Sunday, April 27, 2014

2014 Great Strides Walk

2014 Great Strides Walk

Hope is the only thing stronger than fear.  
We hope and pray everyday for a cure for this little guy.  
Until that day comes, we will fight to keep him as healthy and strong as we can.  
His strength makes us stronger. 
 His courage makes us face everyday head on.  
His smile makes all of our troubles go away.  
Our future, our hopes, our dreams,  our everything is wrapped up into this one tiny being. 
We will beat Cystic Fibrosis!
People count life time by days, I count mine by every breath.


Introducing Evan's Extreme Team!

We had such a fun time raising awareness and walking for the Cystic Fibrosis Foundation!  Thank you to all of our family and friends near and far for your support.  We love you! 







 Mama and Evan
 Uncle Jay and Aunt Heather
 Grandma & Grandpa Allen
 Evan fell asleep on Grandpa during the walk
 Big brother Jaxson with his raffle tickets
 The Allens
 We love our boys!



Wednesday, April 9, 2014

6 Months ago today

Dear Evan,

We did it!  We made it to 6 months!  The first milestone of many.

It's been 6 months of "heartbeats", therapy, breaking open capsule after capsule of Creon and trying to fit every last bead on the end of of a baby spoon.  It's been 6 months of applesauce, salt, daily sanitation cleaning, doctors galore, shots galore.  It's been 6 months of limited church and public activities.  It's been 6 months of monthly trips to Primary's and holding our breath every time you sneeze, cough, or have even the slightest runny nose.

But, it's been six months of snuggles, giggles, smiles, milestones and love.  And I wouldn't give up one day of any of the hard stuff for one less day with you.  You have been the biggest blessing to our family.  You have given us a purpose beyond our own.

I have learned more about love, sacrifice, charity, and eternity in these past 6 months, then I could have every learned in a lifetime and for that I am  eternally grateful.


The day you were diagnosed with Cystic Fibrosis was the hardest day of my life.  I cried for months, not for the task at hand, but for the burden that will be yours for life.  But, I will be there with you every step of the way.  Cystic Fibrosis does not define you - you define it.  We will provide you with a home where you feel safe and loved.  We will laugh daily.  We will cherish the good days.  We will build memories.




I don't have all the answers.  There will be difficult and sad moments.  But, I can promise you this - no matter how difficult the task, we will do EVERYTHING we can to keep you healthy for as long as we can.  We will fight everyday until they find a cure.  I love you son!

Love, 
Mom




6 Months Later...Reflections

Six months ago today we received news that changed our family forever. It was a Wednesday afternoon, I was at work. A week prior we had received word that Evan's newborn screening test (which all babies born since 2011 must undergo) came back with Cystic Fibrosis 'indeterminate'. Our doctor told us this was nothing to worry about. 90% or more of 'indeterminate' results come back negative once more in-depth testing genetic testing is done.

We weren't worried.

At 3:30 in the afternoon on Wednesday October 9th my phone started ringing. I picked it up and heard Stacy, frantic, on the other end of the phone. I stepped out of my office and asked her to slow down. She said the doctor's office had just called. Evan's doctor wanted to meet with both of us at 6:00 that night. It was about Evan's test results. We both needed to be there.

I rushed home. We tried to think of a possible way it could be good news.  Maybe the tests had shown he had some crazy athletic gene or genius gene. Maybe he would be 7 feet tall and an NBA star. We were grasping at straws.

We got in the car and went on a drive. There was no way I could go back to work, and sitting at home wasn't an option. It was a rainy afternoon in the desert. We drove clear to Pine Valley (45 minutes from St. George). On that drive we promised each other that we would stick together and that, regardless of the trials ahead, we would take care of Evan.

We left Jaxson with some friends in our ward (thanks Bennions and Woolleys) and then went to the Doctor's office. They took us into an exam room.  I noticed that the nurses wouldn't look us in the eye as they took us back. Eventually the doctor came in and said, "We do a variety of tests to look for Cystic Fibrosis, and this time it appears we found it." Genetic tests done in Salt Lake had confirmed Evan had CF.

A wave of shock rushed over us both. And then the questions started pouring out. How long would he live? What would his quality of life be? What the heck is Cystic Fibrosis? What does this mean for our family? Would he have a normal childhood? Could he play sports? Could he serve an LDS mission? Could he have children of his own?

The doctor did his best answering our questions. He then said we needed to be at Primary Childrens' in Salt Lake at 11:00 the next morning. They could, he said, answer all of our questions.

We staggered out to the parking lot.

Once we got into the car, we both lost it. We sobbed for a solid 15 minutes and just held each other. We went back to our neighborhood, picked up Jaxson and went to our house.

Then we called both of our parents. Those were tough phone calls.

I didn't sleep that night. I spent most of the night online researching Cystic Fibrosis and the rest of the night tossing and turning and praying. We left for Salt Lake early. Along the way we met my parents who took Jaxson and followed us to Salt Lake. Seeing them was very emotional, but we were grateful Jaxson would be with them so we could focus on Evan.

The next two days were a blur. We spent a total of 15 or 16 hours at Primary Children's over the next two
days. We met Evan's CF team--a pediatric pulmonologist, 2 CF nurses, a respiratory therapist, a nutritionist, a social worker--and other support staff. One of the hardest things about that trip was when Jaxson had to be tested for CF. Because the disease is genetic, there was a 25% chance Jaxson had it too. The test is not fun. They put Jaxson in a chair, cover his arms in pads, and then basically shock his arms until he sweats a lot. Based on the consistency of the sweat they can tell if he has CF or not. The sweat collects in the pads so they can analyze it. It is a painful test and was hard for a 2 year old boy to understand. We told him that they were testing to see if he was a superhero or not. They wanted to see if he was Spiderman so they had to test his arms to see if they could shoot out spiderwebs. He was a trooper during the 30 minute test. It was tough to watch him be scared and he was, at times, in pain. We were relieved when the test came back negative. Having Jaxson test positive as well would have been crushing.

So...since then we've gotten used to our new realities: 98 pills (and growing) each week, 90 minutes of lung therapy each day, nebulized medications every day, germophobia, monthly visits to Salt Lake, and the realization that there is a higher statistical likelihood that Evan will die before he's 18 then there is that he will have normal lung function when he's 18.  And that a common cold or flu for you or I could, simply, kill him. The most difficult reality is that there is no 'we'll get through this tough trial' mentality. There is nothing to 'get through.' He won't get better. He will only deteriorate. Our goal, simply, is to slow that deterioration.

But we are also encouraged by the medical progress being made. Average lifespan is now around 40 years old--it used to be under 5 years. New drugs are in the pipeline to be released in Q3 2014 that have the potential to make that lifespan substantially longer. We hope and pray every day for a cure.

The nurses at Primary Children's were so kind. They cried with us, they hugged us, and gave us support. Our ward and our friends were incredible. They have been extraordinary. Thank you. My company has been awesome too. They've been very understanding and supportive. Our families, though,  have been our rock. My parents have been totally willing to take Jaxson overnight while we take Evan to see his doctors. We simply couldn't have done all of these appointments without them. Stacy's mom flew down immediately after we found out. Those were a tough few days and we couldn't have made it through without their help.

So, anyway, 6 months later we've made some changes. We realize that worrying about the future isn't the most important thing. The most important thing is having a high quality of life right now (that's the worst financial advice ever, I know). We simply don't know how long 'the future' will be for our family so we're trying to enjoy every day with our boys.

We are 6 months into our new reality and we're doing well. Thanks for your support and love.

Evan Primary's 6 Month

March 24th, 2014

Weight 18 lbs
Height 25.6 in
Creon: 14 (6000 mg) pills a day

Growth Status
Green: Low or No Risk
Weight:  Gained 24.3 ounces (expected weight gain is 20-30 ounces)
Height: Grew 1.3 inches (expected height gain is .9-3.5 inches)


Medications per day
Salt           1/4 tsp
Pulmozyme 1 Vial nebulized daily
Creon       14 (6000 mg) capsules a day
Albuterol   2 Puffs morning and night
AquDEKs  1 mL 
Synagis     1 mL once a day every 30 days


Tidbits


  • Back to green light! Evan's weight gain is excellent!  His height is a bit concerning at this point, but we are going to say it's measurement error at this point and keep monitoring it.

  • Evan cannot be around fires, hot tubs, or onion fields.  All are bad for his lungs.  And he should only swim in pools that are chemically treated and well taken care of.  
  • Evan could possibly qualify for studies at age 2 if VX809 is out by then.  VX809 coupled with kalydeco is showing improvements in lung function so far in people with Evan's mutation.
  • Discussed continuing to increase the fats in Evan's solids with the nutritionist.
  • Meet Dr Asfour - Evan's Pediatric Pulmonologist

Evan Primary's 5 Month

February 10th, 2014

Weight 15.14 lbs
Height 25.2 in
Creon: 14 (6000 mg) pills a day

Growth Status
Yellow: Needs Improvement
Weight:  Gained 12.5 ounces (expected weight gain is 20-30 ounces)
Height: Grew 1.42 inches (expected height gain is 2.3-3.3 inches)


Medications per day
Salt           1/8 tsp
Pulmozyme 1 Vial nebulized daily
Creon       14 (6000 mg) capsules a day
Albuterol   2 Puffs morning and night
Miralax      .25 tsp as needed
AquDEKs  1 mL 
Synagis       1 mL once a day every 30 days

Tidbits


  • Evan was sick with the Rhino virus since his last visit to Primary's resulting in 10 oz lost weight.  We are still trying to play catch up from that.  Just goes to show the importance of keeping Evan healthy and well.  
  • Deep throat swab indicated less staff growth then before.  
  • Discussed a better routine for solids with the nutritionist:
    • Solids twice a day
    • Formula mixed with rice cereal for added calories

Evan Primary's 4 Month

January 13th, 2014

Weight 15.17 lbs
Height 24.29 in
Creon: 24 (3000 mg) pills a day

Growth Status
Yellow: Needs Improvement
Weight:  Gained 11.68 (expected weight gain is 20-30 ounces)
Height: Grew .51 inches (expected height gain is .9-3.5 inches)


Medications per day
Salt           1/8 tsp
Pulmozyme 1 Vial nebulized daily
Creon       14 (6000 mg) capsules a day
Albuterol   2 Puffs morning and night
AquDEKs  1 mL 
Synagis     1 mL once a day every 30 days



Tidbits

  • We were trained to administer pulmozyme.  Pulmozyme must be refrigerated.  Administered through a nebulizer.  Takes 8-12 minutes to complete.  Mask and cup must be soaked in soapy water then sterilized.
  • Our new nightly routine is 2 puffs albuterol, pulmozyme, then CPT.  
  • Our insurance refuses to cover Pulmozyme, calling it a specialty drug.  This is like denying chemo for a cancer patient.  Pulmozyme is primarily the reason the life expectancy for CF patients has increased so dramatically.  Without insurance, it would have cost us $2700 a month for Pulmozyme alone.  We have begun the appeals process.  By some miracle the manufacturer is willing to give it to us for FREE until we finish the appeals process.  Tender mercies do exist!  

Evan Primary's 3 Month

December 5th, 2013

Weight 14.7 lbs
Height 23.8 in
Creon: 21 pills a day

Growth Status
Green: Low or no risk
Weight:  Gained 20.6 ounces (expected weight gain is 20-30 ounces)
Height: Grew 4.29 inches (expected height gain is 4.4-6.3 inches)


Medications per day
Salt           1/8 tsp
Creon        21 (3000 mg) capsules a day
Albuterol   2 Puffs morning and night
Miralax      .25 tsp as needed
AquDEKs  1 mL 
Synagis       1 mL once a day every 30 days


Other Tidbits

  • We asked if we could start pulmozyme at 4 month mark rather than waiting until 6 months.  Dr Asfour agreed.  Why wait if it could help sooner.  
  • Discussed starting solids at 4 months and eventually adding fats to solids to help boost caloric intake
  • Learned that the bigger (stronger) upper body a CF person has the better their lungs.  Evan will be encouraged to participate in high cardio activities and sports as he gets older to help boost his lung capacity.  
  • Jaxson and daddy got to go see the lights at temple square!                                                                
 

Evan Primary's 2 Month

November 18th, 2013

Weight 12.13 lbs
Height 23.2 inches
Creon: 21 pills (3000 mg) a day

Growth Status
Green: Low or No Risk
Weight:    Gained 31.8 ounces (expected weight gain is 20-30 ounces)
Height:     Grew 3.19 inches (expected height gain is 3.1-4.4 inches)

Medications per day
Salt           1/8 tsp
Creon        21 (3000 mg) capsules a day
Albuterol   2 Puffs morning and night
Miralax      .25 tsp as needed
AquDEKs  1 mL 

Labs & Xrays
Routine blood work to determine vitamin fat absorption levels. The techs had difficulty finding a vein. Results: Good

Chest xray indicated very mild signs of CF.  The lines in the lungs were a bit darker compared to a normal xray.  

Deep throat swab showed some growth of staff but nothing unusual or worth treating.  CF patients usually have some growth of staff at all times. 

Fecal Elastase test came back pancreatic insufficient

Other Tidbits
  • We enrolled in CF patient registry
  • Discussed starting pulmozyme at 6 months
  • Stools are still irregular.  Decided to up Miralax to see if it would help regulate bowl movements
  • Discussed working with our pediatrician to order Synagis shot (RSV inoculation shot) for winter months.  
  • Thank you to Grandma & Grandpa Allen, Auntie Heather, and Nana Pettingill for coming and supporting us that weekend and following week!


Evan Primary's 1 Month

October 10, 2013

Weight 10.23 lbs
Height 20.75 inches
Creon: 7 pills a day




Sweat Test
Final test to determine Cystic Fibrosis.  Evan produced more sweat than any patient ever.  Results: positive.

Fecal Test
Indicated that not yet pancreatic insufficient but on the lower range. Dr Asfour anticipates Evan will be pancreatic insufficient by next visit.

Met with

Sue Mills - CF Nurse Coordinator
  • Gave us a bag with CF resources including binders, books, therapy onesie support group information, etc
  • Evan's mutation is Pancreatic insufficient
    • Showed us how to administer Creon on a spoon with applesauce and salt
  • Discussed support groups and future appointments
  • Most important thing we can do to extend Evan's life is his therapy!

Dr Asfour - Pediatric Pulmonologist
  • Gave us an overview of Cystic Fibrosis and what we can expect
    • Delta F508 is the most common mutation in Caucasians 
    • Severity varies case by case.
    • Median age in the 80s was 5 years old.  Now it is 37 years old.
  • Discussed latest advances within the field of study
    • Kalydeco essentially reverses the effects in 3% of CF population
    • VX809 is an upcoming drug (similar to the effects of Kalydeco) for Evan's mutation that he could qualify for when he is two.  Pending FDA approval and further tests at this point.  
  • Explained CF like a battery.  We all start out with 100%.  Whenever "normal" people get sick, their batteries go down for a bit, but then recharge again.  However, when people with CF get sick, their batteries never recharge.  If antibiotics have to be given when sick, eventually their bodies get to the point that they can no longer fight off the sickness.
  • Decided it best to keep Evan home from church and Jaxson home from nursery until the cold and flu season is over
Social Worker

  • We learned we do not qualify for anything....surprise!
Nutritionists
  • Continue with nursing unless Evan begins losing too much weight down the road.
Respitory Therapist
  • We decided to learn how to perform CPT (Chest physical therapy) to jump start Evan's therapy.  They usually wait until second visit to train parents.   
  • Two puffs of albuterol given morning and night followed 'tapping' on 8 spots on Evan's body for 3-5 minutes a spot.  
  • Sent us home with blue tappers, albuterol, and mask. The mask is to be soaked every night for 15 minutes in soapy water then air dried.  


Interesting Tidbits

  • On the way home we stopped by a Wendy's to eat.  This was our first attempt at administering the Creon on our own before Evan nursed.  We totally freaked out an elderly lady in the booth next to us.  How dare we try to feed solids to a newborn!  She got up, walked over and said "Well that's interesting!"  
  • Jaxson was also sweat tested.  We called it the Spiderman Test to try to take away some of the scariness of it.  He does not have CF, but may still be a carrier.  We will test him later.