Pippa Rea

Pippa's Journey with a Brain Tumour

Small Improvements

I’ve been reluctant to write a post simply because I’m feeling like I might jinx us.

We had mostly bad days across November, December and January and any days that were better didn’t last very long.  Even on good days the bad ones lingered in the background like a dark shadow on a cold winter’s night.   During the treatment in Melbourne I was told 3 times to be prepared for the worst.  Being told is one thing, but actually feeling it is by far another thing altogether.  I haven’t counted how many times since we returned I have “felt” it; it’s not something I wish to count and sometimes the feeling wouldn’t leave my heart.  Pippa always pulled through and I could let myself take a breath and would try and push the feeling away for a little longer.

That’s why on the day Pippa went to Tony’s Sungold Field Days I was thinking the good day would stay with us for only a few days.  It was 2 days before her birthday and I assumed she was rallying herself and finding all of her inner strength in preparation for turning 11.   Being in the wheelchair is tiring enough for any outing, but bouncing around over acres and acres of tracks through paddocks to see everything she wanted to see meant Pippa came home and fell asleep utterly exhausted but not before telling me how much she loved me.  It was the first time I had heard her the sound of her voice in over 2 weeks!

After the field days and Pippa’s birthday I was waiting for the decline to come again.  It didn’t.  Instead since the 11th February we’ve now been seeing improvement.  Small Improvements.

To break it down…………

She couldn’t drink; now she can drink milk, freshly squeezed orange juice and she’s even managing some water.

She couldn’t chew or swallow anything other than jelly and ice cream; now she can manage small amounts of foods that I either make or adapt for her and there is definitely a chewing motion and tongue movement.  I still have to carefully monitor choking with both eating and drinking though.

Although I didn’t realise at the time, now that it has returned, I know that she had lost, to some degree, her sense of smell and taste.

Likewise, her sense of touch is now different; she used to know that her feet were cold but for many weeks she lost that sensation; now she can recognise that again.

The TV is no longer up to detrimental volumes for the rest of the family so her hearing must be somewhat better.  We still need to speak directly to her and eliminate background noise or other people’s voices so she can hear properly.

She couldn’t move her left hand, arm or leg or shrug her left shoulder; now she has a small amount of movement in each of these areas.

Pippa had no trunk or neck strength, now she can manage some level of support to move and hold her body and head.  Her neck gets tired and aches if she’s using it for too long but she recognises when she needs a rest (unless of course she’s determined to push through and finish something!)

She couldn’t bear her own weight when standing; now, whilst she still needs to be held and supported, she can weight bear ever so slightly and move her legs (sometimes her left one freezes up)

She couldn’t speak, move her tongue or make a sound; now she can formulate words, make sounds, speak sentences and of course poke her tongue out.  It’s quiet, sometimes more breath than voice, and we still need to concentrate very hard to understand what she is saying but she can, at times, have some clear short phrases – my favourite one of course which I can always hear clearly is I love you mummy.

She was no longer able to hold things in her right hand and some days even touching the ipad to communicate it was difficult to hit the correct letter; now she is holding a modified spoon at dinner time if she’s not too tired and recently at school she held a texta to draw a dolphin.

Pippa is comfortable and is no longer on any pain medication.

Finally, Pippa is singing!  It’s not singing that we can necessarily hear, but her music plays, she can mouth the words (sometimes with a little sound) and she is enjoying it.

Whilst this is all fabulous, it feels much like waiting for a bubble to burst.  Instead though, we keep living each day in the moment, one day at a time.   Pippa is going to school for short periods most days and some days school even comes to her.  The grade 5/6 students now have a laptop program which has given Pippa incredible enthusiasm for her work and the night she received it she spent over 3 hours doing homework to complete her first project – one finger typing, with a slow moving arm but it was a maths project so she was determined.  We try and focus a lot on maths as it’s Pippa’s favourite subject, but it’s also great therapy for her brain.  Usually it’s just Pippa and I walking to school but occasionally we have a visiting entourage that comes to the classroom!

We have had a trip to the beach to try out a chair that can go in the water.  At the same time, it was a good excuse to do a “patrol” in the ATV!  Pippa now watches the weather reports closely to see when the next opportunity to go to the beach will be.  Of course next time she wants to go out deeper than just half way up the wheels and she’s started asking whether maybe one day she can manage to lay on a board!

Whilst Pippa still gets sad and very frustrated with everything that is physically different from the girl she used to be she is exactly the same Pippa on the inside with her beautiful, engaging and exuberant personality.  It’s my job to hold her tightly when she’s sad and to be supportive and encouraging of all those great traits she hasn’t lost.  Pippa has learnt a few magic tricks and enjoys baffling everyone with her talent.  All the tricks require the use of her brain and her memory both of which function completely normally.  Her physical ability to play games has improved again and she likes to make people laugh by introducing them to the fun game of “Fibber” with her noses already on!  The hysterical fits of laughter take a while to subside before the game can start.

Why is this improvement showing so long after we finished our additional treatment that was initially thought not to be working? And why has it come after such a long and drastic period of decline?  I don’t know.  Nor can anyone give me much insight.  Regardless, it is what it is.  I can’t change, worry or over think it.  What I can do though is be respectful of Pippa and this period of time.  It would be easy to sit Pippa in her recliner chair and watch TV all day but that’s not her.  Watching TV is now “resting” after periods of hard work on her part – school, physio exercise, homework, sitting on the daybed outside, outings in the car (she still needs to be lifted in and out) or in the chair.  I don’t know how long this improvement period is going to be for or whether it will continue, plateau or decline.  I have started to do physio with her.  I have had her capabilities assessed and our creative physio friend has devised some great fun activities that will hopefully compliment her current situation.  I’m not giving Pippa false hopes but I feel it is my duty to capitalise on any movement her muscles can achieve.  I also make sure that across the day her food intake includes something from all five food groups.  In fact, if I don’t Pippa reminds me!  Likewise, she ensures that she does her exercises and stretches. Even if I think she’s tiring she won’t stop until she’s not only done them all but done them all well.

These are all small but significant improvements.  We are enjoying them and hanging on to the roller coaster for longer.

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Making Every Day Happy

On Pippa’s list of important things one simple word stood out loud and clear – Happy.  Being happy, feeling happy, having happy days.

With that in mind, we now have a special nightly routine at bed time.  Whilst waiting for me to heat up her “snuggle sacks” (two to keep her feet warm and one to feel cosy on her tummy) and organise medication, eye drops and eye gel, Pippa types up a list of what is happening the next day that will make it a “Happy Day”.  We then read through it together.  Usually it is some quite simple things:  wrapping Christmas gifts, decorating the Christmas tree, going to school for a couple of hours, seeing a friend or a cousin.  Even having only one or two things on her list, I explained, could make a day happy – we don’t have to have full days, we just need to enjoy something each day.  So far this week each day has been happy for Pippa and somedays surprises have happened or something unexpected has occurred that has added to her happiness.

Some happy times for Pippa…….

Of course we could focus on all the negative issues at hand, but when you have to live one day at a time, focussing on happiness is a great way to do it:  ending a happy day happily thinking about the happiness that lies in store the next.

Oh, James and Patrick are pretty happy at the moment………they have a very cool “paddock bomb” to drive around in for a little while.  Not a bad way for boys to clear their minds for a bit 🙂

And Nibbles is pretty happy too………

 

 

 

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Steroids

Today Pippa’s oncologist feels she has plateaued and is perhaps stable – I’ll take that.  Tomorrow instead of having an extra day of treatment he has told her she can go on whichever rides she likes at the Challenge Christmas Party!  When I queried him about the head spining, jolting rides she will undoubtably seek out he shrugged his shoulders and said, “Who cares, maybe she shouldn’t but let’s just let her have fun.”  He’s right, she’s been to the edge, a fun ride can’t do any worse than that.  Pippa’s in bed nice and early and is looking forward to it.  The poor little darling is so tired each day.

Today we had invited Pippa’s teacher to come and see her so she could show her around the Royal Children’s Hospital.  This was something that Pippa herself had suggested a while ago but it never eventuated as our treatment and visits ended before we could arrange it.  Thus, we decided to do it this time around.  In hindsight it would have been a wonderful visit to do much earlier in our journey.  As Pippa said, “then she knows where I am and what I’m doing when I’m away from school”.

Yesterday I needed to fill another script of steroids for Pippa which I did whilst she was on the radiation table at Peter Mac.  When I was called to collect the script the hospital pharmacist asked to speak with me.  He was quite concerned about the high dose of medication and knew it had been for a prolonged time based on how recently I had filled the previous script.  He was checking that I understood how to take the medication, that I was counteracting some of the side affects with other medication and wanted to know how long I had been on that high a dose and if I knew how much longer it would be required.  He was being very thorough but also very kind.  I reassured him that I understood everything and that yes, we were having occasional issues but I was essentially managing everything as best I could with appropriate medications.  He was comfortable with that.  It was not until the end of our discussion when I corrected him that my script was not for me but my rather petite 10 year old daughter.  He was speechless.  We shared a look of sadness and I quietly left clutching on tightly to the bottle in my hand with tears welling up in my eyes.

Pippa has been on this dose of steroids for 2 weeks now.  It is almost twice as much as the highest dose she was on last year and that was only for (I think from memory) about 5-7 days at the peak of being on steroids for approximately 5-6weeks.  Dexamethasone reduces the swelling around the tumour so the radiation can have a chance at working.  Neither of her oncologists is ready to risk taking her down from this dose just yet.

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There’s a Monkey in Pippa’s Chair!

Recently Pippa’s teacher and I were searching for resources to assist not only Pippa and her teacher, but also her class and school community when necessary.  Among other information and support, we came across a program called Monkey in My Chair.   A phone call to the organisation Missing School resulted in  a connection to the Cure Starts Now who manage and distribute the Monkeys in Australia.

Pippa’s Monkey (aptly named, Monkey) arrived yesterday complete with his back pack full of extra information and ideas, a picture story book to explain his purpose and a “Monkey Junior” to stay at home and go to hospital with Pippa.  We thought before rushing into things it would be best to make sure that Pippa and Monkey got along.  His arrival was perfectly timed to test out his dancing skills………..

After passing that with flying (dancing) colours there was no doubt that he would easily slot into class so off he went to school today for his introduction to the rest of D4 and his first day at school.

Apparently, Monkey likes to sit very still in class, is a great listener and his long arms and legs are perfect for giving hugs.

Monkey will get straight to work and sit in Pippa’s chair while she is away Thursday to watch Patrick and his St Joseph’s team mates play in the State Football finals and then again on Friday when Pippa is in hospital for some surgery on her eye to tighten and loosen the muscles.  The aim of the eye surgery is to hopefully give her some single  vision (instead of always seeing double) by tightening and loosening the eye muscles.

Lets hope Monkey doesn’t monkey around in her chair while she’s away and get up to mischief!

 

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