more current update on Alice.

Tyler and I were overwhelmed and confused to learn of Alice's new warm antibody development and hemolysis which presented itself about two weeks ago.  Since we have discussed with her doctors what that really means...the latest is:  Alice's doctors feel it could be related to the fact that her body is trying to switch to her donor's blood type (A+).  This process typically happens a few months post transplant. The most challenging blood type to switch to is (A).  Alice is trying to switch from (O+) to (A+).  This is a difficult switch.  Apparently blood types (A) have more antigens and make the process tricky. Currently Alice is mixed blood, but mostly (A+).

According to the bone marrow team this is likely the explanation and the process can take anywhere from 3 months to 12 months to complete.  Does this require her to receive blood transfusions in the meantime...we don't know.  In few cases the process is very difficult and aggressive medications and intervention are required.

The good news is, this past week in clinic her counts were awesome.  In fact we were all surprised how good they were.  Aside from her good counts, she showed something promising with her ability to produce red cells.  When the body is hemolyzing red blood cells the marrow is required to work harder to keep up with the demand.  Two weeks ago her red blood cell production number was 7.25%.  This is high.  This week in clinic it had dropped to 2.13% and her hemoglobin was still good at 13.7.  A normal production rate is .5%-1.5%.  We were very happy about this.  Basically this means she wasn't hemolyzing as much, however, the blood transfusion she received of type O+ could be acting as a bandaid and making it all look good.  I won't go into more detail regarding this...it's complicated.  We just hope the explanation of her switching blood types is it, and that it goes smoothly.

May 12th Counts:

ANC 2500

Hemoglobin 13.7

Platelets 126

Some other big improvements have occurred with Alice.  More medications have been removed.  She requires Amlodopine (blood pressure med) only once a day now.  Her blood pressure was 92/55.  Her best yet!  Reglan (stomach stimulation med) was stopped.  And most excitedly she is completely off all nightly fluids.  It has been 8 months of consistant nightly nutrition/fluids, this is huge for us.  More sleep for Tyler and I, and Alice too.  Technically it has been 2 1/2 years of nightly fluids...since her first transplant...to be exact.  It's hard for us to remember when one transplant process ended and another started.

The next few months will indicate in more depth what Alice's body is truly experiencing, and we will keep an update.

Natalie's ear and cough was doing well, until last week her symptoms returned and we have put her back on antibiotics and some additional ear drops.  She has been stable from a seizure standpoint.  In a week's time she will start to feel good again.  Recently we informed Natalie that we have enrolled her into a summer school program.  She is not happy about it, but we know it is necessary.

Natalie has a strong competitive personality, she is highly motivated when she puts her mind to something.  We know that these attributes will benefit her greatly.  She will be a stronger and better person because of her struggles both physically and intellectually.  Much work ahead!!

Lisy

Alice's hair is long enough for a pony tail.

Evie wanted me to take a picture of her pony tail too.

On Saturday (May 3rd) Blair decided to test out how fast his bike could go.  From eye witness Matthew he apparently was speeding at least 30 mph and caught plenty of air over the curb.  The neighbors were doing some yard work and thankfully came to his aid.  He was bruised and scraped pretty good.  Needed 4 stitches in his eyebrow and seven in his arm.  We are so glad it wasn't worse. 

Natalie and Matthew wanted to come support Blair in the E.R.

A very nervous smile.

Blair tried really hard to talk the doctor into letting him have a butterfly bandaid. hmmm...
So sorry for the graphic photo.

All better and ready to go.  

May 4th

 I definitely need to explain what is going on in this picture.  Most importantly I strongly advise all those who wear contacts to carefully rinse hands after using household cleaner and before inserting contact lenses.  I thought I had rinsed my hands enough after using a Clorox wipe, but didn't.

I had my contact in for six hours before I finally pulled it out.  Some Clorox residue was trapped under my contact lens and gradually over a six hour period it burned away the outer layer of my eye.  I noticed my vision was blurring more each hour, however it wasn't particularly painful until finally I removed the contact and my eye immediately began to burn.  It was excruciating pain.  The nerves were now exposed with the contact lens removed.  We are grateful for an awesome Ophthalmologist.  After some antibiotic eye drops, eye cream/ointment, and a few days my eye improved.  The intense pain was only a couple days, thankfully...the rest is mostly healed. 

I'm not sure why I let myself post this picture....so beautiful!  I wasn't about to wear make-up on one eye.  It's worth posting, if it prevents someone from making the same ridiculous mistake.

Alice discovered Angle Food Cake!  She loves it.  She calls it a giant donut.  We had to monitor her Angle Food Cake intake, after she ate two pieces at a time.

 Natalie loves to put on puppet shows for Family Night.  She does a great job.  Alice and Evie are her best fans.

Silly Boys!

Matthew's second grade field trip to the pioneer museum...he was so happy that I agreed to go, he stayed up late packing his lunch and mine.  Later when we came home I asked him what was his favorite part of the field trip; he said, "It was being with you".  I know he loved having me there, even though he was too embarrassed to hold my hand in front of his friends. 

Meet Anna and Elsa!

Just waiting for dinner.

The kids found a snake after their piano recital, perhaps a perfect ending to a great performance.

Update

Alice's transfusion went well. She looks more pink and healthy with the additional blood. We did not get results back from the previous blood draws on Monday. They will be in sometime next week. Once we know of the results we will post an update.

Tyler

I didn't see that coming.

Before heading up to clinic today I had thought perhaps Alice would be in need of more blood. She had complained of headaches and looked pale a couple days previous. Driving there she showed the usual excitement of going to the hospital. The possibility of her needing more blood didn't bother me so much as its been close to a month since she's needed it. The more healthy she gets the longer the stretch between transfusions. After her usual blood draws came back there was good news as well as anticipated news. The good news was Alice's ANC was at 2.3. The anticipated news was that her Hemo had dropped to 8.1. Usually that number is just above the threshold for a transfusion, but since she looked to be on a downward trend the doctors wanted to "top her off" just in case. "No problem," I thought. I had prepared for it anyway. So the orders were made and sent to find a match for transfusion. While we waited Alice played games with some of the toys, and I read. Alice's blood is a tricky match so when an hour passed by I didn't notice. However, when the third hour expired I started to wonder. Then the nurse came in and relayed news that left me picking myself up off the floor.

"We can't find a match for Alice because they've found "warm antibodies" again in Alice's blood. We need to reschedule Alice to come up Wednesday for a transfusion. We need more time to find a match." 

I could muster no more than a, "huh?" The antibody issue should have been solved through chemo. Granted, it is possible that these antibodies are new and therefore are from her donor. Then again they could still be from her body previous to transplant. Either way its news not anticipated and therefore deflated me for the rest of the day. Going back to the hospital so soon shouldn't bother me, but this time it does. Its because the worries I thought had flown to a faraway place returned, and they now will be an constant companion until we understand why the antibodies continue to be a problem for Alice. We will know more Weds. The drive home was long and the thoughts I had were not the ones I  had anticipated. 

Once again, we wan't to say thank you to all of you who continue to lift us up with your words of encouragement. It helps so much.

The footage below is of the new entry to Primary Children's Hospital. I think they did a great job. We are excited for when it is complete, they're coming down the home stretch.

Tyler

Good Week Off!

This past Monday came and left...it seemed strange not to spend the day at the hospital.  I continued telling Tyler that it felt like I was forgetting something.  Alice continued to ask, "When do I go to the hospital?"

So far so good.  She is doing awesome.  I can't even remember the last time she vomited.  Surely its
 been at least a couple weeks.  She eats like the rest of the kids.  I can't even describe the difference it has been for us. I will be honest and admit that I have struggled to find a direction lately.  I spin circles because I feel like I don't have an agenda of my own and now I find that gap between having to be somewhere and do so much for Alice...and not having to be somewhere and do so much for Alice hard to bridge.  Of course none of these feelings are new to us, it's a constant cycle we experience, you would think we would have mastered it by now.  Having a routine, not having a routine, having a routine, not having a routine...it's tricky.  I continue to say "I", but I believe these are Tyler's words too.

We would like to think that we are on our way to recovery and the hospital life will become less frequent. We know however, we are far from being in the clear, even a days time can tell another story.  With that said we continue to place two feet in different locations.  We feel worried to leap them both in front of us only to learn that we will fall back again; yet the excitement of moving forward is incredible, but still comes with a bit of difficulty and adjustment.  It seems silly, quite silly actually; however, the concept of changing a style of life, regardless of  it's style; is awkward and does not come without adjustments.

Anyway, we are so happy and feeling the urge to move along, thinking about Alice leading a more normal life is like a dream come true.  We hesitate to rush anything, as our track record has taught us the contrary, yet naturally the current is moving forward. :)


Natalie's update.  She continued to have drainage from her ear longer than hoped.  The doctor decided it was time to start her on an antibiotic.  Likely a regular viral process left behind a secondary infection she couldn't clear.  Her ears and cough have improved and continue to do so.  She is clearly feeling better, thankfully.  The bacteria that was grown in her culture was Haemophilus Influenzae.

With Alice feeling better, we have had more time to reflect on things, it is incredible how blessed we are, from every direction.  Often times we feel we don't deserve such blessings, yet they continue to come.

Lisy

Here's to a good week of feeling better!!!!