Friday, October 2, 2015

Crazy September

It's been a whirlwind of a month.  I'm glad to see it go and welcome the arrival of October.

It all really started this summer.  Bun Bun and I both got back to back sickies.  When school started, Bun Bun picked up yet another sickie, the third for the summer.  Then, those little spots showed up and spread.  Those dreaded petechiae that almost always spelled trouble.  Every year, Bun Bun gets lab work done to make sure nothing is funky with her blood since incidences of leukemia is increased in kids with Down Syndrome.  This year, I was told everything looked normal, until the pediatrician thought we needed a second opinion on Bun Bun's consistently lower platelet counts.

When platelet counts are low, petechiae show up.  These little thrombocytes help form clots when there's bleeding.  So, when there aren't enough of them, small red dot appear on the skin where blood vessels break.  This may be life-threatening if there's trauma in the body, especially in the head.  The patient may bleed out.  A decline in platelet counts can be caused by viral infections, autoimmune diseases, or leukemia.

To be on the safe side, we were referred to a hematologist who, being overly cautious, wanted to follow Bun Bun's platelet counts more carefully.  At least once or twice in the last couple of years, Bun Bun seem to break out in a petechial rash all over her body as she recovered from respiratory infections which go away on their own after a few days.  So, when this happened soon after the third sickies, I wasn't terribly worried and thought this might also be virus-induced.  BUT, when Bun Bun's doctor called and told me that her platelet counts had plummeted down to super low levels and that she needed to be admitted to the hospital for a platelet transfusion, I knew this wasn't good.  They had also wanted to observe her and do a bone marrow biopsy just to rule out autoimmune disease or leukemia.

Brave Bun Bun endured numerous needle sticks, some to get blood samples for analyses and some to start IVs.  [Note to all you readers: be wary of resident physicians, freshly out of medical school, who want to draw your blood!]  The doctors quickly ruled out autoimmune disease.  Bun Bun wasn't making antibodies that reacted against her own platelets.  After two weeks of analyzing her bone marrow, they couldn't find anything wrong; there were no cancer cells, hence no leukemia.  Bun Bun only stayed at the hospital for two nights.  A week after she was discharged, they transfused another unit of platelets.  These cells only last in circulation for about a week.  So, was this going to be our routine?  If Bun Bun can't produce platelets on her own and the doctors can't figure out the cause of these low counts, then yes.  On the bright side, most of the little red dots have disappeared at this point.

This past Wednesday, on the last day of September, we went back to the hospital for a third transfusion.  They always take a blood test and determine platelet counts before transfusions.  Platelets are from donated blood; donated blood are collected at Red Cross blood drives; they are precious commodity.  If a patient did not need a transfusion, they will not give it.  Bun Bun's platelet counts that day came back up!  I don't think her doctors and nurses quite believed it either at first.  Bun Bun did not need that third transfusion after all.  Now, we dance the dance of joy!

We will go back to the hospital next week to check on her numbers again.  My best guess is that the platelets were wiped out by some viral infection.  As she recovers, Bun Bun's stem cells in the bone marrow are cranking them out again.  For now, we praise God!  Many, many prayers went up to heaven on behalf of this little girl.

I am reminded once more:  God is good.  He is sovereign, even over platelet production!

Other vignettes...

Earlier in September, I had a bright idea of converting Bun Bun's crib into a toddler bed.  All this means was that we take off one entire side of her crib and attach a short panel to, at least, prevent her from rolling off.  She would still have some space to climb into and out of bed by herself.  The entire reason for doing this was that we didn't have to lift all 32 pounds of her out of her crib.  This lasted for three days.  As soon as Bun Bun realized she could freely come and go, that's exactly what she did.  When she went to bed, someone had to stay in her room with her so she didn't get out every two seconds.  For some reason, she had a terrible time falling asleep; maybe because without the one whole side, it didn't feel as cozy or secure.  So, either Daddy or I had to stay with her for at least 2 hours every night, until she was asleep.  On the third night of doing this, the crib went back together.  Everyone is happy now.  We might try this again over Thanksgiving or Christmas break.  We might forgo nap time all together since she may not need them any more; this way, she is tired by bed time.  We might add some sort of mosquito net-like contraption to make her bed more cave-like and cozy.  Will update later.

Update on potty training:
I have pretty much given up but I am optimistically hopeful that it won't be long before Bun Bun will be completely potty trained.  I have refocused my efforts on teaching her how to pull her pants and diaper up and down by herself.  She has picked up on the task nicely, even those really tight leggings.  That's progress!

First day of pre-school, again!  In case you're wondering 婆婆 buys most of Bun Bun's clothes.  What do you think of this outfit?  Like her hot pink sneakers?  I did pick these out.