Salt Therapy

I'm not ashamed to admit, I've been struggling in the last week. I have felt like I haven't been the mum I should be or the mum I can be. But what's been even worse, I have felt like my kids feel the same way.

Late this afternoon, our day was taking the same path as it has been doing lately. Kids getting cranky at each other, me getting cranky at them, setting ourselves up for a night of tears from all parties involved. It was nearly time to start dinner but I decided to take an impromptu trip to the beach. I wanted to get out of the house. I decided I should take the kids with me. (joking, joking, I was always going to take them).

10 minutes later we were down at the beach. Eliza headed to the water straight away to jump waves. Ruby, in true little sister style, followed straight after her. But she wouldn't let the water touch her feet, she was too scared.

So I went in to where the waves were mid-calf and she ran after me. Facing out to sea, she stood behind me and wrapped her arms tight around my legs. Every time a wave rolled in, she clung tighter, pressed her head against me and squealed with laughter. For 15 minutes she clung there. Her grip never faltered the sand swallowed her feet and the small but powerful waves rushed past her. She made me feel strong and happy. I was her rock, she trusted me 100% to keep her safe. It was exactly what I needed to remind me of what I mean to my kids. And what I need to be for them.

Eliza's need was totally different. She spent her time running in the water, jumping waves and chasing imaginary fish. She was content to play on her own, without any interruptions, periodically looking over her shoulder at me to make sure I was watching out for her. Which I was. I will never stop watching out for her.

We came home happy and salty.

Closer

My skin is getting thinner instead of thicker. My bubble is popping. Reality is setting in. I don't like it, it shakes my soul. I have started this journey backwards.

Most people who have had a baby diagnosed with a chronic illness start off on shaky ground. They are worried, fearful. Who can blame them for thinking the worst? Their whole world has been turned upside down, and not for the better. After time, they start to find normality. No sorry, normality is the wrong word. Nothing about this is normal. They learn to live, and see the positives through the shit. They find hope in medical advances, feel purpose in being proactive. Like most things in life, I seem to have gone about it the wrong way. I started off full of confidence and purpose. I hit the ground running. Don't get me wrong, it didn't take me long to find out what CF was about. I made sure I knew as much about it as early as possible. And to me, this was (and still is, always so much more to learn) a way of coping and preparing. Much like you explain to young children what is going to happen in a check-up so they know what to expect be less fearful, I have tried to prepare myself for whatever challenges may come. Osteoporosis, diabetes, IV antibiotics, more hospital stays, lung function decrease, nasty bug, transplant list. Can't shock me CF, I know it all. And I won't let you scare me enough to fear life itself.


But now, Cystic Fibrosis has taken on a form for me. It's dark and fluid, and just out of the corner of my eye. It watches me give treatments to Ruby, it follows me around. CF isn't scared of me anymore, it's just loitering around us. Nothing has changed with Ruby health wise. In fact, she is clinically doing quite well at the moment. But it's still there, waiting.


Cystic Fibrosis claims lives all the time. You just have to be part of any CF group online to see how often. It hurts when we lose a member of our community.

 Then someone you know personally dies of CF. Someone I knew as a real-life person, separate to the CF world where we are joined by the same disease. Someone I got to know before I had Ruby and even knew what CF was. And it rips my heart out. It's the pin that pops the bubble. Her death leaves me wide open to questions I usually I would not tolerate. To the fact that this journey will not end well. No matter what I do. But most of all, I feel sadness for my friend who has lost her sister. I hope with all my heart that Eliza and Ruby will have the same kind of relationship that J & A did.

What difference does time make? If you know you are going to watch your child die, why should that hurt any less now, compared to when it is actually happening? Is the knowledge just as bad as the event? I'm guessing not. There is always more room for pain.

There are older people with CF out there. They teach us that there is the chance that my daughter can live to past her 30s. I should take comfort in this. But instead I get a bit sad that these people have something special about them, and that special something is their age. An age that is midlife to the rest of the world. Greedy me, I want Ruby to grow old and wrinkly.

I don't really know where I am emotionally at the moment, but I am happy to just drift along and see where I land. What will be, will be.


Dum Spiro Spero

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. 

Clinic Visit May 2012

All 4 of us made the trip to Westmead today. I swear the hospital shrinks every time we go there. It used to be a huge imposing city within a building, now it doesn't seem so big, and only slightly less daunting.

As soon as we get there, Ruby gets weighed and measured. Her weight had dropped ever so slightly but that is to be expected after the 3 months of fighting pseudo. Now that the pseudo is gone, Operation Fat is number one priority again. You would think that keeping your child a healthy weight is easy, but actually it is quite hard. It requires planning, calculating, coaxing and buying extra high fat food. And you can't relax about it, it is never ending. Then you have to factor on the enzymes. No point working hard to serve healthy, high fat meals if you are not giving enough Creon (pancreatic enzymes) to cover it. 

Her lungs sound good, her fingers show no signs of clubbing. Although they were embarrassingly dirty! Eliza took the opportunity to ask the dr if people with Cystic Fibrosis were allowed rabbits, and was very pleased when the answer was yes! With precautions of course with cleanliness. 

Dr Eliza!

Ruby had another sputum sample collected. She has finally worked out that a jar of jellybeans follow the procedure, so no fighting occurred. 

Our CF nurse suctioning for a sputum sample

We took in our new Aeroneb Go nebuliser, and our CF nurse and physiotherapist had lots of questions about it. They were all happy with how it worked, even though Ruby didn't want to wear it for them. They have been recommending to to patients but haven't had many personal reviews on it, so we were happy to provide one. They were amazed at how quick it nebulised 4 mls of hypertonic saline. 

Speaking of saline, the concentration that Ruby has been having was increased. So she was on 3% (which is the same as sea water) and now she is on 6%. Hopefully this will produce a more productive cough.

A while back, Ruby's Vitamin A & E levels were very low so we doubled the dosage of liquid vitamins that she was on. So today she had to have blood tests to check the levels again. And my little warrior didn't even flinch. She just watched the needle go in and then showed off her pretty bandaid. That's the first time we have had no tears xx

Showing off her pretty bandaid (and yet another specimen jar of jellybeans!)

We have booked in to go back for a sweat test. This is one of the ways to diagnose CF. It measures the amount of sodium in sweat. A high reading indicates CF. Although we don't need to confirm Ruby's diagnosis, it is good to have a reading to use as a baseline, especially if she is chosen for any clinical trials.

We also booked in for our next visit which will be her annual checkup. My baby will be 2 years old soon, sob!

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