Freya’s Story (14)

IMG_5742-0

Freya has been back to Sheffield Children’s Hospital this morning for a follow-up appointment with the Rheumatology Consultant.  He was really happy with how Freya is doing and took one last blood test to see if all her results are back to normal.  We are not expecting any surprises but the last time her blood was tested a few weeks ago, the ESR levels in her blood were still not normal and the doctor would like to see that where it should be.  Had fun trying to catch a wee sample in a pot!  How is it that if I take Freya’s nappy off at home, she pees immediately if I haven’t got a clean nappy at the ready.  Half an hour with her nappy off with me staring at her bits and bobs waiting for any sign of a wee, and I was nearly ready for giving up!  We got there in the end though, wee caught, tested and all ok!

The drugs that Freya was given have suppressed her immune system.  IVIG (intravenous immunoglobulin) uses antibodies as a means of regulating the body’s normal immune response, steroids reduce inflammation and reduce the activity of the immune system and Infliximab is a chimeric monoclonal antibody (artificially developed in mice) that switches off the protein TNF-a which is a protein involved in systemic inflammation.  As a result, she has not been able to have any of her routine vaccinations, missing her 8 week immunisations whilst she was in the hospital receiving treatment means she has a lot of catching up to do and in the meantime we have to be careful about what/who we expose her to, so it’s been a bit of a dull school holidays so far.  Luckily Fin is obsessed with Minecraft, and Eliza is out with her friends most of the time (she’s gone camping with a friend and her family for a few days actually, so that’s been great). I was concerned that I was being over-cautious though and had a good chat with Freya’s consultant about the immunity issue so I could be sure I wasn’t forcing my family to miss out on life unnecessarily.   He was happy with the precautions I have taken.  We tend to limit any outings to things that are outdoors.  If friends want to visit, we ask if they are well and if their children are well.  We also make sure the children are up to date with their immunisations.  We know chicken pox can be dangerous if you are taking aspirin, so Freya needs to stay well away from anyone who has, or may have been in contact with chicken pox.  If I’ve needed to do some shopping (2 kids birthdays in the Summer holidays make that a necessity) I’ve avoided indoor shopping malls.  We shouldn’t fly until Freya is up to date with her immunisations, so no holidays abroad for a while.  The doctor confirmed that Freya can have any killed vaccines now, but mustn’t have any live vaccines until she has been clear of the steroids for 3 months.  Rotavirus and MMR are the only live vaccines we currently give babies in the UK.  Some babies will also be immunised against flu which is in the form of a spray; that’s a live one too so Freya can only have the flu vaccine in injection form.  He said the further away from the acute stage of the illness and the medication we get, the less worrying all this will be.  But he did say it was time we started living a ‘normal’ life.

Normal.  Let that sink in for a minute.  Yes, I guess it is normal for us now.  It’s a new normal, but it’s normal nonetheless.  It has been 8 weeks since we discovered that our baby girl had suffered some damage to her heart as a result of the Kawasaki’s.  Thinking back to those days, back to the first weeks of her illness when she was unrecognisable to us, back to being told our daughter could die…well I don’t even know what to say.  Even typing now I am shaking my head in disbelief.  Did all that really happen to us?  If someone had told me back then that one day very soon I would feel like everything was ‘normal’ I would have laughed in that person’s face.  If someone had told me that one day very soon I would be able to look at my daughter without feeling immeasurable sadness, I would have stared in utter disbelief.  And yet here I am, 8 weeks on from some of the worst days of my life, and I really do feel calm and happy in our new ‘normal’.

I think I’ve already mentioned that during those dark days after we spent a week in the cardiac unit, I was referred to the hospital psychologist.  Let me tell you about that – it was quite amusing really when I look back.  I remember one night in the Children’s Hospital when I was feeling particularly melancholy.  I had either called the on-duty doctor to come and see Freya, or they’d come for a routine check or to take some blood or something.  Anyway, I was talking as the doctor was examining Freya and I must have started rambling a bit about how I felt during my pregnancy.  On the Monday following our stay in Leeds, both the Immunology Consultant and the Rheumatology Consultant came to see me.  The consultant over at Leeds had warned them that I might want to discuss why the diagnosis came so late.  I felt so angry and let down now that I knew that a late diagnosis might well have sealed my daughter’s fate.  They explained how difficult it was to diagnose Freya because she didn’t present the typical symptoms of Kawasaki Disease, and that some of the tests they needed to carry out to rule out other illnesses just couldn’t be done any sooner because Freya was too frail.  Then they said that they understood how terribly difficult this was for me, and that they had spoken to the hospital psychologist to see if she would meet with me.  It was then that I found out there was a note in Freya’s medical notes that I had told a doctor that I had predicted my daughter’s death when I was pregnant!!  Now, I know that I was an absolute mess at times and I rambled and cried to the nurses and doctors a lot, but I’m pretty sure I didn’t say anything as nuts as that!  What I think I said was that when I was pregnant I was convinced something bad was going to happen to my baby, and I was so pleased when she was born healthy and perfect; that it was so cruel that now she was so ill after I had been lulled into a false sense of security.  I guess in the middle of the night the doctor needed to paraphrase, so I became known as some kind of lunatic who believed she could predict the future!! You’ve got to laugh.  Anyway, I accepted the offer of a chat with the psychologist and (after a bit of a wasted trip to see her, a double booking and a few tears) she came to see me in our cubicle.  Seeing her was a turning point for me.  I was desperate for her to tell me how to deal with this, and she answered me simply.  She said you don’t deal with something like this, and there were no tools she could give me to help me come to terms with what we had been through or what was yet to come.

Tuesday 22nd June 2015, 17:00pm

“Mummy had a chat with a Psychologist today.  Her name was Rachel and she was really lovely.  This has been such a tough journey so far my sweetheart, and I’ve needed someone to talk to that isn’t also feeling sad that you are poorly.  Luckily she thinks I am normal, haha!  What I am going through is perfectly normal.

The fact is, no one can make this better.  I cannot control the outcome.  I can only hope that your little heart repairs itself or that it holds out long enough for something to be done.  The lady said that what I am feeling is called ‘anticipatory grief’ and is perfectly normal for someone who has been told their child has a potentially life-threatening illness.

I asked Daddy today if we could have you, Eliza and Finlay christened.  Not because I think we need to do it for any morbid reason, but because I don’t think it can hurt to order in a bit of extra protection for my beautiful children.  I have never been really sure if I believe in God or not…At Leeds General Infirmary I wrote on a prayer sheet “Dear God, prove them wrong”. The odds are stacked against you little one, so lets hope He hears our prayer and reaches out to heal that broken heart.

IMG_5289

The doctors have been trying so hard to be positive, always focusing on the great blood results or your observations or just how great you look.  But every time someone says how beautiful you are or how well you are doing it feels like a knife jarring through my heart.  The fact that you look so perfect on the outside makes what is happening on the inside all the more cruel, and even harder to bear.  

Looking at you now, how beautiful and healthy you seem, it is hard to believe there is a possibility that this disease could kill you.  I will always be afraid.”

47 days on and I am less afraid, in fact I go most days without feeling any fear at all.  As I write this, I am reminded of another mum just like me who is at the start of her own terrible journey with her baby boy who was just a little older than Freya when he was diagnosed at 10 weeks old.  I wish I could make her pain go away.  I know too well all the emotions she will be going through right now, because we lived through them at this stage in our journey with Freya.  Sadness, fear, despair, hopelessness, anger, guilt, grief; until all those emotions had taken any reserves I had and I was left feeling nothing at all.  But speaking with the psychologist helped me to understand that I wouldn’t be able to package up any of those emotions and move on.  So instead I started to read anything I could get my hands on, and my research skills and tenacity would really come into their own over the coming weeks.  I couldn’t change where we were, but I certainly wasn’t going to accept our fate without a fight.

Freya’s Story (13)

So we had a follow-up cardiology appointment in Leeds on Thursday, and those of you who follow Freya’s Story on Facebook will already know we had good news.  The right coronary artery has normalised, measuring 2mm now.  The left coronary artery was the worst affected to begin with, with the largest dilation measuring 5.2mm.  That has now reduced to around 3mm, which was fantastic news!  I asked the registrar if it was unusual to see such dramatic improvement so early on, given we were told it could take 1-2 years for that to happen, and he said that it is unusual, but not so unusual in very young babies.  It seems they are more resilient and able to repair themselves more quickly.  I am still confused about the ‘a’ word.  When the first echo showed dilation of the coronary arteries the doctors didn’t use the word ‘aneurism’.  A few days after that, and after a dose of IVIG, the echo showed that Freya’s arteries were further dilated and there was at least one aneurism.  When we were in Leeds, the doctors talked about the aneurisms and told me the risks associated with that.  Now they don’t seem to use the word, referring more to a general dilation of the arteries, known as ectasia.  I asked the registrar on Thursday to clarify this, and he said that it didn’t matter what we called it, the risks were the same and we shouldn’t get too hung up on a name.  He used the phrase “as far as I can see”, which I questioned.  So now I know that an echocardiogram can only show so much of the arteries; they can see about 3mm into each artery, but no further.  In order to see further into the artery a cardiac catheter is required, which he said would be ‘overkill’ in Freya’s case.  You can’t help but worry when you hear things like that, but I have to put my trust in the doctors that if they felt it was necessary to carry out further tests they would have done it.  For now, I’ll take the good news!  I also asked if the risk of stenosis (narrowing of the arteries) would be increased due to the speed of recovery of Freya’s arteries.  He replied that this is the time that the risk of stenosis is increased anyway, but the risk wasn’t any higher in Freya’s case.  I guess that it is the period in which the repair is taking place that the risk of stenosis is there – it is basically a narrowing of the arteries caused by a build up of scar tissue.  Freya will be seen again in a month, so we will wait until then to see how things are going.  The other bit of good news is that they are going to see if we can be transferred to the care of the Cardiologist at our local hospital, which will make things much easier logistically speaking.  We are still having the battle over her medication though, so the hospital gave us a prescription for her aspirin for the next month and we have left it in their hands to battle it out with our GP.

The thing with this illness is that there are so many ups and downs.  As a parent it is so exhausting.  Being positive one minute and feeling hopeless the next is emotionally draining and really takes its toll on you mentally.  Reading back through my journal to bring Freya’s Story to you has really brought that to light.  One day the entry would be full of sadness and despair, and the next day would be a ‘normal’ day, sometimes even bright and happy.  If you read post number 12, you will have felt the fear and sadness I did on the days after we returned from the cardiology hospital.  The weekend was pretty tough.  I was devastated and I felt more alone than ever.  And yet my journal entry the following day was a complete contrast;

Monday 22nd June 2015, 18:00pm

“What have I got to tell you about today then?  Not very much to be fair.  We had a quiet morning and you slept through until 6am, clever girl!  After a feed you went back off to sleep so I managed to sneak out to Starbucks to bring back some coffee and breakfast.  You were still asleep when I came back.  After I’d finished eating you cried a little, so I took you out of the cot and we snuggled up on my bed just like we did at home sometimes, and you slept in my arms for 2 hours!

Daddy came to see us at lunchtime.  I think he must miss having us at home, especially you.  I gave him the Father’s Day card you made him…Yes, you made it last week at the hospital in Leeds!  They painted your little feet yellow and stamped them onto the card.  He really loved it.  We will save it for you so you can see it when you are older.

 

The doctors came to see you today.  They are very pleased with how you are doing.  Mummy got a bit upset because I find it so hard to hear the doctors talk about how well you are doing when inside your little heart is broken…They want to keep you here this week to continue to observe you, and keep taking blood so they can make sure the inflammation from the evil Kawasaki’s stays away.  The plan is to wean you off the steroids and keep an eye on your blood results to make sure it doesn’t come back when you stop taking the medication…

..We talked about your illness and whether anything could have been done to diagnose it earlier.  The Immunology Consultant said that you have taught them many things about Kawasaki’s as yours was such an unusual case.  

We went to x-ray again this afternoon for another echo scan on your heart.  The sonographer said it was your left coronary artery that has the aneurism.  She also said it has not got any worse since the last scan she did, so that is good news.  Hopefully this means the Drs have switched the inflammation off.  

We have had a lovely day together.  I’ve not thought about the bad stuff once, I’ve just enjoyed your smiles and almost-laughter, and lots and lots of cuddles.  I do hope your story has a happy ending.”

Freya’s Story (12)

Saturday 20th June 2015, 23:55pm

“Nothing much to say today sweetie pie.  Very uneventful day.  I’ll be honest, I woke up feeling pretty miserable and angry at the world, and so I resolved to spend the day in my pyjamas with the curtains closed.”

We had arrived back at the Children’s Hospital by ambulance late on the Friday so didn’t get to see any of Freya’s doctors.  I remember feeling quite abandoned.  I felt betrayed; like the doctors had all known what was coming but chose not to prepare me.  I now realise that wasn’t the case.  Freya’s doctors knew that her situation was serious, but not being cardiology specialists didn’t feel it was there place to discuss it with us.  That’s why the sent us to the specialists to ensure Freya received the proper care, and so we could all truly understand the extent of her condition.

The Thursday had been all the harder to deal with as my husband was away on business that day, and wouldn’t be returning until Saturday.  I felt it was unfair to contact him while he was away, knowing that he would feel helpless being so far away.  So I held onto it until my mother-in-law arrived for a visit and I couldn’t stop myself from falling apart, despite my best efforts to shield my family from my real concerns.  I arranged for my mother-in-law to sit with Freya at the hospital on the Saturday so my husband and I could go out for a meal to discuss what had happened in Leeds.

As was usual over the weekends, there was very little activity.  That created a solitude that was unhealthy for me given the recent events, and I began to come apart at the seams.

Sunday 21st June 2015, 17:07pm

“I hope you are here to teach me a lesson about faith, because if I lose you to this illness I know that I will never believe in anything ever again.  I’ve reached a point where I can’t even begin to trust that everything will work out okay, because I don’t think that I can face the disappointment.  I haven’t given up on you sweetie, but I’ve given up on hope.  Daring to dream feels like a bad [omen].  Perhaps this is a lesson to teach me what real drama is.  All the thing that have made me angry, sad, hurt in the past were nothing compared to this.  Nothing else could hurt like this does.

I took a beautiful photograph of you today, but I can’t shake the feeling that that photograph is going to haunt me forever.   I’ve been holding you in my arms for 2 hours now, and I don’t want to let you go.”

 

22:50pm

“I am really struggling tonight sweetie.  People tell me i need to be positive, but I feel so much pain I can barely breathe.  I want to believe you can fight this and that your heart will get better, but everything I read suggests that your chances are poor.  If this illness doesn’t get you now, there’s a chance the complications with your heart will get you later.  You are too tiny to fight this.

I wish I could fill this journal with encouraging words so you can see that I always believed you would get better.  Tonight I fear you will never get to read this.  I am consumed with thoughts about losing you, and torn up by fear that I will wake one morning and find you dead.  Every noise, every cry, every wriggle I am jumping thinking something bad is happening.

I have never felt fear or sadness like I am feeling at this moment.  I have no idea how I am supposed to handle this.  Every time you smile, my heart breaks a little more.  I could not bear to see a day where I wasn’t greeted with that smile.  You have been here for only 10 weeks and yet I can already see what an amazing little girl you are.  I need you to get through this and live a long and happy life because I know you are going to be special.

I am not only scared of losing you from my life, but I am petrified by the unknown, and by how suddenly I would lose you if the worst were to happen.  I am scared that I could lose you right in front of my eyes and there would be absolutely nothing I could do to protect you.  If only love were enough to keep you safe; the love I feel for you would protect you from anything.  I don’t think I could live a life without you in it.  You have made me whole.  Without you I am nothing, I am worth nothing. The person I was before you came into my life is not someone I want to be.  I can only exist in this world whilst you are a part of it. You are the best of me sweetpea.”

The next morning the doctors would notice a marked change in my manner.  In the weeks before our transfer to Leeds, I had been inquisitive and challenging; the doctors knew they needed to come armed with information and one said they had a lot of respect for me for the amount of research I had done, and how much interest I had shown in the full details of Freya’s condition.  That morning (Monday 22nd June, Day 23) was different.  I had nothing left to give.  No amount of questioning was going to change the fact that my daughter was forever changed.  It didn’t matter to me anymore.  The doctors commented on how well Freya looked and I nodded, whilst inside I was screaming! Who cared what she looked like on the outside?  On the inside she was broken.  My changed behaviour would earn me a referral to the hospital psychologist who I would see the following day.

Writing about it tonight brings those feelings flooding back as if it were happening now.  Back then I would never have believed that I would be sat writing a blog whilst my daughter slept upstairs.  I would never have believed that I could feel any different than I did in those dark days.  Some days are brighter than others.  Mostly we just get on with daily life, I mean you have to when you have children don’t you?  I still have to listen to tales of Minecraft and complain to my daughter about her untidy bedroom.  I have ironing to do and meals to cook, and find that I can take my eyes off Freya for long enough to do all of those things.

Tomorrow we are off to Leeds for Freya’s 3rd follow up echo.  The first following our stay up there showed a 20% reduction in the most badly affected sections of Freya’s coronary arteries.  Even the Cardiologist remarked aloud, “Wow!”, when she took the measurements.  It was more than we could have hoped for so soon after her diagnosis and I wept with relief.  The next scan showed no change, however that was to be expected and it could take 2 years for us to understand the long term effects on Freya’s heart.  Tomorrow we also hope to secure a more robust plan for Freya’s medication.  Our GP is not willing to prescribe aspirin for an infant as young as Freya despite the necessity for it, so we are currently battling to get a better solution than hours of travelling to pick up a prescription whenever we run out.  It is a hurdle we could really do without.

Freya’s Story (11)

Not many people like to say their worst fears out loud.  I guess I’m different.  For some people voicing their fears can give those fears validation that is not welcome.  Some worry about being judged by their words.  Some are too concerned with what they should say and not what they feel.  We all have our own ways of handling our issues.  For me it can be destructive to keep my thoughts in my head; kept in there they play over and over like a stuck record and my old friend ‘Ant’ makes them her friend (for those of you who haven’t read my earlier bluemama posts, let me introduce you to Ant (Automatic Negative Thoughts)).

When I started blogging, I made a decision to be completely candid about whatever I was feeling, be it light or dark.  For me that is the only way I can really even try to help others who may suffer similar feelings or worries; to help those people who might not want to say it out loud realise that they are not alone.

I said in my last blog that the most cruel thing about Kawasaki Disease is the unknown.  We don’t know what causes KD.  There are a number of theories, from carpet cleaner to soy, and a strong opinion that it is a combination of environmental and genetic factors with a viral trigger thrown in for good measure.  Because no-one knows the cause, no-one can create a test and as a result many cases go undiagnosed or receive a late diagnosis like Freya.  Whilst it is rare for KD to reoccur, there are no guarantees that it won’t.  We are unsure how long Freya will continue to display the symptoms, what other health issues she may encounter throughout her life, or whether her little heart is strong enough to repair itself.

I guess it’s time to share with you the worst day of my life.  Thursday 18th June.  Day 19.

Thursday 18th June, 07:30am

“I could tell you that during your time in hospital I never left your side, but that wouldn’t be true.  Sometimes your Auntie would come to visit and take me somewhere for tea to make sure I was eating a proper meal…And last night I decided that the best thing for me was a good night’s sleep.

I left you on the HDU ward at about 10:30pm last night.  I changed your nappy, fed you and gave you your medicine and left you in the care of the nurses.  I trust them to do a fantastic job of looking after you, but it still didn’t feel right walking away.

…I had a full 8 hours sleep and do I feel better?  No, I feel even more tired than I did before, and to add to that I feel wholly wretched for leaving you…I arrived at the ward only to be sent away because the nurses were doing their handover.  So now I am sat in the parent room…writing in this journal, with no idea if you are awake or asleep, happy or sad, well or unwell.

Today is a big day – new drugs.  If everything goes according to plan we could be home by the weekend.  But this rollercoaster journey has taught me not to look too far ahead for the good stuff because we only end up disappointed.” 

That day Freya received an infusion of a drug called Infliximab.  We had to give our consent for it to be given to Freya as it is not a human product; it is made from the antibodies of mice.  At around 4pm I received a message from a friend, “How did Freya tolerate the new mouse IV?!?!” to which I replied “She’s very chilled.  One might say as quiet as a mouse!!!”  It took a number of hours to infuse, and Freya was closely monitored for a number of hours after for any signs of her body rejecting the drug.  Just like everything else on our journey, Freya took it in her stride, and it was considered a success.

In the afternoon, Freya’s Cardiology Consultant came personally to perform an echocardiogram.  The Rheumatology Consultant had kept his promise, and the Cardiologist was very informative, explaining everything that she could see on the screen.  She showed me the normal sections of Freya’s coronary arteries, and the bulges (the aneurisms), the largest of which was 5.2mm in diameter.  To put that in perspective, Freya’s heart would have been about the size of her fist or a large walnut.  The coronary arteries in a healthy baby’s heart are approximately 1mm in diameter.  Freya’s arteries were the size of a teenagers.  The consultant asked me if I understood the risks involved with Freya’s heart condition.  I said that I thought I did, that I understood that her blood needed to be kept thin so it would continue to flow freely through her arteries and not swirl and clot in the aneurism to prevent a heart attack.  I then said that I felt like Freya was a ticking time bomb.  I remember looking right into the Consultant’s eyes, waiting for her to give me a smile and tell me that I was over-reacting and that Freya’s situation wasn’t that serious.  She didn’t.  Instead she said “Let’s go somewhere private and talk shall we?” 

My heart was beating out of my chest as she led me to a room down the corridor from the HDU.  We went in and sat down; the consultant, our nurse and me.

Friday 19th June 2015, 07:38am

“Yesterday I left you with a note about thinking positively.  What irony there is in that as I write this morning.  On Tuesday we were brought to [the hospital] to see specialists in cardiology.  Their job is to fix hearts, but instead they broke mine when they told me they can’t fix yours. Can’t.

I didn’t update the journal yesterday even though it was an eventful afternoon and there was lots to tell you.  But I couldn’t face telling you.  It seems that in all of this ‘excitement’ and all the knowledge that I have picked up along this journey, I appear to have suppressed the bit about the risk of a coronary aneurism rupturing.  That’s a pretty big deal.  And it could happen to you.  And they’ve told me that there is nothing they can do about it now, and there will be nothing they can do about it if it happens.  So that’s that then.  Seems I was right about you being a ticking time bomb sweetie pie.  And right now I am really not sure how I am supposed to deal with that little nugget of information.

I have never been so scared of anything in my whole life, and I will never feel this scared again.  Losing you would be unimaginable.  My heart is already broken at the very thought of it.”

I will never be able to forget that day.  When we were all sat down, the doctor began to talk.  She reiterated what she had already said about the risks when we were out on the ward.  She said that one risk was that if the blood was able to swirl around within the bulge, it could cause a clot which would result in a heart attack.  That is why Freya would be taking aspirin for life.  She told me that there is a risk that if the aneurism begins to repair itself, it can become too narrow which would also cause a heart attack.  That is why Freya would have regular monitoring, ECG and echo scans to keep an eye on things.  Then she told me of the third risk.  She said, “There is a risk that the aneurism could rupture.  There is nothing we can do to prevent that from happening, and I’m sorry to tell you that if it does happen, there will be absolutely nothing that we can do.”  Those words will never leave me.  I immediately broke down.  I thought I’d cried before, but I literally sobbed so hard I could hardly breathe.  The doctor continued to talk, but I couldn’t tell you what she was saying because all I could hear were the words that will haunt me for the rest of my life.  Both the nurse and the doctor eventually fell silent and all that could be heard were my cries.  I think deep down I already knew.  I’d referred to her as a ticking time bomb on a number of occasions, and no-one had corrected me.  But I’m a neghead aren’t I?! I’m the one who always looks on the negative side and should think more positively.   They were supposed to tell me to get a grip, that I was being a drama queen.  They weren’t supposed to tell me that this disease could take my daughter away from us.

Eventually I composed myself and felt that I just needed to get back to Freya, so I left the doctor and headed back to the HDU with the nurse.  I can picture the scene as if I were watching a silent movie.  I turned the corner into the room intent on picking my baby girl up in my arms and never letting her go.  Except when I rounded the corner and saw her I couldn’t bear it, and I backed away and ran for the door.  The nurse followed me and I fell into her arms.  I didn’t know how I was ever going to embrace my little girl again, knowing that she could be taken from me.  I talked for a while longer with the nurse, and after some time returned to the ward.  The parents of the other 3 babies on the ward were with their children, so the nurses closed the curtains around Freya’s bed.

That evening I cried and cried, and I emotionally distanced myself from Freya.  I dreaded feeding time, using the fact that she was attached to the monitors as an excuse for not picking her up.  I felt like I had to stop myself from loving her any more than I already did.  We were sharing the HDU with 3 others; 2 babies and a 7-year old boy who had all undergone heart surgery.  I felt like we were frauds; that it was unnecessary for Freya to be in a high dependency unit and that she was taking the nurses time away from those more severe cases.  That morning I had cried with the nurses about the fact that I felt we were in the way, that we were using up valuable bed space for more serious cases than Freya’s.  The nurse said Freya wouldn’t be in the HDU unless it was considered necessary, and I sneered that they would if they didn’t have a bed for her anywhere else.  That night I cried bitter, angry tears.  I could not believe that earlier that day I had felt we were a burden, that Freya wasn’t as sick as the other babies on that ward.  I suddenly felt angry at the other babies.  They were being fixed, but they wouldn’t fix mine.

I could leave it there, but I don’t want to leave you with the fear that I had on that day.  A lot has happened since then, I have a much better understanding of Freya’s heart condition now, and there has been some improvement since that day.  Freya is currently what her consultant describes as “nice and stable”.  The build up to her follow-up appointments causes me huge anxiety that manifests itself in shouting at the kids or nagging at my husband.  It also awakens the fears that I try to suppress on a day to day basis.  I feel physically sick as I climb the stairs when I go to check on Freya whilst she is sleeping.  I am always afraid of what I might find.  People have asked me if I sleep ok.  I sleep perfectly well.  It’s waking that I am most afraid of, too scared to open my eyes sometimes.  The relief I feel when I hear her move or breathe is intense.

My husband and I thought long and hard about what we should or shouldn’t share about Freya’s condition.  We didn’t want our children to find out things we’ve decided not to tell them.  We didn’t want Freya herself to be told before we have told her what she needs to know.  We didn’t want to be judged by people who might see us doing things with Freya that they think we ought not to be.  And we didn’t want pity.  I don’t want people to look at Freya with sadness.  There is a strong chance she will beat this thing; she is after all our miracle.  She is a beautiful girl with a lovely temperament. She sleeps through the night, and wakes up smiling.  It is impossible to stay sad for long in her presence – a less content baby would have made this journey all the more difficult.  She has softened every blow with her bright blue eyes and cheeky smile.  My love for her is overwhelming and I will forever be in awe of her.  Sometimes when I’m holding her and she is smiling up at me, a sadness seeps into my consciousness as I contemplate a world without her in it.  But I bat it away because although it is true that the day her heart broke mine did too, she doesn’t need a mummy who is sad all the time.  She needs me strong, smiling and by her side.  Always.

http://www.facebook.com/freyasstory

Freya’s Story (10)

The most cruel thing about this illness is the unknown.  The second most cruel thing about this illness is the false sense of security that it lulls you into when everything seems fine on the surface.  You can’t see what Freya has been through when you look at her.  What you see is a beautiful, happy little girl.  She is in all aspects (with the exception of the Kawasaki Disease and it’s ‘gifts’) the perfect baby.  She sleeps through the night from 7pm to 7-8am, and when she wakes it is not with a cry but with chatter and that beautiful smile.  With the exception of a couple of symptoms that remain – thick yellow finger nails, one of which came off yesterday and sore, dry lips that crack and bleed when she cries – she looks the picture of health, and other cliches.  Her last follow-up appointments were 3 weeks ago.  Since then we have been allowed to ‘forget’ about the journey we have been on.  Life has become the usual routine again; washing, ironing, picking up after Freya’s siblings.  The 6 weeks we spent in hospital seem like a distant memory, the only reminder being in the mornings when I prepare Freya’s daily medication.

Tomorrow is Freya’s next cardiac follow-up appointment.  And just like that, we are shunted from our 3 weeks of ‘normal’ and back into that dark place where we live with Kawasaki’s.  Just then my fingers hovered over the keyboard for minutes trying to think of what to write next.  I don’t have the words.   I’ve often referred to this journey as a rollercoaster, but the more I think about that the less appropriate it seems.  I love rollercoasters.  Love the breathless anticipation as the car makes it’s ascent up the tracks.  Love the exhilaration as you tip over the brow and race downwards, screaming wildly with joy.  I’d say the climb has some similarities, it’s just that the drop brings no joy.  It is a nosedive into a deep dark chasm.  Tonight I have a heavy heart, as again I am given a stark reminder that we are still on this ride, and we have no idea when we will ever get off.

Returning to the hospital where my worst fears became a reality always shakes me.  The memories of that week at Leeds General Infirmary are still so raw.  Up there I felt my most vulnerable, isolated and alone.

Tuesday 16th June 2015, 23:00pm

“I am sat by the side of your cot in your new temporary home.  We arrived at Leeds General Infirmary around 1pm and you were taken immediately into the ultrasound room for the new doctors to carry out another echo on your heart.  I can’t remember much about what was said as I seem to have hit a brick wall this afternoon after very little sleep last night.  What I do remember is that they confirmed what Sheffield had reported…I am too tired, and I am too exhausted with bad or worrying news.  You got very hot in the ambulance and all through the scan you just got redder and redder.  I could feel the panic rising inside of me like bile from the pit of my stomach.  They took your temperature: 36.4. Phew!  I cried with relief.  Last week I cried every time your temperature peaked, and now I’m crying when it doesn’t!

A new doctor came to see you today.  He is [the rheumatology consultant’s] equivalent…He wants to test your blood in the morning, and see the results of a further echo before he will make the decision about giving you another drug (Infliximab).  At the minute we are not sure whether you have beaten the Kawasaki’s, nor do we have a full report on the condition of your heart.

You are currently on the high dependency unit within the children’s cardiology wing of the hospital.  The staff and surroundings seem lovely, however I am not allowed to sleep with you on this ward, and have been given a key to a room in the parent’s residence.  I cried a lot when they told me I couldn’t stay.  I’ve been by your side all through this adventure sweetheart, I couldn’t leave you now in this strange new place.  I am sure they all thought me a very foolish and over-protective mother, and all of them tried to reassure me that you were in good hands and encourage me to go and get some sleep, but no matter what they say I will not leave your side tonight.

Daddy and I walked down to the parent’s room to drop my bags off.  The room they expect me to sleep in, away from you, is in a completely different wing of the hospital!  It is a 10 minute walk from where you are.  There is not a chance that I would spend tonight alone that far away.  I know you wouldn’t know I was gone, but I think I need you more than you need me at the minute. I love you dearly…These past few weeks when you were not yourself I have missed you more than you can imagine.  Now that you are back with me, and you know who I am…I don’t want to let you out of my sight. You are too precious to me.”

The nursing staff tried to encourage me to leave Freya and go to my room for some sleep.  They said that it was important that I look after myself to have the best chance of looking after her.  But I was stubborn and resolute; I would not be leaving her alone.  I fed Freya at around 1am and could feel myself dropping off as I held her in my arms.  After I laid her down to sleep I sat for some time considering what I should do, worried that if I stayed awake for the next feed I could cause her harm if I fell asleep.  I thought about it for 2 hours, and at 3:30am I slowly rose from my chair and with tears rolling down my cheeks I left her.  I am crying now, as I recall that memory.  I felt so much fear, sorrow and guilt; I still feel it now.  I guess it was around 4am when I finally settled down in my bed, although it was an anxious sleep mainly because of the situation, but partly because of the LGI ghost story that had gone viral on Facebook the week before!  I slept with the light on and one eye open!  When I awoke, I showered and rushed back to the ward where Freya was sleeping soundly.

“I guess you didn’t even miss me, but every minute I was away from you felt like an eternity.” (Wednesday 17th June 2015)

Freya had another echo that day (Wednesday 17th June, Day 18).  There had been no change from the previous day, but the doctor confirmed that Freya’s aneurisms were large and that the aortic valve continued to leak.  They said that otherwise her heart function was fine, but that she will need follow-up care for life, and would need to take blood thinners (aspirin) for many months to come, if not forever.

The Rheumatology Consultant came to tell us that he wasn’t happy with the inflammatory markers in Freya’s blood sample, and that it was time to tackle the Kawasaki’s more aggressively.  I had to give consent for Infliximab to be prescribed.  I believe it is unlicensed for use in children.  The hospital had to apply for funding for it as they did not have permission to use the drug in a baby as young as Freya.  The drug would switch off a protein in Freya’s blood called TNF alpha – one of the risks associated with that is increased potential of developing lymphoma, although the doctor assured us that this was more likely where there was prolonged use of the drug.  Freya would have only one dose to begin with.  It was no choice at all really, but we had to put our trust in the doctors and they were clear that we needed to switch off the inflammation to prevent any further damage to the coronary arteries.  I asked the consultant if I would have a chance to speak properly with the cardiology consultant as I felt that I understood the Kawasaki’s Disease pretty well, but was less confident in my understanding of the effects that it had on Freya’s heart.  He told me he would make sure I had some time with the consultant the next day.

And so we prepared ourselves for another drug.  Freya had been on various antibiotics (amoxicillin, meropenem, cefotaxime and gentamicin), antiviral medicine (acyclovir), paracetamol, ibuprofen, steroids, aspirin and a drug to protect her stomach from the drugs (lansoprasole).  She had received a blood transfusion, and two doses of immunoglobulin.  The next day she would receive yet another drug – the last they could really offer to help her situation.  I did not know that that day would also be one of the hardest days of my life.   Whether I am able to write about that tomorrow will very much depend on the outcome of our follow up appointment.  Keep your fingers crossed for her, will you?  And if you believe in God, please keep her in your prayers.

Freya’s Story (9)

Monday 15th June 2015, 08:25am

“I am sorry to say that I woke up feeling a bit hopeless this morning.  I woke at around 5am and decided, foolishly, to dedicate some time to carrying out more research on your condition.  I had been so focussed on the results of the blood tests in relation to the infection itself, that I completely overlooked the complications surrounding your little heart.  You see, whilst the treatment has been fantastic in fighting off the disease, it cannot reverse the damage that has already been done to your heart. Continue reading

Freya’s Story (8)

I don’t remember much about the day we got a diagnosis for Freya’s condition (“D-Day”).  Perhaps I was numb with all the information I had to take in?  I remember my friend was visiting.  I remember going for the echocardiogram.  The consultant who carried out the echo was kind of eccentric, and Freya loved him.  She cooed at him and laid there smiling while he did his work.  It was him that told me he had been asked specifically to look for Kawasaki related issues with Freya’s heart.  He mentioned Kawasaki Disease, and was profusely apologetic when he realised that was the first time I had heard that word mentioned.  I immediately googled it on my i-phone, attempting to surreptitiously arm myself with information as he continued to scan Freya’s heart.  I wasn’t able to read much, as the consultant was talking to me about what he was doing, so I resigned myself to waiting until I got back to our cubicle.  He finished the scan and said that his report would be available in an hour or so. Continue reading

Freya’s Story (7)

On the morning of Friday 12th June (Day 13 on this journey), Freya threw us another curveball.  I awoke to a strange noise and found her gasping for breath.  She looked like she was drowning.  Her nasal passages were blocked, but she kept closing her mouth and when she couldn’t catch a breath she wouldn’t open her mouth and was gasping for air.  She had to have a saline nebuliser that morning, and again I felt like we had taken a few steps backwards.  She had an x-ray in her room that morning; her 4th chest x-ray so far.

At 8am that morning I wrote:

“This isn’t fair, none of it is.  I’ve had enough little one, had enough of seeing you poorly, of watching you go through test after test and for what? They are not making you better!”

I didn’t write any more after that morning because the events that unfolded that day didn’t allow me the time, and I didn’t have the heart to put pen to paper.  I was lost.

Saturday 13th June 2015, 08:45am

“Well, what a day we had yesterday.  A day that whilst filled with angst and emotional turmoil, may have just marked the beginning of your recovery in earnest.  They’ve found it!  After days of tests and numerous medical professionals scratching their heads, they reached a diagnosis.  You have a rare autoimmune condition called Kawasaki’s Disease.  It was a relief to finally get there, but as the information poured in and the extent of the illness became clearer we realised this wasn’t going to be an easy ride.  I had hoped with all my heart that they would find an infection that could be treated with antibiotics.  That they would up the dose, and we would go home.  Unfortunately that wasn’t to be.

Remember I told you on Thursday that the Rheumatology Consultant had been to see you?  I told you that he had asked for more tests, including another ‘echo’ heart scan.  Well you had that scan yesterday morning…The scan identified dilated arteries in your heart, and that my sweetheart was the final piece of the puzzle.  The Consultant came to see me and told me that you needed immediate treatment.  You were to be given two doses of Immunoglobulin.  Basically, it is a collection of antibodies from lots of different people’s blood – an army of special forces designed to go into your body and wipe the nasties out, along with your silly blood cells that decided to embark on a bit of friendly fire. Our immune system is an amazing thing.  Our blood cells are always on the look out for things that shouldn’t be there, so when a virus turns up uninvited, your body sends the white blood cells in to send it packing.  In your case though, it would appear that something…triggered an autoimmune reaction, and instead of attacking the virus, your white blood cells started attacking the healthy cells in your body.

The symptoms you presented as a result of this internal battle (prolonged fever, rash, dry lips) are collectively known as Kawasaki’s Disease.  It is a very rare condition, affecting only 8 in 100,000 people. And although it is more common in children under 5 years old, there have been few babies as little as you with this condition.  The Doctors have had lot of conversations with specialists in Newcastle and Great Ormond Street Hospital in London to decide your treatment.  So it is 2 doses of Immunoglobulin…aspirin to protect your heart, and steroids to suppress your immune system while all this is going on.

I broke down yesterday and with each new detail I was given I began to unravel a little at a time.  So much to take in, and so much pressure.  No treatment is without risks and we found ourselves making decisions about drugs with possible side effects, or non-treatment with potential long-term effects.  The steroids may affect your normal development.  I guess if you are reading this now we will know if that was the case or not.  I was scared about that, but the doctors strongly advised the treatment so we had to trust them to get you better.  We won’t know yet if there has been any permanent damage to your internal organs, particularly your heart.  Daily ‘echo’ heart scans over the next few days, weeks, months, will show us that.  I hope we can mend your broken heart and I am so sorry that I couldn’t protect you from this my darling.

I would be lying to you if I didn’t admit that I looked for all sorts of reasons to blame myself.  Did I not look after myself enough during pregnancy? I should have taken more vitamins, I should have breast-fed you for longer.  Today, I have to accept that this was no-one else’s fault…This just happened…I’m going to have to try really hard not to wrap you up in cotton wool for the rest of your life, and I don’t doubt there will be a few wasted trips to A&E over the course of the coming months and years.

I am struggling to come to terms with this whole thing if I am honest.  To think that 13 days ago I took you to the doctor with nothing but a high temperature…

That evening I remember trying to settle Freya when a woman entered our room, announcing that she was the surgical consultant on duty.  She needed me to give consent to a PICC line for Freya.  Basically, they were concerned about the longevity of the cannulas in Freya’s body and wanted to provide longer-term access.  I was anxious about my daughter having to be subjected to further surgical procedures that would require a general anaesthetic.  I will never forget how matter-of-fact the doctor was as she received my signature from my left hand, as my right hand was busy soothing my screaming child.

A few hours later, 2 doctors came to our room to say that they needed to take a blood sample as an earlier sample had shown something concerning that they wanted to check.  The female doctor asked me if it was ok to take blood from a vein in Freya’s left arm.   It was midnight and I had not long since managed to finally settle my baby to sleep.   The pressure of the day got to me, and I screamed at the doctor, “What are you asking me for?  If you want to take it from there, take it!! You’ve done nothing but take her blood every day, so take it! Take it all!”  The poor doctors didn’t know what hit them, and they slowly backed out of our room.  The nurse began to move Freya and I started to worry that because of my emotional outburst they were taking her away from me.  The nurse told me that the doctors wanted to take Freya’s blood in the Treatment Room.  I really thought they were going to take her away and have me committed under the Mental Health Act until the nurse asked me if I wanted to go with them.  I wanted to stay in our room and cry.  Instead, I brushed myself off and went to the Treatment Room and held my child whilst they took more blood.

Freya underwent an echocardiogram daily over the weekend, and each day showed that there had been no change, for better or worse.  I felt like I understood the illness, and how it was affecting Freya’s body, but I had seriously underestimated Kawasaki’s Disease.

Freya’s Story (6)

I’ve not written for a couple of days as I’ve been busy with my family, keeping a promise I made to myself and to Freya to make our time here count.  It was my son’s 6th birthday on Friday, so this weekend he has taken the limelight, and Freya had to take a backseat for a few days.  I’m not sure she liked being back there much, but no matter what she has been through or what she has to come she is going to have to learn to share the people in her life sometimes.

I left you on the 10th June, where I had returned home from the hospital for some rest.  Rest that I didn’t get as I knew Freya had a big day to come.

Thursday 11th June 2015, 13:31pm

“…I didn’t sleep very well last night.  I guess I was kidding myself that I would rest well at home when I knew what was coming today.  I set off from home at 7:30am to make sure I was at the hospital in time.  Daddy looked shattered bless him!  He had slept in his clothes so he looked all crumpled!  You had a temperature again, so you’d just had some paracetamol…You were pretty grumpy because you weren’t allowed to have any milk after 2am.  I was so pleased to see you.  When I am away from you it feels like I have a little hole in my heart and I find it hard to breathe…As soon as I have you back in my arms I feel whole again.

At 10 o’clock the nurses came to take us to theatre.  You had to wear a little surgical gown – it was tiny, but still too big for you…When we reached the theatre wing the staff gave Daddy a buzzer [to let us know when you were awake], and I went with you into the theatre.  There were lots of people there.  They laid you on the operating table.  You looked so tiny.  I wondered how many lives {might have been] saved on that table.  I sat with you when they injected the anaesthetic.  It was one of the worst experiences I have ever had, watching you fight the anaesthetic until seconds later it took you off to sleep.   Your eyes didn’t close fully.  I cried.  I had to leave then, so I kissed your forehead and went with Daddy…and sat in the park opposite the hospital.  I can’t tell you how long that hour seemed to take.  Eventually the buzzer went off and they took us to get you.  You were fine; you had woken up…”

At around 4pm the haematologist came to deliver some good news.  Freya’s bone marrow aspirate showed no immediate cause for concern.  Freya’s cells appeared healthy and there was no sign of the ‘C’ word.  Again this was considered a sign that we were dealing with an infection caused by a virus and that Freya’s red blood cell production had been temporarily halted by the illness.

“…The Rheumatology consultant has also been to see you, and although he has asked for some more tests (heart scan tomorrow), he also feels that this is more likely to be an infection…Today has gone a long way toward helping mend my broken heart.”   

I wrote one last entry that night before going to sleep:

“Do you know little princess, I think you were sent to me to teach me a few things about how to live this life.  Looking back to the challenges I went through when I discovered that you were coming into this world, I can’t help but think that you are a little miracle.  Perhaps the soul that was looking for a body had been watching over me and saw how troubled I was, saw that much of this wonderful life was passing me by whilst I focussed on the very worst that could happen.  So it chose you, and me.  I’ve learned that you can’t always have a plan.  That sometimes there is joy in the unexpected, and…contentment from just letting life take it’s own course and not the one you meticulously carve out.  Life isn’t always about the big bang moments; sometimes it is the smallest events…that leave the most lasting impression on you.  Things happen for a reason, I truly believe that.  That’s the first lesson you taught me – let go, forgive, forget, see the beauty and freedom in a life without a pre-determined course.

I’ve got a feeling that this experience right now may well be the second lesson you have for me.  Twelve days into a hospital stay and you have some of the best of our medical profession stumped!  Haematologists, Rheumatologists, Immunologists – none of them can find an answer.  Because maybe there isn’t one.  I have a hunch that you are going to get well very soon, and we will be leaving this hospital without any diagnosis.  And it won’t matter, because you will be well and the family will be complete again.  I will have you home, and my heart will be mended because maybe it is okay for there not to always be an answer or a reason.”

Reading those last journal paragraphs for the first time since I wrote on those pages in the hospital, I feel like I’ve been punched in the chest, and tears that I had managed to stem flow freely again.   I thought our journey was nearing its end; I was full of hope.  I believed that as the bone marrow aspiration was the final test and there was nowhere else to look, all avenues had been exhausted and she was getting better.  I had no idea what was about to unfold the following day, or that the days ahead would be darker than anything we had endured so far.

Freya’s Story (5)

Moving to the specialist hospital came with its challenges.  It was a logistical nightmare for a number of reasons and put me an hour away from my children.  But it was the right place for us.  Initially Freya was under the care of an Immunology Consultant who worked with her team and the laboratories to try and find whatever this infection was, and where it was hiding.  By the time we left our local hospital, Freya has just one cannula in; the one in her head had been removed.  She still had the feeding tube, but she was much more accessible for cuddles with all the tubes and wires gone.  She drank a full bottle on the first evening, and I went to bed feeling that she was turning a corner.  The Children’s Hospital would now do their best to diagnose the illness, but said that there was a chance she could just get better and we might never know what made her so poorly.  She was a bit of an enigma to the medical staff.


It did feel like there was a real investigation under way.  Freya went for an echocardiogram on the Monday morning (Day 9) which showed nothing but a slight murmur, considered normal at her young age.  Her temperatures were settling down and she was feeding almost normally.  I truly believed she was getting better and we would be discharged without a diagnosis.  Some of her medication was changed.  I think they stopped the Gentamicin and replaced it with Meropenem.   They also added Acyclovir which is used to treat the herpes virus.  Her haemaglobin was low and the decision was made for her to have a blood transfusion.  I remember feeling shocked by that as it seemed such a drastic measure, particularly when I thought she was on the mend.  An MRI scan was planned to check Freya’s brain for any collections of infection that might be lurking there.  That’s where Group B Strep would be most likely to hide.

Freya received a blood transfusion on Tuesday 9th June.

Tuesday 9th June 2015, 12:52

“You now have someone else’s blood entering your body.  Seems the blood I gave you wasn’t quite up to the job…I just found out that your blood group is B Negative.  Mine is B Positive (which is ironic really as I can be such a neghead at times!). But the good news is (if I remember my maths lessons correctly) that a positive plus a negative equals a positive.  Which is grand, because that is exactly what we are together.” 

On Wednesday 10th June (Day 11) it seemed like we had taken 3 steps forward but 2 steps back.  The temperatures that I thought were a thing of the past returned, and Freya stopped feeding.


That was also the day of the MRI scan.  When the doctor told me that Freya would have to be sedated I fell apart.  I have this fear of general anaesthetic, always worrying that you might not wake up from one, so to be told my child would have to be put to sleep was hard to take.  I cried. A lot. I was relieved when in the morning the doctor said that they would try without sedation.  I had to feed Freya before we went down, and I had to swaddle her as tightly as I could in a blanket to keep her comfy and still.  I went in with her, and I was told that they would try Freya for a few minutes but if she wasn’t still they would have to pause and sedate her.   They gave me a set of ear defenders and I sat down next to the machine and cried silent tears as I watched her tiny swaddled body enter the tube.  She shouldn’t have to go through this at her age.

  
I’ve heard that MRI’s sound like an aircraft, and yes that is true of the background noise.  What I wasn’t prepared for was the periodic sirens and hammering sounds that were deafening to me even with my ears covered.  Freya slept through 25 minutes in there without moving a muscle.  I took it as a sign of how good and strong she was.  Her consultant was concerned that she was too sick to be affected.

Wednesday 10th June 2015, 12:55

“The good news is that the scan didn’t show any abnormalities…  They were looking for collections of pus that would indicate an infection in your brain.  You have a big day tomorrow.  The doctors want to take a sample of your bone marrow.  That means that you will have to be put to sleep with a general anaesthetic and they will take you to theatre  for surgery… I won’t lie to you sweetheart, I am scared.  I know that one of the things they look for in bone marrow is cancer. I am sure that isn’t the case…but they are concerned that you don’t seem to be recovering very well and there could be an underlying condition that is hindering you from getting better.  And I am so frightened that you won’t wake up from the general anaesthetic.  Silly I know,  but I can’t help being scared because you are so precious to me.  Part of me doesn’t know if I can be there…when you go to sleep, but a bigger part of me knows we are in this together.  See you in the morning.”

That night I went home to rest.  It was a stupid idea.  By the time I got home I was a nervous wreck.  I hadn’t made any arrangements for the children in the morning, but if I did the school run I could be too late for Freya’s procedure.  Luckily, my mother-in-law and sister-in-law already had it covered.  I had a large glass of wine, and went to bed where I worried more than I slept.