Ten Things I Hate About You

Before we were introduced, I hadn’t really had any real drama in my life. The biggest thing I had to worry about was what we were going to have for tea, or whether I’d overindulged too much to fit into that dress at the weekend. And then you came along, and everything changed. Everything. And even when we met, i didn’t appreciate the impact you would have on my life, and everyone in it. Because what at first seemed like something that would have an effect on just one of my family, very soon demonstrated that it’s effects were more far-reaching than the immediate victim. Your tentacles reached across to touch all of my dear little family, and slithered into every part of my life. And whilst I try hard not to forget the good that came from meeting you, I refuse to accept that you gave those gifts to me. You did not effect those positive changes – those changes came from the strength that I managed to produce in spite of you, not because of you. And so let me tell you, Kawasaki Disease, all the things I hate about you.

I hate that you stole perfect from me. Because that is what you did. You stole the most perfect joy I had ever felt in my life up to the point that my daughter was born. When I look back now to those blissful weeks with my newborn baby, they are over-shadowed by the unseen threat of you. When I look at the few photographs I have of those precious weeks, I can recall the pure contentment that I felt whilst I drank in every inch of my perfect little girl. But there’s something else now when I look back as I find myself searching for signs of your appearance; how long had you been lurking, waiting to make your presence felt? Days? Weeks? Not months, as you made your entrance when Freya was just 7 weeks old, and took my perfect from me before I had even had the chance to accept that this was my life. I hate you for that.

I hate you for the damage that you caused, to my little girls heart and my own. Your physical attack on my daughters body caused damage that has since repaired to spite you, though we will never know what lies around the corner as you sneer at us from afar. The effects of the emotional and psychological onslaught that you raged upon me went far deeper than any physical impact you created. Far deeper and perhaps more permanent still. Anxiety is one of the gifts you bestowed upon me, and sadly you declined to accept returns.

I hate that you took me away from my family, particularly my son. I hate that your presence resulted in my absence and caused a fissure in relationships that, theee years on, we are still fighting to mend. I hate that you created mistrust in me, from those who trusted me the most, because my attempts to protect them from what you were doing to our little Freya were seen as dishonest and insincere. Because of you my children learned that sometimes parents lie. And you can sugar coat it as a white lie if you want to, but to a boy of 5 who is just adjusting to not being the most important one any more, a lie is a lie. You have no idea how much damage that has done to a vulnerable little boy who trusted his mother the most in the whole wide world. For that, I will always hate you.

I hate that you made me afraid. Afraid of life, afraid of death. Your ego will tell you that you taught me not to take life for granted, and maybe there is some merit in that. But you took away my innocent enjoyment of a life and replaced it with a life where I am constantly looking over my shoulder, wondering when time may run out for me or any member of my family. You can tell yourself that the fear of losing them has made me love them more, and that might be a little true, but mostly that fear has made me edgy and anxious and sad, and those feelings threaten any chance I had at savouring every uncertain second that we have on this Earth. I hate that you gave me that.

I hate that you show up, mess up and leave. The lucky ones manage to avoid any long term damage you try to cause, but there are still so many who are permanently impacted by your arrival. Less lucky ones might face an uncertain future with broken hearts, but at least they get a life.

But worse than that, you are too often allowed to take a life too young to be taken, and for that I hate you. I hate that we don’t know who you are, what you are, where you come from, or how to get rid of you. You are not welcome, and yet you show up anyway. The lives that you rudely interrupt are forever changed by you, but you don’t change. You just move onto your next victim, sending another family into turmoil and uncertainty and fear. I hate that we haven’t stopped you yet.

Proving them wrong..?

So today was Freya’s first cardiology follow up of 2017.  In case you don’t remember where we are at from the last visit, I’ll quickly bring you up to speed.  We had a cardiology follow up in September 2016 where I questioned the Cardiologist’s desire to carry our a cardiac catheter angiogram.  At that appointment I was told that I needed to trust the doctor or she would have no choice but to refer Freya to another hospital.  However, shortly after the appointment I received a letter which allayed some of my fears, and so I made an appointment with the Cardiac Intervention team to discuss the procedure.  At that appointment I was made to feel more at ease about the procedure itself, however the doctor said he was not happy to perform it on Freya given she was still so young, and asymptomatic.  I left it with the two of them to argue the case, and eventually it was decided that whilst there was a degree of anxiety about the speed of the remodelling of Freya’s arteries, it was in Freya’s interests to wait a while longer, and she was placed on the waiting list to undergo the procedure in the Autumn of this year (2017).  That was good news for me, as it seemed like a good compromise, although I then felt quite nervous about what could happen in the interim, and gave my consent to wait as long as Freya was reviewed regularly in between.

I believe the idea was for Freya to be seen in 6-months (from the last appointment), however I was keen to evaluate Freya’s current situation before we go to Mexico, so her appointment was made slightly sooner than planned.  And that brings us to today.

Now, at Freya’s last appointment they were unable to obtain an ECG reading as Freya was hysterical and kept pulling the electrodes off (“stickies” as she calls them).  Even when we managed to get her to lay still, she was just too distressed to get a proper reading.  Since then she has developed an acute fear of stickers – all kinds! She wouldn’t even allow us to go near her with a sticker, not even to stick one on her clothes.  So we’ve been working really hard trying to beat that phobia, and we had a breakthrough last week after a visit to Cannon Hall Farm.  I’ve spent the last week chatting to Freya about the hospital visit, talking about the ‘stickies’, where they’ll put them and that she has to be brave and not wriggle or cry.  On the way to the hospital this afternoon she told me and her Dad that she liked hospitals, and chatted away about the stickies and how brave she was going to be (I say ‘chatted’ but it was more like a mantra – “I like hospital, stickies on me, my legs, my tummy, me not cry, me blave.”)  I was hopeful that today’s appointment would be more productive.

When we arrived we were sent straight for an ECG.  Sitting in the corridor, one of the nurses that had looked after Freya before came and had a chat with us.  She made a fuss of Freya, and after a while asked if she would like her to do her ECG for her.  Freya said she did, so the ‘nurse’ (not sure what her actual job title is) went and asked the other staff if she could do this one as Freya is very nervous and she knew how to handle her.  She decided to place the electrodes on her arms and legs only, leaving her torso free.  Despite her best efforts, Freya still screamed at them to stop.  I managed to calm her down (by telling her that Paw Patrol would be on the ECG screen any minute!) for just long enough to get a reading, although I gather that it wasn’t a full reading with it only being on her limbs.  Freya then refused to be weighed or measured so we had to leave that part too.

We went into the Cardiologists room almost straight away, and she asked how Freya had been.  We updated her on the chicken pox vaccinations, which are now complete.  The episodes of single fever spikes in the early hours of the mornings (can be associated with angina) had ceased, and Freya was no longer having periods of suddenly lying still on the ground, so it must have just been a phase she was going through.  The doctor tried to do an echocardiogram but Freya resisted (for the first time so far on this journey), and the Cardiologist wasn’t able to keep her still for long enough to get a look at her coronary arteries, let alone measure them.  She kept fighting to get away, shouting “Stop it, stop it, please help me!” which was so upsetting to watch.  She did however get a look at the heart chamber and could see that the heart was functioning normally – this was also confirmed by the ECG results, and to be fair, heart function has never been a concern in Freya’s case. As long as Freya’s blood can keep flowing nicely through the arteries everyone is happy, and that’s what the daily dose of aspirin is there for.

I must admit I felt more than a little uneasy about not being able to get a close look at Freya’s arteries.  I mean, it’s the arteries that are the issue and I really wanted to be sure that there had been no further narrowing from her last appointment.  The doctor didn’t seem to be too concerned however so we sat down for Q&A before setting off home.

So, what did we learn? I am going to bullet point it to make some sense of it all:

  • The Cardiologist referred to the latest paper on the long-term treatment guidelines for Kawasaki Disease, and said that what she had read had given her some reassurance that the speed of remodelling in Freya’s case is not as unusual as she first thought.  I think she may have been referring to the latest JACC review which I actually sent her after our last appointment (I can forward it to anyone who would like it – you can contact me through the awareness page www.facebook.com/freyasstory).  Her initial anxiety was that with Freya’s aneurysms remodelling so fast it might be a sign of stenosis occurring.  However having read the paper, she established that actually it is common for remodelling to occur within the first 2 years, particularly in cases where children are treated more aggressively than the standard treatment, as in Freya’s case.
  • Freya was treated with the standard IVIG and high-dose aspirin at the time of diagnosis, with the addition of intravenous steroids.  Resistant to two doses of IVIG she was then given another drug called Infliximab.  This is not widely given in the UK, although there is a strong case for it’s use, particularly in severe or high-risk cases.  As a very young baby, Freya was in the high-risk category for heart damage, and also presented with a severe case of the disease.  The hospital had to apply to NHS England for permission to administer Infliximab to Freya – I still have a copy of the letter granting that permission.  Freya’s Cardiologist believes that the Infliximab was instrumental in Freya’s cardiac recovery from the disease and I have to say that I agree.  I think Infliximab saved Freya’s life.
  • I asked about our impending long-haul flight, and we were reassured that there should be no concern.  We should make sure we don’t forget Freya’s aspirin, and should keep her hydrated on the flight, but that was the only caution. Oh, that and that we had to remember to send the doctor a postcard 😉
  • I also asked about cholesterol testing, as there has been some information circulated about undergoing the test one year post-diagnosis.  We were advised that it may be standard in cases fitting the ‘normal’ age bracket for KD, but that Freya is too young for a low-cholesterol diet and would not be treated with statins for high cholesterol as her brain is still developing.  I guess that’s where we have to trust the individualisation of our children’s cases compared to the standard protocols.
  • I have also read that aspirin is best taken at night to reduce the risk of cardiac events during the nighttime hours.  Freya has always had hers in the morning, but with her soon going to be with a childminder, I wanted to switch it so I can give it to her before bed.  This is not a problem, and the anti-platelet effects of the drug will remain long enough for the longer delay between doses when I make the switch.
  • The last thing I asked was in relation to specific care plans/patient specific protocols required for the childminder, for example.  The doctor said that as long as the childminder knew what to look out for – becoming pale, sweating and quiet – there were no other ‘special’ arrangements to be made.  I expressed my concern that in the event of a potential cardiac issue, were an ambulance called it would take Freya to our local hospital which is not a PCI centre.  The doctor is going to provide me with a letter outlining the care Freya should receive in such an event, and advised that in coronary cases, Freya would be better transported to a local hospital for immediate care than risk the journey to Leeds.  Once stabilised, she could be transferred by the EMBRACE medical transport service to the cardiac unit if necessary.

We agreed that Freya will be seen again in 6-months, and that although they feel less anxious about the progress so far, they will still carry out the angiogram later this year.  I agree that it is prudent to take a closer look to be sure we know the full picture.  I also explained that whilst in the past I have questioned the steps they wanted to take, it was never from a place of distrust but only from making informed choices about what was best for Freya.  Even though I was the one who wanted to delay the procedure, I have still had to live with the fear that I may have made the wrong choice, and something terrible could happen without warning.  Overall it was a very positive visit today.

But (yep, there’s always a but with me isn’t there!), I can’t help but still feel a little uneasy that what was decided today was not based on what we could actually see (with the exception of the heart function being ok).  For all I know, Freya’s arteries could have remodelled even more than the last appointment and now be heading dangerously towards narrowing. I guess that is a possibility, but we have made decisions today based on probability.  The doctor thinks it is improbable that Freya is in any real or immediate danger.  Hopefully the aggressive treatment Freya received in the acute stages of the disease have set her up for a bright future.  There are still many unknowns, some of which we won’t get answers to until much later in Freya’s life.  For now, perhaps it is time to have a little faith

For some reason as we reached the exit level of the hospital, we turned the wrong way out of the lifts.  It wasn’t a big problem as you can get out either way.  This way, though, took us past the Brotherton Wing – the old part of the hospital which houses the parent accommodation where I had to stay, alone and far away from Freya when she was being taken care of in the cardiac high dependency unit.  As I walked past the entrance to the old wing, I couldn’t help but feel a deep sense of sadness at the memory.  And then I remember the chapel that I used to pass on that long, lonely walk to my room every night when I couldn’t keep my eyes open any longer.  I don’t consider myself a religious person, but not wanting to leave anything to chance, I had entered the chapel the day after being told there was a chance we could lose our daughter.  It as the day Freya was taken  back to the Children’s Hospital, and as a parting gesture I had taken a slip of paper from the table inside the doorway of the chapel and wrote on it, “Dear God, prove them wrong.”    I am beginning to think He might just have been listening.

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Living with a Broken Heart

I have written many blog posts over the last two years, sharing our journey with Kawasaki Disease, but it struck me this morning that I have never really been able to articulate how living with this disease day-to-day feels for a parent.  It is a feeling I have become so accustomed to now, that it almost feels normal, and that is why I think I find it hard to describe.  My goal today is to try, so that I might share with you a glimpse into how our world changed in June 2015.

In a nutshell, Kawasaki Disease is a form of vasculitis, causing inflammation in the medium to large blood vessels when it strikes.  It is generally contained to children, mainly affecting those aged between 2 and 5 years old, though not exclusively (my daughter was 7 weeks old).  It is characterised by a number of symptomspersistent fever, red eyes, rash, swollen extremities, sore/cracked lips or strawberry-type tongue, and swollen lymph glands in the neck.  With no known cause, there is no diagnostic test to differentiate Kawasaki Disease from other similar childhood diseases (Scarlet Fever looks very similar and is a common misdiagnosis), and therefore a diagnosis is reached based on presentation of the afore mentioned symptoms.  Given that these symptoms don’t always show up at once, and sometimes not all of them are present, Kawasaki Disease can be a tricky illness to diagnose quickly.  And the speed of diagnosis is important, as research has shown that treatment within 10 days of onset of symptoms can dramatically reduce the risk of heart damage in affected children.  You see, 75% of children who get the disease will recover without long-term complications, whilst the remainder will sustain permanent damage to their heart if not treated (this reduces to around 5% with timely treatment).  Sadly, this means that no matter how good the doctors are at diagnosing the disease, 5% of children who get Kawasaki Disease will suffer heart damage that will remain with them for life.

Whilst mortality rates for KD are considered low, at around 1% of cases, I’ve always felt that the statistic gives unreasonable hope to those of us with children whose hearts were damaged.  I would be willing to bet that any deaths resulting from Kawasaki Disease are exclusively related to heart damage.  So if there are 100 cases of Kawasaki Disease, the statistics say that 1 of those children will die.  But when you consider that, with timely treatment, just 5 of those 100 children would suffer permanent heart damage, and you factor in the 1 child who will lose their fight, suddenly the numbers seem very different – especially if your child is one of the 5%.  Suddenly that 1%, when factored into the heart population alone, becomes 20%.  Now, whilst those numbers give the fear some perspective, I don’t want to cause unnecessary alarm for those of you living with a child with a broken Kawasaki heart – another bet I would place is that the majority, if not all, of the deaths resulting from Kawasaki Disease occur from misdiagnosis, or no diagnosis at all.  Like the little girl who was diagnosed with rhinovirus and died 6 weeks later when her heart failed her.

So, I guess that sheds light on a couple of things:

  1. My daughter is one of the 5%.  Unfortunately at just 7 weeks old when she became sick, she was in the high risk category for heart damage.
  2. It took 13 days to diagnose Freya, and therefore treat her (outside of the ‘magic’ window).  Add that to the high risk factor,  and she didn’t really stand a chance.
  3. Under the circumstances, it is pretty normal for me to feel afraid.

Thanks to Kawasaki Disease, my now 22-month old daughter Freya has a heart condition.  She was born with a healthy heart, and after just 7 weeks in the world, and 13 days with a mystery illness, Kawasaki Disease broke it.

Looking back I don’t think it was the diagnosis that changed our lives.  Hearing that the doctors had actually reached a diagnosis after two weeks of tests and various failing treatments, was a huge relief.  Even when they told me that it was the damage to Freya’s heart that provided them with the conclusion, I didn’t realise they were talking about something that would stay with her forever.  I presumed the damage to her heart was a symptom, one that would go away with the treatment.  I was wrong about that.  A week after celebrating Freya’s diagnosis I would be sitting in a room with a Cardiologist and a nurse as they told me that if my daughter’s coronary arteries (which had dilated to over 5 times the size of a normal baby) ruptured, she would die.  They could not prevent it, and they would not be able to save her.  That is what changed our lives.  Until then I had never considered the possibility of losing a child.  Facing that possibility head on, with no sugar coating, rocked the very foundations on which I had built my perfect, indestructible life.  Of course, nothing is promised, there are no guarantees, life is fragile (and all those other clichés you see on Social Media memes), but I really didn’t think any of that applied to me. Stuff always happens to other people, doesn’t it…

20 months post-diagnosis, and I think I can dare to say that we are in a pretty good place (frantically touches wood).  Freya’s coronary arteries showed significant improvement in the months following her diagnosis.  Her heart function appears normal, her coronaries have remodelled to within ‘normal’ parameters and she shows no signs or symptoms of anything troubling going on in there.  Good news, right? I guess that’s how we take it for now.  The thing is though, that dealing with Freya’s heart is one thing, but add in the complications that come with ‘rare’ (KD affects just 8:100,000 children in the UK each year) and you find that ahead of you is a lot of uncertainty, confusion and contradiction.

There are a number of long-term complications from Kawasaki Disease.  We often hear the words ‘normal’ from Freya’s cardiologist, we are also told by world leading specialists in this disease that Freya’s heart will never be ‘normal’.  We are told to celebrate remodelling, but warned of possible stenosis (narrowing of the previously dilated arteries).  We are told stenosis will take decades to occur, but read stories of emergency heart bypass surgery within months of diagnosis.  We are told to live a normal life, not to worry, but research shows that 80% of children who suffer significant damage to their hearts as a result of KD will require surgical intervention later in life.  Our doctors talk about what they see and know, but do not give confidence that they are familiar with all of the ways in which KD alters the child’s heart.  I won’t even pretend to fully comprehend all the possible risks associated with Freya’s heart.  I read about fibroblasts, myocarditis, and damage to the heart muscle, but I can’t begin to understand what those things mean in relation to Freya’s heart.  No matter how much I have learned and think I know about this disease, I didn’t spend years in school learning about human hearts.

When I allow myself to think positively about the prognosis for Freya, I believe she has a good chance of living a normal life.  But then I worry that I am becoming complacent.  Freya’s doctors have shared that they have a degree of anxiety over Freya’s condition, and need to take a closer look.  They’ve postponed that closer look until later in the year, and I worry about what changes might be occurring inside her heart in the interim.  Only a few days to wait for some reassurance on that score (Freya’s next cardiology follow-up is on Monday 13th March).

When I consider that there is a possibility (though perhaps not a probability) of Freya suffering a heart attack, for example, I find myself suffocated by the thought. It’s like there is no end to the suffocation because you never know when something like that will strike. And I know that can be said for anyone, but the worry is more tangible when you are faced with a known condition with associated risks. When I wake in the morning, I lay paralysed in my bed until I hear something through the baby monitor that will defy my worst fears – a rustle of a sheet, a snort or a murmur from my sleeping girl. Not until I hear a sound do I let out the breath that I’ve been holding since I opened my eyes.  I’m sure every mother could say the same, we all worry about our children don’t we.

Aside from my concerns for Freya’s future, the uncertainty that came with our daughter’s heart condition has caused me to question my own mortality too. I was never afraid of death before, I don’t think I gave it any thought. Now I am terrified. Until just now I thought it was just because I love my family so much that I am afraid of leaving them behind and missing out on what is yet to come. But actually I have come to realise that I am not afraid of dying, per se, I am afraid of dying too young. I have had to work so tirelessly, stay so strong, fight so hard to keep on the front foot with our daughter’s condition, that I fear for her future if I am taken from her too soon on her journey with this disease.  I am afraid that she will enter into adulthood not realising how important it is that she keeps her heart healthy, or how she may need to have a cardiologist on hand in labour if she ever has children of her own.  I worry that others will forget about all of this, because they can forget.  There are no visible reminders of what this disease did to Freya, so it wouldn’t be hard to put KD firmly in the past.  Me; I’ll never forget. The last 2 years are etched in my memory so deep that I can play the entire journey in my mind as if I were watching a video recording.  And my overactive imagination has managed to convert my fears into a DVD that plays for me over and over – I have ‘seen’ moments where life ended, clearly enough to feel the loss as if it were real.  Perhaps the intense fear that I have about losing my daughter is one of the lasting gifts that KD gave me?  Perhaps it has helped me to treasure what we have more than I may have done without it?

I think I would have been able to handle the effects of Kawasaki Disease better had it been more commonly known.  The rarity of the disease means that we don’t really know what the future holds.  We can guess, we can use the limited amount of information that is available from adult KD studies, we can trust that Freya’s doctors understand what they are dealing with.  We can have faith that it will all work out, that Freya is a little fighter,  a tough cookie, a miracle.

People tell me I should stop worrying.  They tell me that no amount of worrying will change the future.  Some tell me that the future is out of my hands, that ‘someone’ already has a plan for us and we should put our faith in ‘Him’. Some say that any one of us could get run over by a bus tomorrow or struck by illness.  They are all right of course.  Except accepting that something could happen, and knowing that something might happen, are two completely different things.  The fact is that the most important organ in my child’s body is faulty, and she only has one of them.   I am finding it easier to deal with that with each day that passes.  I find it easier to be optimistic about the future, even if only cautiously so.  But I won’t ever be completely free of the overwhelming sadness that this disease brought to my doorstep, and I will never stop being afraid of what this disease might yet have in store for Freya .

Kawasaki Disease didn’t just break Freya’s heart.  It broke mine too.

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Return to Cannon Hall Farm

Dear Freya

I must admit the title of this blog post made me smile a little!  Sounds like one of those old stories I read when I was a child, usually involving four or five intrepid children and a dog off on some treacherous adventure.  Today was not quite so dramatic as any of those stories, but it was an adventure for us nonetheless, and I must start by saying thank you for making today wonderful, when it might have been otherwise.

Today we visited a local visitor attraction, Cannon Hall Farm.  It is about a 45-minute drive from home, in Barnsley, South Yorkshire, and is home to lots of animals that you can get close to. At this time of year, in the Spring, the farm gives birth to new life in the form of tiny piglets and little lambs and if you are lucky with the timing you can get to hold a guinea pig and stroke a fluffy rabbit too.  We arrived just after 11am, and you were excited about seeing the ‘aminals’ as soon as we got out of the car.  I’ve visited many times over the years, but this was the first time you were seeing it with your eyes, and it was magical.  I love seeing life through a child’s eyes.  Everything is new and wondrous and those big blue eyes sparkled with excitement at every new thing that you encountered.

We paid our £5 entry – there’s a special offer on at the moment and you were free anyway, so it was most definitely good value for money!  We bought a bag of animal feed too, so you could interact with the animals.  We were presented with stickers to wear to show that we had paid our way, but even though I confidently placed mine on my coat, you were reluctant to allow me to do the same with yours.  See, you have developed this fear of stickers, presumably a mixture of ECG memories and the steady flow of sticker offerings at every medical appointment, but whatever it is those stickers cause you to recoil, and back away like I have some kind of venomous creature in my hands.  I managed to convince you within about half an hour that you had to wear your sticker if you wanted to feed the animals – you may only be 22 months old, but you are  bright as a button and you were really keen to send the food down those chutes.  I took the small victory, and punched the air in my mind.

You were mesmerised by the Meerkats and ran up and down the enclosure as they chased you from the other side of the glass.  Seems they sensed your fun and wanted to join in.  And then we went on to the breeding barns, led by a very eager you running off ahead, giggling “What’s in there?!” as you ran. You adored the pigs and their piglets, and toddled excitedly from barn to barn shouting “Bye bye!” to the animals as we left them.  You weren’t too keen on the tractor cleaning out one of the stalls, but we moved on quickly enough for you to forget about the monstrous roar of it’s engine as it shovelled away all the muck and straw.  You gambled on the blue ferret to win the race, but sadly it had no intention of leaving its starting block and lay there curled up in the warm Spring sunshine, along with green and yellow, while red took the title with ease.  We walked past the birds on our way to the sheep enclosure, where you delighted in the sounds of the lambs, remarkably like new born babies crying for their mummies, until one of the ewes decided to utter a deep, groaning “baaaa” and you ran screaming “Help me, help me mummy” until I scooped you up and headed back towards the centre of the farm!  As we passed the birds again on the way back, I saw the network of tunnels in the children’s play area out of the corner of my eye.  Silly really, that it was the sight of those tunnels that drew an inward gasp and brought a tear to my eye, but I quickly brushed the thought away as we headed back to see the meerkats again – they would bring back the smile in an instant.

We had pretty much exhausted your attention span, and the use of your little legs, by around 1pm so we popped into the restaurant for some lunch.  I ordered a sandwich and chips for us to share and we took a seat in the corner where I could pen you in at the end of a row of benches!  You like to wander, and I needed you to stay put and eat some dinner.  On the table next to us were an elderly ‘couple’ (I could tell by their conversation that they were not married, and later found out that they were both widowed friends).  Both the lady and the gentleman were showing an interest in you.  I mean, at risk of sounding sycophantic, you do draw attention to yourself. Those huge ocean blue eyes, and your little curls, along with this way that you carry yourself that defies your 22-months on this Earth, seem to gather interest everywhere we go.  You are quite simply captivating.  I don’t know what it is that you have, but I guess although it sounds like far too mature a word to use to describe you, I would say that what you have is charisma.  Oodles and oodles of charisma.  Whilst I am most definitely your number one fan, you seem to be gathering a following wherever you go.

Anyway, to get back to the point of our ‘adventure’.  After a number of musings and comments from the couple next to me, the gentleman remarked at how clever you are – he had been observing you when you were let down from the table and noticed how considered every move you made was.  He said you seemed to be well aware of everything and everyone around you, and he said “She’ll go far that one.” He said you seem ‘lively’ and I laughed and said “Oh yes! She keeps me on my toes!” and the lady replied, “Yes, but better to have them like that,  than in hospital poorly.”  I could have brushed over that comment, but instead I remarked that you had indeed had your fair share of that, and of course this sparked some interest in your situation.  “In fact, the last time we were here was the day before she became sick.”

And there it was; the reason for our visit.  We have not been back to Cannon Hall Farm since that day before our lives were changed forever.  Saturday 30th May 2015; you were 7 weeks old and it was our first outing as a family.  I don’t know why we haven’t returned to visit the farm really.  There is absolutely no suggestion that your illness was linked to the farm, and whilst the cause is unknown so it could never be completely ruled out, it is more likely to be just a coincidence and bad timing.  I think I just didn’t want to undo the memory of that perfect moment in our history.  I mentioned earlier that the sight of those tunnels was the only thing that triggered an emotional response (though I had been working hard to suppress the emotions I could feel crushing my chest all the morning).  I guess it’s because we spent a while there whilst your brother and sister got themselves lost in the maze of tunnels.  I think I fed you as we sat on a bench and watched the children playing in the early Summer sunshine, and congratulated myself on this perfect life we had created.  And up to that moment, Peanut, it really had been perfect.  You were perfect.

That day in 2015 at Cannon Hall Farm marked the end of perfect for us, or so it seemed.  It feels so unfair that things changed so early on in your life, before we had a chance to make any more perfect memories.  I guess I’ve wanted to preserve the memory of that day, hold on to the precious moment that is captured in sepia images in my mind.  It has been a huge flag on a timeline, marking the change from perfection to imperfection, and giving me something to grieve, to pine for.  But do you want to know something, Freya? What I realised today is that there was really no need for me to hold that moment on a pedestal as something to be quite so treasured.  Because, with the exception of 6 long weeks in a hospital cubicle and all the trauma of 2015, every single moment with you is something to be treasured.  Yes, I felt sadness wash over me when I remembered how carefree and wonderful our lives seemed on that day at the farm, but when I sat and thought about it I realised that without what happened to you, without Kawasaki Disease and it’s gifts (yes, you detect sarcasm) then we wouldn’t have experienced the wonder of today.  Without Kawasaki Disease, I would have returned to work after a year on maternity leave, and our moments would have been reduced to the same precious hours on weekends that your siblings were lucky to grab in between the mountains of washing and ironing.  Because of Kawasaki Disease, you now have a broken heart and an uncertain future.  But because of Kawasaki Disease, I now have a heart that is capable of feeling more than it ever had before.  It showed me a glimpse of what it might feel to lose someone I loved, and made sure that I will never take you, or anyone else I love, for granted.

Of course, I wish that we had never been introduced to this insidious disease.  I wish that you hadn’t been so little and therefore susceptible to the very worst that the disease had to offer.  I wish we didn’t have to face a future with hope, but no guarantees.  Our lives would have been so different without it, but I am not sure if our lives would have been better.  Is that wrong? I don’t know.  I just know that what happened to you in 2015 created an opportunity for me to be a better version of the me I had once been.

Today, as I saw the wave of sadness cross that lady’s eyes when I told her that you had a damaged heart, it struck me at how terribly unfortunate your circumstances must seem to someone on the outside, even if, as the lady said, “You wouldn’t know to look at her!”  But to us, this is just our normal.  Today I realised that what we have is not an altered you or a changed you.  The you we had for 7 weeks at the start of your life with us was wonderful, but it was not a patch on what was yet to come.  You have given us 22 months of extraordinary, and I cannot even begin to put into words how grateful I am to you for today, and all the days just like it, both in our past and in our future.

Whatever it is that radiates from within your little body, it takes my breath away and  I love you with all my heart.

On why I might once have been angry…

I had a conversation recently with a Paediatrician at our local hospital, who whilst discussing a current medical issue brought up that he was concerned that he had heard that I was angry at the hospital for failing to diagnose my daughter when she became sick in the early Summer of 2015.  He mentioned that I had taken my folder with me to our last visit, and that the staff had commented that I was very angry at the time.  I am not sure when he was referring to, as our recent visit when I took the file was actually a positive experience, and I was impressed by the communication between the three hospitals involved in Freya’s care.  Yes, I took my folder with me, but I take it with me everywhere.  That folder contains the letters from every clinic appointment Freya has had in the last 18 months – Rheumatology, Cardiology, Immunology.  I take it everywhere with me in case a medical professional needed to see the history, and actually it was useful because the hospital hadn’t been copied in on the letters and took copies from me while we were there.

The fact that the doctor brought it up has been niggling me for a little while, so I thought I would try and capture why in this blog post and try to explain why a parent might act in a certain way when their child has been critically ill.

When Freya became sick in May 2015, she was immediately admitted to hospital and her condition very quickly deteriorated.  Within hours of being admitted, she went into septic shock. When the first doctor who saw her decline started to take action, I felt like she was in good hands.  They moved swiftly but calmly as they got her into the High Dependency Unit to administer fluid resuscitation.  I remember the Consultant giving out instructions to the doctor and the nurses in the room, and they responded quickly, without any alarm.  I could feel the tension in the room, and I watched through the bars at the end of the cot in quiet disbelief at what was happening in front of my eyes.  But I watched in awe, not really knowing what they were doing, but feeling that it was right, whatever it was.

For 6 days, Freya was treated with a number of antibiotics.  The main suspect was meningitis, but she was too sick and weak to have a lumbar puncture to diagnose it.  During that first week, Freya displayed a fever that would not abate with the usual paracetamol and ibuprofen combination.  She had sore, red, cracked lips – with hindsight that was a symptom of Kawasaki Disease, but it was attributed to dehydration at that time.  She developed a rash all over her body, but in the first week that would disappear almost as quickly as it came.  Her hands and feet looked puffy and swollen, another symptom of Kawasaki Disease, but with KD being so far from everyone’s minds with her being such a tiny baby, it was put down to swelling at the cannula sites.  Numerous blood tests were taken in an attempt to identify whatever it was that was making Freya so sick, but nothing except the common cold virus (Rhinovirus) would show up in that first week.  That wasn’t enough to make my little girl so very poorly.  A lumbar puncture on day 6 would be inconclusive – elevated white blood cells, but no definitive sign of meningitis.  Perhaps the cocktail of different antibiotics delivered intravenously in that week had dealt with it? So why wasn’t she getting any better?

Apart from one locum doctor who visited Freya in the HDU and suggested we stop all the medication rather than find a new cannula site (I know, right?!), every nurse and doctor that took care of Freya in our local hospital was fantastic.  Not only did they take care of Freya, but they took time to take care of me too.  They treated Freya as if she were one of their own children, and they showed an interest in me, listened to me and showed me nothing but respect.  Some of the faces I can’t even remember, but there are a few that stand out and are etched in my memory, even if I can’t remember all their names.  There were moments too, that I’ll not forget. The time that one of the senior nurses removed all of the equipment from the room so that we could allow my other children to visit without frightening them, that was a highlight.

I hope that the nursing staff know how much I appreciated how they took care of Freya.  If I had any complaints at all they were tiny – it bothered me that the syringe packaging was sometimes left at the end of Freya’s cot.  It didn’t cause anyone any harm, just paper and plastic, but it made me feel bad because her cot wasn’t a dustbin.  The time the heart monitor failed in the night and they replaced it, but left the broken one at the foot of the cot; it was my baby’s bed, and although she took up very little room in it, I didn’t want those things left discarded like it didn’t matter.  And that’s it really, my only criticism.  And I know it might sound petty to share, but I hope that any nurses reading might think about how such a small oversight even when they’re obviously run off their feet, could make a new mother feel when she has too much time to think.

Even though the first hospital failed to reach a confirmed diagnosis, I do not feel anger towards them.  It is easy for me to sit here now and say that Freya’s symptoms were clearly indicative of Kawasaki Disease, but hindsight is indeed a wonderful thing, and I don’t know that they could have done anything differently.  In fact the Paediatrician said that he could understand my anger had Freya been diagnosed within hours of her transfer to the children’s hospital, but it took them a further week to diagnose her, so it was clearly not an easy undertaking.  I said that they had looked for KD on the first day in the new hospital and he said that was right, because it was he who had suggested that was what they should look for.  And now it makes sense why when they told us they were moving Freya, that they mentioned a heart scan.  I thought it was just a routine thing, but clearly they had a suspicion that needed to be confirmed outside of their own local facilities.  And that’s probably my one and only criticism of the doctors of our local hospital –  I wish they had told me what they were considering.  The problem is I never really asked them what they were looking for.  I was naive.  I thought they could just take her blood, plug the results in and hey presto! technology would have the answer.  So I let them do their work, and didn’t ask a thing.  The only question I wanted answering was one that I didn’t have the courage to ask.  I gave that task to my husband; is she going to die?

Had the doctors mentioned Kawasaki Disease, would it have changed anything? Well, you know that is a question that has haunted me since Freya’s diagnosis.  My instincts tell me that I would have read about the disease and asked more questions.  I would have asked the most important question of all, “Why isn’t it Kawasaki Disease?” And when they told me she didn’t have some of the symptoms I would have cried, “Yes! Yes she does, see?!”  They would have reached a diagnosis and given Freya the treatment on day 8, not day 13 when the damage had already been done.  We would have left the hospital, emotionally bruised, but with a child that had been very ill but was now well.  And we would have gone back to our normal lives…

The reality isn’t quite so straightforward.  Would I really have come to the conclusion that the doctors couldn’t, simply by reading what I could find on Google? I have heard of cases that have been diagnosed entirely because of the parent’s knowledge.  Would I have done that? Or would I have read about this obscure disease with it’s stupid motorbike name, laughed and moved on?  I guess even if I had helped them to reach a conclusion, even if they had managed to give her the treatment within that magic 10-day window, Freya was in the category with the highest risk of heart damage – a neonate, female, displaying severe symptoms which we now believe was KDSS.  When she finally got the treatment, she was resistant to both doses, and needed much more aggressive treatment to finally halt the path of the disease.  Maybe she was biologically destined to be one of the unlucky ones?

That said, I wish the doctors had told me about Kawasaki Disease.  It might not have come as so much of a shock when it was finally diagnosed, I might have been better prepared.  The Children’s Hospital decided not to mention it too – had they told me that was what they were looking for when they did the first echocardiogram on day 9 which showed them a reasonably healthy heart (a small murmur) and led them to rule it out as a prime suspect, perhaps I would have reminded them of the symptoms they hadn’t seen for themselves the previous week when we were at the local hospital?  And perhaps I would have had more respect for the doctors in the first week had I known that they suspected it first, but weren’t in a position to confirm it.  That’s why they moved Freya.  They wanted the Children’s Hospital to confirm or deny their hunch.  The Children’s Hospital did an echo and the results lead them to turn their investigations elsewhere.

I felt angry about that for a long time, in fact I’m not sure if a part of me is still angry.  I was initially angry at the local hospital for not getting it in that first week. Let’s face it, when we finally got the diagnosis and learned that Freya’s heart had sustained permanent damage, we were angry at the whole bloody world.  Now I know that the local hospital had KD on their radar, I feel less angry.  I only wished they’d told me.  So how do I feel about the Children’s Hospital?

Much like my experience locally, I met some really fantastic nurses during our stay.  In fact in all three hospitals (Freya would be moved to a Cardiac Unit in another hospital upon diagnosis) we met some of kindest, most caring people I have ever had the pleasure to meet.  I guess that’s why they do the job that they do.  It was a much busier hospital, so there was less time for chit-chat and the nurses seemed run off their feet moving from patient to patient to carry out observations and deliver medication. We were in a private room with Freya so were quite out of the way, which was isolating at times.  There were a couple of issues with medication – an oversight that meant she nearly didn’t get the second half of the drug that was meant to be saving her life and was only pointed out by me when I awoke to see there was no IV going in; that was a big one.  A lot of the time I felt like we were more of a number than we had felt at the previous hospital, but I’ll play Devil’s advocate that they were just so busy.  The majority of the nursing staff were wonderful, especially with Freya, which is what matters.  The nurses that came to talk to me in the night when I lay there crying on the foldaway bed, those that rocked Freya to sleep when I didn’t have the energy or the heart, they’re the ones that have stayed with me since our ordeal.  The actions of the nurse who accompanied us on a transfer to the cardiac unit when the ambulance didn’t arrive to return us until well after her shift will never be forgotten.  She saw it as her absolute duty to care for Freya and made arrangements to ensure that Freya’s medication and observations were carried out in that delay.  She had finished her shift hours before and had her own child to get back to, but all she could think about was keeping Freya safe – it distressed and frustrated her that she was unable to care for her patient, and she did something about it.

The Doctor’s at the Children’s Hospital were always around, either popping in to check on Freya, discuss possibilities.  They always seemed to be busy looking at the files, searching for answers and I don’t doubt that they lost many winks of sleep trying to work out why this beautiful little girl wasn’t getting any better.  I didn’t know until way after her diagnosis that KD had been considered and ruled out.  I wish they had told me at the start.  But again, maybe it wouldn’t have changed anything.  I would like to ask them now why they didn’t think it could be KD, and not just because the first echo was clear – you can’t diagnose KD from an echo.  They believed that Freya’s only symptoms were the fever and a rash.  I believe that her cracked, red lips and the swollen hands and feet were also symptoms – enough symptoms to confirm a diagnosis.  Had they understood more about the disease, might they have also known that whilst KD is very uncommon in young babies, young babies are more likely to suffer from Kawasaki Disease Shock Syndrome? Had they considered that, might they have realised that whilst thrombocytopenia (low platelet count) is not a common symptom in KD (in fact is is usually very high), it is a characteristic of KDSS?  Might they have looked back over the previous week and seen that everything about her was synonymous with a KDSS diagnosis?

Perhaps my expectations of them are too high – they cannot possibly know every single childhood ailment in detail.  There are over 7000 rare diseases in this world and KD is just one of them.  Some doctors won’t ever have seen a case in their career.  They spend most of their career dealing with ‘horses’ and are not on the look out for the odd zebra that might turn up.  Is it only hindsight that allows me to see now what they couldn’t then?  I do know that they have learned from Freya, that she has taught them a lot about the disease.  I do know that they are less likely to make the same ‘mistakes’ again.  Again, I just wish they had told me what they were looking for, and why it couldn’t be Kawasaki Disease.  Because when they ruled it out, for whatever reason, no matter how unusual Freya was, they got it wrong.  They got it wrong, and I will never know if that decision was responsible for the damage that KD did to her little heart.  I cannot change the past, though, and so I have to be thankful for the doctor who came to see her when the rash appeared on day 12 and suggested she be sent for another echo.  That echo showed the damage that confirmed it had to be Kawasaki Disease.  That doctor may just be responsible for saving Freya’s life.

So let me get back to the point of me writing this blog.  I guess I wanted people to understand that I may well have been angry at times, but that my anger does not mean that I do not appreciate everything that all those medical professionals did and have continued to do in taking care of my daughter.  At the time I wanted someone to blame for breaking Freya’s heart. And mine.  I was angry at life.  I was angry at a God that I’m not even sure I believe in.  I know now that no amount of anger or blame was going to change anything, but it is one of the stages of grief.  I could not believe that I had taken my perfectly healthy child to hospital with what looked like a virus, and took her home with a heart condition.  That had to be someone’s fault, didn’t it?  Who knows.  Nothing is going to change.

Do I think that a diagnosis might have been reached sooner? Yes, I do.  Do I wish that they had asked me what I thought, told me about Kawasaki Disease and asked me if I could think of anything that they might have missed? Absolutely.  Do I consider myself lucky that Freya fell ill on a Sunday at 7 weeks old and was therefore too much of a risk to leave to chance? That I didn’t have to face countless appointments with GP’s who might have sent us home with the usual ‘virus’ diagnosis? Yes, yes, and yes – when Freya went into shock, she was absolutely in the right place; what if that had happened at home?  Do I thank my lucky stars that regardless of all that anger and confusion, regardless of whether it was ‘too late’ or not, that the right doctor walked in at the right moment on the right day and helped them to reach the right decision? Yes, a million times yes.

I have found peace with that part of our journey now.  I am just grateful that Freya was strong enough to fight, and that she is here, bold and bright and beautiful.  I used to refer to her as ‘damaged’, ‘broken’.  I don’t see her that way anymore.  The hidden faults within her heart are no longer what defines her for me.  And whilst I can’t change the path that we have been down, I can make a difference to the future of Kawasaki Disease by sharing our experience and never giving up when it comes to raising awareness.

I hope you will continue to support us.

www.bluemama.co.uk          www.facebook.com/freyasstory              Or Tweet @freya_story 

Then and now…

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A (rainy) Day in the Life of

When I was working, I often used to think about stay at home mums and wonder what on Earth they did all day.  I imagined it was countless coffee mornings and baby yoga sessions, and although I thought it could be quite a dull existence, I often envied those mums who got to spend all their time with their children.  Now I am one of those mums – well, for a time anyway.  I am not a forever SAHM, but I am on a career break following a year off on maternity leave, and am now 17 months into a 2-year break from my job.  And in my new role I have gained more than enough experience to know exactly what SAHM’s do all day, and it varies from minute to minute and day to day.

Mostly I consider myself lucky. Lucky to have my daughter here to share the time with (see previous blogs tagged Kawasaki Disease if you are not familiar with my daughter’s story), and to be able to share so many precious times with her.  It’s also nice to be able to take the other children to school, and to be here when they come home, cook a meal, do ‘normal’ family stuff.  One of the huge positives for me is that I pretty much always have a clean and tidy house, and I have never been on top of the laundry so much in my entire life to date!  Boring, I know, but I have a child who sleeps for three hours in the day so I have to keep myself occupied (although I will confess, I have been known to spray some polish into the air and watch a movie or two!).

Yesterday was a pretty nothing kind of day.  The weather forecast suggested it would rain  so I had already decided it would be an indoors day (much to my annoyance, given that we spent all last week on house arrest with my youngest whilst she battled chicken pox, hand, foot and mouth, or both!) Oh, joy!

So, here is what this SAHM did all day yesterday…

07:01     Text oldest daughter “What time do you get up?”

07:05     Text received “Now”.  Well that’s that sorted! The parental heaven that is a 12-      year old that can quite easily manage herself in the mornings.

07:10     Screaming of the house alarm! Eldest has remembered to let the dog out, but has forgotten to unset the house alarm before opening the back door.  Again.  For the millionth time since we got the puppy!   Baby stirs, lay as stiff as a board with teeth clenched, hoping for the chance to hit the snooze button!

07:40    Wake middle child (cue “I don’t want to get up!”, “I’m still tired!”, “I hate school!” or any combination of the three).  Manage to cajole him out of bed to get dressed (again to complaints that this isn’t the order he likes to do things in – he prefers to eat breakfast in his pyjamas, aka pants, but I want him organised as soon as possible!).  Go downstairs, feed the dog, make breakfast for the awkward one and prepare packed lunch.

08:00    Wake baby up.  She greets me as always with a huge cheeky smile – the only one of the family who seems to be happy to be awake! But then she did go to sleep 14 hours ago so I guess she’s all done with sleep!  In the interests of being organised, today I get her dressed before breakfast and vow to be extra careful with the Weetabix!

08:30    Leave for the school run.  Although it’s only just under a mile and a half we drive, because quite frankly we would have to be up far too early to get there on foot with my son.  In my defence, I do sometimes leave the car at school and walk home, returning on foot at pick-up time to get some daily exercise, but only on dry days or when I can be bothered!

09:00    Get home from the school run and make a cup of tea.  I made a decision yesterday that Freya needed more stimulation, and vowed to spend at least an hour per day in some kind of valuable developmental pursuit.  Got the painting stuff out and proceeded to paint at the kitchen table (or in Freya’s case, ON the kitchen table!).  Good job this stuff is washable!  She was bored after about 30 minutes – ok, ok, so it was me who was bored! I think she would have painted all day long if I had let her! But she’d managed to paint about 5 masterpieces using mainly her hands and the wrong end of a paintbrush, so I figured that was enough.   Took photographs of said masterpieces and posted on Instagram to show world just how good I am at this mummy stuff (I’ve got to love Social Media for allowing me to share all these perfect, wonderful moments.  Not sure the world is ready for the screaming banshee selfie!)

09:30    Bribe youngest with a biscuit to allow some sofa time and a bit of The Wright Stuff. Email Immunologist to ask for advice regarding the postponement of Freya’s MMR vaccination.

09:40    Check e-mail.  No reply. Eat half a packet of Rich Tea biscuits with a cup of coffee.  I don’t even like Rich Tea biscuits!

10:00    Check e-mail.  No reply. Anyone would think this doctor is busy….

10:20    Google “What to do with a toddler all day long.” Roll eyes at Netmums.

10:30    On first sign of tiredness, make up small bottle of milk (I know it’s a bad habit that I need to stop!) and put Freya in her cot for a nap.

10:42   Check e-mail.  Still no reply.  Consider phoning the hospital but decide to leave it until tomorrow. Very reasonable of me, I thought.

11:00    Through the baby monitor – “Mummyyyyyyyyyy”.  Half an hour isn’t enough for a nap, so I speak into the monitor, “Go to sleep!”.  And she does.  For another two hours!

11:10    Google “What to do all day when your toddler sleeps for hours”.  Limited resources available on this topic.  Eventually give up before I risk finding something I should be doing.

11:30    Settle down on the sofa with the puppy on my lap, and watch daytime TV – namely This Morning (got to love a bit of Phil and Holly) and Loose Women.  Check Facebook (ok, I don’t think this was the first time I did that, but you can make the assumption that I check  it every 5 minutes and save me writing every time down!).

13:00    A boring and uneventful day is broken up by a momentous happening – the postman arrives with mail!! Ooh yay! Excitement! Except for the fact that the mail seems to be a rock in an envelope and makes such a thud that it wakes the baby up.  Damned postman!  And to add insult to injury it is a Jojo Maman Bebe catalogue, sent by a company who clearly have no idea how skint this SAHM is!  

13:05    Discard catalogue in bin, and get baby up.  Change nappy (as with checking FB, please note this isn’t the first, or last, nappy change of the day).

What to make for lunch….

13:10   Decide to make omelette for lunch.  Whatever I make it will end up being a race against time to catch it before it hits the floor and the eagerly awaiting puppy.  I make sure she sees me cutting the cheese (“eeeese”, her favourite) and ham, (“am”, another favourite) in the vain hope that this might make the eating of the finished article more likely.  At the last moment before pouring the mixture into the frying pan I am struck with the notion that Freya may be more likely to eat the omelette if it is presented in a novel way.  Out come the pastry cutters; a star, a circle and a car.  She is sure to eat omelette if it comes in quirky shapes, right? Well, don’t bother trying it at home.  The mixture leaked out from underneath the cutters and by the time I had prized the cooked omelette out from the metal objects I was faced with nothing more than a heap of omelette.  I served up the omelette (“Urgh” <chuck>) with some sticks of red pepper (“Urgh” <chuck>), some cucumber slices (“Urgh” <chuck>),  and four little squares of cheese (“Mmmm eeeeese!”). On the third scream of “DOWN!!!” I took my little angel out of her highchair proud in the knowledge that after all that effort, the darling ate four fingernail-sized pieces of cheese.  Groan!

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14:00    Determined not to be put off by the epic fail of lunch, start to prepare vegetables for batch cooking of spaghetti bolognaise/cottage pie.  Cut vegetables with one leg firmly planted against the drawers to discourage attention-seeking daughter from removing all kitchen utensils and feeding them to the dog.

14:30    Chastise baby for pulling books from the bookcase and tearing yet another cover.  How is it that the bookcase has survived two children, and I now find myself blessed with a destroyer of one of my most prized possessions? Baby looks sorry, so I forgive her.

14:35    Chastise baby for pulling books from the bookcase and tearing yet another cover.  Replace books and repeat 58million times.

15:15    Bundle daughter into car and drive to school to pick up middle child.  He’s had a good day (“100%” – my son provides his evaluation of the school day in terms of percentages).  Remember one of my favourite movies – Rain Man.

15:40    Chatting with a mum outside the school gates ends in tears when Freya’s ‘unkind hands’ scratch the face of the little boy who is trying to be nice.  Make swift exit.  Must send mum a message when I get home to apologise for toddler’s assault.

15:55    “Can I play on Minecraft?” Most uttered sentence in middle child’s vocabulary.

16:00   Text mum to apologise for toddler’s assault.

16:30    Dish up lovingly prepared spaghetti bolognaise.  Wonder how much will end up on the floor. “Not again!” (Son’s affectionate response to being served pasta).  Surprised when youngest wolfs down an entire bowl of pasta and half a dozen pieces of bread.  Remember lunch.  Consider skipping lunch in future…

17:00    Clear away dishes.  Make tea for mother-in-law.  Sit and drink tea safe in the knowledge that there is now a second pair of adult hands in the house! Chastise baby for pulling books from the bookcase and tearing yet another cover….

17:30    Bath baby, pyjamas on, milk.

18:00    Put baby to bed.  Aaaaaand relax.

After that things are pretty easy.  Another hour before middle child is off to bed.  Dinner.  Eldest takes herself off to bed at some point during the evening.  Watch Cold Feet.  Go to bed.

And that’s about it.  In fairness, I try to avoid days like these, but with money fast running out I don’t have many options on rainy days.  Being a SAHM is a constant mix of emotions.  I’m lucky and glad, and lonely and sad all at once.  I would not change the opportunity I have to stay at home with my daughter, and I am lucky that she likes to have a long nap in the daytime, leaving me some free time to do whatever I choose.  Problem is, I get so bored of my own company whilst she is sleeping and it often makes me feel a bit miserable.  Right now, the house is silent but for the hum of the baby monitor beside me;  Freya’s nap was a little late today on account of us making it out of the house this morning for a visit to the local wildlife park.  In about 10 minutes I will have to wake her up to take her on the school run.

Today was a different kind of day, with a lovely (if wet) trip to Yorkshire Wildlife Park for a couple of hours this morning. The weather forecast was wrong though, and we got completely drenched.  Freya seemed freaked out by the rain dripping on her, and as a result I had to carry her around the entire Park! As an annual pass holder, entrance was free – result! Except for the amazing sweet shop on the way out where I spent more than the ticket price on Pick ‘n’ Mix and nougat! Doh!

With Autumn approaching, and Winter just around the corner, I need to have a serious think about how we are going to spend our days.  And I need something to pass the time whilst my daughter sleeps every day.  All suggestions welcome!

Everything changes

I have just returned home from handing back all my equipment to my employer as I embark on this new chapter in my life.  Funny how strange it felt handing back a laptop and a mobile phone that have only been locked away in the garage for the last year anyway.  I guess it felt somewhat symbolic of the final step towards (temporary) detachment from my career.  And just being there in the restaurant, drinking coffee like I used to every morning when I was there, felt quite surreal.  More so, because I had you by my side, and a rice cake in my hand instead of a notepad.  I was very aware, having just finished a year of maternity leave, that under normal circumstances I would have been there alone.  I would have been the one rushing off to that conference call, or heading off to a meeting.  I have no regrets, however. Non, je ne regrette rien.   I consider myself incredibly lucky to have the chance to take some additional time to concentrate on your immediate needs, and to regain some of the time we lost last year.  With your brother and sister I would have missed so much of what I get to see every day with you sweetheart.  Watching you develop and grow is a source of constant amazement for me, and I don’t think I will ever tire of spending time with you.

The effects of the last year were not just felt by me.  I’m sure they were felt by you, but I have no idea how because you can’t tell me yet.  I hope that you don’t remember any of it. That all you remember is how we used to go on the train for days out, or for coffee and cake and to the park.  I won’t ever forget that the backdrop for all of those things was an imposing hospital looming behind us.  But hopefully you will just remember feeding the ducks in that nice park, and you won’t have noticed the tears in my eyes that came because I was saddened by the memories that the park evoked.  One day we will be able to go to Weston Park and sit on a bench and let the warm sunlight wash over us as though it were sent right from Heaven.  We will lie on a blanket and make pictures in the clouds, feed the birds and the ducks and watch the fish in their shady hiding place under the little bridge.  But we will always make our place on the other side of that park so as to spare the mums who, like me last year, watched other families enjoying the summer through the windows of a hospital cubicle.  The nurses thought they were helping me by moving me to a room with a view. The brick wall which was our previous view had been quite oppressive, but no more so than watching mums play with their babies in the shade of the trees.

Back then I thought I did a pretty good job of protecting your brother and sister.  We told them that you had a cold but needed the nurses to help get you better because you were too young for Calpol.  It was a white lie. Quite a big one, but white nevertheless.  And you did test positive for Rhinovirus in that first week, so it seemed like a plausible excuse.  We also kept your siblings from the hospital.  They visited you on your last day at the local hospital (after a week), and then maybe once or twice when we moved to the Children’s Hospital.  We didn’t tell them when you were moved to Leeds, so they didn’t see us when I was in my darkest place.  What I didn’t know was that our attempts to protect them probably made their anxiety worse.  I underestimated Eliza.  She has told me since  that she was very worried that I would be coming home without her baby sister.  She wasn’t stupid; she knew something must be pretty wrong and that a common cold wouldn’t need her mum and sister to be away from them for as long as we were.  So she actually worried more, because she knew it had to be bad for us to want to hide it from her.  And Fin? Well he went off the rails a bit. His behaviour at school hit an all time low, and the effects of last year have only just begun to wear off with a huge amount of support from the school.  He was the baby of the family before you came along, you see.  He was excited about getting a baby sister (although I do think he might have secretly been hoping for a brother to play Minecraft with!), but suddenly not being the baby anymore is quite a lot for any child to get used to.  And then just 7 weeks after we brought you home, just as he was probably getting used to you being around, he lost you and me for a while.  6 weeks.  That’s a long time in a 5-year old’s life.  Because we played down your illness so much, he couldn’t understand why his Mum would leave him.  He thought that I had chosen you over him, and his little head wasn’t quite ready to work that one out.  His self-esteem took a huge knock, and he became very insecure for a while.  No need to feel any guilt about that though, not you or I.  I made the decision to protect them for all the right reasons and I wasn’t ready to tell them that they might lose their little sister.  They didn’t need that worry.  And by the time you read this, you will have seen that none of this had a lasting effect on them; they probably won’t even remember it when you’re old enough to be reading this.

I am not the same person that I was before I had you.  I might even go as far as saying that you are lucky that this happened to you.  You have had the very best of me this last year, and I dare say  that you will continue to get the best of me for as long as we are both here.  I have not taken a single moment with you for granted, and because of that I think I am more patient with you than I might have been with the others. I am most definitely more intuitive about your needs. Perhaps some of  that is due to age (I was 40 when I had you), or experience with having done it twice before.  But I think most of it is the incredible bond that we have developed by spending so much time together since you came into the world.  Because I am scared of you getting very poorly again (I’ll tell you one day about chicken pox and the medication that you take), I have kept you away from large groups of children in the main.  I don’t take you to baby and toddler groups or play areas where the risk of infection is a constant worry for me.  I don’t wrap you up in cotton wool either – rather than avoid all situations, I tend to weigh up the situation based on my anxieties and I guess you could call it damage limitation, rather than complete avoidance.  That will become easier towards the end of this year (2016) when you have received the MMR, Chicken Pox and Flu vaccines.  Until then, we will stay together in our little bubble where we see just the right amount of people to allow you to build relationships with other children, but not enough for me to worry about you becoming sick.  I know I cannot protect you from everything, but I have to protect you from what I see as a risk, no matter how small that risk might be.  I cannot bear the thought of seeing you that sick again, Peanut.

My social circle is a little smaller than it used to be too.  There are lots of reasons for that. I’ve become very immersed in a Kawabubble over the last year and I don’t have an awful lot of time and energy for much else.  Most of my attention is on you, and getting you through the next challenges that the effects of KD will throw at us.  A lot of my attention has turned to our little family; this experience has made my family much more important to me than I think I allowed it to be before.  It’s also very difficult for me to spend time with people who cannot relate to our situation.  I don’t want constant sympathy, but I want compassion and understanding.  People that think that everything is ok now because I wear a big smile, and you look so amazing, don’t know me very well.  They don’t know how much I still struggle to come to terms with what has happened to you, and what the impact of the disease will have on your future.  70% of children in your situation will have to have invasive treatment later in life – a heart bypass, or a stent perhaps.  100% of children who have suffered coronary aneurysms as a result of KD will suffer myocarditis (inflammation of the heart muscle) which causes degeneration or death of heart muscle cells.  I don’t know how to compute the possibility that my child may show symptoms of myocardial infarction (a heart attack).  Just doesn’t seem real.  Later this year, whether it be through cardiac catheter angiogram or CT angiogram, we should get a closer look at the cause of the remodelling of your coronaries to better understand what the future may hold.  Right now I have to take the cues from your outward appearance and development, and you look mighty fine to me.  It’s very confusing though.  I’m still not sure if there is any chance that you could have complications today, tomorrow, next week.  I guess we have to take each day as it comes.

I don’t want people to think that I am a victim in all of this.  That I don’t want to let go of it.  In fairness, I can’t let go.  Partly because you are still affected by the disease and will be for many years to come. Partly because I feel I have gained a purpose; I can help make things better for other sufferers of the disease, whether it be through raising awareness to help speed up diagnosis, or by providing useful information to other parents going through this.  Kawasaki Disease is now a very big part of my life, of our lives, and it isn’t likely to go away.  Perhaps over time it will become a smaller part of life for all of us, but I don’t think I will ever stop talking about it to anyone who will listen (and a few who don’t!).  It’s too important for that.  I am in contact with parents and grandparents who have seen this illness first hand, some who have suffered the worst consequence of all.  For them, I will always do what I can to help change the future of Kawasaki Disease.

Having a child diagnosed with a rare, or little known, disease is life-changing for parent and child.  And when there is no known cause you never stop asking yourself ‘Why?’.  Why did this happen to you? I hope we find out one day.  I believe the specialists are getting closer – it’s just that research costs money and KD research is severely underfunded.  They believe they have identified the combination of genes that make a child with KD more susceptible to the disease.  And they are pretty certain that they are looking for an infectious/toxic agent that completes the perfect KD storm.  I desire two things; that we can gain a greater understanding of your condition so we might have a better handle on what might be around the corner, and that the mystery of Kawasaki Disease is unravelled in our lifetime so we might gain some closure.  Solving that mystery will also result in a test for the disease so that children might be diagnosed more quickly, and better treatments that further improve the possible outcomes for children with the disease.

My whole perspective on life has changed.  Things I was afraid of before no longer occupy any space in my mind.  I no longer sweat the small stuff.  I have a lot more compassion for others – through our journey I have come into contact with so many parents who have suffered challenges with their children, KD or otherwise.  Before this, I was ignorant to all that – it was happening to someone else and that didn’t matter to me.  Now it does.  The only fear I have now is of losing you, or losing any of the people that I love dearly.  I will not allow people to hurt me anymore, because nothing can come close to the pain I have felt over the last year with you.  None of that matters.  Yes, everything has changed. Our lives are different than they would have been if KD hadn’t crept in.  But it’s not all bad. It’s different, but not bad.

Sometimes I am scared, often I am sad.  I worry a lot about the future for our little family.  But above all that, you will grow up knowing that you are loved and cherished more than you could ever fathom.  You are a special little girl who will achieve great things one day, and I will be there by your side with every step you take towards greatness.

I love you, Peanut. 

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The World keeps Turning

What’s in a date? According to the dictionary, a date is “the day of the month or year as specified by a number.” It’s that simple.  And yet dates mean so much to so many people.  Every day of every year marks something significant in somebody’s life; a birth, a death, a wedding, a break-up, the anniversary of good and bad events that have occurred in a lifetime.

For us, today brings mixed emotions.  It would have been almost impossible not to face today with some sadness at the memories of this day last year when we watched our 7-week old daughter slip away from us with the fear that we may not ever get her back.  It is the day she became critically ill, and marks the beginning of our journey with Kawasaki Disease; Freya’s Story.   It feels somewhat surreal to be sat here today, putting the washing on, clearing up the aftermath of the children’s lunch, normal everyday things that a parent has to get on with.  A year ago today our lives were changed forever.  Changed in so many ways, some bad some good.  How did last year change me for the worse? Well, for one it altered my perspective on this thing we call life.  We all believe we have the right to live our lives how we choose, and rarely stop to consider the consequences of the actions that we take.  Being faced with the possibility that your child might actually die turns your entire belief system on it’s head.  I had never considered my own mortality before then – why would you? You just coast through this life taking it for granted that it is yours for as long as you want it.  But there are much stronger forces at work than any of us are able to prepare ourselves for, or protect ourselves against.  People get sick.  Kids get sick.  This world is full of illnesses and diseases that affect everyone else, and we read stories about them in the News or on Social Media, and think “poor them”, but we rarely stop to consider that the trials we see other people facing from a distance may land themselves on our own doorsteps one day.

I had never felt so much anxiety about the brevity and uncertainty of life before the events of last year.  Now I find myself living a confused life, where on the one hand I wish to grasp it with everything I have whilst I have it – make memories, move mountains – and on the other hand I face it with a fear of the unknown, and a desire to stop time so that we might be able to let go of that fear, just for one day.  Wherever I walk I see beauty in everything, magnified like I’m seeing through the wondrous eyes of a child, but out of the corner of my eye I can always see a shadow lurking and I imagine that the Grim Reaper is sharing every moment with us.  I am reminded of that movie, Final Destination; you can’t cheat death, can you?

But, the 31st May is just a date.  It doesn’t really matter what the date was, Freya got sick.  It doesn’t matter what date we got our diagnosis, Freya had Kawasaki Disease.  It doesn’t matter what date they told us her heart was damaged, Freya’s heart suffered.  Even so, it is hard not to see these dates as milestones, those first hurdles you have to get over after any loss.  And I know I should be grateful that we didn’t have to suffer true loss, but this is still part of a grieving process, and I do grieve for the loss of that perfectly healthy, normal little girl that I was holding in my arms on the 30th May 2015 and all of the 50 days before it.  Some would say I am ungrateful, that I should get over it already.  I don’t blame them if they haven’t been through something like this.  And it isn’t like I don’t want to let it go.  Of course I do – that’s why I see a counsellor every week to help me with the trauma of the last year (as well as a few other troublesome things).  If anyone thinks that I want to be stuck in this perpetual limbo between sadness and joy, that I get any gratification from feeling tears prick at my eyes every time my youngest daughter shows me just how special she is, is mistaken.  I want to be able to move forward, forget the last year, make plans for the wonderful future that I promised myself for my family.  But KD doesn’t let you do that.  It doesn’t just leave, like a cold, or a sore throat; KD leaves permanent scars, physically and metaphorically.

I will allow myself to feel what I feel on these dates, these first milestones.  The day of her diagnosis (12th June) is likely to bring up a lot of the same emotions.  Hopefully I will be better prepared and can plan to do something that will change the memory of that day.  I had hoped to do something today that would give me a new memory of the 31st May, but the awful weather and the restrictions I place upon Freya’s indoor activities (I don’t want her in an indoor play area, during half term, in chicken pox season!) put a stop to that notion. So instead I have tried to distract myself with the children and the chores.  But I sat for a moment and watched the raindrops run down the window, an image that my eyes immediately chose to mimic, and it has left me feeling wretched.  Out there new memories are being made and new anniversaries created and the world just keeps on turning.  And I keep breathing in and out, and whispering to my heart, “It will get better one day.”

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Stealing Joy

A year ago, on this very Saturday (though it was the 30th May), we had our last day of ‘normal’.  My parents had visited from Kent to see their new granddaughter.  Freya was 7 weeks old and we went on our first family day out since Freya was born, to a local farm.  The sun was shining; it was a glorious day that told us that summer was on the horizon.  The unexpected baby we had thought would ruin everything was proving to be our best ‘mishap’ to date. We were smugly happy with our perfect little life. We watched our older children play in the sunshine, whilst their baby sister slept in her pram, and it was like we had our own little slice of heaven right there.

That evening my husband and I went out for dinner with my parents, and my mother-in-law sat home with the children.  It was a pleasant evening, and when we returned home there was nothing to report, other than the fact that Freya hadn’t wanted all of her bedtime bottle.  It was unusual, but not exactly a serious situation; perhaps she was too tired, too full, or maybe there were some teeth on the way.

The next morning Freya would wake for her morning feed, around 6am.  Except she was so snuffly and bunged up that she just couldn’t take the bottle and gave up pretty quickly.  I was concerned, because she had gone for so long without a feed through the night (I remember celebrating our first proper night’s sleep), but I put it down to the fact that her nose was just too blocked up to let her feed.  At around 9am, I made another bottle and tried again, but just as before she couldn’t manage to take the feed, and fell asleep in my arms from the effort.  “She’ll feed when she’s hungry,” I told myself, and put her down in her bouncy chair.  A couple of hours passed, and I began to get quite fretful that she hadn’t fed since the previous day, so I decided to wake her and try again.   It was about 11am.  When I went to get her out of the chair, I noticed how hot she felt and so I took her temperature with a digital thermometer.  38.3F.  She had a fever.  I remained calm, I mean kids do get sick, and she has an older brother and sister who come into contact with all kinds of germs at school.  She had been snuffly for a couple of days; she had probably picked up a bit of a cold.  So I sent my husband to Mothercare to buy a medicine dispensing dummy (if you haven’t seen these, they are fantastic for getting medicine into a little baby).  Meanwhile I hunted out the Calpol. From 2 months.  That’s what it says on the front of the box.  Many would have given the medicine; I mean, she was only a week away from 2 months, what harm could it do? But for some reason, I felt like I couldn’t take that chance.  Unsure what to do, I called the out of hours GP service (it was a Sunday, remember).

The doctor called us back pretty quickly, and asked me to explain what symptoms Freya had.  She wasn’t feeding.  She was sleepy (but she was a newborn baby, and sleep was pretty much all she did).  She had a fever.  And come to think of it, her little tummy was moving up and down quite a bit – she was working hard at breathing.  The doctor said we should take her to A&E, as it was unusual for such a young baby to have a fever for no reason.  And that is what we did.

I’m guessing it was around 3pm in the afternoon by the time we were seen at the local hospital.   I don’t remember what was said by the nurse/doctor that checked Freya over.  I remember telling them that I had tested positive for Group B Strep during the pregnancy, and that although I was treated with IV antibiotics during labour, it was pretty tight timing wise.  I was on high alert for late onset GBS infection in Freya, and I knew that if she had contracted GBS during labour, there was a chance that she could develop meningitis.  They did too.  So they sent us up to the children’s observation unit with a view to keeping her in overnight for observation.

That part is all a bit of a blur too.  I remember sitting in the waiting area, Freya, burning up, lying across my knee.  She was laid on some paper towels whilst my husband and I attempted to catch a wee in a kidney dish. We went into a small room, and a doctor came to check her over.  I can’t remember what he said, or why he felt she should be admitted to the Children’s Ward.  I don’t remember when they put the IV antibiotics in.  I just remember that’s what happened.  We were admitted to a private room, and my husband went home to our older kids.  I sat in a chair in the corner of the room with Freya sleeping in my arms.  She was connected by the IV to a machine that dispensed the medicine, and every time I moved the machine would set off alarming, and the nurses would come in.  I think I stayed there until the medicine had all been delivered to Freya’s tiny, hot little body, and then I decided we both needed to get some proper sleep.  By this time, it was quite late.  It may even have been the early hours of the morning.  The nurses came in every hour to complete their observations, and then I put Freya in the cot so she might be cooler, and I might manage some sleep in the chair.

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As I laid her down, I noticed that all familiar smell – she had a dirty nappy.  “The poor thing just needs to sleep, I’ll not disturb her” I told myself,  and I went back to my chair in the corner.  I’m not sure how long I sat there trying to get to sleep before my conscience got the better of me and I decided that I could not leave her in a dirty nappy. Disturb her or not, I needed to change her.  And it was as I lifted her vest that I noticed a pin-prick rash over her torso that I could just make out in the dim light.  I think it was about 5am, because it was starting to get light outside and I could hear the birds singing outside of our window.  Were my eyes playing tricks on me in the half light?  I was so tired.  I turned on the light and went to get a better look, but still in the fluorescent lights I couldn’t work out what I was seeing.  I walked over to the window and opened the curtains, and in that light I could see that this wasn’t an illusion.  Freya was covered in a rash.  I called the nurse who came to have a look, and we both spent so much time scrutinising that rash that I can’t remember to this day if it blanched under a glass or not.  The nurse called the on duty doctor, and by the time he arrived (which wasn’t long at all) the rash had spread down Freya’s legs and across her arms.

It was in that moment, watching the doctor silently complete his review of my baby, that I noticed the atmosphere change.  They called a consultant who joined the doctor in his silent inspection. It was very calm, but the air felt thick. I thought Freya was sleeping.  In fact she was unresponsive.  I remember hearing words like “shutting down”, and the doctors started to wheel Freya in her cot into another room.  It was the High Dependency Unit (HDU).  They delivered fluid boluses to Freya by stealth.  At 6am I called my husband “Gavin, I think you need to come quick.”

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If you’ve followed Freya’s Story, you will know what happened next.  You’ll know that she became stable, but did not get any better for the next week, despite numerous antibiotics.  Her fever would not come down with antipyretics, and when her fever spiked (above 40 at times), so her heart rate would soar, and her oxygen levels would plummet.  She was very sick, yet it would take 13 days, lots of medication and countless tests before a diagnosis of atypical Kawasaki Disease would be reached.  Three hospitals would be responsible for her care during a six week incarceration (!) which began on the 31st May 2015.

I want to allow myself to believe all the motivational cliches about things happening for a reason, about how far we have come, about how lucky we are to have Freya here in our lives and how we should count our blessings.  But today that all feels like bullshit.  Today I find myself in mourning for normal.  I want to go back to that day at Cannon Hall Farm, where everything was blissful and beautiful and picture-book perfect, and somehow re-write history.  Today marks the anniversary of the last day we knew what normal was.  I wish that day were Groundhog Day and we could live it over and over and over so that the 31st May would never come.

I don’t want to wallow in the misery of the last year, believe me.  I want to be thankful for what we have, and cherish every moment.  I want to believe that this happened to us for a reason, that we will all be better people for it, that I will look back on all this one day and laugh at how wrapped up I was.  I will allow that to come, I’m sure (and the counsellor will give me a good kick up the arse if I don’t!), but for now I am allowing myself some wallow-time.  I have every right to feel sorrow, and to mourn the loss of the life I planned to have.  I have every right to feel angry that Kawasaki Disease came into my daughter’s life and robbed her of her health so soon after she arrived in this world.  I have every right to feel angry that the world keeps turning, and that people are moving on even though I seem to be stuck in this perpetual Kawahell.  Today, I hate Kawasaki Disease.  It broke my baby’s heart, and it broke mine too.

Most of all, I hate that this disease took away some of the joy that I ought to feel from moments like this…

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The Gift that Keeps on Giving…

“Mum, remember when you thought you might not get to see me grow up? Bet you feel silly now?!”

They say that you shouldn’t wish for your children to grow up, that you should will them to slow down because in the blink of an eye your once tiny baby is all big and independent and doing things you never thought possible.  Well, in a way Peanut that is true.  But as bad as it may sound, there’s a huge part of me wanting you to hurry up! Hurry up and talk, hurry up and walk, hurry up and grow big and strong so that I can be sure to have had the chance to see it all in case it is taken away from me.  I’m scared.  Scared that I won’t get the chance to know you like I should. Scared that Kawasaki Disease has not finished with you just yet.

Today we took you to the hospital for your cardiology follow-up appointment.  You were last seen three months ago, where the cardiologist remarked that the speed of which your coronary arteries have been remodelling is concerning, and they would like to carry out an angiogram to take a closer look.  I knew she was referring to possible stenosis; that the reduction in the internal diameter of your coronaries might not be healthy, and is more likely to be the result of a build up of scar tissue or layered blood clots that have effected  the change.  But I have read that stenosis can take decades to cause any ill effects, and as such I felt it would be prudent to give you more time.  More time to grow, so that less invasive procedures might tell them what they want to know.  Apparently an MRI or CT scan isn’t as effective in giving a true picture in such a young child, and an angiogram is the only option that will show them what is really going on in that little heart of yours.  I asked the opinion of 3 experts, all of whom concurred with my view that there would be no harm in waiting, perhaps even up to a year, and carrying out a less invasive procedure.  I put that question to your cardiologist, but she seemed pretty keen on pushing forward and continued to voice a preference for carrying out an angiogram a year post-diagnosis; June.

I decided to wait until your next appointment to understand more fully why the consultant was so eager to press on.  That appointment was today.

We arrived at the hospital just in time for your appointment, and were sent straight down the corridor for an ECG.  It took the cardiographer 20 minutes to get a reading from your heart because you were wriggling so much! We had to bribe you with ‘sweets’ (little fruit things that we call sweets because they’re as close as we will let you get to confectionary at your young age!) to get you to sit still for long enough! You’re not as easy a patient as you were last year, this time pulling off the electrodes and yanking on the wires, but he got there in the end!  Nothing was said about the result, and I am guessing that means that, as usual, the ECG showed normal heart function.  Next it was time to weigh and measure you (you weigh 8.46kg and are 74cm in height), and then you were called into the examination room.

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It wasn’t your cardiologist that called us in; it was a registrar.  She introduced herself and asked if we had any concerns since the last appointment.  We had none.  She then asked us to take you over to the bed so she could perform an echocardiogram, and I asked if we were going to see your doctor today.  She said that we would, and that she was just with another patient.  I guess they were helping each other out so they might all finish the day at a reasonable time.

Surprisingly, you laid quite still for the echo.  Okay, so you had to be given a probe of your own because you do like to take matters into your own hands, but she got there (with the help of a bottle of milk!).  She didn’t say much, but as usual I clocked the numbers appearing on the bottom of the screen and was able to catch that your LCA (left coronary artery – the one that has caused the biggest worry on this journey so far) measured 2.8mm.  Was that bigger than the last time? I seem to remember it being closer to 2mm, but what’s a fraction of a mm between friends, eh?  Your consultant then entered the room, and continued the appointment with the registrar present.

She looked at the screen, and remarked that your RCA (right coronary artery) looked almost normal.  She seemed happy with function and blood flow.  It seemed that she was about to suggest a routine follow-up appointment and gave the impression that it would be a longer period next time, but the registrar mentioned that an angiogram was mentioned at the last appointment. Ah yes, remarked the consultant. I reminded her that she was considering the procedure because she was concerned about the extensive remodelling that your arteries have undergone in such a short space of time.  Ah yes, she remarked, and commented that at worst, the diameter had measured 8mm.  I corrected her.  Unless I missed something along the way, the largest measurement was 5.2mm.  Whilst small in comparison to some children affected by this disease, they were more than 5 times normal size and in a baby as young as you were was considered significant and cause for serious concern.

I told the consultant that I had a few questions, and pulled out my notebook (I know! I do like to make notes!)  The first question I asked was why she felt it so important to carry out a risky, invasive procedure now? What benefit could it have? What was her thought process, and what were her concerns?  I had thought that she might concede with a “perhaps we ought to wait” kind of statement.  But instead she told me that she thinks it is highly likely that the remodelling has come about as a result of stenosis – anything other than that would be nothing short of a miracle.  I asked if there wasn’t a chance that the remodelling has come about as a result of the aggressive treatment you received to stop the disease in it’s tracks (you received steroids and a dose of Infliximab when two doses of IVIG proved ineffective).  She agreed that was possible, but didn’t seem convinced.  An MRI/CT would be effective in providing a better picture of aneurysms, but in a child as young as you they would not be as effective in showing stenosis.  I asked what would be gained by doing it now? Stenosis can take decades to develop before the arteries might close enough to prevent blood flow.  And if the angiogram did show evidence of stenosis, how would that change the treatment plan? And then she used words that I had not considered would be used in your lifetime. Stent.  Bypass surgery.

I guess I knew what her concerns were before I asked them.  I mean, she isn’t likely to put you through an unnecessary procedure, is she! I told her that I would prefer to wait, but that if she felt that waiting would put you at risk I would trust her judgement.  She said that she would really like to get a look, and it dawned on me that you are quite the case of interest.  One of the youngest cases to be handled, aggressively treated, showing almost too-good-to-be-true recovery.  Yes, of course they would like to get a look.  I said I appreciated the medical interest in understanding what has been happening with your heart, but that you are not a specimen, you are my baby.  She reluctantly agreed to see you again in three months, and noted that whilst there was a great deal to be learned from you, that she would not consider the procedure for medical knowledge alone.   She agreed to discuss your case with at the next MDT meeting (multi-disciplinary team) with a view to negotiating with me further then.  She has already discussed your case with the surgeon, and they too believe it would be prudent to do an angiogram sooner rather than later.  That said, she still agreed to give us another 3 months (which will end up being more if the waiting list is as long as I expect), on the strict proviso that if we see any evidence of angina we are to contact her.

Let me take a moment to tell you about the symptoms of angina;

  • Chest pain or discomfort (not sure how you will tell me about that!)
  • Pain in your arms, neck, shoulder or back accompanying chest pain (ditto!)
  • Nausea (won’t generally know that one until you actually throw up!)
  • Fatigue (hmm, should I be concerned that you sleep through the night?)
  • Shortness of breath (you don’t get above a fast crawl yet, and I’ve not seen you panting!)
  • Sweating (nope)
  • Dizziness (again, how would I know?)

So apparently the only way I might be able to tell if you are suffering with angina would be if you are playing one minute, and then go quiet, and maybe glaze over for a moment.  This could be interesting :/

It would seem we are not yet out of the woods, my darling.  Just when I thought that there could be a future where KD becomes nothing but a distant memory, here it is threatening to place a dark cloud over the years to come.  The only thing I can hold onto is hope, but that is so hard when I feel like I am fighting a losing battle with this disease.  I have no control over it, none.  It came, it messed you up real bad, and it just won’t leave us alone.  I know there is a chance that they could do the angiogram and discover that you are indeed the miracle I had started to believe in.  But I also fear the worst.  And I know that there are far more complicated procedures happening to very sick babies, with huge success, every single minute of every single day.  But they are not happening to my baby.  And I so want to bury my head in the sand like an ostrich and pretend that this isn’t our life, that this isn’t your life.  Today for the very first time I saw ahead of me just how complicated your life might be, and it has made me incredibly sad.

And because with this disease the hits just seem to keep on coming, I returned home to a voicemail from your GP.  We were given the green light to crack on with catching you up on the routine immunisations, and also later given the go ahead to give you the MMR vaccine.  It was unclear, however, what timing/order the Immunologist felt these should be given in.  You’ve had the 8 and 12 week immunisations now, and I was hoping that we might be able to intersperse them with the MMR, Chicken Pox and Flu vaccines rather than wait any longer than necessary.  This family needs a holiday far, far away from here.

Sadly, the advice was more disappointing than I had anticipated.  The instruction has been to wait until after the final routine vaccinations have been given (around June).  Because you are a unique case, they are not comfortable in progressing to the remaining vaccines until 3 months after that.  So at best, you will get the MMR in September.  No mention has been made of the Chicken Pox or Flu vaccines, but I can only guess they will want to wait longer for those too.  I just wanted us to do some normal stuff, Freya.  Mix with other kids, in places where normal kids go.  Jump on a plane to somewhere warm where we can forget all about this for a time.  I am sick of being restricted by my fear, but I cannot knowingly expose you to illnesses that have the ability to take more from you than KD already has.  I’m talking about Reye’s.  And yes, I know it’s rare, and it hasn’t yet been linked to low doses of aspirin, but it’s a risk I cannot bring myself to take.  What were the odds of you getting KD at 7 weeks old?? Exactly.

I’m sorry, my tone is getting quite unpleasant isn’t it? And I am sorry for burdening you with this worry.  Almost a year ago I asked a God I don’t believe in to prove the doctors wrong.  If he’s listening, this is his chance to show me what he can do.  I can only hope that if you are reading this, it means that you have already proven yourself to be the miracle that we all hope you will be.  I don’t want to live in a world without you in it.

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