I’m here to tell you it’s gonna be okay. Virtual school is hard, but it’s not impossible. Impossible would be losing you, Hills. Besides, we’re already one step ahead cause we have borrowed laptops and WiFi. I sold my bike for this month’s bill.
We’re the lucky kids, so try not to complain too much. There’s no playground or swings, but there’s good grass and you’re allowed to scream. And sing. As loud. as. you. want.
Your pyjamas are now your day-clothes. Just accept it. Comfort comes first. And, don’t skip showers. The water is sacred here and some people don’t even have it to drink.
Don’t insult the lunch lady. We need her. She makes breakfast and dinner, too. The caf can be a scary place, but you have to eat what’s on the menu. It’s not à-la-carte. You get what you get and you don’t get upset. If you whine, you have to meet with the nutritionist, and that is NOT fun. Lots of scary vegetables.
Don’t worry, there will be pizza parties.
Breathe. Blow on those cookies. They want you to be able to calm yourself down. We’ll take a day off to create a safe-place together using what we have. Your closet is perfect. It’s empty anyways. We’ll fill it with our homemade fidget toys and your mini piano. You can go there whenever you want, no questions asked.
If you can print it or draw it, ditch the digital. It’s fun to learn on paper, and you can hang it on the wall after — or mail it to someone lonely, like Nana and Baba. Besides, math without a tablet and pen is stressful, and we need less of that.
Don’t worry if you fall behind submitting work. Every new day is a fresh start, and you shouldn’t look backwards. It makes it too hard to walk ahead.
Don’t listen to the gossip. They’ll tell you your brain will turn to mush or your legs are gonna fall off if you sit on the couch watching too much YouTube. I know for a FACT your brain and legs will work for at LEAST two-and-a-half years of this, so. 😉
Leave the subtitles on, for everything. Mute your browser tab if you can’t concentrate on your work. Bring your chargers with you when you switch rooms. The IT guy doesn’t like searching for cords. He’s busy.
Keep your headphones ready. It’s supposed to be noisy — like school — but everyone has to take turns. I’ll mute when you need me to, if you do the same for me. Press Ctrl+D to do it quick.
If baking class is available, take it. They make you do a lot of math and measuring, but you get to lick the bowl. The oven timer is the school bell so listen for that, too. And don’t waste. There’s a Food Bank box in the garage and the guy across the street needs leftovers, okay?
Sing O Canada loud and proud, or else you’ll forget the words. Same with prayers. We need extra of those.
Scribble homework with marker on the front window. It comes off. It’s better to think outside the box right now. The box has COVID in it. That reminds me, I gotta go change the filter in your air purifier.
It’s okay to have your camera off. You don’t need a good reason right now. It’s a global pandemic. Ctrl+E to turn on and off your camera as much as you want. You’re still there. It’s going to be okay.
Raise your hand. Don’t interrupt. Say thank you before you Ctrl-W leave. I want to be a teacher someday and I know how hard they work. Plus, you don’t want Mom teaching again, trust me.
If you complain — to anyone — make sure you have one solution to offer.
Take two stairs at a time. Soon, they will seem so small.
Keep your hands to yourself. No fighting or pushing. The nurse is overwhelmed right now so we have to stay out of the office. I’ll keep asking people to donate blood for you, just in case you need it.
If you need to skip class cause you’re sick or sad, I’ll skip whatever I’m doing, too. The teachers take attendance, but the numbers don’t matter. The real present is that we tried.
You don’t have to follow my advice. The opposite might work better for you. Just remember, I’m always here for you, and I have a note here to remind me to tell you that every morning when you wake up. I know you need to hear it.
We don’t have much, but we have each other. We’ll figure out the rest later.
Giving up school for you was the easiest decision I ever made.
Love always, your big sister, Alyssa
P.S. Look out for is this thing they call….leverage. It’s more like blackmail, but it works for everyone, so make as many deals as you can, first thing in the morning.
It has been two months since our last update. I have no new blood test results to share for the first time in two years. Hillary is in the best health she’s been in since before this nightmare began. She is just two years older now.
Her third annual biopsy to determine cellularity is deferred. We are undecided if we will take her in for May bloodwork to check her levels. Looks like we will be operating on faith until things are more stable in Ottawa.
Last week, I read a new Harvard peer-review journal forwarded by our primary hematologist. The findings were a terrifying reminder of the roller-coaster we’re on. Of the 314 children included, 29 died during the five-year study — six died on the first day of treatment. I remember our nurse saying, “I’ve never done this before.”
Of the 285 survivors, 110 of them needed second-line treatment within five years, in the form of another round of immunosuppressive therapy or a transplant.
Many of them at 24 months.
That is exactly now.
Of those 110 children, 68 underwent an unrelated donor transplant. Sadly, 20 of them died.
The journal concluded that event free survival is significantly longer with an unrelated donor transplant over a second round of immunosuppressive therapy as second-line treatment, but standards differ greatly around the globe. Hillary is also part of a research study — I can’t let her go down the wrong path just because she is part of a specific cohort.
Which brings me to…here. The exact same feeling of desperation I felt in that hospital armchair two years ago when I opened a Twitter account on my iPhone and created #StartWithHillary. I knew then that this was for life.
The journal kicked me so hard in the stomach that I decided to do something about it. In just two weeks, I am nearing completion of the first ever Global Aplastic Anemia Registry: A Voluntary Patient Database for Aplastic Anemia (AA) History, Treatment, and Outcomes. This time, I’m in an uncomfortable IKEA armchair in my room while the kids take over my bed, night after night.
I’ve sourced two similar online registries (for COVID-19) in other countries, and it looks like I can pass an ethics and privacy check with disclaimers. I have an informal steering committee ready to review and support my launch. I’m aiming for respondents across the globe thanks to the power of the social media networking groups I belong to. And yes, I’ll be tracking COVID-19 and vaccination responses. Maybe I can even get a research grant so I can stay home with my family. I haven’t walked past the end of the driveway in six months.
The last big database I created examined Educational Standards of Personal Support Workers (PSW’s) in Canada. The findings were incredulous. I used to work on contracts so I could stay home longer when the girls were born.
Looks like I’m high-functioning in a crisis. Never knew that.
Monday, I have a phone call with Canadian Blood Services (CBS) to discuss my other brainchild which came to me as the third wave washed over the city last week. A real phone call. I hope I make it through without choking.
I’ve literally been frozen since the pandemic began in terms of promoting diversification of the stem cell registry. Little tweets here and there. Most of the time, I find it too painful to share stories of others searching for a match. But, I think I finally have a sustainable idea that can help save lives, that doesn’t include Drake.
I’m excited about this one. I’m writing it into existence here.
Check this. Every high school student in Canada must complete 40 hours of community service hours in order to obtain their high school diploma. Pre-approved activities range from coaching sports teams to tree-planting to reading to seniors. During the pandemic, the hours in Ontario have been reduced to 20 in order to graduate, and in-person volunteer activities rendered impossible during lockdowns.
What a beautiful opportunity to introduce the idea of joining the Canadian stem cell registry as service to your community.
How many ethnically diverse 17-18 year olds in this country would be willing to maybe watch a video, take a quiz to determine eligibility, engage virtually with a real patient…before deciding to become a potential living hero? I’m hopeful CBS will offer these students the same comprehensive transparency and marketing genius they apply to everything else they do. They are world-class.
The part I like most is that it’s completely voluntary for these students. That’s critical, especially for the follow-through when it comes to actually donating if called upon. It’s a personal decision, and one that should be considered carefully. In Germany, ALL the cool kids do it.
When the Ottawa Catholic School Board (OCSB) agreed last week to allow participation, I was elated. Talk about putting the dignity of the person above ALL else. Setting the bar at the highest level, as usual. I can’t believe they even got back to me during this busy time. We danced in the basement and talked about all the fun things we could do for students over the years. Hillary wants to gift students this blood-red, fidget-putty from a local company, and I agree it’s perfect.
The only thing I seem to be able to do is fight for Hillary’s life.
Today, Hillary said, “I’m so proud of you.” Her smile was huge and her eyes were bright and she said it in her lower, slower voice and with so much love as she was swinging on her basement swing with Alyssa. Then she repeated it to me louder, with a little laugh at the end, like she really meant it. Tears welled up in our eyes. This is going to save lives.
This is my destiny — it would appear.
Hillary’s destiny is yet to be fulfilled, I hope.
Hillary is exceptionally gifted. Her light shines too bright. It makes me sure I’m going to lose her. Ottawa Councillor Diane Deans asked Hillary to participate in virtual International Women’s Day last month, and it again demonstrated that Hillary resonates. She still emphatically wants to be a world-famous singer. After three weeks off virtual school with no visible improvement in headaches, our Naturopathic Doctor suspects her constant singing could actually be contributing. It’s been a breakthrough, let me tell you. Our neighbours are about to get a taste of why, with the camping trailer going in the backyard this year. xo
Make-A-Wish Eastern-Ontario honoured Hillary again this year by asking her to be the Spokeschild for the 2nd Annual Great Make-A-Wish Campout in June. They say it’s for life, and we agree. She will share the adventure with Ollie, who just got his wish after an urgent, life-saving, haplo-identical sibling transplant during the first wave — and he has the exact same birthday as Hillary. Their stories are so intertwined, it’s eerie. (olliesbump.blogspot.com)
I still think the hardest is yet to come.
Hillary will literally need a bodyguard for the rest of her life, or at least until there is more focus on infallible PPE. I still fight daily for her terms of care. The things that I vowed to accept are no longer acceptable. Ignoring Hillary’s reality during all stages of her illness and recovery is dangerous and plain selfish — it doesn’t matter if your reason is to bring her the joy she rightly deserves. It creates a harm that can’t be undone.
She doesn’t want to go back to the hospital. We take the highest road possible and it’s gotten us this far. She doesn’t want it any other way. We embrace the many sacrifices we have to make to stay together.
The kids are happy as can be. They game on their laptops all night while talking to their friends on their iPods. JustDance before breakfast and walk laps in the backyard with birds and chipmunks. Pack thermos lunches and sit in the (unused) electric car with the radio blaring. They’ve started counselling and art therapy and complain it eats into their play time, just like virtual school. It’s a perfect mess.
We have food, power, water, and most importantly, WiFi.
Let’s just hope we have blood.
Evolving literature right now around COVID-19 and AA posit that immunosuppression might actually be beneficial in reducing the likelihood of the COVID-19 cytokine storm responsible for ICU intubation — but researchers admit there isn’t enough data. They also suggest Hillary’s immunocompromised body could act as the host in which allows coronaviruses to mutate, hence creating stronger variants. But they wanted her in school.
A pandemic is exactly like a rare disorder — you have no idea what you’re dealing with as you race towards a cure while fighting to survive.
The only way is to put life before livelihood. To truly put the children first.
It will never be fair.
This society keeps ripping the bandaid on and off instead of letting the healing take place, and it’s hard to watch. SickKids Hospital in Toronto is now accepting adult COIVD-19 patients into their ICU. That was our only transplant centre.
Event free survival (EFS) is measured from the start of treatment until the need for second-line therapy, or death. The longer I keep her safe, the better chance she has of surviving.
I can’t have an event.
We’re drifting in the boat in high winds, too close to the rocky shoreline. I wish we were alone in the boat, but there are others surrounding us, causing more waves, threatening to crash us ashore.
I am not fatigued. My guard never goes down.
The only thing I’m tired of is the holes in the armour we’re using.
If you need a reason to start giving a damn….
It’s been over two months since our last update. We just got Hillary’s blood results back yesterday, and are overjoyed to relay that she is holding.
Her hemoglobin held steady at 117; her platelets grew again to a record high of 165; and her neutrophils remain just below normal at 1.2. Her doctors call it “Hillary’s normal.” They’ve reiterated that her neutrophils might never come up, and that her immunity is stronger than average in spite of the numbers.
The platelet increase represents independent cell growth, without the use of medicine. It is huge. We were again reassured that it is a very strong indicator of success, but an unrelated transplant still formed part of our phone discussion with CHEO.
After a great deal of careful consideration, we requested to take Hillary to our community blood lab rather than return to the hospital. The busy hospital waiting room is unnecessary when other options are available, and the enhanced safety measures at Dynacare (along with their mobile app) rank at the top of our list.
Going to Dynacare was emotional and cathartic. Two years ago, at the same location, on an early Saturday morning, the girls and I had made a special trip of it. That’s her in in the photo (right), white as a sheet. It was Hillary’s first blood test ever, and she didn’t cry. Later than night, she would need three blood transfusions just to stay alive.
Last week was a little different in our winter gear and PPE. But, would you believe the same phlebotomist took her blood? Hillary remembered Many instantly, even with her surgical gown and mask on. She was efficient and sincere.
We waited all night for that phone to ring just like it did on Mother’s Day. Instead, we coasted through Valentine’s Day and Family Day… just not knowing. During our phone appointment with CHEO, Hillary was referred to a neurologist to try and ascertain where her migraines are coming from. Yesterday’s headache was so bad, we were sure it would bring on the most-dreaded F-word imaginable. Fever.
She got through. She told me what to do and I did it.
I’m trying to chart her headaches as they coincide with sleep, exercise, air quality, technology, gluten, dairy, stress, fluid intake — but there is no emerging pattern thus far, except for continued blood growth. All of Hillary’s nutrient levels have remained excellent since diagnosis — Vitamin B, B12, D, K, Iron, Folate, Magnesium…everything. It’s perplexing.
I can’t find the missing code.
Last week, we met virtually again with a Naturopathic Doctor to try and ramp up some supplements and reintroduce probiotics. We revisit Dynacare in three months for her next blood level check — followed by a phone call with CHEO — with the possibility of heading in earlier depending on our opinion of her presentation.
We’re also seeking the expertise of an Ear, Nose and Throat (ENT) specialist to address throat pressure and a new dentist to deal with her extensive ongoing dental needs. We have so many other needs that simply can’t be addressed due to lack of resources right now.
It’s challenging. There is a lot of fear there. I don’t know if I’ll be strong enough if that time comes. I really don’t.
One thing is for sure. Hillary is a warrior.
Like the bravest soldier, Hillary pushes through every morning — the first to rise. She leads.
She’s committed — with an unwavering focus of beating this unspeakable disorder that robbed her of her freedom for so many years. Never fatigued by the necessary protocols required to remain honorable in her fight. Not deterred by the beaten path that lies ahead.
She’s honest. Decent. Self-disciplined in everything she does.
Courageous in the face of extreme peril.
Proud to serve her country.
Her meritorious work continues.
Hillary was the opening philanthropist guest for the first-ever Kids Edition of An Hour To Give with Sam Laprade on CityNews in January. She spoke by herself for twelve minutes advocating for stem cells, teachers, and her family.
Maverick died on January 11, 2021 after the most courageous battle we’ve ever seen a human endure. Truly. He was 9. He skipped ATG and went right to a transplant from an unrelated donor. His four brothers were not a match.
Hills said yes last week when MediaPlanet partnered with the Canadian Organization for Rare Disorders (CORD) for a national campaign on rare disorders, and asked for our input as patient and caregiver. We tried to fit it all in 350 words.
Kathy died on January 20, 2021 after decades battling multiple infections, including COVID. She was pretty and lonely and she shared her journey in great detail so we could learn.
When the Make-A-Wish-Foundation asked Hillary to make a video message for Jacob who is heading into brain surgery next week, Hillary offered to write him a song on her piano.
Dianne relapsed last week. She lives in Ottawa and shares the same birthday as Hills. She needed two blood transfusions this morning.
And now, Hillary’s rosy red cheeks pop up on Instagram feeds across Canada to help with yet another #getswabbed campaign for Canadian Blood Services, Hockey Gives Blood, along with CanadaLife Insurance. The colour in her face is something we rarely see, and we know who to thank.
It’s all so connected…this community we live in. Right down to the blood flowing through our veins.
When we are asked to help, we say yes.
That’s how I was raised. Our motives are not ulterior.
I’m not sure if Hillary’s understanding of this duty will change as she matures. I keep reminding her about the lasting effect of her digital image, and she just does not want to stop. She’s fiercely proud and it seems I might be holding her back. TikTokCanada liked one of her Tweets, and she is just on cloud nine.
The dire truth of it though, is — we need Hillary. Like, the collective we.
As you could imagine, people are quite hesitant to join the stem cell registry right now as they grapple with the realities of the evolving pandemic. It’s understandable. Ottawa was forced to temporarily close their main blood donor facility (which also houses stem cells) for the first time ever in an unprecedented effort to address a COVID outbreak amongst staff in the blood collection facility.
If little Hillary can show us how to weather this storm, can’t we at least help her and others like her?
I have a lot more to say. These blogs are too long, yet I could write every single day and not get it all out.
I forgot a couple things when I was describing Hillary above.
She’s stunningly beautiful, incredibly funny, and truly gifted.
All that we ever asked from her as parents was that she was kind.
It has been just over one month since our last update and six weeks since Hillary last took her medicine.
I think Hillary has been gifted the miracle we’ve all been praying for, everyone.
She is doing exceptionally well with stable blood levels.
Hematologists at CHEO have been monitoring a little closer since stopping her immunosuppressive therapy — with visits every two weeks instead of monthly — and the last two blood tests showed stable levels.
With Aplastic Anemia, it’s all about the levels.
Her hemoglobin hovered at 117, 113, 118; platelets at 145, 141, 149; and neutrophils at 1.2, 1.3, 1.2. We were fully expecting to see a significant dip on at least one of the cell lines, but are beyond overjoyed to report that her levels are holding nicely — completely on their own.
I had to wait for at least two blood tests to share her progress with you.
I had to make sure there was a positive trend. Plus, things were a little shaky there for a while and… we really weren’t sure. Hillary had three virtual ER appointments in the last three weeks to address minor infections. I went from thinking she had mucor lesions in her nose from crashed neutrophils to a persistent case of impetigo, treated with prescription antibiotics.
Don’t Google it.
All three issues are resolving thanks to early intervention, her headaches are decreasing in frequency and intensity, and she is ramping up with exercise and nutrition/supplements. We feel it will take at least six months to see all of the side-effects subside as her body detoxifies from the cyclosporin. She already looks and feels different.
We continue to work hard, pray, and give thanks.
But each day is truly a mystery. Today is a headache day. We can’t ever give up.
Our gratitude for those donating blood and blood products is immeasurable. Platelet growth is a strong (if not primary) indicator of recovery with this particular blood condition. Back when she was in the very severe category (VSAA), Hillary needed platelet transfusions daily — and platelets have a short shelf life of seven days.
Local blood donors — our neighbours — literally saved Hillary’s life.
Two days before her appointment last week, a flock of 30 evening grosbeaks stopped by the backyard feeder before virtual school. It was like a flash of light. We’ve lived here for over a decade and never seen birds like this — they’re on the Ontario Species at Risk List. The bright yellow songbirds with white wing-bands sounded incredible and mingled closely with the cardinals, blue jays, and doves.
I don’t know what’s next. Auto-immune conditions such as these most often come in pairs. I’ll always be waiting for the other shoe to drop. We go back in late January for a blood test. We might even wait three months.
We might have to wait.
The grosbeaks left after her CHEO appointment and haven’t been back since.
They were a very special gift and it snowed a pretty snow while they were here and I hope they return. I wake before sunrise each day to put out fresh sunflower seeds, and I think I can hear one nearby.
Please continue to pray that Hillary is one of the lucky 30% who achieves lifelong remission from this mysterious blood condition that has taught us all so much.
I believe all of our lessons have been very different.
I hope one of them has been how great sacrifice can lead to something greater. In our case, it’s all been for Hillary’s survival.
We are extremely humbled by the support of our neighbours this Christmas. We feel safe and sheltered in Ottawa. Our hearts and minds are overloaded with gratitude for our humble home and circumstances, the nurses and doctors at CHEO who saved Hillary, the teachers and caregivers who are ever-present, and essential service heroes working similar miracles, and the turkey which will be dropped at our door on Christmas Eve by loving family.
We attend church in bed with warm cloths on heads, and sleep by the digital flickering light of our homemade Advent wreath. There is Peace, Love, and Joy here.
You have provided the Hope.
To quote Dickens’ all-too-relatable-now Tiny Tim blessing this December 23, with the utmost sincerity from our sweet Hillary to all of you:
“God bless us, every one.”
It has been one week since our last update. Friday the 13th was the last day Hillary took her immunosuppressant medicine. Ever.
Her blood levels rose on all three levels for the very first time. Ever.
Her hemoglobin rose to an all time high of 117. Her platelets to 145. Her neutrophils to 1.2.
We are now back in the watch-and-wait phase. We go back in two weeks for bloodwork at the lab again, then back two weeks later (mid-Dec) for more bloodwork and a meeting with a hematologist.
So far, so good.
Friday’s appointment went exceptionally well. Hills serendipitously got her favourite phlebotomist, Kevin, who she hasn’t seen since it all went down on the 5th floor of CHEO two years ago. His needles don’t hurt. He also HLA-typed our family in a rush to see if we were stem cell matches. Nope. Just three 6/10s.
A 10/10 match is considered the “cure” for Aplastic Anemia in the medical journals.
I want that 10/10 to be there for her.
Just before Hillsies’ appointment, the Right Honourable Justin Trudeau, Prime Minister of Canada sent out a call-to-action on Twitter. He heard the cry of little baby Boston in Winnipeg, and urged this great country to simply retweet his message to help Boston find a viable stem cell match.
What a gift. What a man. It’s just a simple tweet, pointed to a noble cause.
We watched as 6,500 retweets circulated — Canadians ordering their #getswabbed kits and sharing their experiences. Canadian Blood Services responded to every single question, and comment. We engaged with as many as we could, and will forever return to thank more generous strangers for joining the Canadian stem cell registry.
We hugged. Celebrated.
Friday was beautiful. Hills had a cute interview with CTV News’ Matt Skube just before dinner. We pumped ourselves up before going on so we could deliver a happy message of hope.
We ate East Side Mario’s by candlelight with music. Made our own Shirley Temples. Left a mess. Watched Night at the Museum on our mattresses in the living room. Just the four of us. Just how we like it.
Instead of doing her medicine routine at 8:00 pm, Hillary cut into THE most “profesh” bloody drip cake — something she has always wanted. The girls ceremoniously placed all of Hillary’s medicine and accessories in a cloth bag to be put away for keepsake. We couldn’t break the bottle like she wanted. We might need it again. We need to remember that.
Hillary’s back on CTV Morning Live on Monday morning, just before virtual school.
I don’t know how she’ll be feeling. But today, she’s great.
There is something divine working here.
I truly believe that part of the divinity we are experiencing is because of the prayers and energy constantly being directed towards our family, by all of you.
This might work.
We might make it.
Please keep praying.
It has been one month since our last update. Hillary’s monthly appointment was easy on her body, but hard on the mind and spirit of our family. We don’t have answers to all of our questions and are now bracing for an unexpected change in her treatment path.
Hillary’s hemoglobin rose from 104 to 111, but her platelets fell from 140 to 136, and her neutrophils are back down from 1.4 to 1.0. Still below normal on all three cell lines.
Despite her slow partial recovery status, the decision has been made to stop Hillary’s immunosuppressive therapy six weeks earlier than planned. Her last day will now be on Friday, November 13 after an early-morning blood test in the general lab at CHEO, bypassing the extra-sterile Medical Day Unit (MDU) for the first time. We pray that her blood levels are up and that the appointment goes smoothly.
We are counting down the days. The doses.
We might be looking at a new normal for Hillary — or may be headed to an allogeneic bone marrow transplant — is what we were told by our lead hematologist. The only thing that is clear is that it’s quite unclear.
Both scenarios leave Hillary vulnerable heading into this winter.
The day we got home from the hospital, a hawk snatched one of the baby doves off the feeder as I stood outside. I watched them struggle, feathers everywhere. The baby dove looked me in the eye before it slipped through the fence.
There are still many unknowns. Hillary’s overlapping Paroxysmal Nocturnal Hemoglobinuria (PNH) clone is still of concern but will not be retested since she does not have observed current hemolysis (breakage of red blood cells) and the test is costly. We’re committed to keep pushing for this data to ensure Hillary receives the proper treatment should this condition progress.
We requested a thyroid test due to some concerning symptoms Hillary has been exhibiting and the results came back outside of the normal range (more overactive T-cells) and we are still anxiously awaiting an interpretation from a doctor and how it relates to her idiopathic blood disorder and her current health.
We have no idea if we have a stem cell match in the Canadian registry.
Nevertheless, we are so excited to stop this dreadful-tasting, life-saving, cyclosporine medication which Hillary has taken twice per day for the last 18 months. We have to take this step. We long to see the side effects subside — stomach distention, bone pain, fatigue, gum overgrowth, feet peeling, weight gain, excess hair growth, and dangerously high kidney and liver levels. It’s been hard on her cute little baby body.
But will stopping the medicine also stop her blood production?
We have to believe this will work — on November 13.
We need you ALL to believe.
Her blood levels are on an upward trend. Her bone marrow biopsy showed undeniable improvement. Her creatinine, urea, and ferritin levels are improving drastically with each monthly blood test. Hillary feels happy and healthy. She is no longer sick on a daily basis.
Blood research continues to advance at a rapid pace. It’s astounding to read about how far we’ve come from the first attempt at a blood transfusion back in 1666 between two dogs using a goose quill, only to have it banned by science — and religion — for a hundred and fifty years until the discovery of blood types.
Last week, they announced the first ever at-home pill treatment for Myelodysplasia (MDS) — the blood cancer that Hillary is now at life-long risk for since undergoing immunosuppressive therapy.
I’m still not sure if we are lucky or unlucky.
I think it’s more…we are the lucky unlucky.
Virtual school is working beautifully. Halloween at home was perfect. We are still able to afford and get food, medicine, and other necessities completely contactless.
If this treatment works…my God, I just might believe again.
We still don’t know when Hillary will ring the bell. I’m still waiting to taste that wine.
I can’t believe there are only four more days left of Hillary’s medicine.
The doves keep coming back.
The hawk is still here.
On Friday morning, Hillary and I will wake up early to get to the blood lab first. We won’t sleep the night before. We’ll listen to JUMP 106.9 on the way there to laugh at the call-ins and free our minds. We’ll meet Nana and Baba in the parking lot, as always. We’ll race home to Alyssa and Daddy to see two huge balloon AmongUs characters that we ordered from Brad the Balloon Guy. We’ll eat East Side Mario’s takeout for the first time in a year with the gift-cards Glenna gave us and move our mattresses into the living room for a movie-slumber party. The Great Make-A-Wish Campout continues.
On Saturday morning, Hillary will sleep in for the first time in years. No more medicine.
We will never be the same. We are praying for survival.
Please pray for Hillary.
Thank you for your collective forbearance respecting the current pandemic. For helping keep our hospitals, schools, and food chains working. For donating blood. For spreading the word about joining the stem cell registry.
Little baby Boston can’t find a match.
Neither can Olivia.
They are waiting right now.
It has been seven weeks since our last update, and things continue to improve for Hillary as she battles this rare blood disorder called Aplastic Anemia. Thank you for your continued inquiry and prayer.
Please take comfort in knowing that Hillary has achieved another major win. Her last monthly blood test revealed an increase in neutrophils from 0.8 to 1.3.
Finally. Over 1.0 for the first time. We screamed out the windows of our electric car on the way home. Her hemoglobin rose to 104 and her platelets rose to 140. She presented just below the normal threshold on all three cell lines.
I’ve been hesitant to share this positive development with everyone. We haven’t even spoken with a doctor about it yet.
We’ve been quiet on Twitter again.
This is the calm before the storm.
We are at a critical time point in Hillary’s care. We have numerous questions for our lead hematologist when we go in this week — some of the questions simply don’t have answers. If her normo-cellular bone marrow is now operating at 60%, could we not harvest it and give it right back to her if she needs it in the transplant phase later? Her stem cells show no genetic abnormality. Her T-cells were merely overactive when she was requiring blood transfusions.
No matter what, we simply must proceed with ceasing her medication on December 24 to determine if the treatment was a success or a failure. I hope there is a free hospital bed with abundant blood products under the Christmas tree if it doesn’t quite work out…maybe with some of those hard-to-find, short shelf-life platelets wrapped in a bow.
She already needs her two front teeth. She lost her top front four this past month, and she looks unbearably cute. Last night before bed, she said she thinks the cure for her condition is happiness. I thought we were really happy before. I don’t know where she is looking.
Her treatment is working. Her levels are rising.
She still has nap-inducing-headaches twice per week, but her nosebleeds have stopped entirely. She looks well and eats well, but sleeps too soundly. We’re treating an ailment on her foot which I hope resolves in my healing hands soon, and there are other things. I don’t share it all. It’s private. I can see it when she walks. Sense it when she sleeps.
Most nights, I long for this world to implode as I stare up at the night sky so I don’t have to experience losing her to this lingering illness. I make wishes on water and long for Father Peter’s soothing voice to fall upon my ears. I send constant condolences to parents who are experiencing what I never want to, and offer advice to families trying to boost the stem cell registry so their child can live. This week, my heart aches for Isabella, Maverick, Melissa, Evie, and Brantley, and their families.
All five of their stories are truly unbelievable and unbearable.
I can’t look away. I have to watch and learn.
During the day, I pray that life is just a simulation — all the glitching talking heads and hilarious coincidences — and once I acquire the cure in my inventory (those elusive stem cells), I will finally skip to the next level…or plane of existence…or vibration. If it IS all a simulation, COVID19 was a major error. I wanted the whole world to know what it was like to live in isolation, but not like this. Not with this level of miscommunication and misinformation.
But my children are indeed real, and I’m supposed to wake up and operate on faith — set an uplifting, hopeful, moral tone within my household at all times.
Model a healthy mindset.
A morning dove hit the bedroom window during breakfast on the first day of school. The girls and I stepped out back and watched it take its last breath.
What followed was the best first day of school ever and another wish come true. We have nothing but the deepest gratitude for the OCSB Virtual Academy and what it has done for Hillary who missed an entire grade and a half of school. Both girls are learning. Getting frustrated. Recovering. Catching up. Socializing. Dreaming. Flourishing. Online.
In fact, virtual school has had an incredibly positive impact on the wellness of this entire family in such a short amount of time. We feel like the luckiest people on Earth. So many sacrifices are being made so Hillary can stay well.
Nine baby doves currently visit together each morning. I make sure there is enough food.
People continue to donate blood in Hillary’s honour to help with the critical shortage. Daddy gave last week. Uncle Denny gave today. I give again this month. Hillary makes two YouTube videos a day, and never forgets to mention how easy it is to #getswabbed, #giveblood, and donate to #makeawish. It’s now our official obligation to assist these causes, and we are honoured.
We also realize at this point that we are a bit of a social experiment. If Hillary were to contract COVID under the precautionary measures we’ve had in place for the last 18 months, I’d sound the alarm on the current epidemiology. Hillary has gone six seasons without illness or infection, and that’s without an immune system, with a sister in school…while sucking her thumb.
It’s not fear that drives me. It’s not control.
And I really don’t suffer fools well.
Like last Thanksgiving, when a relative held her mask off her face the whole time so she could talk to Hillary in my sterile, purified living room. Or last Christmas, when I sent our regrets by email and received the insensitive “family is important” response. That was the last time I bothered to explain myself by email or text. Those shallow experiences only made my resolve stronger. I never said anyone couldn’t visit — I simply insisted it had to be on my terms. I think that’s perfectly fair.
Hillary doesn’t deserve to be at risk while we decide what’s careful enough for her.
Just ask her. She is opinionated, well spoken, and educated on the topic. No shyness there.
We’ve had zero exposure to any indoor environments other than our home. We attend monthly hospital appointments wearing masks, visors, and behave carefully with frequent handwashing.
No haircuts. No patios. No stores. No exceptions. We get online groceries, do curbside pick-up, and masked drive-thru only. We wipe down our groceries but not all of them, and not all of the time. We stick with the same providers — always Moncion’s Grocer. We change our furnace filter every month and run an air purifier and dehumidifier — never a humidifier. Car windows stay up in town. Public washrooms are banned. We have window visitors but not backyard gatherings.
We clean a lot. Daily walks are mostly masked for Hillary to avoid dust from vehicles, dirt, construction debris, fungus, campfire smoke, and people. Her choice. We wear our masks at the same time for her. Our choice. We look back often. We always say hello and wave. Damp, windy days are met with extra caution regarding people proximity. We order Gabriel’s Pizza for Ollie. We pay online. We dress warmly to avoid catching the sniffles.
We skim the research, drill down where we can, and take the strongest advice. It affects every part of our very existence.
As if I’d take a relaxed approach. She’s one in a million.
We’ve adopted a clear stance as we face down the threat of COVID. We’re going to meet this beast head on. She’s gonna tell her T-cells to fight. We know we can avoid getting sick if we can control our surroundings. We know we have to have the right people around us to do that.
But our bubble — please don’t burst it.
The hospitals…please keep them open.
There are people IN this….and there are people completely out of THIS.
Our girls have friends in school. Playing competitive hockey. Swimming.
We have family providing essential services. Dining on patios. Hugging at birthdays.
Our colleagues are teaching in schools. Saving children from the darkest homes.
We go to hospital appointments. Open veins and pray.
This is where WE fall in the circle of life at THIS point in time. It’s certainly not where I expected to be. I don’t think I like it very much. But it’s from this stance that we will continue to present our best selves to ensure Hillary’s survival. No matter how severe the mental anguish feels from fear of the unknown, the only option is to completely sacrifice everything to make sure she lives.
It’s coming for her. During the darkest winter in human history. I’m not allowed to say it to anyone.
The birds know it. The baby cardinals are here too often.
Thank you for wearing your uncomfortable mask. For staying in. For protecting Hillary.
Please stay well, and stay with us.
It has been eight long weeks since our last update, and we have incredibly uplifting news to share with all of you who have invested hope in Hillary’s journey with Aplastic Anemia.
Hillary’s bone marrow biopsy and aspirate came back last week as 60% normocellular.
That is, not hypercellular (too many cells which could indicate cancer)…nor her previous 20% hypocellular (too few cells which means her aplasia persists).
This one is…normal.
Her blood test showed a rise in all three levels for the first time.
Her hemoglobin finally broke 100. (normal 110 to 130)
Her platelets grew from 114 to an at all-time high of 135. (normal 130 to 380)
Her neutrophils rose to .9 after a dip to .8. (normal 1.5 to 8.0)
All of the additional genetic tests came back negative. No dysplasia was detected. Her nosebleeds have stopped. Her pentamidine IV infusion has been stopped. Many other side effects are lessening more each day.
It’s considered a remarkable success thus far by her team of doctors. It was all smiles at our last visit, seen through kind eyes.
We truly feel one step closer to the miracle we are all desperately praying for. Her blood levels are rising despite the fact that she is weaning off the medicine (which is no longer at a therapeutic level). This is…perfect, essentially.
But, those neutrophils. They’re still so low.
Her overactive T-cells continue to attack and suppress her bone marrow, preventing the manufacturing of the one thing she desperately needs. Protection.
Hillary still has a long journey ahead before she can ring that remission bell. Upon inspecting the bell at her last visit at CHEO, she really thinks it needs to be fastened more securely to the wall before she gets a hold of it.
We agree completely.
First, she still has two more wean stages (30% reduction every 2 months) before she is completely off the cyclosporine immunosuppressant.
The day that she finally stops will be so incredibly nerve-wracking. This is the next possible crash point in this marathon towards remission. If her T-cells realize they’ve been tricked, they attack and destroy all of her blood production lines. We have to be able to recognize the symptoms (petechiae, lethargy, pallour) and be ready to go in at the drop of a hat.
According to her medical records, her last dose of medicine will be on December 24, 2020, Christmas Eve.
My head spins. How can that possibly be, to the date? What a gift that would be.
If she can hold — and she is a miracle so far — we undertake the task of having her numerous immunizations re-done since they’ve been wiped out by the immunotherapy. Her doctors may choose to test her blood for any remaining useful antibodies before beginning the vaccination schedule, or they may just give all of them again for good measure.
Then, the six-month mark following the cessation of medication is the next milestone to be achieved. That will mark two years of strict isolation. Hillary’s 8th birthday.
Maybe then she can ring the bell.
But she may be doing so with a new normal.
We are deeply grateful for the incredibly thorough, yet, laissez-faire approach of our lead Pediatric Hematologist/Oncologist, Dr. Robert Klaassen, who represents an entire team of professionals at CHEO working together, with us, to ensure our child’s survival. They are all quite impressive.
We all feel confident that the best treatment path was chosen for Hillary.
She goes back in one month for a dentist appointment and blood level check. She currently has four loose teeth — and a lifetime of dental work ahead of her.
We continue to use social media as a support system to help us navigate this rare condition. Every single human experience offers a sobering and valuable lesson on how we should move forward with this rare disease.
When we got home from the hospital last week, we learned that a fellow warrior lost her battle with AA. She was 7-years-old, and five months into immunosuppressive therapy. She had .9 neutrophils, just like Hills.
She’s why I won’t let up.
Hours later, an 8-year-old friend, Evie, had her only 10/10 match in the world (from Germany) pull out the day before transplant. They are now literally waiting for someone to join the registry so Evie can survive.
That someone could be you.
You could actually be Hillary’s match.
Our doctors affirmed last Wednesday that she might need one someday. There is just not enough documented evidence that this treatment can provide life-long remission. Bone marrow failures are extremely complicated, particularly the pediatric and idiopathic ones, like Hills.
But wow, have you seen the research being conducted in the area of T-cells at the moment? Daily studies are being published in mainstream news. In many ways, we feel extremely fortunate. The silver linings don’t go unnoticed or under-appreciated.
Still, not knowing if Hillary has a match is the most helpless feeling I’ve ever experienced. And it’s constant. We inquired again at our last visit and it’s just not the type of information we are entitled to have. It’s hard to sit back and wait.
Sooooooo… we won’t wait! We’re go-getters!
We vowed to #StartWithHillary and never stop helping to promote and diversify the global stem cell registry. We hope our continued efforts will help us secure a match in Canada, since the transportation of stem cells across borders has changed drastically since COVID19.
Awareness is everything. In helping ourselves, we are helping countless others. We are leaving a mark. Making a difference. It’s something to be proud of.
We just want to pack up the camping trailer, fill it with #getswabbed kits, and travel across Canada…going door to door. But Hills is not well enough. I can’t shrug it off or deny it.
So we do what we can, from home. Hillary’s offer to pay-it-forward to The Make-A-Wish Foundation continues, as they have extended their awesome #TheGreatMAWCampout for another week. The girls are busy making videos, and are always bouncing around in the trailer. I can’t help but notice these experiences keep opening up. These chances for the girls to shine. If you have 5.15 minutes, please watch Hillary’s latest video to thank Make-A-Wish Eastern Ontario. She makes one of these videos every, single day. Thank you for continuing to donate so that others can have a chance at experiencing some real magic, like Hills did.
Alyssa celebrated her 10th birthday by organizing and leading her own Zoom party with six of her BFFs. They painted together, played cards, ate cupcakes…saw each other. It was perfect in every way, and we are so relieved she didn’t want a parade. Or a trailer.
Together, Alyssa and Hillary represent hope. They see the darkness, but rise above it, every time.
They never let it change them.
I’m trying my best to be as strong as they are.
From a medical standpoint, not much has changed for Hillary since last month’s update.
She did not require a blood transfusion last week and her levels remain the same — stable, but still aplastic — with hemoglobin at 95, platelets 114, and neutrophils .9. She continues with her pentamidine infusion medication as a precaution until her neutrophils come up, and she begins another stage of weaning today, Canada Day, off her immunosuppressant.
But .9 is a record high for her white cells.
She continues with such a rare presentation: no major infections; no organ damage; low neutrophils; but, growing platelets. She could even do another course of ATG before a transplant, as our doctors continue to urge that an unrelated donor transplant is a last resort, especially now with the pandemic.
That rare presentation allows Hillary to give back.
To do some good.
To be a voice for others who can’t speak…or see.
And boy, does she have a voice.
Last year, while in isolation at CHEO, Hills completed a Make-A-Wish (Eastern Ontario) questionnaire. They asked her to describe and draw three wishes. Her number one wish was to ride Space Mountain at Disney World. We talked about it every single day — no days off. We watched Disney parades on YouTube for weeks and went to sleep imagining the sights and sounds we would one day take in.
We packed a bag.
It truly incentivized Hillary to work harder at getting better — affecting self care, nutrition, discipline….everything. We had promised her the world anyways, but this wish was a magical promise from someone more important than us…Make-A-Wish understood her.
Then COVID19 hit — travel was suspended and Disney closed. She never complained. When asked again, Hillary wished for “a big bag of money to give half to the homeless people…..or a camping trailer.”
Make-A-Wish couldn’t hand out a bag of cash — and the trailer was really too much for us to accept.
We had to give back.
We are so grateful to Make-A-Wish for nourishing the spirit in Hillary to be their spokesperson for their #TheGreatMAWCampout weekend campaign. They were beyond professional and understanding with our limitations as we tried our very best to represent.
It was a tough gig — we’ve already asked for blood and bone.
Yet, the girls took over another interview on CTV Morning Live and really got the message across, again. The interview was hilarious. We camped out and tweeted all weekend, and feel fiercely proud once again to have helped raise awareness for yet another cause guiding us on this journey.
It’s the least we can do.
There was a beautiful outpouring of support on social media. NHL buddy Anthony Duclair DMd Hillary a couple of times to wish her Happy Birthday. She told him #BlackLivesMatter and he appreciated that a lot.
Then NHL’s Nick Foligno came on board to support the campaign, along with some other very important advocacy heroes, like Ian and Sonia Mendes and family, CTV’s Patricia Boal…the OCSB’s Nicole Brooking, blood and plasma donor hero Glenna Gosewich….Ollie’s sister Abby, Micheline, Megan, baby cousin Freya, the Eggink family…………….
Thank you — on behalf of the 300 children currently waiting for their wish — for camping out and making a donation in Hillary’s name. She received a card for every donation and saw all of your names, just like a birthday party. It filled her up.
My list of beautiful people is so long.
Hillary was joyfully surprised on her birthday with a new tent trailer….to keep. It sounds really crazy when I type it out…more crazy when I look in the driveway. The video made by Alexandria Camping Centre to capture the moment is the most beautiful memento we could imagine.
As if that weren’t more than enough, Make-A-Wish also organized a birthday parade for Hills that evening. You 35 cars felt like 100 trains. It overwhelmed us….we screamed and cried and waved our hands in the air like we were on a rollercoaster — just like Space Mountain.
She says it was the best day of her life.
If you drove by and saw her crying, you must have come right after her former ECE drove by — Ms. D. It put her right over the edge…but they were happy tears.
For those who wore protective face masks for Hillary, please know that we still saw you as clear as day. What a beautiful gesture filled with unconditional compassion, love, and respect. Hillary noticed right away and loved it.
For those who didn’t wear masks in their vehicles while driving by, that is fine, too.
Not to wear our face masks for the parade was a difficult decision made after several family meetings over several days. Not only do we want to protect Hillary, but we want to continue to lead by example. But the parade was for Hillary. She knew it would make her overheat. We’ve experienced it all over the past year. It’s up to US to protect our family, and we were ready for all eventualities while outside, mask in hand.
Thank you for making signs, decorating your vehicle, taking that second lap to talk to Hillary, for honking, waving, smiling…Alyssa took photos of all of you…..we are working on our thank-yous. We are particularly grateful again to St. Leonard School for continuing to support Hillary on this journey.
Hillary has not left the trailer.
She takes her medicine in it and says her tummy no longer hurts. She thinks she’s all better, and we will not beg to differ.
It might be magic.
The next appointment in three weeks is a big one — the highly anticipated bone marrow biopsy and aspirate. This look ahead (inside her marrow where the blood is manufactured) will tell us if we’re on the right track. It will also tell us if her condition has evolved. It could tell us she’s in remission.
We still have so many options, and we are still hopeful.
It’s anyone’s guess when this miracle will happen.
I don’t know what’s next.
But I do know we are indebted for life to a very long list of organizations and individuals.
No amount of campaigns can ever even that out.
Thanks Ian Mendes for affirming that.
It has been seven weeks since our last update. We are relieved to relay that Hillary has been holding, not requiring any blood transfusions so far as she weans off her immunosuppressant. She has good days, bad days, and scary days, but they are days with us at home.
She continues to hover at around the same level — hemoglobin 96, platelets 109, neutrophils .8 — but that is on the incrementally reduced dose of medicine, so that’s a win. As a partial late responder, we hope that Hillary’s marrow continues to work at producing blood cells, and that her overactive T-cells stop destroying them.
A bone marrow biopsy and aspirate would offer a good glance ahead at her bone cellularity, which was previously 20-30%. It would also tell us if her condition has evolved into Myelodysplasia (MDS) — something we dread so much that we don’t discuss it. But, her biopsy was deferred from next week to next month, closer to the one year mark since her therapy began. We continue to be ever so grateful for CHEO’s conservative approach.
So, we wait.
While we wait, we keep busy.
We were shell-shocked to learn that Canadian Blood Services is actually running low on donations now that surgeries have resumed and social distancing guidelines have impacted donation procedures.
I never thought that would happen. Ever. It quite frightened me.
So, what do we always do when we’re scared here? We campaign! We crafted a new kind of wreath for our front door with some bristol board and smelly markers, took to Twitter to encourage blood donation during World Blood Donor Week, and did the best interview on CTV Morning Live. It was so nice to see Alyssa speak so confidently…very hard to see Hills yawning so much.
But, it worked.
Thanks Brian. Thanks Matt. Thanks Stephanie. For giving blood. The girls made you bracelets.
Then, just last week, Hillary graciously agreed to be this year’s spokesperson for The Great Campout for Make-A-Wish Eastern Ontario. To officially kick off this challenge and campout weekend, Hillary will be surprised with her wish on Friday June 26th, her 7th birthday!
That’s next Friday. I can barely event type.
Receiving her wish on her birthday offers another opportunity for healing for Hillary. She says her last birthday was the worst day of her life. We are extremely grateful to Make-A-Wish for replacing a sad, scary memory with a joyful surprise.
Hillary and Alyssa are having an absolute blast being involved with giving back in this way. A couple nights ago, we set up the tent and made a YouTube video together, learning iMovie for the first time. Deep learning. They make us fiercely proud.
So, in the spirit of spreading awareness for another worthy cause, to learn what Hillary’s wish is, visit Make-A-Wish’s website and get ready to see the girls in all their cuteness. The photos there represent greatly cherished memories for this family.
If you can’t donate blood, maybe you’ve got a wish to spare. Hillary’s friend Ollie has the exact same birthday. He’s holding out for his wish to swim with the dolphins in Atlantis, Bahamas. We can’t wait until he gets there. Alyssa is donating $20 in his honour. His mom holds me up. http://olliesbump.blogspot.com/
Like every parent does, we asked Hillary what the one thing she wants for her birthday is — other than some bone marrow, of course.
All she wants is a car parade, with all of you.
Please join us, if you can. Drive by at 6:00 pm on Friday, June 26 to see Hillary from a safe social distance, enjoying her Make-A-Wish with her family. Private message me for our address, or email Hills at email@example.com. NO presents. Hills says pay it forward with a donation.
Leaving no stone unturned.
Saying yes to every opportunity.
Maybe this will work.
We are overjoyed to share that Hillary’s blood has finally shown growth on all three levels. Her hemoglobin rose from 91 to 98, her platelets grew from 100 to 119, and her neutrophils climbed to an all-time high of .8 from .5.
This is the sign we’ve desperately been waiting for these past 365 days of isolation from viral, bacterial, and fungal pathogens — upward movement on all three cell lines. We are by no means out of the woods, but Hillary remains transfusion independent and out of the hospital.
Since her platelets have stayed consistently over 100 for the past three months, the decision has been made to begin weaning (or slowly coming off) her medication. We trust our medical team implicitly and agree this is the right path for Hillary at this time.
Things are moving fast again.
While the immunosuppressant (Cyclosporine) medication is the only thing keeping her overactive T-cells from destroying her own bone marrow, weaning allows us to see if the treatment has worked.
A proper shutdown before her miraculous immunity reboot takes effect, if you will.
We are now on Day 4 of the wean and are on high alert. It can cause a quick crash requiring a transfusion — fever, bruising, lethargy. Yesterday, Hills woke up with her worst headache ever and was violently ill for hours. Later, she wrote a song on her piano for Mother’s Day.
I’m not sure what today will bring. I have no idea if her platelets are holding.
I wonder if we’ll end up exactly where we were one year ago today — rushing her to the hospital in the middle of the night. If this wean doesn’t work, we go immediately to transplant. All of these coincidences make me feel manic.
For instance, I always knew I’d write. I’d sit and listen to my dear Nanny tell stories of the 1918 Spanish flu and I longed to put in on paper for her. It was so interesting…unfathomable. Who knew I’d be writing during another historic global pandemic. Strange.
Then my Poppy died of Myelodysplasia (MDS), a non-hereditary blood disorder that can emerge in old age and closely mimic Aplastic Anemia (AA). He was the reason I began organizing blood donor drives for Canadian Blood Services at my work, before I had children. In fact, without a transplant, Hillary’s condition can evolve into MDS. Doctors assure us it is mere coincidence.
Oh, and the COVID-19 pandemic: originating from a region with the highest incidence of AA; causing an immune response just like Hills; forcing the entire planet to live in isolation, just like us.
We were ready.
Alyssa and I watched Trump’s late-night address live on Twitter where he halted travel to Europe. The next day, I borrowed money to fill Hillary’s prescriptions, pulled Alyssa from school and inquired about truancy laws, and said goodbye to my parents with their last in-person grocery drop. I knew with certainty that I could also no longer mitigate the risks associated with Steve’s work, school, hockey, golf, meetings, lunches, retreats, celebrations (on top of the dust, spores, and bacteria) in addition to the new pandemic considerations. The world had to stop once again for us to keep Hills safe.
Two days later, Canada declared.
Then it was March Break.
Enforcing the right level of isolation has been a delicate balancing act, particularly over the changing seasons. I’m constantly calculating risks and always opting for the most cautious route. She’s one-in-a-million. I did not quite implement the full-blown bone marrow transplant recipient protocol, but I adopted many of its elements. Then I implemented them for myself. Alyssa wasn’t far off.
It just makes sense, and Hillary has remained infection free for one whole year.
We don’t go for scenic drives. If we get into an accident, Hills doesn’t have a fair chance.
You will see us out walking down our street, but we wore our masks last year on our walks. We also have exceptional neighbours.
We aren’t having fun eating out. We ration our food to save money and eat farm-to-table as much as possible with a quasi-neutropenic diet in play.
I haven’t had a glass of wine in three years; and I love wine. I’m staying alert. No breaks.
One thing is for sure — isolation began the moment that phone rang in the middle of the night on Mother’s Day. It had to. No haircuts. No driveway chats. No body. There’s no temporary lockdown, quarantine, or social distancing — it’s #survival. I’m no martyr. She depends on me.
One whole year later, we cling to the hope that Hillary’s little body can achieve remission…or better yet, spontaneously recover, never to see this rare disorder again. I think that’s why I was so desperate for a signal boost for her from a celebrity on Twitter. I fantasized about how an adrenaline boost might jolt her immune-system into proper functioning…forever.
Lately, Hillary has been feeding a chipmunk before doing her medicine which she often vomits and has to retake. Last week, a blue heron landed in our yard just after Hillary bled from her ears. At night, we hear the buds growing on the trees in our forest backyard while we manage night sweats, headaches, and nose bleeds. It’s challenging, but extremely peaceful here in our first family home.
We really have no choice but to live in the moment. Hillary makes that possible. Her positivity is not a gimmick. She lifts us up. You should see her homemade YouTube videos. I have not had the heart to post them.
Please pray for her to stay strong. She is working hard and is very proud of herself.
At our last appointment, there was no mention of transplant.
This has to work. Right now.
She goes back to CHEO in a month for a bone marrow biopsy and pentamidine treatment.
This is Hillary’s Life List. It’s just the beginning.
Ride a bike without training wheels.
Make dumplings from scratch with someone old.
Jump in a ball pit.
Visit my old daycare.
Buy glitter. A lot of it.
Watch Monarch butterflies break free from their cocoon.
Get some really good black lipstick and wear it.
Jump in a muddy puddle.
Learn how to ballroom dance.
Talk to YouTuber Rebecca Zamolo.
Drive in a Tesla.
Go to a bone marrow drive.
Dance on a rooftop patio.
Spend the day in Mommy’s office at the OCSB again.
Swim in a public pool and make sure an ice cream truck comes by.
Go to Bora Bora.
Revisit my school fairy garden spot.
Spend the day at the public library.
Take a sleeper train.
Attend Midnight Mass.
Go to an Ariana Grande concert.
Release a live dove.
Pick garbage out of the ocean.
See the ocean.
Be a Girl Guide.
Get mailed in a box somewhere.
Wear a watermelon bikini.
Write a global anthem.
Visit the hidden 7th floor of CHEO.
Go strawberry picking.
Take gymnastics lessons.
See inside the house at 6357 Emerald Links Drive.
Save the planet.
Get an oxygen swimming pool, for my blood.
Pet a pony.
Go to Comic-Com.
Wait for a city bus in a bus shelter.
Go through a homemade Halloween haunted house.
Play with golden retriever puppies.
Get a PC to play Minecraft.
Play with a big bucket of slime.
Mail some slime to Rebecca Zamolo.
Do a paint night with my mom, dad, and sister.
Sleep in my bunk bed at Waupoos Farm again.
Break boards with a karate chop.
Run in a marathon for Aplastic Anemia.
Wear cut off jean shorts.
Get a service animal.
Eat from a food truck.
Watch a movie outside and kiss someone.
Ride Space Mountain one more time.
Double everything above for my sister.
Ride a school bus again.
Ring the bell @CHEO that says I beat it.
Enjoy the time it takes to plan your life.
It has been 10 months since Hillary began living in isolation — the only way to stay completely safe as she battles this rare blood disorder called Aplastic Anemia.
Her monthly blood test showed a rise in platelets from 97 to 100 — a number we went to bed dreaming of the night before. But, her neutrophils fell from .7 to .6 and her hemoglobin also fell for the third month in a row from 107, to 98, to 93.
Still, this is very promising.
Hillary continues to thrive at home. This morning, she woke up with rosy cheeks and a big smile. She really does look better. Different, but better. Each day has its own set of health challenges, but nothing we can’t meet and treat with time, patience, and the right supplies.
Thank you for your continued support and inquiry.
Please think of her as very happy and know that she is well taken care of. She thinks it’s just absolutely fantastic that the world is staying home, just like her.
Hillary and I go back (alone) to CHEO just before Easter for another blood level check, her pentamidine medication infusion by IV (to prevent bacterial pneumonia, not viral), and a serious discussion with our team of specialists. Please know that Hillary’s lungs have always been incredibly strong and healthy. Hold that close to you.
Preparing for our next appointment is intense. We are comforted by the measures put into place thus far by CHEO. They are doing an exceptional job.
We continue to watch the unfolding of the current global pandemic, COVID-19. Hillary falls within a vulnerable demographic — an immunocompromised patient with a hematologic disorder — but for bacterial and fungal infections as well as viral. Any one of these three infections would put her in danger, at any time.
Imagine being in isolation, and then imagine being in isolation within that isolation.
Yes, it feels a little perilous at this time. (I write as I laugh maniacally)
The blood bank is running low. If her oxygen goes below 70, she will need another blood transfusion. Blood has a shelf life.
Hillary is two months overdue with her immunosuppressive treatment plan, and it’s beginning to show a slight increase in liver, kidney, and ferritin levels.
We’re not yet sure what direction will be recommended to us by CHEO. It’s a complex decision. But, her prolonged neutropenia (lack of white blood cells) is concerning, especially now.
Stem cell transplants from unrelated donors have been postponed all over the world…some proceeding, and some being switched to half-matched sibling transplants instead.
Most likely, we will do some more waiting while continuing our effort to keep her infection-free and out of the hospital. We just have to keep doing what we’ve been doing.
And yes, social distancing works.
You may be branded an alarmist. It will impact the life you thought you knew. You will see the selfishness — and selflessness — of others in ways that you were indifferent to before.
I feel so proud to have been persistent with Hillary’s care.
So many times we sat in the parking lot weighing the risks of going in.
There was always a better choice.
The better choice is life.
In a way, what is happening here is what I’ve always dreamed of. To be together — just us, our family unit — without obligation except to better ourselves while enjoying, and protecting, God’s creation. I just can’t believe we are dangling so precariously close to the edge.
I am not going to preach. All of the things I wanted to say, the lessons I wanted to bestow, the changes I wanted to fight for, the resources I longed for, the financial help we needed….the world is doing it for us…..like footprints in the sand.
Thank you to the angels that fly by on Twitter every hour from people donating blood to Canadian Blood Services (the safest place to be right now), working the front lines in the hospital (like my hero neighbour Michelle), and promoting ways to #FlattenTheCurve. Please keep up the good work doing this in the most reasonable ways you can. My only brother and his beautiful wife are both uniquely essential service….and I have no words.
This has not weakened us. It has unified us. We are strong.
Please dream of the number 120 for Hillary.
Check out Hillary on 1310 News with host Sam Laprade, where Hills talks about making sure others have beans and lettuce during this difficult time. Click here, and then select the March 20, 2020.
At her last appointment, Hills met Katie Perry, a CHEO superstar.
Hillary is holding well and we are unbelievably grateful.
This month’s check-up showed an increase in neutrophils from .6 to .7, an increase in platelets from 87 to 93, and a decrease in hemoglobin from 102 to 97.
This keeps her in the Moderate Aplastic Anemia (MAA) category, and best of all, transfusion independent and out of the hospital.
This was a big appointment. The six month mark.
After a thorough discussion with the lead hematologist to review risks and desired outcomes, we agreed with CHEO’s recommendation to continue with the current immunosuppressive therapy treatment for another two months.
Hillary has not yet achieved remission, but she has also not relapsed.
This is the highly delicate balancing game that is Aplastic Anemia. It’s all about staying alive.
Standards for weaning off the cyclosporine medication differ greatly across the globe, and these standards change often as new research emerges. Current protocols recommend beginning to wean now, at six months.
But, not surprisingly, Hillary continues to present as exceptional. Where many others hit a wall, Hillary just keeps jumping the hurdles, remaining off all other medications and avoiding treatments. Her body is tolerating it well and showing signs of blood growth.
It just means more waiting.
While we wait, we continue to advocate for the global stem cell registry.
I can’t believe that the kids and I went door-to-door to ask people to sign up. I can’t believe my brother drove around the entire city for weeks dropping off flyers. I can’t believe over 630 of you showed up that day, and another 400 went online to sign up.
I can’t believe how many were guys.
I can’t believe I didn’t remember that until now.
I can’t believe how desperate this feeling is.
I can’t imagine what it must feel like to not have a match.
Hills has been very busy on Twitter promoting the most recent stem cell drive event on February 13 at the Children’s Hospital of Eastern Ontario (CHEO). Another 86 brave people joined for Sue, a CHEO nurse with Aplastic Anemia whose life was saved from a bone marrow transplant. Our girls made little flags for everyone who got swabbed. CHEO continues to show us why they are a world-class hospital.
The next event is at Notre Dame Catholic High School on March 5. This one is for Dawn and her son Ollie. Dawn reached out to us very early, simply as a mom of two who felt our pain. Who could know that months later, her son Ollie would fall suddenly ill. He is now on the same desperate path to find a stem cell donor to cure his Anaplastic Large Cell Lymphoma, since his sister was not a match.
We are not alone.
We celebrated the six month milestone as we do with every level check — with a modest, healthy, home-cooked meal…together. When you’re this close to the edge on so many different levels, having food, and being able to eat it is…well, I am extremely grateful. I can’t imagine not being able to feed my kids.
Thanks Nana and Baba for not making us have to choose between groceries and bird seed as we buckle down for the long haul. Those who have visited here know it’s like Snow White’s backyard. It’s as if this house was made for this fight, and these birds….they make us feel human.
That’s Alyssa, the night before Hillary’s check-up, losing a tooth. She’s as lovely as ever — calm and conscientious. She’s proof of the resiliency children possess, and we are fiercely proud of her for getting on that school bus every day, never a complaint.
We have worked very hard to not feel sorry for ourselves.
It’s a skill I never had to hone for myself, or my kids, until now.
Waking up with the birds helps.
And so, we push on.
It’s been over four weeks since our last update — the longest Hillary has ever waited for a blood test since being diagnosed with Aplastic Anemia nine months ago.
There were a couple days there when we really weren’t sure if she had enough. Making the call not to bring her in has been trying, particularly with the accompanying nosebleeds, pallor, fatigue, vomiting, headaches, and low temperature.
It really tests your faith…in God… and science.
Yet, Hillary continues to thrive at home, with special accommodations, in isolation. Isolation itself is not hard. It’s keeping everything out that is the challenge with this record-breaking childhood-influenza-year we are having.
Hillary’s out-patient visit this past Wednesday at CHEO was busy but overall positive. She received her anti-pneumonia pentamidine medication infusion by IV and her bloodwork showed another sign of growth.
Her hemoglobin stayed the same at 98 (normal is 110-130), her neutrophils remained the same at .6 (normal is 1.5-8.0), but her platelets grew from 76 to 87 (normal is 130-380).
She did not require a blood transfusion, and her liver, kidney, magnesium, ferritin, and blood pressure levels remain within normal range. She is now out of severe (SAA) and back in the safer moderate category (MAA) for the disease. She is doing exceptionally well, as usual.
This is classified as a promising response at five months post hATG treatment. Some take up to a year to recover to a normal range. Her cyclosporine medication level is again below the therapeutic threshold, so we have just increased her daily dose. Due to this, the past couple days have been more challenging. Hills is working hard again to stay well. But we have to get that level up.
We have to kill more of her overactive immune system to allow for regular function.
And so, the question lingers as we get closer to the six month mark. Is this genetic or auto-immune? Even though the treatment path would have been the same as it is now — in the absence of a sibling match for immediate transplant — I have to at least try to connect the dots to prepare us for what lies ahead.
Being pregnant with both Hillary and Alyssa was joyous. I had zero complications and both girls were born naturally on their due dates. That never happens. They were perfect.
But on Hillary’s fifth day of life, Canada Day 2013, something unexplained happened.
After spending her first day outside, I lay Hillary on her pink floor mat in the living room while I cooked nearby. It was a quiet day with a newborn at home. It was blissful. I looked over to check on her since she had been sleeping for a couple hours already, and her legs looked blue. I tugged firmly on her leg, and all of her colour came back. She looked fine. Maybe I imagined it.
But she was sleeping.
And nothing I did could wake her. I clapped my hands, pinched her legs, poured water on her head, tried to feed her…she just kept sleeping and breathing.
We took her to CHEO.
After driving in and waiting to be seen, she had been asleep for 10 hours, too long to go without feeding. The very minute the doctor slid the door open, Hillary woke up. They looked her over and told me to appreciate a sleeping baby. We agreed with their balanced and appropriate assessment. We drove home very quiet in the fireworks.
After that, Hillary was great. She never, ever got sick. We always thought we might have saved her from Sudden Infant Death Syndrome (SIDS).
Three whole years later, in 2016, Hillary came into contact with a sibling of a newborn with confirmed hand-foot-and-mouth disease — indirect contact. That night, she developed a fever, and spots started to appear on her hands and feet. For four weeks, she fought a seriously scary case of the normally harmless condition. She was covered, but not in any pain whatsoever.
Major infection number one. Viral.
Two years later, in 2018, a dental exam revealed four seriously infected molars, and Hillary had to undergo “baby root canals” and crowns by a pediatric specialist. She has since had two of these teeth pulled to prepare for possible transplant. She has never had teeth pain.
Major infection number two. Bacterial.
One year later, Mother’s Day 2019. A hunch led us to insist on a blood test due to some bruising, resulting in the diagnosis of Aplastic Anemia. Immunosuppressive therapy begins and simply by the sheer number of times her intravenous line was accessed for medicine and blood transfusions, she developed a central line infection, keeping her in the hospital for 27 days.
Major infection number three. Bacterial.
I’m not sure what this is.
But if the illnesses continue to grow in complexity, well….I’m bracing for impact.
There is no confirmed research correlating the type of event experienced on Hillary’s fifth day of life with the onset of AA. In fact, there isn’t much research on aplastic anemia at all. Yet, her condition remains idiopathic, or of unknown etiology. While I remain desperately hopeful that this immunosuppressive treatment will work, I’m merely trying to take a peek at the path ahead by looking into the past.
Hence, my desperate plea for those willing and able to join the global stem cell registry. This truly is a global issue, and we have the unique opportunity to save lives while combating the increasing number of immune related ailments which benefit from stem cell donation.
Hillary right after her last appointment, making her cherry celebration cake.
She is still very active on Twitter @StartWithHills promoting the global registry. She sent a song along to Linda, a Montfort Hospital (Ottawa) employee who has been waiting for over a year for a stem cell match. She has been given three years to live if she doesn’t find one. The Bruce Denniston Bone Marrow Society held another stem cell drive in Linda’s honour at the Montfort Hospital last week.
February also looks busy for this hero organization, who works with Canadian Blood Services to hold swabbing clinics all over the city of Ottawa. The next #getswabbed event in Ottawa will be at CHEO on February 13, from 3-7 pm at the Children’s Hospital of Eastern Ontario (CHEO).
And so we wait, and remain highly vigilant. Another four weeks will bring new blood results, and new hope.
Caring for Hillary now is much like having her as a newborn again. We continue to empathize and pray for those in difficult circumstances, and hope for strength to make it to the next step in this journey. We want Hillary to be joyful.
Please tell someone new about Hillary. Tell five people. Tell someone of a different ethnicity.
Tell them she loves to play Lady Gaga on her keyboard with her school ECE Ms. D. via Facetime.
Tell them she loves puppet shows before she falls asleep.
Tell them to join the global stem cell registry.
It’s been a month since our last update…eight months since we found out Hillary had Aplastic Anemia. We are so pleased to have wonderful news to share with you just before Christmas.
At Hillary’s appointment last week, her blood levels again showed an increase, and she did not require a transfusion. Her hemoglobin rose to 98, platelets to 73, and neutrophils to .6. Still all below normal levels, and still quite low in the white cell count, but increasing nonetheless.
We are overjoyed to be able to have Christmas at home together.
When Hillary left the hospital, she ran to the car in the light falling snow with tears in her eyes yelling, “I feel so alive!” It’s forever ingrained in my memory.
Thank you for all of your thoughts and prayers. Your positive energy. Your inquiry and support. Your open minds and hearts. Your prayers for Hills.
We know we are not the only ones facing difficult circumstances during this holiday season. We also have many Aplastic Anemia friends who won’t quite make it home this Christmas.
We can only hope that sharing Hillary’s story helps you feel gratitude for the blessings you do have. We catch ourselves saying how lucky we are all the time, and we truly do feel that way, even now.
Please feel alive with Hillary this Christmas. Don’t waste it.
We dare you not to smile while listening to Hillary in today’s radio interview.
Hillary's radio interview from December 23 - 1310 FM, An Hour to Give with Sam Laprade, CFRE
We met with CHEO specialists this week regarding Hillary’s progress battling this rare disorder. We were all pretty nervous, and I want to acknowledge the Social Workers at CHEO for supporting us on this journey.
Hillary had some bloodwork done, along with another two hour IV infusion of pentamidine to prevent pneumonia. But she remains transfusion independent. This is wonderful for her. Her blood production levels continue to show promise. In two weeks, her hemoglobin went from 89 to 91, platelets grew from 55 to 63, but her neutrophils fell from .6 to .4.
Her strange PNH clone remains the same at 3%, and her cyclosporine medication level has fallen below the therapeutic threshold, so we have to get that number back up as a matter of priority. Clearly, we are not out of the woods by any means, but this is promising at 3.5 months post ATG treatment, nevertheless. The transplant centre at SickKids in Toronto continues to monitor Hillary and is also pleased with the response thus far.
Since her neutrophils have not made the climb into the normal range (the white blood cells to fight off infection) we remain in isolation. We still get outside every single day for fresh air, and plan strategic outings (while wearing masks) to minimize germs. There’s nothing like being the very first one in the library doors. To balance it all out, we stay social using Google Hangouts and FaceTime. We think it’s a good strategy in this day in age, and it’s working beautifully.
We head back to CHEO back in three weeks, the longest stretch of time without measuring her blood levels. We now strive for normal levels at the six-month mark — February. We continue to be so grateful of the moderate presentation of this disease. The complications others are experiencing with this disorder are unbearable and too triggering to share.
Life continues to be busy and challenging for us, but it is for everyone else. Everyone experiences health challenges, time conflicts, and life changes. And some people are doing it completely alone, or often without the support of their family.
We firmly believe that the love that surrounds Hillary, from all over the world, helps lift and carry Hillary above our heads while she heals.
And so we press on and remain vigilant.
The rest can wait.
Thank you for your continued prayers.
We are happy to report that Hillary’s out-patient visit last week was short and uneventful since she did not require any transfusions! This is a big deal. Her hemoglobin rose from 80 to 89 on it’s own, keeping Hills above that critically low 70 threshold. Her platelets saw a small rise from 49 to 55, and her neutrophils remain low, moving from .5 to .6. Overall, this is a favourable response at Week 12.
During her visit, Hillary received her flu shot as recommended by CHEO and had no adverse reactions. We were not a flu shot family prior to this diagnosis. Everyone close to Hillary is now getting it to keep her as safe as possible.
Hillary is doing exceptionally well in all areas.
She says she thinks her immune system is finally coming back from its long vacation. We celebrated the three-month mark with our favourite home-cooked dinners (yes, four of them) and a cautious trip to the quiet Ottawa Art Gallery, which she had never visited. It was really good to get out, despite the risk.
Our discussion with the specialists at CHEO was delayed by two weeks, so we just keep hoping her numbers continue to climb while we work to ensure she remains infection-free. We are still waiting to see if her mysterious PNH clone has increased in size, and if her ferritin level is decreasing. Every day, we are presented with a strange new set of symptoms, but they are all minor compared to the struggles others are facing.
I’ve spent a considerable amount of time looking back…however useless it may be….going through every photo since her birth and charting/analyzing her health timeline. Since her condition remains idiopathic (or for unknown reason) there is always that lingering question: Is it genetic or auto-immune?
I think it all started on Day 5 of life -— a day I remember vividly. Or maybe it was 2016 when she caught that virus. Were her teeth problems caused by the anemia or did the anemia cause the teeth problem? When you map it out, it’s all so interesting and interconnected. Some of it is truly unbelievable…as in, I’m having a really hard time grasping reality.
I will share more, when I can, and will be sure to update you all before Christmas. We’re not sure what Christmas looks like for us yet, but we know that we just need to stick together and stay positive.
We are extremely grateful to have Hillary home and feeling well.
And so, we wait.
Life remains on hold.
Check out our sweet Hills in March 2017 at the young age of 3. She’s always loved YouTube.
We would like to share some good news with our family and friends following Hillary’s journey.
Hillary is showing a partial response to the immunosuppressive therapy after ten weeks. Her platelets grew on their own from 17 to 49 (normal is 130-380) and her neutrophils went up slightly to .5 (normal is 1.5 to 8.0). Her hemoglobin has yet to start increasing on its own (still at 80 and dropping), and another blood transfusion might put her into iron overload, so we are really hoping to see a rise in oxygen this week.
To celebrate, we fixed up her room with an air purifier, salt lamp, bed rails, and her keyboard and she’s back to sleeping in her own bed (with mommy snuggled in close). It gave her back some balance and much needed independence. She is feeling amazing….confident, secure, and happier than ever.
Next week marks the three month mark since immunotherapy began. This is when we discuss options moving forward. This is when we are supposed to decide whether these early signs of blood production are good enough to continue trying with the therapy, or if we should proceed to transplant.
This is when the search for a stem cell donor would actually begin by the hospital we ultimately choose for the procedure — Montreal or Toronto. If you’ve been told Hillary has a match, you’ve been misled. Hillary remains at the mercy of time and the selflessness of some other human being to see if a match will be there for her when she needs it.
Stem cell drives in Hillary’s name continue to be held in schools/universities across the globe — Edmonton, London, Toronto, France, Ireland — giving us hope and encouragement. I personally think it’s A LOT to ask someone to donate any part of their living body, so to see thousands of people mobilizing to hold these events is incredibly uplifting.
Are we headed to transplant? Will there be a match for her? Will they still be willing to donate? Will they pass the physical? Will they be a perfect HLA match? Will they be willing to donate again if the first transplant fails? Will they have antibodies that will complicate the procedure? Will Hillary survive a transplant? All unknown.
We do not have a match for Hillary, but we don’t want one. We want this therapy to work.
If we continue with the therapy, we should see Hillary’s levels continue to slowly increase. She would hopefully start attending school in the Spring when her neutrophils are in the normal range, and she would continue the medication for another year before being slowly weaned off.
If she is weaned off and her levels stay stable, she will achieve remission…possibly lifelong remission with no further complications or limitations. But if her blood levels start to drop from this point forward — over the course of this lifespan — we head to transplant. She may not need a transplant this month, but she may in a year, two years — maybe ten years.
And life? Well, it keeps happening. Alyssa was sent home from school on Halloween with a suspected broken arm and spent the day at CHEO and a couple days at home. The well has finally been repaired and the water has been retested, but two weeks without safe water was ….cosmically disturbing. Winter is coming…..and so is the flu. Please show your love for Hillary by getting the flu shot and staying away if you’re sick. She’ll be the first one to respectfully tell you to stay out of her bubble.
Most mornings, the height of the wall appears far too tall to even try and climb, for me anyways. But the kids….they jump out of bed as if every day was like a gift or something. They rub their eyes not to remove the evidence of sleep but to brighten their view for the fun day ahead. They don’t stop. They are resilient and fearless.
Each day is a celebration of life as we work at essentially surviving this rare illness they call “the beast.”
This is a big week coming up. Please pray for Hillary.
It has been five months since Hillary was first diagnosed with Idiopathic Acquired Severe Aplastic Anemia with PNH Clone, and we are now in Week 10 of isolation for her immunosuppressive therapy treatment.
She is doing very well. She is happy, active, eating well, and still singing.
She continues with her daily cyclosporine medication twice a day, along with anti-pneumonia medication (Pentamidine) intravenously every two weeks since her neutrophils (white cells) are almost non-existent at around .3. She remains highly vulnerable. Prolonged neutropenia is of great concern with this condition.
Hillary continues to present as rare and does NOT require blood pressure medication, magnesium by IV, anti-fungal prophylactics, or frequent blood and platelet transfusions like so many other patients do. In fact, her platelets grew on their own from 17 to 32 in the last two weeks, which is extremely rare and promising.
Still, her hemoglobin continues to drop, and she has been struggling these past couple days with fatigue, irritability, and a high heart rate. We are headed in to CHEO for a transfusion, just in time for Halloween.
We take zero risks.
Supportive care plays a large role in remaining infection free. We follow the numerous guidelines established by our medical team, but also do so much more in our desperate attempt to keep Hillary as healthy as possible. It means saying no to a lot. I hope we end up being proof that it might make a difference. She is just doing so well.
This past week has been particularly….challenging.
The line from the water well to the house broke (after 12 years) so I’ve been driving two hours a day to and from my parents’ house to give Hillary an epsom salt bath. Staying clean is an integral part of Hillary’s recovery since a common bacteria could prove deadly. Living with the possibility of groundwater contamination for a week with a severely immunocompromised child is like walking circles in Dante’s inferno. Quite the lesson in resiliency.
Thank God I’ve come to embrace some of the adversity experienced early on in this diagnosis. Some of the darkest times now seem so meaningful, so necessary — they happened to keep her safe and protected, and for that, my eyes are wide open. Blessings in disguise. Watch out for them.
I’ve also come to appreciate the power of social media. Since day one, I’ve been a member of a Facebook Aplastic Anemia support group which allows me to navigate this rare disease — in real time — along with 3,000 other “fighters” from all over the globe. It is powerful. Every test, medication, symptom, reaction, level, outcome….fear….I can talk to people all over the world before making an informed decision about our care for Hillary. I’d feel pretty alone without it, particularly since there is a significant lack of current research on this rare disease.
Sadly though, I’ve already witnessed four families lose their battle in a few short months — half of them because there was no stem cell match available in the global registry. One fell through at the last minute when the donor failed their physical exam.
After holding stem cells drives in Hillary’s honour at several universities last month (Carleton, Ottawa, Brock, and Guelph), there is another one coming up on November 12 at Algonquin College. This date marks week 12 of treatment…the week we hope to see a rise in all three levels. Another meaningful and moving event in support of Hillary and others in her situation.
Thank you for all of your words of encouragement over these past months. Just because we can’t come to the party doesn’t mean we don’t like being invited. Thanks to those inviting us to stay in the game of life, and for totally understanding when we say no. Hillary enjoys FaceTiming her friends and family and is making the best of her situation.
She met with the Make-A-Wish Foundation who gave her some awesome gifts and told her they are excited to make her wish come true! Wondering which wish gives her so much hope and encouragement.
We had a wonderful turkey with all the trimmings on Thanksgiving at home, just us.
We went and voted together with “McKibbin pizza and park” afterwards, our little family tradition.
The girls are going as creepy porcelain dolls for Halloween. We’re so proud.
Alyssa is good. We are all working very hard to keep balance for our sweet Alyssa, and it’s working. We won’t let up.
Every single night, I lay beside Hillary, holding her, waiting for her blood to grow. I watch her chest move up and down. I hear her dreamspeak. I pray on her. Today is fraught with complications and challenges, but at least we are here to conquer it together.
It’s all just strengthening our armour.
We will win this war.
We’re keepin’ her.
Two weeks ago, Hillary proudly walked out of the hospital and into her cozy home. The first thing she did was march straight up to her room to play her keyboard.
The first week back was challenging. Her sister Alyssa caught a small cold and had to stay home from school…and then Hills got sick. But, her doctors are encouraged that her body was able to fight off the minor cold on its own.
Hillary is now six weeks into her immunosuppressive therapy treatment. She received another hemoglobin transfusion last week, and her platelets have remained “stable enough to sustain life” without a transfusion. She was also given pentamidine, a medication given by inhalation which she will receive monthly to prevent bacterial pneumonia.
Her doctors gave us just a couple of other rules to follow.
No school. No large gatherings or crowds. No animals. No gardening. No mold. No sun. No contact sports. No rough play. No swimming. No physical exertion. No construction sites. No travel.
Don’t be around anyone who is sick (or has been sick recently), and if you must have people in the house, limit it to one or two at a time. Don’t go near daycares or hang around other kids. Enforce herd immunity and have everyone around her get the flu shot.
Be extremely careful with food preparation. Have her wear a mask when you go out. Put a bottle of hand sanitizer in every room, and use it often. Dust often, and keep everything very clean. First sign of fever, head directly to the emergency room.
She knows every single rule, and advocates for herself. She does not feel sorry for herself. She is a fighter. She is amazing.
Her doctors also told us to get plenty of fresh air, eat well, and be joyful. And, so that’s what we’re doing. We go for daily walks with our hats and umbrellas. We cook farm to table every day. We adoringly put Alyssa on and off the bus and make her feel special. We sing, dance, craft…snuggle. We are very busy decorating for Halloween. This year, we are going all out with a scary, not a cute Halloween. I think it’s safe to say we’re all pretty fearless now.
It will be 12 weeks on November 12. This is when we want to see her numbers go up — her hemoglobin, platelets, and neutrophils. These are the three blood components that are suppressed by the aplastic anemia. To give you an idea of where we are at, in simplified measurement terms:
- A normal range for hemoglobin (red cells/oxygen) is 120-150. Hills presented at 48, and sits between 70-100 now with regular transfusions. Her heart beats fast.
- A normal range for platelets to clot her blood is 250 to 450. Hills currently has 10. She can not bump her head.
- A normal range for neutrophils (white cells) to fight off infection is 4.3. Hills is around .2. She can’t get sick.
She basically has no immunity of her own. Interestingly, she will have to get all of her childhood immunizations over again. The current measles epidemic has me a little shaken.
Sorry that when you see her, she looks perfectly fine and approachable. She is not. Let me protect her.
Sorry to St. Leonard Catholic School that we could not come inside the school to see the 1,000 paper cranes that were made to pray for Hillary. Thank you Mme. Roy and Ms. Lalonde for organizing such a beautiful gesture of community. We were moved beyond words.
Sorry to all those coming out to join the stem cell registry in Hillary’s honour… that I can’t be there to meet you. That’s been hard. Thanks to Nicole Brooking for going and shaking hands on my behalf.
Sorry to all those who want to help, but feel helpless. I can’t have you over. I don’t know what to ask you for. All I can do is follow the rules to protect my kids. I can’t focus on anything else.
Sorry, sweet Alyssa. Sorry I had to cut your bangs in the CHEO bathroom the night before school. Sorry you have to bite your tongue when things are unfair. Sorry you’re scared. You’ve been the best big sister, and daughter, we could have ever hoped for.
I’m not strong enough to put it in writing.
Let’s beat this thing and then jump in a muddy puddle together.
Check out Hills on KISS FM 105.3 with her favourite radio host and advocate, Amy Volume, a person who really understands.
Hillary is going home tomorrow, after 27 days in isolation. We are ecstatic. We can’t wait to sit in the backyard. Cook. Walk up and down the stairs. The simple stuff.
Hillary received a hemoglobin transfusion yesterday and will receive a platelet transfusion tomorrow to prepare her for discharge. Thank you anonymous donors. Hillary’s neutropenia remains severe at .1 so we won’t be taking any chances with germs or infection. This is such a peculiar and rare condition — one that requires constant vigilance.
So for now, it’s just a waiting game. We continue the am/pm cyclosporine medication at home, and visit CHEO twice a week for blood tests. She will need several more transfusions, but one day, at around three months, that blood test will come back with the news that she is producing blood on her own. We’ve visualized it. Drawn the picture. Written it down as an affirmation and framed it.
Reflecting on our time here, with these emotional blog updates and our quest to increase the stem cell registry, we’ve come to believe that Hillary was chosen for this. Chosen just like the rest of the kids here at CHEO — to teach the rest of us a thing or two about life and how to live it.
The fight isn’t over. The game has just changed. We now have the home advantage.
This blog post would have been unfairly difficult to digest before the joyous school start-up earlier this week, so we’ve waited a little longer than usual to update you all. Since then, things have indeed improved, but our sweet Hillary still needs your prayers and positive energy.
We were expected to have been done with the first stage of her immunosuppressive therapy treatment after eight days, but it is now Day 19, and Hillary and I are still in isolation at CHEO, with another 14 days to go…maybe longer.
It’s difficult, but not a surprise. My connections with other strong mothers fighting this rare disease alongside their children provided advanced notice of the complications that would inevitably arise. They warned me this journey would be extremely long and arduous — almost impossible. I was ready.
The past two weeks have been very challenging for Hillary.
She has endured unimaginably painful headaches, violent screaming steroid rages, CT scans, ultrasounds, a heart echo, daily blood cultures, hourly IV medication infusions, cups full of pills, fevers, night sweats, swelling, and several platelet transfusions. Her blood pressure is all over the place and and her organs are working hard. She was in a morphine sleep for four days straight. She did not look or feel like herself.
Hillary’s headaches have finally become manageable after three adjustments to her medication doses. But on Hillary’s scheduled discharge date, she developed a staph infection in her blood. When the overnight attending physician woke me in the middle of the night and took me outside to talk about Hillary’s blood culture coming back positive for “gram positive cocci” — that was my darkest night thus far. I thought I was strong up until that point. Not so.
It’s quite common to develop an infection while your immune system has been essentially wiped out to nothing with this treatment. Some infections are worse than others, and some you can’t come back from. We are just relieved that the blood infection has been identified, and is being treated with the proper antibiotics. The infectious diseases team is involved daily and we strive to attain that coveted negative daily blood culture. It’s coming.
We are very fortunate to have CHEO’s diligent team of doctors, fellows, and nurses springing into action every single day for Hillary, because every single day brings with it a new challenge. A small fever is treated as an emergency, and every night is sleepless. Hillary’s room is a revolving door. She entertains around 15 different medical specialists each day.
We need to get a grip on the headaches, the infection, but most importantly, the aplastic anemia. Hard to explain to a normal six year old….. but not Hills. She gets that no matter how much it all sucks, we absolutely have to push through, and take our medicine even when we can’t open our eyes. She is astonishing. I’ve seen Hillary during her strongest fight response…. no filter. She is a hero and an inspiration — there is no doubt about it.
As of yesterday, Hillary has turned a corner and is now singing again.
You wouldn’t believe how resilient she is. She used the self-regulation exercises she learned in Kindergarten at St. Leonard School to breathe through the pain of her headaches. She is showing teenagers how to swallow pills. Thanks to some new Nike shoes from Baba, she gets up in the morning, and does a dance workout.
Hillary also started Grade 1 this week with M.F. McHugh Education Centre. Her daily in-room lessons from her teacher, Reg, are….moving, to say the least. I weep in secret each morning as Hillary packs her backpack and waits by the door for Reg. We even get visits from fellow fighter Nancy Kawaja, an educator with McHugh who is overcoming health challenges of her own. I’ve never seen education delivered this way — with pure patience, understanding, compassion, and joy… all from a hospital bed. How fortunate are we.
We would not have made it this far without my parents…Hillary’s Nana and Baba.
They’ve given up everything. They cook healthy food all day for both myself and Hillary (whatever she craves), do all of our laundry, buy us whatever we need (toys, games, supplies), provide relief for showers, take Alyssa for sleepovers … sometimes they just sit in the parking lot and wait. They are here every single day, and on call all night long. They are truly selfless, and we will forever be grateful. If you see them out and about in Orleans, know that whatever they are doing, they are doing it for Hillary. Give them a pat on the back.
I’m able to write this because I do envision a successful outcome with this treatment. One that offers complete life-long remission. We can be part of that 70% that does not have to proceed to transplant. I have a band of mothers at my fingertips stepping me through every single moment.
Erica in Saskatchewan has been through it with her son. It didn’t work, and they went to transplant for full remission. Their only match was a 60 year old woman from Germany.
Lori in Toronto did it, fought it, and had to settle for an unmatched donor for lack of an available one in the database. She is caucasian, like us. They are doing great.
Amanda in Nova Scotia is currently in it with her daughter, two months ahead of us, waiting for the immunosuppressive therapy to work. I get hourly updates.
What will our story be?
Well, I can tell you it won’t involve us not finding a stem cell match if we need one. Not on my watch. It was very difficult to miss the stem cell drive at my former high school, St. Matthew High School on August 29, facilitated by the Bruce Denniston Bone Marrow Society.
Natalie (Dixon) Spence, you went way above and beyond to support my family by organizing all aspects of the event. Not sure what we did to deserve you. Thank you. Kalum Figura, for repeatedly mobilizing the air waves to promote these stem cell drives…you play a large role in educating the public on this issue which is heavily misunderstood.
Amy Volume from KISS FM — we’re not sure what motivates you to go to the ends of the earth for Hillary, by getting Gabriel’s Pizza to donate pizza in exchange for a cheek swab…but thank you. Please keep loving her.
Nicole…thanks for shaking hands for me at the drive event, for reading Hillary books at bedtime via Google Hangout, and for bringing me chocolate. Susan, thanks for rushing to my side with your mom on our toughest day, for lighting prayer candles for Hills, and for bringing me chocolate. Victoria, thanks for bringing me chocolate, and a sweatshirt to hide it.
Corey, Hillary loves her necklace wears it every day. Glenna — just seeing your name on a card moved me. Molly Penny, your daily visits mean so much, and you never deflect from the core function of your role here at CHEO. These are only a few of the people who require our gratitude. But this is all I can offer right now from this room.
Life here is surreal. I’m pretty sure I have already died. Sorry.
I plug my daughter into a wall every night to sleep. I watch as they pull vials of blood from her bruised and pale arm every day while transfusing her with someone’s else’s blood into her other arm at the same time. I wear gloves to feed her medicine that would harm me if I got it on my skin. I no longer sleep in a cot on the floor. I sleep holding Hillary in her hospital bed.
It’s been dark. But, the light is beginning to shine through. And it’s brighter because we’ve witnessed true darkness with our heads held high.
It shines through our commitment to promoting Canadian Blood Services. It shines through the continued stem cells drives planned in Hillary’s honour, like the one coming up at Ottawa University on October 3. It shines through Twitter — where hundreds of people mobilized to help find single donor platelets for Hillary. It shines through the Grade 12 student who got swabbed for Hillary, and has already been contacted to be a potential match for someone in need. He said he will follow through.
It shines through Hillary.
She will forget. I will be re-born. We will heal.
Thank you for the thoughts and prayers that have encircled Hillary over the last several days. I can physically feel your angst as you await an update on her status.
The first six days of Hillary’s immunosuppressive therapy were not without incident, but they were pretty manageable in terms of what could potentially happen with this treatment — some hives, sore ankles, and mood changes. We were able to make crafts and read while lying in bed for her six hour daily infusions. She was a little disappointed when she swallowed a loose tooth, but she and Molly Penny figured it out with research and letters to the tooth Fairy. She was happy. Her doctors were very pleased. She was rockin’ it, as evidenced by her tweets.
But on Day 6 (Sunday), late in the evening, Hillary experienced a severe reaction. It was like a light switch went off, and Hillary felt as though her brain was melting. The long and extremely violent event (exacerbated by the steroids) sparked a spot call (emergency) in the hospital to bring experts to her aid as they tried to alleviate her symptoms. We called family to her bedside. It was unspeakably terrifying.
Thanks to the fast-actions of nurse Judy (whose paisley scrubs and kind eyes are forever ingrained in my memory), Hillary received several doses of morphine, lorazepam, some blood pressure medication, and a life-saving platelet transfusion. Words cannot express the relief felt when you hear that blood is available in your child’s blood type from the blood bank, ready to use. It gets me every time.
Hillary continued to be sedated throughout the night to manage her pain, and had a second headache episode in the morning. We were hoping the incident was isolated, but it continued and increased in frequency through Day 7…Day 8…Day 9….tomorrow is Day 10.
An ultrasound revealed healthy kidneys, liver, and spleen, but blood levels revealed elevated levels of cyclosporine. Her medications have been adjusted, and we will stay at CHEO until she is stable enough to return home. Hillary has been on 12 different medications, some have to be administered with gloves due to their toxicity. Balancing the doses of these mediations is like….an artistic science. Too little, and the therapy won’t work. Too strong, and her organs can be damaged. But one thing is clear — if we don’t treat, Hillary can’t live.
And so we push on, for her, and her sweet sister Alyssa.
Once discharged, we will return to CHEO three times a week for blood work and frequent transfusions. Hillary will need both hemoglobin and platelet transfusions on Friday. She may develop serum sickness. She could develop an infection. Emotions are high. Fear is real. Communication is hard. But Hillary is amazing, and everyone who comes into contact with her agrees. I can’t even begin to describe how strong she is.
Hillary not singing right now, but she’s humming. And, she’s not the only child suffering in this hospital. I’m not the only mother sitting on an arm chair alone in the dark, afraid to sleep, eat, move.
Our story is not unique.
Please become a blood donor.
Please join the Canadian stem cell registry.
Please think bigger.
The fast track to treatment has been fast indeed, and tomorrow, Monday at 7:00 am, Hillary will be admitted to CHEO for the start of her immunosuppressive therapy treatment.
It will be an intense 8-10 days in isolation (with only mommy and a nurse) to bring down her immune system with hATG — to essentially stop her T-cells from attacking themselves. The more challenging part will be when we are sent home to administer the cyclopsprine medication ourselves for three months, without the CHEO army at our bedside.
Our doctor tells us this will be her most vulnerable time yet. She will have low neutrophils for the first month, which means she will have no chance of fighting off infection. Her lungs will be highly vulnerable. She will grow hair. A lot of it. She can’t be in the sun. She will gain weight. She will need frequent blood transfusions. She will not attend school for at least six months, and visitors will need to be carefully screened.
Our doctor told us this is also the most difficult part for families and relationships — not everyone understands the explicit nature of isolation. But this can work. It has to.
Acquired (not inherited) and idiopathic (meaning unknown).
Last week’s visit with SickKids Hospital in Toronto lent more insight into Hillary’s disease being auto-immune rather than genetic. Since all tests have come back negative for any underlying genetic cause (or stem cell defect), and since Hillary also developed an extremely rare PNH clone, her aplastic anemia is likely acquired.
Still idiopathic, meaning we will never know why, but acquired in that a virus or event likely happened along the way that made her body put up some defences and began attacking itself instead of the invader. This means this treatment path might work and bring with it life-long remission. We have hope.
While in Toronto, we met up with an aplastic anemia survivor. Naomi, we could not believe you were real. Naomi reached out to us very early in Hillary’s diagnosis by text. She is a 25 year old transplant recipient now in recovery. We have bonded for life. She gave us so much hope. We also met with a friend from high school.
Thank you, Colleen, for meeting us for cookies and a hug. Isolation can be pretty lonely. You made the world of difference with your friendship and laughter.
Meeting with Colleen made me realize….twenty years can’t interrupt the sense of community and belonging that the OCSB’s St. Matthew Catholic High School has afforded.
Like Natalie. Nat showed up at the last drive event, then went a step further and organized another bone marrow drive at our former high school in Hillary’s name. Join us on Thursday, August 29 from 3-6 pm at St. Matt’s in Orleans where the Bruce Denniston Bone Marrow Society and Canadian Blood Services will have 500 kits on hand. It takes 10 minutes to join the global registry.
#StartWithHillary and do it for Jeremy, who’s having a hard time finding a stem cell match since he is half-Chinese. Read more about #Match4Jeremy here, and please help give his family a chance at keeping their Daddy. More donor drive events have been confirmed for Caribbean Culture Days on September 28 and Ottawa University on October 3. A great deal of sharing is going on within Twitter, and Hillary will keep tweeting her savage tweets @StartWithHills to increase awareness on this critical issue. And if you have any doubts, read more here: Elmoazzen: Stem cell and cord blood donations can save countless lives (August 2, 2019).
Back to Ottawa and a sobering reality.
After our visit to Toronto, we rushed Hillary back home for two life-saving transfusions — hemoglobin and platelets. Then, the following day, dental surgery to pull two molars — a common procedure in order to prevent any possibility of infection. Then, some awful-tasting medicine and recovery.
Summer has always been a joyous time for us, filled with camping, boat-rides, food, and family. The days have been tougher this year. But, one thing about Hillary — she’s a winner.
She is to be highly credited for her current state of health — it’s quite rare to have remained infection free up until this point. Her precocious nature is a gift that has helped her make mature decisions about her health. She does not mind wearing a mask, and is now practicing swallowing mini Sweet Tarts in preparation for taking pills.
We work at getting through each day, and that’s it. Tomorrow is not promised — but it is planned. Please dream thoughts of wellness for Hillary as she works so very hard this coming week to beat this rare blood disorder, and come out the other side, singing.
Yesterday was Alyssa’s 9th birthday and another bittersweet day for the family. After a morning visit with CHEO, we were told Hillary is back in the “severe” range for aplastic anemia, particularly due to her low neutrophil levels. This puts us on the fast track to treatment. The risk of a deadly infection from germs, bacteria, and fungi are far too great to chance it. No more watching and waiting. It’s time to act.
This comes after a very eventful long holiday weekend, including an ambulance ride for a bonked and bloody nose. Thank you 911 Emergency Services, Ottawa Police Services, and Ottawa Paramedics Sam and Sebastien for your fast response, your calm competence, and your compassion for three, very scared girls. Alyssa’s coolness under pressure will never be forgotten. Hillary still thinks that she experienced “true magic” when she floated out of the back of the ambulance as the legs of the stretcher unfolded out of her field of vision. After some blood tests and a CT scan to check for a cranial haemorrhage, we were cleared to go home.
Our donation experience was moving.
On holiday Monday, we gave back in the best way possible by donating blood at the main office of Canadian Blood Services — Mommy’s 12th and Daddy’s first time ever. We saw several men donating platelets, which are interestingly yellow in colour. We watched as they sat for an hour and a half to filter the platelets from their plasma — a painless experience done as often as every two weeks. Women who have had children cannot donate platelets, and so these men…well, they are also life-givers, aren’t they. One of the men was making his 500th donation. Another, serendipitously, happened to be volunteer Stephane Goyer, who helped run our first bone marrow drive. And our phlebotomist, Christine, shared a story of love and loss with us. Hillary will need platelets this week. She warmly thanked several donors in person. It was a truly moving experience to say the least — not to mention, easy and fulfilling.
This is what the fast track includes.
Everything has been expedited. We’re off to Toronto on Sunday to visit with SickKids. When we get back, we head right into dental surgery, and will likely be admitted the following Monday to begin treatment, depending on how well she does.
If Hillary had access to a matched sibling donor, we would be going directly to a bone marrow transplant. Since we don’t, immunosuppressive therapy is considered the safer, less invasive, first-line treatment. The treatment begins with intensive administration of hATG medication for eight days in hospital followed by three months of daily cyclosporine medication at home, in strict isolation. It will not be easy. There are complications and visible side-effects. If it works, we continue for a year, maybe longer. It offers a 75% chance for remission. You can try the therapy first then go to transplant, but you can’t try it the other way around. We have hope that it will work.
The gift of life must be under that Christmas tree.
If it doesn’t work after three months (around Christmas-time) then we will go to transplant. We are hopeful there will be a 10/10 unrelated donor match waiting for her in the global registry. But hope alone is just not enough for me as a mother. Not when there is something I can actually do about it. I am in contact with too many people who were told there was a match, only to have it fall through. I cannot take that chance. I will not. I would want someone to fight for me. All it takes is to raise awareness. That’s it. The rest is up to you.
Even if Hillary doesn’t need a transplant now, she may need it in a year, in five years, in ten years. And what about the other 800 people in Canada waiting for a match? The other 18,000 around the world? More than half of the people waiting will not find one. Like this 9-year-old who is desperately searching for a stem cell match for aplastic anemia, just like Hills. It takes 10 minutes to #GetSwabbed to see if you can save a life. There are several upcoming opportunities in Ottawa to join the stem cell registry. Stay tuned for more information, and look for Hillary in Maclean’s magazine in September. She’s being featured as part of a national campaign by MediaPlanet for her efforts in raising awareness on this critical issue.
Unbelievably, the hardest is yet to come.
We’re told it’s a marathon, not a race. And while it’s being done in isolation, it’s not being done alone. Thank you to my parents for being there for every single appointment and procedure since day one, no matter how difficult or inconvenient it may be. Thank you to Anna for providing the only respite us three girls had this summer while Steve was at school. Driving to the east end of the city and swimming in your ozone pool every day with no one around was pretty much the best gift Hillary could have been given, especially because it came with your complete understanding. Thank you to the OCSB for letting me feel useful at work, for the very little I can do right now. You truly walk the walk when it comes to how to #BeWell, #BeCommunity, and #BeInnovative in the workplace. Thank you everyone who came out to celebrate Alyssa’s birthday on such short notice. She really deserved a stress-free day. She said it was “the best birthday ever” so that’s a win.
Thank you Nicole for rushing stuffed animals to the emergency room in the middle of the night. Thank you Stephanie for mobilizing an entire army of lacrosse players to spread awareness. Thank you Uncle Billy for installing a hot water tap outside for Hills to swim safely. Thank you Nadine for understanding. Thank you Dani and Kristi for rescuing me over and over. Thank you Mme. Brownlee for being Alyssa’s favourite birthday guest. And, if any of you fellow golfers out there really want to help us thank the Bruce Denniston Bone Marrow Society for saying yes to every bone marrow drive, please register for their upcoming September 20 golf tournament, their only fundraiser of the year. Click here: http://www.dennistonsocietyottawa.org/rcmp-denniston-bone-marrow-golf-classic-2019/
And Hillary. How is Hillary doing?
She is absolutely amazing. She is happy and has no problem making good choices, which is why she is doing so remarkably well. She’s very smart. She craves power-walking along the canal and loves playing her piano. She is not in pain and does not feel cheated. She’s fighting. She sees the big picture. And she never, ever stops singing.
This is the scariest place we’ve ever been. Please continue to send your light and love in Hillary’s direction.
“The little reed, bending to the force of the wind, stood up again when the storm had passed.”
“A rare presentation of a rare disease” is how the senior transplant specialist categorized Hillary’s condition during our visit to Chu Sainte-Justine in Montréal last week. In all of their years treating patients with aplastic anemia, they’ve never come across a patient quite like Hillary. That’s her in the photo (right) in the awe-inspiring Sainte-Justine hospital atrium.
Hillary continues in the watch and wait phase. She is floating in the “grade 2 non-severe” category right now, but can dip into life-threatening “severe” at any moment. She might need to go to transplant as an emergency, she could coast at the moderate stage for years on immunosuppressive therapy drugs, or she could still snap out of it with a spontaneous recovery.
After taking Hillary’s rare presentation into consideration, Montréal suggested a more conservative alternative before going to transplant, and CHEO concurs. It has a chance of working, but they’ve never tried it. After another 1-2 transfusions, instead of treating Hillary with hATG and cyclosporine, we are going to try the less invasive cyclosporine alone, without the hATG. If it doesn’t work after three months, we will go to transplant.
Does Hillary have a stem cell match?
We have been told that she does have a common HLA type, so that is promising. But, securing her transplant match can only be done when she needs it, as an emergency measure. Understandably so. They can’t secure a match now when someone in a more dire situation may need that match sooner. Makes perfect sense. Guess they can’t keep it in a cooler on ice for us.
This means that even if there is a match in the global registry for her right now, there might not be one in three months when we need it. What’s more concerning is that even if a match is found, getting in touch with that donor, having them pass their screening test, and making sure they follow through also has to happen. This takes weeks. We know someone right now who only has one match available in the entire world to survive, but the donor’s phone number is out of service. That’s right folks.
This is why we can’t stop.
Donor clinics continue to be held all over the country in Hillary’s honour this summer. We are planning another large drive event in Orléans at the end of August (date and location to be determined).
Until then, our calendar is full. Hillary needs to have two teeth pulled, to prevent a potential, dangerous infection. Alyssa and Mommy are taking a tour of the cord blood facility at Canadian Blood Services to learn more about that process (even though sweet Hills requires a bone marrow transplant). We are headed to SicKids in Toronto in the end of August to meet the foremost aplastic anemia specialist in the country — the only doctor conducting expansive research on this disease.
That’s why we have to #StartWithHillary and never stop. Alyssa said it best last night before drifting off to sleep. She said it’s like playing the impossible level of a video game.
I asked her how we should beat the level. I said fight. She said pray. We’ll try both.
It’s been several weeks since our last official update, and so much has happened. Thank you for patiently waiting and understanding how difficult it has been. We’re actually not quite sure how we are functioning as a family, but we wake up each morning and start again.
Our appointment with the Hospital for SickKids on Hillary’s birthday was difficult. Their transplant team went over the various treatment options, risks, and possible outcomes. We also received some news that Hillary had developed a peculiar Paroxysmal Nocturnal Hemoglobinuria (PNH) clone, which now makes her condition even more rare. It’s not “classical” PNH, but a clone. As her PNH clone changes (in either direction) — and her Aplastic Anemia fluctuates between severe and moderate — different treatment options come into play. Her condition remains idiopathic (meaning for an unknown reason) with different signs leading both towards and against it as a immune-related response. More tests are out all over the world. Our doctor said it best — we are in no man’s land. We now know it’s okay to be emotional, unbalanced, and exhausted.
The experts at CHEO and SickKids have been incredible, and they fully support our decision to welcome another opinion from the transplant centre at Chu Sainte-Justine Hospital in Montréal, Québec. They want to see Hillary. And so, we are off to Montréal this week to help us make the most educated, informed decision we can regarding the survival of our daughter.
Here are our possibilities as they exist at this moment.
Watch and wait. This is where we have been for the last two months. This means frequent blood tests to check her hemoglobin, platelets, and neutrophils, and giving her blood transfusions when needed. Hillary remains neutropenic, meaning she can’t fight off infection, so we are staying at home in isolation. It’s tough. But if anyone gets it, Hillary does. She’s not sad. Short term pain for long term gain. We can handle that, if it means we get to keep her. But, each blood transfusion adds new antibodies to her system which can change her chance of success for a bone marrow transplant, and transfusions over the long term can cause organ damage. So, we watch and wait, but are planning for imminent treatment.
Immunosuppressive therapy. This treatment involves bringing down her immune system with anti-thymocyte globulin (ATG) for five days in hospital, and then trying to kick start her bone marrow with strong drugs for a year at home (cyclosporine). But, it only works half of the time, and many go on to a bone marrow transplant anyways. While it is less risky than a transplant, she can still develop a deadly infection during treatment. And, the disease may come back later in life, in a more serious form. Calculating the odds.
Going to transplant. If we had access to a 10/10 sibling stem cell match, we would have gone immediately to transplant. If Hillary dips into the “very severe” category, we go right to transplant. Hence, the desperate quest to find a 10/10 unrelated donor match. But, the dangers of proceeding with a bone marrow transplant are serious and life-threatening, particularly with an unrelated donor. First, is finding that perfect match. While we still remain confident that her match is out there due to her common HLA type, and that a potential match will follow through when called upon to donate (God, please), it remains unconfirmed at the moment. A transplant will mean relocating to either Toronto or Montreal for at least 100 days. Praying for her survival will be the most time-consuming part.
Clinical trials. Half-match (haploid) transplant. Immunosuppressive therapy variations. And of course, there is still the chance of a miracle….a full unexplained recovery. Still.
We will continue to encourage the world over to join the global stem cell registry to increase Hillary’s chances of having a match available when she needs it. We are in contact with so many families who have found their “one” match in the world, so many people waiting for it to happen, and so many whose children have died waiting. We simply can not fall in the latter category, and we will forever advocate for everyone to have an equal chance at survival. In the words of Hillary’s favourite Princess Jasmine in the new Aladdin, we will not go speechless.
We have always been very cautious parents when it comes to caring for our children. Making this decision will be the single hardest thing we ever do. Your compassion and support is all that is needed. The rest has no meaning.
Hillary received a welcome hemoglobin transfusion today to give her some energy for the weekend. It turned her cheeks a rosy pink which we have missed seeing. This is her in the parking lot at CHEO right after her transfusion, feeling great.
During some fun in the backyard at home, Hillary took a tumble walking up the stairs and it was back to the emergency room for the McKibbin family. Hills was examined for a leg bruise and sent home relatively quickly after some late night ice cream. It was a long day but everyone was happy, so we didn’t count the hours.
Thank you to the anonymous donor from Canadian Blood Services who helped keep Hillary singing today. Hillary thinks that each pack of blood should have an avatar/emoji on it showing the type of person who donated, and we think that’s a great idea.
Please know that Hillary is happy, active, funny, and feels very loved and secure. Oh, and for those who know her best, she has not stopped singing.
#GetSwabbed in #Ottawa for @CanadasLifeline RELOADED. Please come back to St Francis Xavier High School on July 4 from 3-6 pm to join the global stem cell registry. There will be more staff and 1,200 kits available. #StartWithHillary and remember why.
Well, Ottawa. You did it again. After an unprecedented 630 of you joined the global registry on June 24, another 251 of you showed up to our second bone marrow drive. Another 600 of residents in the Ottawa region applied online for a swabbing kit since the beginning of our campaign on June 17, as evidenced by metrics provided by Canadian Blood Services. Almost 1,500 in this city alone. That is simply incredible.
We have so many people to thank.
Thank you to Steve from the Bruce Denniston Bone Marrow Society and his volunteers who have given countless hours to this campaign, with competence and sincerity. To Paul, the RCMP Mountie who stood beside us as we shook every hand. To the group of PetroCanada employees who came in after work to get swabbed together. To Moncion’s Your Independent Grocer for providing cookies, crackers, and water for both events. To Gabriel’s Pizza in Riverside South for attaching our drive poster to every pizza delivery box. To Sheldon of Best Green Hedges for filling in the ditch Hillary dug on Mother’s Day…you made it into a garden instead of a graveyard, and we will keep it healthy forever. To the Ottawa Catholic School Board for lending their school facility, setting up each event, sharing our call through your vast online network, and most of all, keeping our family in your prayers… we are forever grateful, but not surprised.
To Tom for making it happen, to Kristi for taking care of sweet Alyssa, to Kalum for no holds barred, to Nicole for being everywhere, to Anna & Vicky for getting me through, to Tommy for making Hills’ video, to Amy for speaking volumes… to Greg, Doug, Stu, Carla, Jon, Victoria, Patricia, Dani, Mary, Susan, the Ostapyks, Thomas, Kay, Erica, Molly Penny…to Mayor Jim Watson, to CHEO President Alex Munter, to Dr. Leibman, to both of our workplaces (the OCSB & OCDSB), to our family who was there for us, who understood our pain, to Nana and Baba for taking care of Hillary, just the way we needed it…
Please God, get us through this, so we can spend the rest of our lives thanking those who have helped us. Thank you, Ottawa. Thank you.
This morning, we met with the transplant team at Sick Kids Hospital in Toronto via telemedicine. It has really sunk in, now. So many of you messaged birthday wishes to Hillary. So many have sent personal messages of hope. So many have asked for an update, and we have so many people to thank. But, today was simply the hardest day of our entire lives thus far… juxtaposed with the pure joy and happiness of our now six-year-old child. It’s been very hard keeping her bright light contained while we try to keep her safe and infection free, but we are going to continue to fight for Hillary’s safety.
Please give us some time to provide an update. We need to spend time together as a family. We need to rest for a minute. We need to regroup.
Once we’re ready, we will come back fighting — stronger and more unified than ever. We will be ready for the second July 4 stem cell registry event, and the one after that. We vowed to leave no stone unturned for our daughter, and that’s exactly what we’re doing. There is no feeling like it in the world. Steve and I will be there on Thursday to thank everyone personally for such selflessness.
Thank you for your patience, support, and understanding. Please continue to have hope in your hearts for Hillary as she battles this bizarre medical mystery. Positivity is the most important gift we can give her… and her sweet sister, Alyssa.