Was this in the Plan?

Sorry if you thought I had disappeared for a while - it really is so difficult to find the time to sit down and put my thoughts down, I find myself relying on quick facebook updates to stave off the inevitable texts which arrive when I have not been in touch for a while...so, where were we - December....

Daisy has continued to have problems with her repaired hickman line, sometimes itching so much she pulls the dressing off, this is not a good thing.  A couple of times it has looked very red and infected but cultures have been coming back normal, and bloods are OK apart from Daisy's ongoing problem with chronic anaemia, despite nightly intravenous iron. The hickman line is Daisy's lifeline, without this access she cannot get TPN and would not be able to live so I am worried that things are not right with it - you get to know your child's line after a while and this one does not feel right....Daisy is having a Lineogram at GOS next week to see if there is a tiny tear under the skin which is causing the irritation.  It's a difficult one, I hate have having to depend on a line which already has a repair but at the same time a new line would further limit her line access options as we cannot use previously used sites of which there are many, and as we all know Daisy is not good with anaesthetic and line insertions (an interventional radiologist told me once that her veins are very wiggly, imagine that, all those years of medical training for a diagnosis of wiggly veins).

Line worries aside the main thing we continue to be concerned about is Daisy's pain, we had to up her pain medication over Christmas and use buccal ketamine about 5 nights out of seven. We all live with Daisy's pain on a daily basis - in fact during the day she only occassionally experiences pain, night time is another matter and she becomes a different child to the one everyone knows.  Our other children rarely have friends over for sleepovers and we only ever invite "understanding" friends and family over to stay because often the household is woken up by her screaming.  We continue to wait on a date from GOS for a manomentry and other tests to see if the high output from Daisy's small bowel can be managed, I have my doubts....when we do eventually go back in , Andy and I will ask for a second opionion referral to Birmingham Children's Hospital where they have made a lot of progress with children with intestinal failure. We have been told that transplant is not an option, for various reasons, from the risks posed by her Costello Syndrome to the concerns that the pain may remain despite a new gut, but for Daisy's sake we have to leave no stone unturned.  In the remote possibility that Birmingham thinks that transplant may help, Andy and I are not sure that we would even put Daisy through that, but we need to at least have explored all options even if it does confirm once and for all that the only option is life on TPN.

Another option we do want to explore is the possibility of removing Daisy's colon entirely.  The biopsies have shown that it will never work properly and is the likely culprit of the pain she experiences, even though it is defunctioned it still gives her grief with daily mucous and bloody discharge from her bottom - again the worry is, what if this does not help, it's a big surgery to put her through but hopefully one with less long term risks.  Of course all of these conversations depend on us getting back into GOS for our inpatient stay or at least moving Daisy's outpatient appointment forward.  However over the years I have learned not to burn any bridges and to be patient,  Daisy's gastro consultant is the best in his field and he has always done the right thing for Daisy so I will try and be patient while we wait for the call....

Of course since my last post we have celebrated Daisy's 6th Birthday, Christmas and New Year - all of which have been significant dates in life with Daisy to date - this year was probably the best yet - no hospital, she was well and there was even snow!  Daisy loved the snow, especially sledging on the common opposite our house with her big brothers and sister, however it did put paid to our plans to have a proper birthday party for her as everyone was snowed in.  In the end we had an impromtu party with local friends and Daisy's wonderful carer managed to get to the house (probably because she is swedish and not phased by a bit of snow) and did a magic show for the children.

Daisy loved Christmas, especially all her Singing Hands dvds and her ELC Happyland Village.  Daisy knows Singing Hands from many months spent in GOS and now appears in one of their DVDs, we bumped into them while visiting Chase just before Christmas and Daisy was beside herself with excitement.  Singing Hands are probably the main way Andy and I have learned Makaton, Daisy's signing system so we were pleased they have produced a Christmas DVD so we can sign along to I'm dreaming of a White Christmas,....

The start of this year feels more optimistic than previous years - in a way it shouldn't, Daisy's gastro problems are the worst they have ever been, her TPN requirements keep going up and her stoma output remains at an average of a litre, her pain meds are being increased regularly, but cognitively she is coming on in leaps and bounds, she vocalises more and more, shouting for her brothers to come and put DVDs on, or demanding help with games, she is growing up in so many ways and shows us daily how capable she is.  In many ways we now know what is happening with her gut, TPN is forever and the stoma is permanent, we can live with that now.  Tomorrow the palliative consultant is coming to visit to adjust the pain meds and add a new one in, hopefully we will get some answers from the gastro consultant soon about colectomy surgery and second opinion referrals, so more than ever before there is a plan and we know what is happening.

My daily battles still continue trying to get support, equipment and respite help - it is these things that wear you down,  I know what Daisy and the family needs but sometimes we have to jump through so many hoops to get to that point, and I also think that living where we do doesn't help, there is a postcode lottery element to support for children with disabilities.  And beyond these battles we have more mundane issues like the leaking sewer pipes underneath our kitchen floor....at the moment we have no kitchen, all of Christmas was spent with us burning scented candles to hide the smell, hopefully the work will be finished by the end of January and we will have a shiny new kitchen and floor and no more broken sewer pipes...hopefully my sanity will be intact as I fill kettles in the bathroom and washup in the bath....Daisy is oblivious to the chaos of our lives, school is the most important thing in her life, followed by Singing Hands and then her siblings who are at her constant beck and call....she is surounded by love and happiness and that is why, whatever it brings, 2011 will be good for us...