Happy Easter!

Happy Easter from my family to yours!!! 

One Year Anniversary

Oh boy has this been an emotional roller coaster of a week and I don't like roller coasters, well the ones with loops anyway! Over the past few weeks, I've been sharing with you my family’s journey after my teenage daughter was diagnosed with Metastatic Papillary Thyroid Cancer last year. Last time, I left off with the intention of telling you about the initial visit to our family doctor after discovering a thyroid nodule by accident in the ER, but that story will have to wait a while because tomorrow is a pretty special day for us in the Holt household. Why? Well let's fast forward a bit.

This week, March 20th to be exact, marked the first Anniversary of the diagnosis. I say "anniversary" in both a good and bad way. We are extremely blessed that Cheyenne is here with us and seemingly thriving. Chey is enjoying her freshman year at Tarleton State University, of course she reminds me often that she is officially classified as a sophomore LOL. She is a cheerleader, in a sorority and honor society, as well as being on the Dean's List. We are thrilled she is totally immersed in the college experience. Bleed Purple! I really am amazed and blessed at what a spectacular young woman she has become in spite of the obstacles she has faced, and thrilled to see her continue to blossom. But none of that will ever take away the emotions of what March 20th just a year ago brought.

Pediatric thyroid cancer is extremely rare. An article I read during my Mama Bear mode research by Connie Brichford The Facts About Pediatric Thyroid Cancer states that only one child in a million under age ten, and about 15 per million teens 15-19 years old develop thyroid cancer. That's great news right? Not so much when your child is one of those fifteen. Cancer is cancer and having a child diagnosed with it scares the absolute hell out of you! This week, all those fears and emotions came rushing back. One minute I'm okay, then the next I'm back to bawling and seriously worrying about the follow up tests in June. (Chey's tumor marker didn't go down, and she will repeat the whole body scan to look for metastatic disease).

I tell myself and everyone else, it's going to be fine, the marker didn't go up either, but really how do I know? How can this beautiful young person look so good, yet have a time bomb lurking in her body? These are the questions that keep me up at night and make me feel half crazy. But this isn't the worst part, the absolute worst part of all of this is I have to watch my youngest child, my baby girl, go through the same damn thing, only she's the one living with it. She goes to school, works, attends all her functions and seems to take it all in stride. She's extremely talented at keeping that game face on, she had to learn this to survive high school after all - at least there is something I can thank DISD for! Yet I see cracks in the facade. It's the texts and calls to say simply, "Love you" that break my heart. Don't get me wrong here, Chey tells me often that she loves me and vice versa but it's usually "Moon Mom" or "Heart you". When she randomly says the "L" word, she's worried or preoccupied, her mind is working on maintaining that level of security she needs to depend on and grind through it all. Lately I see frequent glimpses of that little girl who used to hide behind my legs, in the woman who now looks down at me. This is her little "tell", I'm not even sure she is aware of it. The heart strings pull tighter as she asks more "what if" questions - my answers, without emotion, are always the same, "We will have to see what the tests show and then do whatever Dr. Athanassaki recommends.

We have done this daily for the last several days. This is our dance, we have performed it over and over again and, this week especially, emotion just takes over me. Yet as draining as it can be I love my children always, (you too Sean), and considering the alternative, I pray we do this dance together for years and years to come, regardless of how many loops I have to roll through on that coaster. It may be cliché, but "To The Moon and Back, Baby."

XOXO Make Everyday Count,
Bonnie

Mama Bear in Action

I had just found out my daughters spine and neck were OK after an injury playing softball, crisis averted right? Not exactly… the doctor had also discovered a nodule on her thyroid during the work up. I look back now and think about all the emotions that were bombarding me from every direction. There was fear, oh my gosh so much fear, but there was also anger and dismay and disbelief as well. All I could think was what the hell, Please Lord, let it be nothing. This kid had already been through so much with our ordeal with her school district. 

We had loaded Cheyenne into the car for the long ride home, her neck was still in the c-collar so we reclined the front seat and tucked a jacket around her head like a baby roll. It was about one in the morning and she had received pain medication at the ER so we hoped she was going to sleep most of the way home. There was a silence so heavy it was like a blanket trying to smother me. I knew my husband had questions but was afraid to ask while Cheyenne was awake, she however, was not going to wait.

She asked me, "Momma, what did he mean, what is wrong with my thyroid?"

I told her I didn't know, we would have to go to the doctor and see what he suggested.

She didn't let that answer slide, instead she asked "With your medical background, what COULD it be?"

I have always tried to be up front with my children and answer their questions directly but without too much detail if unnecessary. I told her that it could be a benign nodule but it could be something more. I told her she would most likely need a thyroid ultrasound and possibly other tests. She asked if we would wait like the doctor suggested or would I look into it sooner. I could hear the underlying fear in her voice as she asked, and the fatigue also.

I told her I would do as I always do, she broke in and groggily said, "Good Momma, you'll find out quick and then we can take care of it" and she gave in to the narcotics and dozed off.

After a few miles, my husband asked if it could be really bad.

I told him, "if you mean bad like in cancer, yes it is always a possibility and that is why we are going in Monday and getting an ultrasound." In my life, I've never known how to do anything halfway, either I'm all in or I'm out. This would be no different.

Momma Bear was on the job. We drove home the rest of the way without too much discussion. My husband knew he had his answer and it was best to let me work out my plan in my own way and just go with it. When I set my mind to something, I do not stray from the goal easily, ask anyone, they will agree. The drive home went quickly as I was Googling all the way home. I then spent most of Sunday on the computer as Chey stayed pretty medicated and we iced her neck often. She had made the semifinals of the 2015 Rodeo Rockstar competition in Houston, top 10 in her age group and was due to perform in only two days!! We had tried to talk her out of going but being the competitor she is, you know the drill by now, she was determined to perform. So, in the midst of this entire ordeal, we were doing everything possible to get her some relief so she wouldn’t miss the show.

As medical professionals, we typically encourage our patients to avoid Dr. Google because they get just enough information to scare themselves half to death or they manifest symptoms they didn't have before--often times delaying true diagnosis of their problem. As patients, we should try to follow our own advice, but I needed answers, and I found plenty. According to several articles I read, (my favorite is thyca.org) thyroid nodules in children are pretty rare but when they do present themselves they are more often malignant, in fact, approximately 26% of them are in children vs. 5-10% of malignancies in adults. Most of these cancers are of the papillary or follicular forms (90%) but there are two additional forms, medullary (mostly inherited when in children) and anaplastic which is a more aggressive type. I also found out that girls are at higher risk than their male counterparts in the 10-19 age group, and nodules could be solid, cystic or mixed. As I investigated more, I found that ultrasound was usually the first test performed and then dependent on the result they would recommend a thyroid uptake scan, (a nuclear study that tests the function of the thyroid) a fine needle aspiration, or both. A fine needle aspiration or FNA is a biopsy procedure where a thin needle is inserted into the nodule to take tissue samples. They would also probably do lab tests and the literature seemed to say that size of the nodule mattered. It would have been helpful to get the CT scan copy or the report, when we were in the ER, but they said only their medical records department could release them and I didn't have it to reference!! It made me nearly crazy wondering about the size of Chey's nodule but now I had direction, I knew the course of action to take and that the first step was to get an ultrasound and then go from there. In the meantime I would continue to learn as much as I could about this potential adversary, with Dr. Google's help and all.

Next time, In the Doctor's Office

XXOO Make Everyday Count

The Day We Got Pickled Part Two

Riding in an ambulance is hell, period. You feel a constant mix of hurry up and get us there, and OMG slow down! The entire time you are trying to keep from bouncing off the seat and onto your loved one, as the vehicle jars your insides around, all the while watching strangers do God knows what to them. One would think, with all the technology now days, they could come up with some decent shocks on an ambulance! But I digress, back to the story at hand. My daughter, Cheyenne, had been injured in a softball game earlier in the day while trying to steal a base. She had hyper extended her neck and injured her back. Every bump we hit, in this roller coaster they call an ambulance, was excruciating for her. She would cry out in pain and then hold her breath trying not to jiggle. The ride took about twenty minutes but it seemed like an hour.

We finally arrived at the hospital and the attendants rolled her into the ER, with me in tow. It seemed to be a slow evening and I was secretly thankful. From previous experiences as a nurse and mom, I knew the wait times could be very long when the ER was busy. We were immediately taken into a room and Cheyenne was moved to a bed, she cried out many times and it hurt my heart to see her that way, especially as I could do nothing but stand by and watch. Those that know me know that I am in no way a stand by and watch kind of girl.

Eventually, a nurse came in and began the intake process, taking information about the incident, Chey’s medical history and our insurance. They wanted to cut Chey’s jersey off, but Chey just about lost it. Typical of my daughter, she was in so much pain but still strong-willed enough to yell out “You can’t cut it!” to the nurses trying to examine her. I explained to them that Coach had told all the seniors that they could have their jersey after the season ended (little did we know, that wouldn’t happen in the end) and Cheyenne wanted hers in one piece. If you ever played sports or were involved in school, the blood, sweat and tears that go into the effort are all memorialized in that uniform. Do an Internet search and you will see site after site of people who are making quilts out of them, it’s really neat and someday I will make one for each of my children, you know in all my non-existent spare time. After much pleading, they eventually gave in and managed, with my help, to get the thing off intact.

During all of this, my husband had arrived and after contacting family, he joined us in the tiny room. The doctor had also made his way in and ordered an IV with pain medicine, X-rays and a CT scan. He was concerned, of course, about a neck fracture or spinal injury. And from there the wait began. Things run slowly in an ER, I have never understood why, but they do. I think it is because of all the paperwork that is required – it’s unfortunately not as simple as taking care of the patient anymore. Through all of this, Cheyenne was muttering under her breath about the pain and how the cervical collar was digging into her skin. It was beyond frustrating to see her hurting and not have any control in getting the process moving. She needed something for pain! It’s important to note for those reading that I am a very direct individual to say the least so it’s no surprise I could not sit there quietly with my daughter in so much pain. You truly never have to wonder what I am thinking because I usually tell you! Soooo, I naturally ended up going out to the nurses’ station and asking them to get her medicine, and yes, the squeaky wheel got oiled. The nurse gave her some Toradol, which is for pain and inflammation.

In the meantime Jesse Horton from The Flash, a local online news source, had contacted me. She was very sweet and genuinely concerned about Cheyenne’s condition. I gave her the information we had so far, and promised to keep her updated when testing was completed. Cheyenne, always the competitor, questioned if Jessie happened to know the score of the softball game. Jessie informed us that the game had been forfeited so the team could join Chey at the hospital. This came as quite a surprise, since no one had come. Now, I told you earlier that there were outside influences that caused some conflict. A major one involved the school district and the school dictated grievance process we were in with them. In a small town, a school district can be one of the largest employers and opinions can be formed when people don’t have the whole story, resulting in families being ostracized easily. In our case, this is exactly what happened and unfortunately Cheyenne suffered greatly for it. I’m telling you this because it had been, and would continue to be, a major factor in Chey’s psyche later. I’ve thought often, what a great social experiment it would be to provide us with the means to start a restaurant. Staff it with extraordinary people in the field and then see if it would succeed. I highly doubt it would, because the small town mentality is often like that of a hive, which is characterized by unquestioned conformity or passive tolerance through inaction, or indifference. I believe we could have a Five-Star Chef and only those few who have stood by us would support it, the rest would continue as dictated.

The day continued to drag on and my husband’s parents arrived in time to sit with him in the waiting room as Chey and I headed to radiology! They did a plain X-ray and I was standing in the technicians’ area (behind the wall) to protect from any unneeded radiation. They moved Chey into the CT machine and as they did, she began to scream and I mean blood-curdling screams. A moan hung in my throat as I found that Mama Bear voice and told them to get her some stronger pain medicine before doing anything else and “By God, DO IT NOW!” I’m a small woman but you know when I mean business. The tech looked at me like I was crazy, but he started toward the door anyway. Luckily, they had timed it just right as a nurse was already on the way with stronger medication. They gave Chey some Demerol and Phenergan in the IV. While they did the CT, I was looking at the monitor with the X-ray on it and noticed it looked strange. There appeared to be white spots in her neck tissue? I had been texting my friend, also a nurse, trying to keep my sanity through out, and told her what I saw. She said it must be an artifact, which is an appearance on the film that is not normally there. Usually they are caused by patient movement or errors in the technique or processing of the films. I thought, ‘Okay, that sounded reasonable, even though it really didn’t look like artifact.’

The Demerol had worked quickly and Chey was much calmer when we went back to the room, she was actually a little on the goofy side as she kept looking up and giggling. Her father returned and informed us that one of her teammates had shown up after all! We can never, ever completely express the gratitude we have for this young lady. Shelby, thank you from the bottom or our hearts for showing that bit of humanity and compassion for Chey. She still often mentions it in our conversations - it really meant a great deal! The girls talked for a short time, we thanked Shelby for coming and she left. She was the only member of the team to visit, the others had gone back to Dublin. It was only just recently that we found out another student had come with her, so Cade thanks to you as well!

In the end, we were in the ER until after midnight that night. Jessie touched base often and we saw posts on Facebook. It was very surreal seeing statements from the school’s Athletic Director about out status, since he had not contacted us throughout the whole ordeal. The test results finally came back and the doctor said there were no fractures, (Thank You Lord) only severe muscle spasms and whiplash from hyper extending the neck. He told us to have Cheyenne wear the cervical collar and gave us prescriptions and instructed us to follow up with our regular doctor on Monday. We thanked him and he turned to leave, but just as he was about to step through the door, he turned back and said, “By the way, the CT showed something on her thyroid. You should probably have it evaluated later when you have a chance.” My heart began to race again, and my mind was spinning out of control as the fine hairs on the back of my neck stood up. Flashes of those white spots were swirling in my mind’s eye, as medical scenarios were flipping like index cards. I turned to my husband and said, “I told you I saw something.” I could see the fear in his eyes as he could see my concern. We loaded Chey in the car for the trip home and I silently tried to take in what the doctor had said while formulating our next step, because waiting until later was absolutely not an option for this Mama Bear.

Next time, Mama Bear in action…

XOXO Make Everyday Count,









Bonnie

The Day We Got Pickled Part One

The game started simply enough. The girls were standing on the dugout railing chanting as an excitement began to fill the air. My daughter, Cheyenne, had already reached base previously in the inning on a walk, leaving her standing on first. The next batter came up and laid down a beautiful bunt, and Cheyenne hauled butt to second base. Always the opportunistic one, she was already eyeing third before she hit the bag and, sure enough, they had left the base uncovered while defending the bunt. Without the thought of hesitation, Cheyenne she turned the corner and was going for third when, suddenly the coach pulled her up. Dang, now she was caught in another run-down, or as we call it, a pickle!! For you non-softball readers, this is where the runner gets stuck between bases and the basemen try and run them down, tagging them for an out. Over the course of many seasons, Chey was in more pickles than I've ever seen, a product of her aggressive base running. What's even more amazing is how often she managed to get out of the majority of them, a feat that is rare in the sport. This particularly time Chey forced ten exchanges and the entire Honeybee team divided between second and third base to get the out. She was really working them, just waiting for a mistake to sneak back into the base and avoid the out.

Their catcher received the ball and chased Chey back toward second base when Chey dove for it!! This is where it all started to unravel. Normally when a player slides they time it so the ground slows their momentum just enough that your outstretched hand can sneak in under the tag from the baseman while your body remains out of reach. However, on this day we were playing on Brock’s artificial turf field, of which is like sliding on a slip n’ slide if you are not used to it, and Cheyenne careened into the base like a bowling ball into pins! The catcher tossed the ball simultaneously with the dive and as the tag was being applied, a massive collision occurred knocking the second baseman forward and down onto Chey's neck and back. The impact of Chey's facemask hitting the second baseman's legs was so intense it hyper extended her neck at the same time as the baseman fell.

Cheyenne is a very tough kid, she had been injured many times throughout her playing career! So with that thought in mind, I waited for her to get up and give the okay signal, but instead I saw her kind of roll half onto her right side, away from her stomach, and curl up a little with her left hand covering her face. The first thought I had was that she had injured her mouth. I saw her raise her lower left leg off the ground and kick the turf a couple of times without any attempt to get up. At this point I could tell something was wrong and I had stood up, dumping everything off my lap in the process, and worked to detangle myself from my sleeping bag when the base umpire waved Coach over. As Coach ran to my child, everything had gone quiet and all I could hear was buzzing in my ears. Like I said, Chey had been injured before but this was different. I ran onto the field through the third-base gate as her father came in from the first-base side. Morphing into nurse/mother mode, I instantly threw myself down onto my belly to access the extent of the injury and to comfort my child.

Cheyenne complained of severe pain to her neck and face and was crying and afraid to move. Her right arm was pinned under and behind her body. Somehow in the collision, her legs had ended up pointing at first base, instead of third. I was scared to death, but I couldn't let her see that. My nursing self took over, and I began to check her peripheral sensation and strength in her hands. I was relieved that she could grip and feel everything, even though her right arm was a bit weaker with some numbness present. She had begun to shiver, probably the combination of adrenalin and lying on the cold ground, when someone from our dugout brought a jacket to cover her with. She was still complaining about the severe pain in her neck and back and refused to move her right lower leg or right arm. I heard someone say we should roll her over and I said "no way" and thankfully, just then an Registered Nurse (RN) arrived from another field and backed me up. (There was no force on this earth that was going to move this child until EMS was in control.) It has never ceased to amaze me, over all the years, how people are so quick to just brush injuries off and get on with the game.

The woman took over (thank you dear stranger from the bottom of my heart) and I just laid on the cold ground holding my baby's hand. An ambulance had already been called, so we simply waited. I understand now how a few minutes can seem like an eternity when a loved one is in need. Once EMS arrived, they placed a cervical collar on her neck and we log-rolled her onto a backboard and then to a stretcher. My husband had left the field, and with other parents' assistance, (Love you, Zack and Monica!!) went to gather our belongings together and load them into the car. As we wheeled the stretcher off the field, one of the Honeybees' players came up crying and upset, apologizing as she was apart of the play that injured Chey. The young lady was actually from Dublin and we had known her for years. I remember taking her sweet, beautiful tear-stained face in my hands (yes, you Ms. Morgan,) and telling her it was just an accident and everything would be okay. We hugged and she said they would all be praying for us and I hurried off the field to catch up with Chey. That was the absolute hardest walk I have EVER taken, I still don't know how I kept from totally losing it. Soon enough the EMS personnel loaded Chey into the ambulance and I climbed in before heading off to Weatherford Regional Medical Center where our story really began to take shape.

Part Two next time...

XOXO Make Everyday Count,
Bonnie