Wednesday, January 7, 2009

Winter time!

Well, I'm a bad blogging mom. But it's time for a Lily Update as there are some big things going on!

First off, HI JEAN!

Ok, now that's out of the way...

Lily came off the Ketogenic Diet over Christmas. It wasn't planned, and I think our neurologist is not super thrilled, but it was the right thing for us to do. Lily had a little stomach flu and couldn't keep anything Keto Friendly in her body. So we initiated the B.R.A.T. diet: Bananas, Rice, Applesauce, Toast. We stuck with bananas and dry toast, which aren't exactly Keto foods. And she was SO SO SO happy. Seriously, we haven't seen her that happy since before starting the diet. We did 24 hours of BRAT, then tried some Keto Foods. And they just went right through her, so back to BRAT we went. And she was so happy, not exhibiting ANY side effects of "normal" food, that we slowly introduced other normal stuff: turkey, beef, milk, cheese, yogurt, etc. We didn't "carb load" her, we tried to stick to higher protein stuff for a few days.

All in all, it has made a WORLD of difference for her disposition. She is having fewer seizures than before her illness. We don't know if they will eventually creep back up, but it just became clear that the diet wasn't helping her enough to make the trouble and hassle worth it. And putting LIly back on a regular diet opens up all kinds of teaching/therapy possibilites because food is a major motivator for Lily. We can use it as a reward for performing certain tasks and activites.

We couldn't be happier with our decision, despite it being an unconventional move and not what we had originally talked about with our neurologist.

Lily is also going to be weaned off of Ganaxolone, the study drug she takes. Marinus, the drug company sponsoring the study, has found that Ganaxolone doesn't provide the kinds of seizure control results they wanted so they're pulling the study & will not be pursuing FDA approval (at least for use in Infantile Spasms...it could be approved for other siezure types). So, we start the wean next Monday and she'll be off by early February.

This leaves us in a bit of a pickle as we're waiting on some genetic testing results before we start the next medication that we want to try (Valproic Acid). We'll set up the plan next week, but we may add a different med to bridge the time before our genetic results are back.

Lily was officially diagnosed with autism this summer. Normally parents don't cheer this diagnosis, but we did! This opens up a benefit in our insurance that will cover the majority of ABA therapy for Lily. I'm working on getting that set up for her now. I'm so excited about this! I just know it's going to do wonders for Lily and that she'll really start to learn. Our friends Cody and Sophie have both exploded in development with the use of ABA.

Lily is 1/3 the way through her first year of school. We really like her teacher and her 1:1 aide, and are happy with how things are going. We're going to revise some of her IEP goals soon now that we can use food as a motivator/teaching tool. There's just so much more we can do with Lily without the burden of food restrictions!

Finally we are working on arranging a trip out to consult with Dr. Harry Chugani at Children's Hospital of Michigan. Dr. Chugani is considered "the" doctor to see among IS parents. He has pioneered the use of PET scans to treat Infantile Spasms and determine if kiddos are surgical candidates or not. It's a path we've considered for a long time, since Lily was 6 months old at least. We haven't been able to pursue it this past year since Lily's been on the diet, but now that she's off we are planning a trip. It won't be easy -- it involves a 24 hour EEG, a PET scan (with sedation) and theoretically, a second kind of PET scan that Dr. Chugani is studying. Then on the fourth day we actually get to meet with Dr. Chugani and discuss all the results.

We'd probably take the whole family to go. It's very important for Hank & Lily to be together as they really depend on each other. It's important for Hank to be a part of Lily's world as it is, and will be, his world for his whole life. He's such a natural caretaker of her -- he is always checking on her, loves to snuggle her, and nwo that she's off-diet, FEED HER! LOL! Anyhow, since we'd be taking all four of us, we'll probably drive down to Maumee, OH to visit Todd's grandma. Hopefully Todd's mom will come up to visit, along with his sister & her kids. The four cousins haven't been together since before Lily was diagnosed -- October, 2005! I can't wait for these kids to be together and play!!

Here are the twins on Christmas Eve:

Saturday, July 12, 2008

Summertime!

Hello friends!

Just wanted to offer a brief update on Lily...

She's doing great these days! We are still on the Ketogenic Diet at a 3:1 ratio, which Lily tolerates fairly well. We go through periods of difficulty, but overall she does well with it. Her favorite meals are eggs & fruit (because I can hide 100% of the cream & butter in the eggs), Ketocal formula, and a smoothie recipe with jello, cream, fruit, egg beatersa, and oil. Sounds appetizing, no? LOL!

Since the diet has been such a big help in her seizures, we've been able to wean Lily off her Topamax. We're still in the process, but we started at 75mg 2x/day, and we're now down to 25mg 1x/day. We're so close to be off of "DOPE-amax", and have really seen a change in Lily's alertness and awareness of her surroundings. Can't wait to be done with this!

She's still part of the Ganaxolone study, and we still think the med helps her. It's hard to believe it's been a year since we were in Los Angeles starting this new therapy for infantile spasms. The study keeps getting extended so as far as we can tell, Lily will be on this as long as we think it is helping.

Lily turned THREE this week! It's just amazing. She enjoyed her birthday dinner of smoothie, and loved watching the candles on the cake even though she couldn't indulge. She loved opening her gifts, though was much more excited about the wrapping paper than the actual gift.

We completed her IEP for the school district in June. We were THRILLED that the school district OFFERED an 1:1 aide for Lily, which we figured we'd have to fight uphill for. We have a little bit of work to do on the verbiage of her goals, but overall we're excited for her to start school in the fall.

We're also pursuing a diagnosis of autism for Lily. She doesn't present as a "classic" autistic child, however she has enough of the criteria (in my opinion) to qualify for a diagnosis. Having this diagnosis will open up lots of doors & therapies for her, including Applied Behavior Analysis which I believe Lily would REALLY benefit from. We see neurodevelopmental in August, so we'll see where we stand at that point.

Lily & Hank are going to a summer camp at the end of the month! There is a fantastic program through a local hospital that is designed specifically for special needs kids & their siblings. The twins will be in a small group, around five kids, and there are two teachers for each "pod", plus each child has a "buddy" which is most likely a high school student doing their extra credit for the summer. I hear that there is a waiting list to be a volunteer and that some of the students enjoy it so much they come back year after year, even after finishing out their credit!

The camp takes place at a HUGE park just north of us, and there are classrooms, fields, playgrounds, and a petting zoo!! So exciting, and I think the kids are just going to LOVE it.

Lily is also on the waiting list at Little Bit Riding Center where she would get hippotherapy. Hippotherapy is "a treatment that uses the multidimensional movement of the horse; from the Greek word "hippos" which means horse. Specially trained physical, occupational and speech therapists use this medical treatment for clients who have movement dysfunction. Historically, the therapeutic benefits of the horse were recognized as early as 460 BC. The use of the horse as therapy evolved throughout Europe, the United States and Canada." Her PT/OT & SLP have both suggested that Lily would benefit from this therapy. Unfortunately, there is a YEAR LONG waiting list at LIttle Bit, so it's a while before she'll get to start.

We're starting swimming lessons with Lily again tomorrow; it's just a parent-tot class, and not specific to special needs, but Lily loves teh water and I think she'll enjoy the playtime with all four of us.

Next weekend is Uncle John's wedding, and Lily is a flower girl! There are actually two flower girls, and Lily will be pulled in a wagon down the aisle. She looks like an angel in her flower girl dress, and I can't wait to share pictures.

OH! Our Epilepsy Walk was a HUGE success! We raised over $3300 for the Epilepsy Foundation Northwest. We are so grateful to everyone for supporting Lily and the disease she battles daily.

Friday, June 13, 2008

Lily is great!

Click here to sponsor our family in Epilepsy Foundation Walk!

Lily is doing really well these days.

We've increased her diet ratio to 3:1, and have definitely seen a decrease in her seizures. She now maybe has only 3 or 4 spasms in a day, and we've even had a few seizure-free days! WOO!!!

We have Lily's IEP meeting tomorrow to write her education plan for the school district tomorrow. I'm nervous, but have gotten AMAZING advice from my good friend Shawna.

We've been able to decrease Lily's Topamax by 2/3rds now, which has made a HUGE difference in her alertness & interaction. It's just so amazing to see our Lily wake up.

Our BIG NEWS is that we are participating in the Epilepsy Foundation Northwest Walk on Saturday, June 21st. Please consider donating to this amazing organization promoting advocacy, education, and research.

Monday, April 21, 2008

Chug-chug-chugging along

Well, Lily's MRI was cancelled at the last moment due to her having a cold a few days prior. The anesthesiologist was concerned as it can complicate sedation, and since he's not right in the room by her, he just felt the (small) increased risk wasn't worht it for what is, ultimately, an elective procedure.

So, we're rescheduled for 4/29.

We've increased Lily's ketogenic ratio to 2.5:1. So far, so good. One really great thing is that I've finally figured out a way to get Lily to drink the cream! I figured out the right combo of dilution (to make it the consistency of milk) & flavoring (a little sugar-free vanilla syrup + 5 drops of bickfords banana flavor). I also created a couple meals with some of her favorite foods. She's now having some Cheerios occasionally (there are actually a good amount of Cheerios in only 6 grams!), and I also found out about Miracle Noodles which are basically just soluable fiber (thus, no calories or carbs) shaped noodles. So I was able to make her a fairly tasty Mac 'n Cheese meal. It has a really good volume to it, so I think she actually *felt* full for once in a long time.

She's drinking water very consistently (hooray!) which is great as we learned recently that her last round of labs indicated some dehydration.

We started the paperwork to transition Lily in to the developmental preschool in our school district. She'll have the full round of evaluations in the next month, and then at the end of May we'll meet to discuss her eligibility. Finally, in mid-June we'll meet to draft Lily's first IEP. I'm already gathering all my information, and formulating what I want on her IEP right now. I'm talking with lots of friends who have knowledge of the process, and getting my arsenal of advocates in my bag.

Todd & I are heading out this weekend to Vegas for our 1st vacation since having kids. I figured out it has been nearly three years since we've been on a vacation of any sort. I'm very much looking forward to leaving the twins with my parents, and being able to just turn off my brain for three days. blissssss

Tuesday, April 1, 2008

Still not much to report!

We had our 1st diet follow-up appointment about 10 days ago. Her labs all look great, and we could probably move up in ratio if we wanted. We haven't pushed for that yet, but may next week.

While we haven't seen a big change in #'s of spasms, we have seen an increase in Lily's alertness, and engaging with us. She's also fairly consistently signing for "more"! This is a HUGE accomplishment for Lily, and really indicates she's learning cause & effect. Naturally, she associates it with food which we want to get away from, but for now we're just enjoying the accomplisment and not trying to change it too much.

Lily has an MRI tomorrow (Tuesday, 4/1). It's just a routine MRI, to make sure the changes Lily experienced while on Vigabatrin are still gone (the Keto diet can make these changes re-appear), and also just to check for any abnormalities now that her brain is a bit more developed. She hasn't had one in nearly two years, so it's kind of a big deal.

Other than that, we're still going to start the transition to the school district next week, and get the process going for Lily's first IEP! YIKES!

Monday, March 17, 2008

Hanging in there

Not much new to report. Lily continues on her diet at a 2:1 ratio. She's still very picky about what she will & won't drink, but she's getting better at sipping water all day long. I pretty much always have a sippy of water laying around, and she'll take a swig throughout the day.

We're still seeing seizures, but everyone seems to agree that her attention & "alertness" has increased since starting the diet. We have our 1st follow up appointment on Wednesday, and I'm anxious to hear what they have to say (along with what her labs look like).

We start the transition into the school district special education program in April. Lots of evaluations & developmental profiles to be completed, and I'm all sorts of nervous about it.

That's all from around here!

Monday, March 3, 2008

Not about Lily, per se...

(Quick Lily update -- Lily continues on the Keto Diet, at a 2:1 ratio. She's eating well, but doesn't want to drink anything. She continues to have seizures, but she does seem to be more alert, present & engaged which is very encouraging. We have quite a bit we can tweak with the diet to keep trying for seizure control, so we're still hopeful.)

I know this is a blog about Lily but we had a lovely afternoon today visiting my Granno to take pictures with all my cousins celebrating Granno's 80th birthday this year.

All of Granno's grandchildren recreated the photo we had taken for her at Christmas in 2000.

Here's the original from eight years ago:


And here we are today, with two great grandchildren:


And of course, the lady of honor (doesn't she look absolutely beautiful?):


My brother & I also got to spend a few minutes in Granno's new condo for the first time today. What a fantastic place! I could immediately feel how comfortable Granno was there, and it made me happy to know that she was in a place she felt happy. She has a lovely view of downtown, with a peek of water & mountains too.

It was a lovely day.

Saturday, February 16, 2008

Keto Diet, Day 4

Today was a better day. We got Lily's labs turned around, and she had much better color and energy. She took most food today & kept it down. She still flat out refuses any liquids, but I think that might be partly due to being on IV fluids for 24+ hours, and the fact that her IV is in her right, dominant, hand so she can't grasp a cup.

We're HOPING they'll let us come home tomorrow. I think if her labs are stable, she's still taking food & liquid (we're forcing the liquid at this point), they'll let us come home. I also think being in her home setting where it's familiar, routine, and comfortable will help Lily.

My grandma has been diagnosed with Angioimmunoblastic T-Cell Lymphoma, a rare & very difficult to treat form of Lymphoma. If you can spare good thoughts, my family would appreciate it.

Friday, February 15, 2008

Keto Diet, Day 3

*sigh*

Things aren't great. I'm ready to give up, really! I'm having major self-punishment for voluntarily putting my girl through this!

We're just finishing day 3, and Lily can't keep anything down. She flat out REFUSES any liquid, which is so so so uncharacteristic for her, and now she's on an IV.

She's in high ketosis, and is acidotic. Her CO2 is very low (10), so they have her on an IV with sodium bicarbonate to try & raise that.

AND, despite all this, I'm still seeing seizures, so it all feels for naught. Honestly, I'm ready to have a meeting w/our neuro & dietician and tell them that unless they can give me good reason to keep going, I'm ready to pull the plug! I'd rather deal wtih some seizures each day and have Lily be happy & herself, rather than no seizures & have her be in this awful, lethargic, horrible state.

All of this is a relatively common side effect of starting the diet. I mean, we're COMPLETELY changing her metabolism which is a shock to the system itself, AND she's on topamax which can make the blood chemistry out of whack as it is, and add to the acidosis. None of this means she can't tolerate the diet and we have to stop. But it is so hard to persevere & push her through this hard time with blind belief that she'll start to feel better and will (hopefully) get some seizure control.

What a crap-sandwich Valentines Day.

Wednesday, February 13, 2008

Keto Diet, Day 1

Well, we've had a looooooooooooooooooooooooooooooooooooooooooooong day here at Children's. First, Lily was to fast after dinner with the exception of "Keto approved drinks" (no-calorie fruit flavored water, or the like). No meds either, until after labs. We were to be here at 11:00 for labs, then a noon admit. After labs, Lily was allowed a cup of "Keto milk" (diluted heavy cream), but she wasn't too excited about it. Well, then our room wasn't ready at noon. Then it wasn't ready at 1. FINALLY at about 2:30pm we were taken to our room, a decent sized single on the medical floor. It's noisier up here than it generally is in the telemetry unit, but the nurses have all been great.

We were supposed to get her 1st meal (1/3rd her calories, at a 3:1 ratio) right after arriving in our room. But the dietician ended up not getting it to us until 4:45. Our girl was NOT a happy camper. But she eat her tiny meal and then fell asleep at about 6:00 for a couple hours.

She woke at about 8:00, ready for her 2nd keto meal (also tiny) and was up for a play time. I had *JUST* gotten her settled for the night when the nurse came in to tell us we were being bumped into a double room because they needed the single for an RSV kid who was being admitted from the ER. *SIGH* What can you say to that?? So now we're all tucked into our new room, Lily is asleep (again, hopefully for the night). She took a while to coax back to sleep, but seems to be resting peacefully for now.

(Our roommates, while VERY nice and sweet, are not super considerate. They have the bright lights on (at midnight), loud toys & TV, and the mom keeps talking to me! Not the worst thing in the world of course (and at least she's really nice), but dude. It's after midnight. TURN YOUR LIGHTS DOWN. Ah well.

If you can, please spare a good thought or prayer (whatever is your choosing) for my grandmother. She's nearly 80 & in the hospital pretty sick. There is some concern of lymphoma & she has a surgery in the morning to remove/biopsy some lymphs. [worry]

Off to bed now. *YAWN*