Thursday, December 31, 2009

Kenna


Kenna Bradley 1996 - 2009 Lawson, Mo.
Lawson, Mo. — Services for Kenna Lee Bradley, 13, Lawson, Mo., will be at 11 a.m. Tuesday at Mellon’s Community Hall in Lawson, Mo. Burial will be in Lawson Cemetery.
Kenna died Tuesday, Dec. 15, 2009, in Kansas City, Mo., after a yearlong battle with AML leukemia.
She was born Feb. 6, 1996, in Kansas City, Kan., the daughter of Kenneth Francis and Rhonda Bradley. She attended Tonganoxie Elementary School and Lawson Middle School. She played softball and was a pitcher.
Survivors include her father and stepmother, Becky Bradley, both of Cleveland, Mo.; her mother and stepfather, Coe Bradley, both of Lawson; grandparents Kenny Bradley Sr., Tonganoxie, and Jackie and Joe Ruble, Ocoee, Fla.; great-grandparents, Henritta Bradley, Kansas City, Kan., and Delbert and Judy Bradley, Lawrence; a stepbrother, Collin Bradley, Cleveland, Mo.; and two half-sisters, Brooklyn Bradley, Cleveland, Mo., and Sammie McDaniels, Tonganoxie.
The family will meet friends from 2 p.m. to 8 p.m. Monday at Mellon’s Community Hall.
The family suggests memorials to the Leukemia Society.
Polley Funeral Home in Lawson, Mo., is in charge of arrangements.

May God hold you close, Kenna you will be missed.

Monday, December 28, 2009

Disconnected from IVs

Docs were here. Discontinuing TPN and Lipids (supplement nutrition via IV) today. Stopping steroids. IV fluid stopping unless she is not meeting the 48 oz/24 hr requirement. All meds are switched to oral (trial basis). Mikayla is unhooked , watching movie in the bathroom while waiting for housekeeping to clean the room. Thank you God ,thank you family , thank you friends.......thank you for answered prayers...Amen!!!!!!
Woke her up at 10 am so she can take her medicine. Again ,she threw up yellow bile and asked nurse for meds. Took her meds orally and had a going in her IV. She wanted to go back to bed for now and get up when food gets here.
Waiting for food and rounding doctors/team to get here and tell me what is going on and the plan for this week. Thank you for all the prayers and support.

Happy about her Dora links

It was mess trying to download Dora Links since Christmas. She was not very happy about the trouble. Finally today Mike figured out and it worked. Mike said , she was very excited and really enjoyed playing. She was unhooked from her IV from 12 nn to 8 pm. IV pain med was disconnected and just as needed, orally. She was able to drink enough without hooking her back to IV fluids. TPN and Lipids will continue until 12 nn. They will give her more oral meds tomorrow and continue to weaning her from her IVs . Had a great day. Prayed for sweet dreams , continuous healing, thanked Him for lots and lots of blessings.......

Sunday, December 27, 2009

Christmas 09

First we would like to apologize for having no update for a while. Between the weather and taking care of things , we got really behind. As far as her skin is concerned , it is looking pretty good. Her skin is healing very well. Thank you for all who prayed for her. As per dermatologists , it is still graft vs host (65%). Bone marrow attending believe it is Stevens Johnsons syndrome. Still not 100% sure what it was. What they say is very hard to distinguish because both are identical under microscope. But for precaution, they will prevent use of drugs who are listed and maybe similar to what can cause the reaction that she had. Mikayla's counts are still looking good. Although they are going down , still within safe level. I was told that due to slowing down to almost stopping steroids, numbers will go down. They will continue to monitor. It makes it hard for us parents when numbers are going down and her primary doc is on vacation. I know we are supposed to trust other doctors but still hard when you see different ones. And each time you get new set of rounding docs , they have to learn Mikayla's case from the beginning. We apply vaseline all over her body at least 2x day to prevent skin from drying and allow flakes to pill easily. So far , her skin looks great.
Christmas was busy. We want to thank all our family and friends, everyone who sent prayers, cards and gifts to us. Thank you. Our friends who came visit and tried to visit , thank you. She complained of abdominal cramps/pain in the last 3-4 days. Threw up as soon as she opened Santa's gift on Christmas day. Tonight the nurse thought that it could be gas from broccoli she consumed in the last 3-4 days. Hmmmmm , maybe just full of air....hehehe. But still overall , we are very thankful for all the blessing we received this Christmas. Ada, Don (our friends driving back to Arkansas and flying back to Florida tomorrow) THANK YOU and be careful . We are so blessed to have all these people who hope with us , fight with us , and Believe with us...Merry Christmas and Thank you so much.

Saturday, December 19, 2009

Awesome morning

Last night, she burst out crying and when I asked her what's the matter, she said "I don't know", so asked her if she is mad, upset about everything and she said"yes" then she reached for a hug and held her all night. I told her, "Baby , it's ok to get mad , upset and cry." And u can yell and cry and mama will be here to hold you. About 2 am my legs are getting numb so I put her back to bed. Then she woke up 6 am wanting food. Cooked rice ans spam (again) ordered chicken (7am) and bacon and ate. This am she sat on the recliner while playing with computer. She also decided she will walk in the room to exercise her legs. Then wanted to sit by the window to paint. After painting , she said she will go back to bed and take a nap. Had 2 packs of swiss rolls, milk and now still napping. Thank you God for this day................

Long week.......

Tues was debridement and dressing change. She was covered wrapped except face , hands and buttocks. Was in a lot of pain but at least she had anesthesia thru her IV. There was a lot of screaming because of pain/discomfort. They increased pain med. Skin is healing according to the docs.
Wednesday, debridement including face. She was raw on the face , parts of her arms , buttocks and legs. Was told trunk looking really good.
Thurs, back to burn unit for treatment. Got pushed to later slot. No food for 15 hours and no liquid for 7 hrs. Long wait. THis time only arms , top of chest and legs are wrapped. Had active bleeding on her bottom. Skin looked like baby skin specially abdomen area and shoulders. Face still very painful.
Friday, at burn unit for treatment. Instead of 1 pm appointment, was told can do her a
t 11 am. Was rushed to get down but things were not ready. Organization and planning was poor. KK was fine going down but was in so much pain after procedure. Goal was to keep dressing for week end and no dressing change til Monday. PA came to rm later this day and told me that there was diasgreement between depts. In this hopsital what I gathered based on my observation, Burn Unit and Derma Dept don't like each other. Therefore, I was told that Burn U. will do what they want and they don't care what Derma. recommendation as to what maintenance cream to apply. That will put me in between. Paged Dr. Myers , her primary attending and he said , whatever will work for KK is what we are going to use. Still yet to be battled on Mon. We will see!!! Healed areas are looking great. Face and bottom/legs still raw. Still has a lot of pain but she is taking baby steps. So proud of her..........Thank you all for your prayers and support. God Bless us all.

Thursday, December 17, 2009

Great Day for Mikayla

It has been rough the last few days. Mikayla had debridement last Monday midnight. I was very upset. I initially decided I will stay in the room but I had to leave because she started screaming and nurse said would be best if I am not there. I was not happy when they started pilling her skin before full effect of sedation meds. I was upset with the resident and asked her to start making phone call to get some answers because I will not watch my child in that situation. Finally the burn surgeon decided to send the team back and just do self debridement and wrap her. She then felt better. I voiced my frustrations to the docs and other staff. I told them that I felt abandoned , alone and helpless that night. Told them that I felt my BMT team was not there to provide the care my daughter needs. I told them that, regardless of what the dx is of her skin, that she should be treated at optimal comfort and that Children's Mercy failed me. They listened and now so many teams are working on her case. All day Monday was rest day since she did not really fall asleep until almost 7 am. Was in a lot of pain. Tuesday, debridement and dressing change happened in the OR. Was still in a lot of pain and some bleeding both legs and a lot of raw areas. Wednesday, much better. A lot of her skin on Upper body is healed , some healing and legs still raw with bleeding. But everyday , it is getting better. New skin is growing. Almost looks like baby skin.

Tuesday, December 15, 2009

This post may jump around a bit, but you should get the overall picture. We still are not 100% sure what is going on with Mikayla. Trying to get an answer has become an unspoken challenge around here. There has been several disciplines of doctors in and out and each has there own opinion. When Mikayla's "rash" started we went to the hospital three days in a row expressing our concerns only to be told that it looks like GVHD and to put cream on it. They finally took us seriously when small blisters began to form on her legs. That was around midnight and the next day everything changed. Her skin began to rapidly transform and withing two days she was covered in red skin with huge blisters. Dermatology was the number one team involved at that point. They really didn't do much besides make Mikayla cry. Mikayla has a synthetic line that comes out of her chest where she receives fluids and medicine called a hicman. Because of the importance of that site wound care treated it. After a few days the site looked great. Not perfect, but compared to the rest of Mikayal's body we couldn't ask for more. So, there began talk that maybe we should treat her body like her hicman site was being treated. Dermatology did not agree. Instead they continued a course of coming in and popping blisters. On Sunday finally somebody put their foot down and things changed. It was agreed that the burn care nurses and doctors would get involved and that dermatology would back off. We were told that the burn team would come in late Sunday and sedate Mikayla and begin to debride her body. Mikayla is at a huge risk for infection so instead of a whirlpool it has to be done manually. They came in and while the nurse was still applying the sedation medicine in her hicman they began to work. Giving no time for the sedation to start its effect of relaxing you. For more than thirty minutes Mikayla endured so much pain her eyes and tongue were bleeding from crying. Very, very cruel act. They only had the heart to do her legs. They muffed the whole thing up. We were not in the room to realize that they proceeded as they did with little concern for her comfort. Rea blew up! She got on to every doctor and nurse that was involved. We got apologies, but that is not what we are after. The conglomerate known as the team decided to change methods. They are supposedly going back through her complete history and trying to dig deep and find out what is the root cause for her condition. Monday Mikayla was given a complete day of rest. Nobody got to poke her. She called during the night and sounded great and her mood was upbeat. Today she will be heading to the O.R. to be put to sleep so that the burn team can begin to extract all her dead skin. Why they didn't do that in the beginning I don't know.

Friday, December 11, 2009

Tuesday through 3

Today started very well. Our nurse Miss Jenny was able to put some eye drops in her eyes before i woke. I was getting Mikayla up to go to the bathroom and housekeeping popped her head in and asked if it was ok to clean. It was a good time because while there I would freshen her up and treat her skin. They told us it was ok to come out after a few minutes. Mikayla has a pretty tough time getting in and out of bed. Its an air bed about three feet off the ground. We enginered some steps, stools, and a chair to make it easier. Mikayla was at the top of this monstrosity when housekeeping was trying to come back in. I told her we were not ready. I was looking for privacy more than anything. Less than a minute later still trying to get Mikayla into the bed she asked again while popping her head in the room if she could come in and get the bathroom. Out of frustration I told her get it done and turned Mikayla around and set her on the bed. I moved the chair so the girl could get past not realizing Mikayla was on an air bed and that the only thing really holding her was the deflating mattress. When I moved she fell out of the bed on to her feet. It scared the hell out of us both. She was shakin up emotionally and some of her skin was damaged in the process. She took some deep breaths and got the courage to go ahead and try to get back in bed but this time with some assistance from her CNA. Her nurse came back soon after and began to treat her with no problems. She took her time and had a good grasp of when to give breaks and what to say. All was humming along pretty smooth then this horde of beetles known has dermotologist came swarming in. In case you can't tell nobody like them. The bed side manners need some real work as well as their piss poor attitudes. They remind you of snotty high school cheerleaders. Two of them were for sure doctors and the other three really had no business there. Mikayla became frustrated very quickly. It was overwhelming with the crowd hovering. Our nurse took a stand and ran a few of them off. We as parents would love nothing more than to not have to deal with them and do it ourselves. It's always high stress when they come. The poke her for up to a half hour with no emotions. They would rather argue with her than to do what she wants. Mikayla and I talked and we agreed that if the one comes back that poked her leg and made it bleed comes back that I would not let her do anything. When they left Mikayla settled down and enjoyed her 8th Swiss Miss Roll. She has relaxed and been calm for most of the remainder of the time. I got word that they will slow the steroids down and weene her off. As for treatment it looks like will continue much of the same course as now. There is a lot of roosters in the hen house and conflicts though slight exist between them as what to do. In the end only one opinion for treatment is all that matters and that is the opinion of her transplant doctor. She is finding ways do deal with different situations. For example her tounge burns when she eats so she has found that q-tips pressed at the point of the burn makes her tounge feel better. She is couragous and inventive.

Thursday, December 10, 2009

GVHD and progress

Where to start? We are still being told GVHD. Our doctor says that Mikayla's case is similar to cases before special transplant drugs like Tacrolimus were around. The Tacro is supposed to prevent this type of GVHD from happening. Who knows maybe we got a bad bottle of the stuff cause it ain't doing it's job. She is considered a severe case. I won't go into detail about how she looks anymore because it's kind of a pointless thing to do. It has settled down a bit. The previous "bad" spots are changing and the old "good" spots are starting to look like the previous bad spots. Kind of confusing. It is like everything wants or needs to break out to a peak before it tapers off. We don't know if this will happen again. One thing that is hopeful is that where the new skin is that skin looks good in color. To my eyes it looks very painful, but Mikayla is doing well with the pain. I think the Dr. has the right mixture of pain drugs to keep her comfortable. Her steroids make her have extreme moods. She is very vocal when she wants things. Most of it is from being scared and some is from the pain. We can not have any visitors for some time to come. Mikaylas Christmas will be spent here in the hospital. We will do the best we can to make sure that she gets everything from santa that she requested. We did get two really solid pieces of good news amongst what is happening now. Mikayla still only has GVHD in the skin and not the GI tract or liver. The other tidbit that really gives us hope is that Mikayla is cancer free. Our road so far has been long with a lot of good times. For the most part she has sailed right through the cancer. The GVHD is by far giving us more fear than the cancer ever had. I think its just a visual thing. You couldn't see the cancer and somehow it wasn't as real as what is going on now. She is asleep finally. Most of her day today was spent yelling at doctors and nurses. I hope nobody takes it to heart because underneath that grumpy facad is still the same sweet Mikayla that most have come to enjoy.

Tuesday, December 8, 2009

Graph Vs. Host Disease

The results of the biopsy are not yet in, but from what all the doctors are saying Mikayla has GVHD (graph vs. host disease). Acute GVHD is graded in 5 steps from 0-IV based on involvement of the skin, liver, and GI tract. Grade 0 indicates no clinical evidence of disease. Grades I-IV are graded functionally. Grade I indicates rash on less than 50% of skin and no gut or liver involvement. Grade II indicates rash covering more than 50% of skin, bilirubin level of 2-3 mg/dL, diarrhea of 10-15 mL/kg/d, or persistent nausea. Grade III or IV indicates generalized erythroderma with bullous formation, bilirubin level of more than 3 mg/dL, or diarrhea of more than 16 mL/kg/d. Mikayla is not spot on in one grade. Her skin is in the grade III catagory, but other symptoms are not there. Her liver and GI are still checking out fine. Grade III also states that nearly 100% of her skin is covered and Mikayla is maybe around 80%. She is on a constant drip of Morphine and other drugs that help stop the process of the GVHD. It is a scary situation. Infection as always is a great concern. If the GVHD stops and infection is avoided we should come out of things ok. If GVHD begins to attack the GI and liver it gets very complicated. We are still in the early stages and trying together with the teams of doctors to grasp what is happening. We have pried as much info as we can from the doctors, but I think that we have to wait on the biopsy to get better answers. Her treatment is very aggressive and should help. The only other cause for this would be that of an allergic reaction to medicine. All though it is the unlikely culprit it is still something that maybe the root of the cause. Mikayla has been a trooper. Even though she is covered in what looks to be 3rd degree burns she is carring on with herself much as she always does.

Sunday, December 6, 2009

Mikayla was admitted back to the hospital around 12 in the morning. Her rash had began to blister and consume all her skin except her face. More info Monday.

Wednesday, December 2, 2009

Ist Out Patient visit

It's a cold am in KC. KK had spam and rice, choc milk for breakfast @ 6:45 am. She can't have anything but clear liquid from 7 to 11 am. Clinic , LP/Bone marrow aspirate today. Pretty much all day in the hosp for out pt visit. Rashes in her body getting worse, hoping it is ok. A little GVHD is ok but not a lot. What is a little and a lot is something I am not certain.Will know more today. God bless, Amen..We will post details of today's visit later. Thank you.....................

Tuesday, December 1, 2009

Christmas Lights

All day today Mikayla asked to go see "Christmas in the Park". It's a trail of Christmas lights in the Lee Summit area. The day wore on and I told her we would have to do it another day around 8:00pm. She seemed down so I told her come on get dressed we will go as soon as you're ready. We arrived there around 9:30pm. She enjoyed it and it was the first time she has done something she wanted in a long time. She has to wake up early tomorrow because she has clinics tomorrow to undergo some tests. One of the tests is a bone marrow aspirate. Her blood counts are really good and the results of the aspirate should come out favorable. When we left the hospital she had a bit of Graph vs Host. My intelligence level on the subject isn't that great so we will update next time with what it means and how good or bad it is. She has done well in the short amount of time she has been out. She is eating and drinking well. She walks around more and plays with her brothers and sister. Taking her medicine is still a chore for her though. Sometimes she does it fast and others it takes up to an hour to get it all in. All and all she is doing very well and continues to get better all the time.