Upper GI

Unfortunately, not much has changed for Maggie and the diarrhea. Her diarrhea has picked up in the last few days or perhaps it never really changed much. Who knows anymore. I had been given the okay to give Maggie milk again and so I did the last couple days. I am wondering if maybe the milk might be increasing the frequency and changing the consistency even though she doesn't have a lactose intolerance. Again, who knows, but we'll withhold what she likes to give her any small amount of change for the better.

Can you tell we're a bit down about all of this? I cannot say enough how hard this has been on Maggie and her body. It's so sad to see her skin drooping on her. It's just not fair at all that she must deal with GI issues on top of cancer. I have learned that life isn't fair, but it doesn't mean that I still don't live by that principle. We need some answers and we especially need a treatment plan THAT WORKS.

With that being said, the nurse from Cinti. Children's contacted me today and said they are going to go ahead and schedule an upper GI with a small bowel study for Maggie. This is what comes next on the list that Dr. Mezoff has created and the last item on the list is another scope. She said they may just have to do another. What a new scope is going to show that the old one didn't I don't know. I'm going to try to schedule this procedure before her next appointment, November 6. I'm not sure they expect to see anything, but again, I guess it'll just rule out one more thing.

Please pray for our little girl. Pray that these GI issues are resolved immediately-- that they find an answer, but more importantly, that they find a successful treatment. And of course, continue to pray for Maggie and for the main reason we started this blog-- that her cancer will go away and never return.

Do the enzymes work?

Unfortunately, I don't think they are going to work for us. Maggie has continued to have diarrhea, with it increasing around bedtime (the reason for Maggie going to bed so late recently). Many of the nurses that I've talked with say that they should work immediately, so if that is the case, they are not our "answer." I asked the GI nurse I am in frequent contact with at Cincinnati Children's about our next steps. It might appear that our next steps are a procedure that involves drinking Barium.

Hopeless is the word that I am feeling. I really thought the enzymes might be our answer, but I guess that was too easy of a solution. Easy is not a word used around this household.

I took Maggie into the clinic today to get her labs drawn again. She received lower numbers on her hydration yesterday so they wanted to keep her accessed while giving her a night off of fluids. We were thinking (and maybe hoping) that the fluids were increasing her diarrhea. Maggie's counts today showed that her hydration (or bi-carb) had risen, however her potassium dropped again (from 3.5 yesterday to 3.1 today). Regardless of this decrease, Dr. French gave the okay for Maggie to be de-accessed. We hope that she will maintain her hydration and we don't need to go back to the hospital on Monday. Another little positive piece is that Maggie's weight has increased back up to its original number- 22 lbs. So it appears she has gained back all the weight she had lost from diarrhea. I don't know if the weight loss was from loss of liquids, but I hope that maybe the weight gain shows that her nutrition is coming around. We'll take weight gain no matter what causes it.

I know that our prayer request becomes quite repetitive, but please pray for Maggie's diarrhea to stop, her body to absorb nutrients and of course the most important, that Maggie's cancer is completely gone forever.

Update

Yesterday was a pretty rough day for us--Andy at work and me and Maggie at home. Maggie continues to have diarrhea, mainly at night when we have tried to put her down. I am getting a little worried that these enzymes just might not work. Maggie wanted to go to sleep last night around 8:30, but before it was all said and done she was asleep with the help of Benedryl at 12:30. It was a long night balancing between her request for hot dogs and green beans and going poo in the potty. Once I did get her down, I was up every hour until 5:00 am changing a dirty diaper. It was very tiring and frustrating that things are not slowing down.

Maggie had her labs drawn yesterday and today, both showing her potassium at 3.4 (it was 2.4 when we left the clinic Monday). In talking to the nurse, as long as her diarrhea slows, tonight will be her last night of fluids. I was hoping that the numbers would be a bit higher, considering she's on fluids, but I guess her body is slow to responding and she is still losing a lot of potassium in her diarrhea.

I noticed yesterday that the steroids still seemed to be affecting Maggie. She was very touchy in that if something didn't go her way, she would immediately start screaming. An example of this was when we decided to go out. It was a beautiful day, mid 60's and so I decided we would go to the Greene, our favorite hang out on nice days. I dressed her like it was winter; winter coat, winter hat and gloves just in case (I had forgotten what the 60's felt like after being so cold lately). When we stepped outside and felt the warmth I took Maggie's hat off and she was very mad. So, she ended up dressed for winter and probably sweating, but she was happy. I guess that's all that matters. So, the day was quite challenging and from the moment I woke up to the time I went to bed I spent 5 minutes by myself, all the while hearing Maggie calling my name. It was a long day and one that didn't get any relief, even once everyone was asleep.

Maggie is doing better today as she has had less tantrums. I just finally got her to take a nap by herself, something that hasn't been done since the Sunday before last. I am hoping the steroids will rid her system soon as I think they have also caused all of this diarrhea, behavior changes, and sleep changes. It will be nice when Andy and I can sit down together again for a few moments to just relax while our baby is sleeping. You need some downtime every now again, right?

Please pray that these enzymes will be effective and that they will stop Maggie's diarrhea and that she will start to put on some weight. I weighed her today at the clinic and she was up to 21 lbs. 7 oz. with a bit of a wet diaper, so there is improvement, but most likely from fluids. We all just want some relief soon.

Rehydration

We went to the clinic today, as we've done the last 3 months after steroid week, to get Maggie rehydrated with fluids. Maggie's numbers showed that she was dehydrated and that she had potassium loss once again. The horrible part to all of this is that we found that she has lost a pound and a half since last Monday as she is down to 20 lbs. 5 oz. She is almost to her lowest weight before they decided that we needed to change things and began TPN.

As I drove Maggie to the clinic today, I called Cincinnati Children's GI nurse who've I've been in contact with many times over the last week. I told her we needed to become more aggressive as the Imodium is not doing the trick. After lots of back and forth conversations today, Dr. Mezoff decided to try the pancreatic enzymes. I also found that one of her lab results on her stool sample showed that she was in the moderately low level of absorption of Elastase. So, with this in mind, they hope that perhaps the enzymes will help her body absorb better and for me, I feel like this is the last viable option. If the enzymes don't work, I don't know what will. Please pray that the enzymes will be the solution to this 9-month problem.

We had Dr. Dole today, another oncologist at Dayton Children's, versus our primary doctor, Dr. French. I won't share my feelings about Dr. Dole, but to say that he goes about treating patients and discussing with parents much differently than Dr. French. With that, Dr. Dole did things a bit differently in that after they gave Maggie a 2 hour bolus of potassium, they rechecked her levels (something they haven't done the last 2 times). After rechecking her levels they found that they dropped rather than raised. Maggie came in with a potassium level of 2.7 (normal 3.7 and above) and after receiving fluids had a level of 2.2. They rechecked it and it came back at 2.4. Dr. Dole came in and told me that they were going to keep Maggie overnight because her levels were critically low. To Andy's later chagrin, I talked Dr. Dole out of keeping her overnight, even though he was uncomfortable doing so. We were being sent home on IV fluids overnight for 3 days, and I have witnessed Maggie do this 3 times now, always to see her levels rise the next day. Along with that, Maggie has been in a very good mood, talking away and not even being a bit crabby with no nap today. So hopefully things will continue the way they have in the past and Maggie's levels will rise by tomorrow.

The plan is that Maggie will be accessed until at least Thursday, receiving IV fluids overnight for 12 hours. Home care will come out daily to draw labs to see what her levels look like. As long as things go well, she'll be off fluids then. This is a new protocol for us, as in the past we have gone home de-accessed and Maggie has done fine. But I think they are doing this per request of Dr. Mezoff (he had wanted Maggie on fluids throughout all of her steroid week, which Dr. French wanted to wait and see if Maggie would hold her own). The other main change will be those pancreatic enzymes. I am told that they work pretty quickly and we should see a change within 3-4 days to a week. Again, please pray that they work because if not, I don't know what will happen next and Maggie cannot continue this way. The poor girl is skin and bones with a protruding belly. It's just not fair to her at all.

Please pray for Maggie in these coming days as she rehydrates and the enzymes take effect. Let this be the healing answer to our countless prayers.

Yep, diarrhea again

Just a quick update to share that Maggie's diarrhea has again become pretty bad. She had 3 pretty wet ones yesterday and then we were up much of the night changing her diaper-- we think about 7 or more times. Today she has had quite a few to the point that we are again starting to worry. This afternoon she had several episodes in a row while laying on the floor. It was just an enormous amount and after talking her into going on the potty to finish up, she had a good cup or more of straight liquid. On the bright side, she did go on the potty, was pretty proud of herself, and got 2 stickers out of it.

So, we are going to make the call to the clinic tomorrow morning requesting a visit to very possibly rehydrate her electrolytes. We are getting pretty sick and tired of this, not just dealing with so many messes and loss of sleep, but looking at Maggie's frail skinny body and distended belly. We'd like to take a picture of her to show you what this diarrhea has done to her, but I'm afraid it might be too graphic.

I am going to put another call into Dr. Mezoff, her GI specialist, to see if there is any way possible that we can move forward with another type of treatment because the Imodium is just not doing it. It's a very sad sight down here right now and we are feeling pretty bummed and hopeless. Please pray for Maggie that her diarrhea will STOP! and that her weight and overall nutrition will increase.

Steroid week

Maggie finished her steroids yesterday evening and so we are hopefully on the road to recovery. This week was much better than last month. Maggie still had her effects of the steroids, but we didn't see the Vincristine side effects, which we were happy about. However, a little part of me wonders if because they reduced the dose this month, if it still did the job on any cancer cells remaining in her body. I pray it did.

Maggie's sleep of course was affected--no naps in bed, but being held. She was able to go down at night for bed, but it took longer to do so. Steroids seems to make her more lethargic, sleepy, and so she layed around a lot on me. Last night and today she seems to be much louder vocally, to the point where you'd think she was a bit intoxicated. It's almost a bit funny and reminds both of us of our nephew when he doesn't get his nap. Regardless, I'm just happy she has continued to talk. Listening to her talk is so wonderful and we really missed it for the 3 days that she stopped last month.

While we are finished with steroids, we have several days before we will see our old Maggie return. She got sick in a restaurant today and her diarrhea has again picked up, so we definitely are not out of the woods yet. We pray though that these effects will go away immediately and Maggie will be on the mend.

I am posting the last of the pictures that were taken on Maggie's birthday. Enjoy!

Playing (or rather eating crackers) with cousin Brendan on Maggie's new princess table.

Our birthday supper at Steak and Shake. Maggie enjoyed the cottage cheese and milkshake (a rare treat since being told she is no longer allowed to have milk).

"Hey you..."

Physical Therapy

We made some leaps and bounds today during physical therapy. Maggie didn't cry! Or at least waited to cry until the very end of therapy (I think she got tired of walking and playing). This is quite remarkable as we have been in physical therapy since June and Maggie has cried at her weekly visits the entire time. I am hoping this might be a turning point in her therapy and better yet, her walking.

When we pulled into the hospital this morning I told Maggie we were going to see Nancy, her physical therapist. She responded, "walk" because of course that is what we do in PT, practice walking. I then asked her if she was going to play and she responded, "balls." I believe that Maggie is a great observer. She won't speak with people she doesn't know, but instead takes everything in to be able to "talk" about it later. She also has a very good memory as she tells us about experiences out of the blue after seeing something that jogs her memory.

So, when we came into the physical therapy room Maggie said she was going to walk. She also told Nancy that she was two (she is so happy to say that). This is an incredible step in that Maggie is speaking to someone else that is not her family member. I tried to get her to talk to Detch, aka Dr. French, the other day and she didn't, but today she was very talkative. Nancy was quite surprised and impressed.

Maggie used the walker to pick out a basket of balls to then throw into a basketball hoop. She did all of this willingly and in case you have forgotten, on steroids! I was so happy that I couldn't help but continue smiling. It has been so difficult for me to take Maggie to PT and listen to her scream the entire time. I have told Andy that since I am responsible for taking her by myself now, I was going to cancel PT. We are both miserable for the 30 minutes of play time, but today, it was a nice surprise.

I think this shows that Maggie is indeed feeling better (or has been feeling better) and because of that she is much more willing to play and walk. At home she has been again cruising along the couch and has even managed to hold onto the wall and my hand to continue walking after the couch has ended. She will tell others that she has "walk, couch" so she is obviously very proud of her accomplishment. Though we have a long road ahead of us before she will begin walking, we are very happy for the interest she has shown. I think that is our biggest obstacle (along with strength, but hopefully GI will be able to help us with that).

Please continue to pray for Maggie as she is half way done with her steroids. She is doing pretty well so far and I just hope it continues. Last month, Thursday through Saturday were our very tough times. Please also pray that this week will not knock Maggie back in her increased interest of walking and development.