Giving Thanks for Good News!

I know that it has been a while since I've typed a blog post...but the saying "no news is good news" holds true for us! We have been very thankful for the good news and progress! Here is an update on both Wade and the baby girl/pregnancy.

Thankful for good news during Thanksgiving!

Wade's Update:
Since the last post in September....

• Wade has been improving in speech therapy and OT. He is making more sounds and words at his own pace. He has also strengthened his core muscles and is making great progress! 
• In October, Wade was finally weaned off the bottle for milk. Before, he would drink milk from only a bottle and now he is independently drinking from a sippy cup! 
• Wade has been gaining weight! We now only weigh him on a monthly basis. In September, Wade was 18 lbs, 0.5 oz. In October, he was 18 lbs, 13 oz, and now for November, he is 19 lbs, 5 oz!
• He was supposed to have his annual bone marrow biopsy in November, but we pushed it to February 2013 for insurance/financial reasons. 
• We also started a family cancer insurance plan with Aflac so in case one of us develops cancer the plan pays cash for various things, such as initial diagnosis, bone marrow transplants, travel, etc.
• Wade scared mommy on Monday this week with a trip to the doctor. He woke up very warm (101.3 F), with a cough, and wasn't himself. We got into the doctor's office right away and they did a CBC, blood culture, strep test, and a chest x-ray. The CBC results indicated that it must be something viral. The blood culture, strep test, and x-ray revealed nothing. We were sent home with antibiotics (just in case) and later that day, Wade was feeling much better. It must have been a one-day thing because he is back to his normal self!

He is drinking from a sippy cup now!

Big boy (23 months) enjoying his meal at McDonald's!

Baby Girl/Pregnancy:

Since the last post at 20 weeks...

• I have had ultrasounds every 4 weeks to check the growth and development of baby girl. Each ultrasound revealed normal growth and no sign of IUGR! 
• The last ultrasound at 33 weeks, she was estimated at weighing 4 lbs, 12 oz and was in the 56th percentile! That was W's birth weight at 40 weeks....so now I get to experience pregnancy with carrying an average size baby! I guess in a way I was spoiled by only having to push out a 4 lb baby, but now I can hope that the average size baby will be healthy!!
• I submitted the paperwork to the St. Louis Cord Blood Bank to reserve the baby girl's cord blood in case W may need it someday. Usually, you donate a baby's cord blood to the public bank, but since her sibling has a blood disorder, we can bank her cord blood privately for Wade if he needs it.
• The nursery is complete! Thanks to my mom, we put up the vinyl tree decoration and thanks to my husband, he hung up the wall hangings! The color scheme is light pink, dark pink, and green. The bedding is flowers/garden. See picture below!
• We have a name picked out....but it's a secret! 

Baby girl's room! Tree vinyl design is from Simply Said.

August Update

I feel like I haven't made a post in forever! Sorry about that, I promise to keep posting! W hasn't had many serious things going on, but there are a few updates to mention:

• W's stools were still really loose on the pancreatic enzymes so the GI doctor finally bumped up the dosage. As of July, he now gets three capsules before he drinks a bottle of Pediasure and two capsules before a meal.
• After about two weeks of the enzyme increase, I told his doctor that his stools have not improved. So the GI doctor explained that sometimes the enzymes' effectiveness can be maximized if the child also takes a proton-pump inhibitor medication (usually prescribed for acid reflux). So, W has been trying out Prilosec to see if his stools improve. The compounded medication is nasty (and I'm talking NASTY because I've tried it) and trying to get W to take the medication was a nightmare. For the first several days, Adam and I struggled with keeping the the medicine in W's mouth from injecting it in his mouth with the syringe. Then, I tried putting it in applesauce, then chocolate pudding, but still no luck with W actually taking the medicine. Finally, I found a fruit juice that masks the nasty flavor of the medication and W is finally able to take his Prilosec. And, I'm happy to say that his stools have finally improved. He actually creates formed stools now!! Hopefully, since we're noticing a change in his stools, we can also notice a change in weight gain? (We've only been waiting for him to gain weight for about 7 months now!)
• We did go to the pediatrician in early August because W was cranky and pulling at his ears. Luckily, no ear infection was present! But we did find out that his right ear tube that was still holding on is now working its way out! I'm frustrated because his left ear tube began working its way out within 10 days of surgery and now his right tube started working its way out 6 months later! The pediatrician ordered a hearing test to make sure W still has good hearing with those tubes coming out. Finally, a happy note with his ears because he passed the hearing test with flying colors!
• Over the weekend, W pinched his finger in a sand bucket and it formed a blood blister. I instantly worried about it turning into an infection and wouldn't you know it--it's infected! I put antibiotic ointment on it tonight but I'm calling the doctor tomorrow. Darn infections!

6 Month Follow-ups

Two Fridays ago, W and I headed up to St. Louis for two follow-up appointments with his specialists at Children's. First we saw his Hematologist and there were two big topics of discussion--Neupogen dosing and baby #2's cord blood. W's doctor received dosing information from the Severe Chronic Neutropenia International Registry for Neupogen that differed from her dosing. She's waiting on the literature/studies that based their decisions but she basically told us that we have two options when it comes to dosing W's Neupogen: 1) current dose that's given on MWF (her suggestion), or 2) smaller dose given every day of the week (SCNIR's suggestion). I found some Neupogen curves online that demonstrate the difference in dosing and how it affects ANC counts, risk of infection, and bone pain. Although the MWF dose is currently working, I can see the benefits for giving Neupogen daily. However, that's 7 pokes for W in one week, rather than 3. Any advice from other SDS-ers? 


The second topic of discussion with W's Hematologist was the various possibilities since I'm expecting baby #2. Like any genetic disorder, the likelihood of baby #2 having SDS is 25%. So, leaving a 75% chance that the baby will not be affected by SDS, we want to save the cord blood for Wade, IF he were to ever need a bone marrow/stem cell transplant and IF baby #2 has the same HLA match for Wade. Once again, a 25% chance exists that baby #2 would have the same HLA as Wade, making it a good match for W to receive the cord blood if needed. I asked the doctor about a cord blood registry that she knew of that banked cord blood privately for a sibling donor. She told me about the St. Louis Cord Blood Registry, a public bank. Although this is a public cord blood bank, they also do what is called a directed donation, meaning that the cord blood from baby #2 will be saved in our family's name only. They are no time constraints on storing the cord blood and no fees in collecting or storing the cord blood. The only time fees would come into play would be if we get the cord blood out specifically for Wade. However, if baby #2 is not an HLA match with Wade or if Wade were to not need a transplant, we can always donate the cord blood back into the "public" part of the bank to be used by anyone else who may need it.


After Hematology, we saw W's GI doctor. I had some questions regarding W's lack of weight gain  in the last six months (total gain of 6 oz in six months = not good enough). We are still waiting for a food log analysis from W's dietitian, but I can already bet that W's pancreatic enzyme dosing needs to be increased. I believe he's eating more than what the enzymes can digest, resulting in loose stools and no weight gain. His current dose is 1 capsule for solid food and 2 capsules for a bottle of Pediasure. The GI doctor also thinks that W's enzyme dose needs to be increased, but he would first like to see the food log analysis. Because I'm me, I asked the question, "What if increasing his enzymes still won't help him gain weight?" and his reply was, "Well, if that's the case after optimizing his enzyme dose, then I would refer you to endocrinology, because we would have exhausted the possibilities on the GI and metabolic side of things." So, that's still a possibility if increasing enzymes still won't help W gain weight. SDS-ers: Is this common to have an Endo specialist? What is their role with the treatment of SDS?


So, after a morning full of labs, appointments, and questions/answers, my brain is now overflowing with "what if's" and endless possibilities that I have to wait out....and I'm not a very patient person!

Down to One

Here is an update on Wade's ear tubes. Ten days after surgery of getting the tubes in, Wade had a 15-month well-baby visit with his pediatrician. After looking in his ears, she confirms that his left ear tube is sitting at an angle and working it's way out. I was so shocked to know that this happened within 10 DAYS!!?! 

Adam and I didn't get too excited about it since he hadn't had any ear infections since getting them in. We had our post-op appointment today with the ENT doctor in St. Louis. They performed a hearing test and luckily he did a lot better than before tubes. They asked me if I had noticed anything with the tubes and I explained to them what my pediatrician said. The Audiologist looked in his ear and confirmed that the tube was out of the eardrum and now just hanging out in the canal.

So, when we actually saw the ENT doctor, she looked in his ear and obviously saw the same thing everyone else has been seeing. So, she asked for a nurse to come in and help hold Wade down so they could extract it. The doctor was able to retrieve it in less than a minute. Of course Wade cried because he was being held down, but I wonder if it actually hurt inside his ear?

Now, we have to watch out for any ear infections in his left ear for the next 6 months before we see the ENT doctor again. If he starts getting ear infections--it's surgery time again. :(

But, the only good thing if he does need another tube in his left ear is that we've already reached our insurance's maximum out-of-pocket for 2012!

Testing and Then Some...

Yesterday was a long day in St. Louis full of medical tests--for all three of us!


First of all, I should probably begin by saying that Adam and I both joined the Be The Match bone marrow registry in hopes to save someone's life if we were to someday be a match to one in need of a bone marrow transplant. After only being in the registry for 4 months, Adam received a call and was told that he was a possible match for a 61-year old man in Indiana with leukemia. For confirmatory testing, Adam had some blood drawn to double check that he was a good match for the recipient. It came back that he was a good match and Adam will be donating his stem cells via PBSC in April. The video below explains the donation process.





The appointment yesterday at St. Louis University Hospital yesterday was for Adam's information session. Adam completed a full physical with a hematologist/oncologist, received an EKG and chest x-ray, and provided a urine sample and blood test. We also got to see where Adam will be doing his donation--which will take five and a half hours! Yet, a small price to pay for potentially saving someone's life!


After all of the testing for Adam at St. Louis University Hospital, we headed over to St. Louis Children's Hospital for Wade's appointment with a geneticist. Although we already know Wade has SDS, we wanted to follow up with a genetic counselor in St. Louis to talk about parental genetic testing to confirm that the two genetic mutations Wade has for SDS came from each parent. This is the most common explanation for Wade's diagnosis-- making me and Adam each a carrier of SDS. However, sometimes, in rare instances, both mutations can come from one parent. All of this information can help determine the likelihood of another child's chances of having SDS. If Adam and I are both a carrier of SDS, the chance of having another child with SDS is twenty-five percent (shown below).

The genetic counselor also discussed the options available for prenatal testing when we decide to have another child. They will be able to test the baby for SDS with the amniocentesis test. She provided us with the phone number for the Prenatal Genetics clinic at Children's.


After talking to the genetic counselor, the geneticist came in and provided us with information about Shwachman-Diamond Syndrome (nothing we didn't already know). He then said that he would like to do a full-body x-ray in order to get a good look of his bones. So we left the clinic with three orders--genetic test for Adam, genetic test for me, and x-rays for Wade.


First we hit up the lab, where it took forever to register three different people. (I'm so freaking sick of signing the HIPAA). Since they were unsuccessful drawing blood from Wade last week, they had to try again. Luckily, a really good phlebotomist was able to get a vein on Wade (which is near impossible)! There were tears, but at least it was only one stick. They also had to take blood from me and Adam for the parental genetic testing--and no tears from us!


Lastly, we headed down to the Imaging Center for Wade's x-rays. The x-ray technicians were awesome in getting the images taken quickly, since Wade was crying from being held down. It actually wasn't a horrible experience like I thought it might be. Maybe I expected the worse--but it was relief to be done in about 10 minutes!


So, a long day came to an end around 5:30pm! Adam and Wade were both troopers for having so much work done on them. We anticipate all of the results and I'll fill you in when I know more!

Appointment Last Week

Sorry for the late post, but W had an appointment up in St. Louis last week to see his GI doctor. My mom went with me for this visit and we stayed with friends the night before. Our day started early because he had a 7:30am appointment to get an ultrasound done of his liver. His liver enzymes had been elevated and they wanted to take a look at what was going on. Poor W had to fast for this procedure and he was not that cooperative when they did the ultrasound. It didn't hurt, but my little boy hates being held down. The ultrasound tech was able to perform the ultrasound, but then had to do doppler--which meant Wade had to be quiet. So, luckily she let him take a bottle during this, otherwise he wouldn't have been quiet.

Grandma and Wade playing in the waiting room.

We finished the ultrasound before 8:00am and had a huge gap in our day because our clinic appointment with the GI doctor wasn't until 1:30pm. We originally thought of going to some thrift stores in the area to pass our time, but since the weather was amazing we went to the St. Louis Zoo. We were able to save money on the parking and the Children's Zoo because we were there so early. We enjoyed the weather, the animals, the carousel ride, the train ride, and the ice cream! However, around 12:30pm, we had to head back to the hospital for our other appointment.

Mommy and Wade having fun at the Zoo.

Back at Children's, Wade had a 6-month follow-up appointment with his GI doctor. He explained the ultrasound results from that morning to us. They found some abnormalities with his liver and some fatty deposits on his pancreas--all to be expected since he has Shwachman Diamond Syndrome. They believe that this is all caused from SDS, but to be sure, they've ordered lab work that would test for any other metabolic disorder or mitochondrial disease that may also elevate liver enzymes and cause these abnormalities. In addition to the ultrasound results, I mentioned my concern with Wade's poor weight gain in the last three weeks (he only gained 2 oz in the last 3 weeks). However, the doctor and I both believe that since he has learned to walk, W is now burning more calories and that has been playing a part in his weight gain. So, it's not an immediate concern, but we will still do weekly weight checks. Lastly, I had to confront W's doctor about his rude nurse that is super condescending to me. I explained the several events in which she is unprofessional and I requested to see a different doctor so that I wouldn't have her as a nurse. He is going to speak with the director of the GI clinic to request a change.


Before leaving Children's, we tried getting W's blood drawn that the GI doctor ordered. However, the lab techs couldn't get a good vein (go figure!). So, we'll have to try again on Thursday when we go up to visit a Geneticist. So, after an early morning ultrasound, a trip the zoo, an appointment with the GI doctor, and getting poked in each arm, we finally headed home! What an exhausting day for all of us--but the zoo was definitely worth it!