A new entry at last

(Finally finished!)

It has been over 10 days since our last entry and quite a few things have happened chez the Hope-Masons. After our second visit to GOS on the Tuesday we had a follow-up appointment with Kate Farrer (NNU) and Suzanne Crowley (Paediatric Doctor specialist in Respiratory Problems – I’m sure I will change this description once I’ve checked it with Dr Crowley herself!). Max & Silvia on the London EyeAs Massimo is so special we were seen last, so that they could catch up with his file and spend time with us, so although our appointment was 9.30 we didn’t get seen till much later. Whilst waiting for our appointment we met Massimo’s Social Worker, a lovely lady by the name of Stella who assured us that she would do her utmost to get us the higher rate of Disability Living Allowance and to make sure that we got a blue badge (what was an orange badge and previously known as a disabled badge). During our appointment Dr Farrer and Dr Crowley saw that Massimo’s breathing wasn’t as brilliant as it should be and although some of his difficult was possibly due to the recent chemo, they decided to try him on ventolin nebuliser to see if this would help but in fact it made little or no difference. His breathing and saturation levels did improve by the weekend, so I think that he was struggling with the chemo. Anyway, we all had a lovely catchup. After our appointment Helen came down to see us and together we decided to redo his Hickman Line dressing so by the time I left SGH it was 1.45 pm!
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Fun and Games at GOSH part II

Well today was a far, far more successful day than yesterday! The Parrot Ward organised for transport to come and pick me up at 10 am and the car was here by 9.30. Once we got to the hospital and onto the ward we called Michael from the Elephant Day Care and he and a specialist nurse were down in 10 minutes. Chemo was administered quickly afterwards, whilst the anaesthetist came to talk to me about Massimo and she agreed to change the trachy tube whilst he was under. At about 2.30 pm we took Massimo down to the CT scanner and I cuddled him as he went to sleep. Less than an hour later I was collecting him again. He was very unsettled when he came round, possibly because his throat was hurting and when he got back to the ward he required oxygen for a while. We are, however, back home and I am eternally grateful for Verna’s presence tonight as I like the thought that she will be keeping an eye on his saturation levels (oxygen levels in blood) whilst I get a good night’s rest. Today, on top of yesterday, has been thoroughly exhausting. Good night all!

Massimo’s great discovery

This afternoon, on returning from our ordeal at GOS, Massimo discovered how to blow raspberries and he has been doing nothing else since, except grin at everyone in sight! When we put him to bed this evening he lay there, eyes wide open, looking around happily and … blowing raspberries! This really is quite an achievement for a little chap with a tracheostomy and therefore very little air in his mouth and no pressure from his lungs!

Fun and Games at Great Ormond Street Hospital

As you all know, today Massimo was due to go to GOS for the usual MOT day, a double dose of chemo and a CT scan. I had organised for J’s Step-Mum to come with us as it is impossible for me to drive that distance with Massimo on my own and J can’t keep taking days off from work. In the end he didn’t go to work today as he was at the doctors’ in the morning and at St George’s in the afternoon!
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Just in case …

… we were getting used to things as they currently stand, today we discovered another problem. Luckily this time it is a very common one and simply fixed with a small op. Massimo has a hernia, which is apparently quite common in pre-term babies. A quick op, another scar and another general anaesthetic to be organised as soon as possible.

Today we had an appointment with the geneticist so that she can work out whether Massimo’s various problems are linked in any way. The upshot of the meeting, other than spotting the hernia, is that she needs to do some thinking and analysing but the likelihood is that Massimo has just been very, very unlucky. Obviously this isn’t a firm conclusion quite yet.

Other news is that Max is now 6.7 kgs (14lbs 12oz), a rough estimate of his height is 60 cms (we bought a height chart – dolly the dalmatian – and I just laid him on there!). He has started grabbing things and bringing them to his mouth although his favourite activity is dribbling lots and then smearing it all over his face!

The web site’s name

Justin and I have been having continuous arguments about the name of this site as I have always disliked “Massimo’s Progress”. For some reason it reminded me of Lorenzo’s Oil. Today I have finally insisted on changing the name to Massimo’s Story. I/we would like your opinions on the matter although we do not promise to heed to any suggestions!

MOT day

Max asleep in his highchairToday was another chemo day or as we now like to call it, an MOT day. Helen and I have dubbed it an MOT day because so many checks happen on the same day: change of trachy tube, re-dressing of hickman line, dose of chemo and/or flushing of hickman line, checking of gastrostomy site (today we cleaned it too!), check over by paediatrician, flexible bronchoscopy (camera down trachy to see how the tumour is growing in the windpipe), blood tests. As you can imagine this all takes quite a long time but unlike last week, this week we were home by 3.30 pm, so a long day but shorter than last week. Next week is a GOS chemo day and along with all the above we will also be having a CT scan to check his shunt is correctly positioned and working. I have a feeling that next week will be a very, very long day! Continue reading “MOT day”

Phew!

Yesterday we arranged to pop in to see the ENT Surgeon during his clinic which is held weekly on a Tuesday. Between an unsettled night worrying about Massimo’s breathing and a grumpy little boy due to the chemo, we didn’t get to SGH until about 12 noon(ish). Mr Daya took us straight in and he had a look down his trachy and into his trachea (flexible bronchoscopy) and said that there is some granulation visible at the bottom of his trachy but the tumour is not visible and that he thought that we would not have any problems before the chemo starts to take effect in about 6 weeks’ time. We have, however, arranged for someone from the ENT team to see Massimo every week just to make sure that his airway is clear and that if the tumour is visible, to organise putting in a longer trachy tube.

Having worked ourselves up into a bit of a frenzy since last night, we were expecting to be admitted so that Massimo could be close to oxygen should he need it. We also took it a step further and thought that we could see no way that they would discharge us for at least 6 weeks. Being home tonight with such good news is an enormous relief.

I forgot to say that Massimo has now learnt that he can make noises with his mouth and spends plenty of time playing with this new toy! He will be blowing raspberries before we know it!

The Tumour has grown

Today we were due to go to SGH (St George’s Hospital) for our second dose of chemo and also to meet the ward that will be looking after us as long as Max is on chemo. Well a possible 2 hour visit ended up being an 8 hour visit and I am exhausted. Firstly we did a trachy change and it is obvious now that this HURTS him and it HURTS LIKE HELL! We guess (and now I know) that we scratch/rub the tumour on the way down with the new tube. After that he was due a feed and fell asleep only to be disturbed by one of the doctors coming to examine him, then another doctor came and we noticed that he was recessing (ribs showing when breathing) which is a sign of bad respiration. The upshot was that they decided to do a snot test (NPA is the official name but a test for viruses of the secretions) and a chest x-ray. The x-ray showed good air in his lungs but very little air in his trachea. This means that the tumour has taken over his airway (windpipe) so much that he has very little space to breathe through. Although we have had some chemo it will probably take getting to week 8 (of 10) before the tumour will stop growing, at the moment the chemo will only slow the growth. So I am off to hospital again tomorrow to see the Paediatric ENT surgeon and/or the Paediatric ENT registrar. Unfortunately we have discovered that they are both going on holiday in August so we will then be under the care of another ENT person who doesn’t know Massimo very well and who isn’t specialised in Paediatrics. I know we will still get excellent care, however we have now met so many doctors and nurses, it would be nice to stick to some that we know already!

So this evening we have Max on the saturation monitor just to keep an eye on how well he is breathing. We are very much on tenterhooks and I don’t fancy my chances of staying out of hospital for much longer. Hopefully we will still manage to go out to celebrate Massimo’s 6 month birthday on Wednesday (a day early but J’s Mum & Step-Dad can’t make it on Thursday).

Signing and other stuff

(Apologies for posting this so late)

I have to say that the signing course was absolutely marvellous and I would recommend this to everyone with children under 2. The idea is that babies over 6 months but under two have developped sufficiently physically in order to use their hands to communicate, but their vocal cords and facial muscles have not yet developped enough to enable speech. Apparently the terrible twos are terrible because children are desperate to tell you stuff but do not yet have the means to do it. Do I sound like an advert? I certainly don’t mind if I do and here is a link to the course I did signing infants!

Other than that some fun stuff has happened. Massimo has found his willy and grabs it at every opportunity – typical male, I think! He has also found his trachy and spends many hours pulling the humidifier off and then has a go at getting his thumb under the trachy to see if he can pull that off too. Not such a clever idea really! His gastrostomy is currently a long tube which comes out of his tummy (it will become a button in due course) and his Hickman line is a tube coming out of his chest – two fantastic things to grab and pull at! He often also assists when suctioning grabbing the catheter or your hand. This new ability means he is making more use of the things on his activity mat. His smiles are bigger, brighter and more frequent and his attention span and concentration have improved vastly. He has learnt that being crotchety gets him lots of cuddles and smiling gets him lots of interaction.
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The details

Max with his nurse at GOS (Lion Ward)On Wednesday Massimo spent most of the day on continuous morphine but in a very small dose for a very small person. He also had a few extra shots throughout the day when the nurse thought he was in pain. He slept an awful lot and basically just got through the day. In the afternoon we were moved from the Peter Pan Ward (ENT) to the Lion Ward (oncology). Here our room size doubled, we had our own en-suite bathroom and air-conditioning! It felt like the lap of luxury.

Max playing peekabooWhilst on Lion Ward the nurses decided to organise a special nurse for Massimo. They felt that their skills with tracheostomies had suffered through lack of use and that they could all do with a little refresher. My put up bed was in a corner and I had a little curtain around me, whilst someone stayed in our room all day and all night looking after Massimo. It felt really strange but it did improve the amount and quality of my sleep.
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We are home

Just to let you know that we are all at home, tired and a little stressed out, but home. I will write much more tomorrow but for tonight I just wanted to let you all know we are home. Chemo happened this afternoon and it was a lot less dramatic than we expected. The first dose is over. Onwards and upwards!

Gastrostomy and Hickman Line

J and I spent all day today at the hospital and have only just managed to get home. We knew that Massimo was on the afternoon list and that he would have his last feed at 9.30 am but only of breast milk (formula can only be given up to 6 hours prior to a general anaesthetic). At about 2 pm the nurse looking after Massimo phoned the anaesthetists to find out if she could give him some glucose and she was told that the first person on the list had only just gone onto the operating table and that there were 2 more children before Massimo. 100 mls of glucose later Massimo fell asleep. At around 4.30 pm we were told that the first child was still on the operating table and that they still had a way to go, so J and I went out with Tara for an ice cream in Russell Square.
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A bigger trachy tube

Last night was an unsettled night for Massimo as he managed to keep his breathing working well and at around 3 am the oxygen levels in his blood dropped and they gave him a little oxygen for a couple of hours. Later at around 5.30 I noticed that a lot of his ng (feeding) tube was out of his nose. The nurse tried to push it back in but as it is a silk tube, it is very soft and difficult to push so they decided to remove it and replace it with a normal ng tube. This was quite difficult to do because the tumour has overtaken Massimo’s throat and there is little room for the tube.
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Not Sunday but Now!

GOS have called to say that actually they want him there tomorrow. Having explained that Massimo is currently in SGH and that we were coming in on Sunday the doctor said she would double check and call us back.

In fact a Registrar called the nurses on Freddie Hewitt and between them they will organise our transfer by ambulance from one hospital to another. I will be going in the ambulance with Massimo, whilst J looks after the dogs and he will come up to the Lion Ward later.