Annual Review 2012

Ruby's second annual review was today. Sort of like a birthday, but a celebration we would rather not be having. All 4 of us took the trip down to Westmead today. I was very organised and packed a bag full of food and entertainment for the kids.

We got there at 9.30 and started with the normal weigh-in and height measurement. Ruby was very compliant and did exactly as she was told. In fact, she was like that most of the day. It takes a lot to upset her.

Eliza lending some weight to Ruby

Her sweat test wasn't until 10.30 so we started off with the normal nurse checkup. Much to our amusement, Ruby and Eliza burst into squeals of excitement when the suction machine was wheeled in, as it has a huge tin of lollies on it. Ruby had her sputum suction and fir the first time ever didn't cry. It will take a few days to get the results back.  Both kids received a specimen jar full of jellybeans!

Physio checkup was all good too. We discussed different blowing exercises and will be starting off with blowing bubbles in the back with a piece of tubing.  We also discussed getting a vest again. Lot's to think about there especially as a long term study has been completed where it was shown that PEP therapy is more efficient than the vest. 

Then we were off to the sweat test. Electrodes were attached to Ruby's skin to stimulate the sweat glands, then some filter paper was placed onto her skin to collect the sweat for analysis. She left this on for half an hour, but unfortunately not enough sweat was produced and we will have to try again another day. All through the process, Ruby just watched intently what was going on and never got upset. Until it was time to pull the tape off, and then it really hurt her and she had a good cry. 

The electrodes that stimulates the sweat cells to test the level of chloride

Then a consultation with the gastro dr who felt her belly for any enlarged organs and hard parts of the bowel but all was good and squishy. We then chatted to the dietitian which is always painful as I can never actually remember all the things I feed Ruby and I get asked questions like "how much cream do you add" or "how much water does she drink" and my answers of 3 splashes, or showing an amount with my fingers aren't good enough. But dieto is happy with the amount she is eating and the amount of Creon that I am giving her, and no changes need to be made, or supplements added.

Finally, we see Ruby's main dr who checks her lungs (all clear) and we talk about new drugs coming and her general health. We decide to start her on Pulmozyme which is a drug that changes the DNA of mucous, making it shorter, therefore thinner and easier to cough up. This drug is used in many countries as a preventative and works really well. It is try expensive ($25,000 a year) and can only be covered by the PBS if you meet a certain criteria. Which Ruby does, based on her age and recent fight with pseudo. As the doctor said, "we are trying to preserve Ruby's lungs until there is a drug available that will manage all of CF" (referring to the new miracle dug being trialed with different gene types, Kalydeco).

So I feel very lucky that we don't have to push our clinic to try these things, and that we have a health care system that makes this affordable to us. I also appreciate that these things can seem inconsistent between clinics. As Ruby is too young to have the lung function tests, she does not have to show lung improvement to stay on this drug. 

New toys from clinic for being a good girl

So then we pick up a huge bag of meds from the CF pharmacy, pickup the bits and pieces that we have gained (including 2 cute dr teddy bears), make a date to come back in 2 months and treat ourselves to lunch at the hospital cafe.  Oh yeah, then walk to Parramatta Park where we had to park.

A busy day, but both kids did well. Eliza looked out for Ruby and Ruby was charming to the staff as always. 

CF never stops. We are always learning something new, can't rest for  second. 

Too Aware?

Eliza became a bit more aware today.

She started to watch the NBN interview on my iPhone (she can work the thing like a 20 year old). The first line came through loud and clear. "if a cure isn't found, 9 month old Ruby will DIE from cystic fibrosis" That was as far as we got as I snatched the phone off her. She looked at me with her big blue eyes and said "I don't WANT Ruby to die"

What did I say? "Don't worry, she won't. Well she will, but not yet. When she's really old. Is that Daddy home? Want an easter egg?"  Didn't handle that one too well.

She didn't say anything more about it until about 10 minutes later. It was obviously on her mind. She stated how clever she was saying cystic fibrosis properly. She asked why Kai and Ollie didn't have CF. "but why does Ruby?'

I hope she understood what I meant when I said that everyone is different, on the inside and the outside.

She knows the names of Ruby's medicine, she checks to see if she needs her Creon. She helps(?) with physio. Eliza is a very switched on little girl. She makes sure Ruby doesn't touch other kids drink bottles and I've even heard her tell someone off for not covering their mouth when they coughed. She is always seeking answers and wanting to know more. No detail goes unnoticed with Eliza. So I have a feeling that Eliza will still be very young when the gravity of the situation hits home for her. When she starts asking the hard questions. When she can't be so easily distracted.

This of course hasn't saved Ruby from the normal sibling rivalry. Which I am grateful for!Nothing like a bit of a shove or a stolen toy to make you feel normal ! Thankfully balanced out with lots of cuddles and gigges together xx

Photo Friday

OK, so I'm a day late with Photo Friday...

SOMETIMES IT'S

OK IF THE

ONLY THING

YOU DID

TODAY WAS 

BREATHE

Breathe-Emptiness by Must Valge

 

Not so distant memories

Will my memories of NICU always be so acute? Will it seem like just last month forever? Does it ever fade?

5th Day - DIET

FAT, CALORIES AND CREON

When we were getting CF explained to us, it was always mentioned how the CF diet required extra fat and calories and salt. I didn't worry about it too much as Ruby was still on intravenous TPN, let alone solids. I envisaged changes like switching from low fat yoghurt to full fat.

That's not quite what they meant.

avocado mixed with Greek yoghurt and grated cheese.

I could feed Ruby McDonalds for breakfast lunch and dinner and get a thumbs up from the nutritionist. I could dip her fruit in chocolate and call it a healthy meal. I could feed her a stick of butter for a snack... ewwwww.......

But I don't want to do that.

So I use other things instead. Here is a typical days meal for her at 9 months old

Breaky: 2 weetbix with chia seeds and milk, or bowl of Greek yoghurt with chia gel.  Vegemite on toast.

Snack: cheese (loves cheese!), avocado, tomato and sultanas

Lunch: meat fingers (made with beef mince, grated vegies, coconut oil)

Snack: baked beans and grated cheese

Dinner: fritata type thing I make in the bowl with egg and vegies and cheese and microwave. Washed down with a drink of Hydralyte

Desert: chocolate (plenty left from Easter still!)

Plus 3 - 4 bottles of fortified formula per day

The snackbox in the CF dietitian's room

When I was introducing solids, I would just cook up some vegies and add coconut oil. Then I started making things specific for her like red lentil casserole.

Before, she was on solids, I did my research. I finally felt like a had a heads up on something. Time to prepare, time to learn. Here was a way I could take control of my baby's health. No prescriptions needed. I could research and make my own decision as to what I felt was best for her. Some interesting thing I have found.

Broccoli helps clear damaged lungs as well as being a great immunity booster

Coconut oil is amazing! Google it! The parts that I like are: increased immunity, proper digestion, had Vitamin K & E, and is has the highest amount of fat. And it smells good!

Chia seeds are also high in fat and are known as a "superfood". They can be mixed with water to make a gel, and have no taste. 

raw tomato, tuna and cheese covered broccoli & carrots

 


I don't do the whole calorie counting thing, I just feed her as much as possible. I adjust the amount of enzymes when I notice her poo is oily, or if I am told to. At the moment, Ruby has 2 capsules/scoops of Creon 5000 for every meal unless the meal is very low fat or I think most of it will end up on the floor. 

Sometimes I feel like I'm trying to fatten up a prize goose to take to market! But I enjoy it, it is therapeutic, and Ruby certainly isn't complaining!

zucchini & mushrooms sauteed in lotsa butter

cheesy tuna & vegie rissoni with coconut oil

.

Photo Friday

Lola © Heartfelt : giving the gift of photographic memories

In the midst of all the stress and emotions of having an ill, premature or stillborn baby, the simple act of taking a few beautiful photos can often be forgotten. 

Heartfelt is a volunteer organisation of professional photographers from all over Australia dedicated to giving the gift of photographic memories to families that have experienced stillbirths, premature and ill infants and children in the Neonatal Intensive Care Units of their local hospitals, as well as children with serious and terminal illnesses.

All services are provided free of charge     

Photo Friday

This is EVA MARKVOORT

A loud advocate for awareness of Cystic Fibrosis, research in the field, and organ donation

Despite a double-lung transplant, Eva’s body could not last.

She passed away on the morning of March 27, 2010.

 

 

 

 

Eva's page : http://65redroses.livejournal.com/

Eliza's Birthday

Family dynamics change when a new sibling comes along. Most parents with more than one child can attest to that! Our daughter Eliza had to adjust to so much so quickly, and without the comforts familiar to her. Her home, her friends, her toys, were taken away from her when she probably needed them most.

That's why we decided to make sure she had a proper 3rd birthday party. Her birthday is 3 days after Ruby and we were originally going to forgo a party for her this time. But she needed some time away from the hospital, and this was the perfect excuse.

 Lucky for us, we have amazing family and friends who organised a party in about a day. Craig and
I didn't have to worry about anything. There was just enough people there to make it special without it being too overwhelming. They were all people important to Eliza. I wasn't able to be there, but I really, truly didn't mind one bit. I was just happy knowing that she was having a fun day with the focus totally on her.

 When Eliza first arrived at the park with her dad, she stopped him and asked if he could please hold her hand while they walked. It took her a while to get into party mode, but with the help of her family and friends, she ended up having a fantabulous time!

Photo Friday

Isn't this a powerful photo? I love everything about it. I love the pose, the colour, her expression. I love that it is a real photo, documenting someones real story. The girl in the picture is Miranda Hutson. She is 22 years old and received a double lung transplant due to her Cystic Fibrosis in Jan 2010.  The hospital tags are hers, the oxygen tank was a part of her life before the transplant. I don't see the picture as being morbid or negative. I don't know why, but I just really love this photo.   Photographer: Curtis Almeter, who was also in hospital with Miranda.

So What If I Have Cystic Fibrosis, I'm Unstoppable!  is a Facebook page that Miranda has created. I love how the majority of the members are teenagers, and I sometimes stalk the page, watching them interact, and just be typical teenagers! It gives me great hope for Ruby.

A Few Memories

I remember being in the special care nursery at Gosford hospital, thinking everything would be ok once Ruby did her first poo.

I remember noticing in NICU how long some of the babies had been there for. Months and months, and they weren't even premmies.

I remember the glass cupboard in the tea room full of books like: So Your Baby Has A Disability, Living With Multiple Sclerosis, Understanding Cystic Fibrosis. I remember being glad that I wouldn't have to worry about anything like that.

I remember wondering why the nurses hands weren't sore, dry and red raw from the antibacterial soap that had to be constantly used.

I remember Craig & I walking Ruby to the operating theatre. I was so scared but I didn't want Ruby to see me cry so I just smiled stupidly at her and told her how much she was loved. I remember wondering if it would be the last time I would see her alive.

I remember relief warming me when the surgeon told us how well the surgery went. I remember fear chilling me when he then told us there was a 90% chance that Ruby had Cystic Fibrosis. I remember confusing CF with Spina Bifida.

I remember the first time Ruby smiled. It was as we were leaving Grace Ward to go home and it was a proper smile, not gas! Good timing bubba! She hasn't stopped smiling since.

My Baby

Oh, my baby Ruby, please don't grow up! You are so perfect in this present moment. It seems too good to be true, surely I can't be blessed so much that you will always be this way? So happy, so healthy, so so cute! I love the little conversations you have with people, quietly but confidently letting us know that you are comfortable with who you are and where you belong in our family. Your sense of self is already shining through, your strength nearly visible. Why do I get the feeling that all the support I give to you will be returned to me tenfold? As excited as I am to watch you grow, I can't help but already feel a tiny bit sad that the days, weeks, months go so fast.

Clinic

Clinic is where Ruby sees a team of specialists to help manage her Cystic Fibrosis. She normally sees  her respiratory specialist, CF nurse, nutritionist and physiotherapist. The team also includes a gastroenterologist and social worker. The clinic is at Westmead Children's Hospital. As a newborn, we were there at least every second week, now that she is a bit older, and more importantly, heavier, we only need to go down once a month. If she stays healthy, the visits will be spaced out to every three months.

Here is a photo journal of our clinic visit today:

 As soon as we arrive, Ruby is weighed and measured. She has put on weight and grown well! Infact she is growing longer so quickly that her weight is just keeping in proportion with her length.

  The staff at clinic always take the time to come and say hello. Ruby gets alot of attention as she always smiles at everyone.

This is the most unpleasant part of our visits. a sputum sample is taken to make sure there is no bacteria growing in her throat. The sample is taken by a suction tube being shoved down the back of her throat. Doesn't take very long to do. 

 This is the snack box in the nutritionists room where the kids are encouraged to help themselves! 

 There is always something going on at a childrens hospital! Today we got a visit from some fairies and superheroes. Eliza was very lucky and was given a bag full of treats! Textas, colouring books, stickers, jewellery, a magnetic "learn chinese" kit(?!)...

 Ruby with her respiritory doctor who is her primary medical carer. He is listening to her lungs to make sure they are all clear, which they are.

We saw the gastroenterologist today who checked out her surgery scar and asked lots of questions about poo!

We picked up some of Ruby's medication for the next few months. We always leave with more than what we came with.

Photo Friday

I finally dragged the "good" camera out the other day and took some proper photos. I took advantage of the natural light coming through the window onto the couch before the opportunity was missed!

A Common Cold?

Ruby in her adult sized hospital bed watching Play School

Ruby got her first cold the other day. Not a bad cold but ended up in a trip to the hospital regardless. Her snot is really sticky, not runny (thanks CF) so it didn't run out her nose. Babies can't blow noses or cough up phlegm purposely so everything ended up being swallowed. This resulted in her being constipated with a big sticky goopy poo which made it's way out with some help! Nothing is straightforward with a CF baby.

But we learn. Next time I won't be so freaked out by seeing green bile vomit and just give her some Glycerol. Next time I won't let Eliza watch Ruby get her temp checked rectally as a think we are in for a surprise when she next plays doctors...