The Financial Side of Cancer

Every person’s story is different with paying for medical expenses, but no matter what, medical care is expensive and is never a fun thing to pay for. Finances are also awkward and often secretive, but a question I thought some people may wonder about, especially since so many people have generously helped us out. I feel like there is a lot I could add to this – and maybe I’m even sharing too much? I’m not sure, but I wanted to at least try sharing about it. By God’s grace we have been able (so far) to avoid medical debt, but it was a really close call. This is the story of how we could have been in a WAY worse financial situation due to the insurance (or lack of insurance) we were on right before the kids were diagnosed!

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EOB from ONE of Eliza’s chemo visits

We moved back from Nebraska in 2016 and started looking at health insurance options. Health insurance isn’t cheap! Seth’s insurance was covered through his employer but to add me and Eliza it would be around $800 a month. We looked around for cheaper alternatives and found Medishare, a Christian health-sharing company that is not officially “insurance” but qualifies as insurance for tax purposes. We only had to pay $316 a month for Medishare! (There are several other companies like this including Liberty and Samaritan’s Purse, but I’m not as familiar with these.)

Medishare does not allow pre-existing conditions, only will pay for 6 months of new prescriptions, does not pay for preventive annual appointments (except for kids), and has a lot of other strict requirements. I thought we were a very low-risk family since we had no family history of significant medical problems so it seemed like a great choice for our family. Things were going fine with Medishare and they paid exactly what they said they were going to pay for Oliver’s birth and care after he was born.

Fast forward to April, 2017. Our pediatrician recommended that Eliza go to a couple sessions of physical therapy to help her learn to walk. I got prior authorization from Medishare saying they would cover 10 sessions of PT. Eliza went to 3 sessions of physical therapy before I got a bill saying they would pay nothing. I thought for sure it was a mistake, so I called Medishare and they said “oh, gross motor delay is a psychological problem, not a medical problem so actually we will not be paying.” I explained how we got a letter in the mail saying it would be approved, etc., etc., and over and over again they said, “We are not insurance, we are not going to pay, there is no way you can appeal it.”

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Eliza will have 4 MRIs per year under anesthesia for the next 2 years.

I was SO frustrated with the whole situation. We ended up paying several hundred dollars cash for Eliza’s physical therapy but I started to get very nervous about what they would and would not cover, ESPECIALLY after getting a letter in the mail saying something would be covered when it was not.

When open enrollment started, Seth and I made the decision to switch our family all on to his work plan. This meant paying over $1,000 a month for insurance instead of just $350. What a HUGE blessing this turned out to be!

Eliza was diagnosed just 8 months later, and Oliver only weeks after that. Our medical bills skyrocketed. I attached a photo above of an explanation of benefits for ONE of Eliza’s chemo visits: $11,600. Eliza gets chemo every week for a year. She also had 6 ER visits this year for fevers. I’m still not entirely sure what Oliver’s whole transplant cost, but it is in the MILLIONS of dollars. This is a picture of a bill from Oliver’s first inpatient hospital stay.

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If we had been on Medishare for the cancer diagnosis, I know I would have spent hours and hours on the phone fighting bills, fighting for pre-authorization, and fighting for things to be covered. It would have added more stress to an already incredibly stressful situation. I really think God used that denial of the physical therapy (which looking back seems like such a minor thing) to direct us to switch insurance.

We also had very kind friends who started a Gofundme for us once Oliver was diagnosed. This was a huge blessing and helped us pay our $7,000 deductible for our insurance which became due very quickly. It will also help us pay our deductible this coming January. We will most likely max out our insurance deductibles every year with the long-term follow up for our kids for the rest of them growing up. The Gofundme money also helped so much with gas for 100+ trips to Seattle, meals at the hospital, getting new carpet for Oliver’s bedroom that did not have pet dander in it, and helping adjust to me suddenly not working for 6 months. It also helped us pay for SPF 50 long-sleeve swimsuits, some over-the-counter medications, SCCA parking garage fees, and so many other treatment-related things. We are forever thankful and grateful for every single person that so generously supported us. Thankfully Seth was able to miss minimal work, but this is not the case for many families going through pediatric cancer treatment.

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We also bought big quantities of Clorox wipes, hand sanitizer, and other cleaning supplies

I know people (including my parents!) that are still on Medishare and are very happy with it. I’m not trying to bash them, I know for some people it is great…I just 100% believe it was God’s grace that pushed us to switch. We are hoping and praying that they never change the rules about pre-existing conditions for our kids. Our healthcare system is so expensive and at times can be so complicated but we are SO incredibly thankful for Seattle Children’s Hospital and the extraordinary care they have provided for our children. They have been so kind and compassionate towards our family and have helped us out in so many ways. We have also been extremely blessed that we have not had to fight for medications or services to be covered by our insurance (so far).

I never thought our family would actually really truly need to rely on insurance, but I am forever thankful we have it!

 

4 Reasons Why Nebraska Should Be Your Next Vacation Spot!

 

I know Nebraska is probably one of the LAST places you think about when you imagine a vacation. I was pretty skeptical when I found out Seth would be living there at least 4 years for school! While living there we fell in love with Nebraska. We lived there 5 years before moving back to Washington to be closer to family! We went there this past weekend for a family reunion and we are hoping to go back soon for a true family vacation. Oliver was not able to come this time since he is not cleared to travel in a plane yet. Here is what we are looking forward to when we do a family vacation there!

Reasons Why You Should Vacation in Nebraska!

  1. The Omaha Henry Doorly Zoo! It seems crazy, but the Omaha zoo is always competing for best zoo in the WORLD! In fact, a CNN article in 2014 listed the Henry Doorly Zoo in Omaha, NE as the #1 zoo in the whole world. The zoo is incredible, adults and kids can spend hours there. They have added huge additions since Seth and I lived there and we had so much fun taking Eliza! Her favorite part was the man-made river, waterfall, and sandy beach in the new Adventure Trails area. They also have an IMAX theater, skyfari, two trains, a carousel, an aquarium with a touch-tank and so many other fun things! Best of all this zoo is relatively cheap to go to! An adult is $21.95 (during peak season), and a child is $15.95. Compare this to the San Diego Zoo where an adult is $56 and a child is $46! I’ve also been to the San Diego Zoo and the Henry Doorly Zoo blows it out of the water in my opinion! If we lived in Nebraska we would definitely have a family membership to the zoo!
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We luckily brought a change of clothes to the zoo for Eliza!

2. Nebraska Football! This one took me a while to figure out since I knew literally nothing about football when Seth and I started dating. We got student season tickets to the football games while we lived there and I was hooked. A lot of Nebraskans are SUPER passionate about football (even though their team hasn’t won a National Championship in over 20 years). They are always hoping this will be the year they regain their glory (haha). Going to games was so much fun and there is such a sense of state camaraderie. Oliver’s transplant poster that the doctors and nurses signed even had a big Nebraska football symbol on it! The starting center on the Nebraska football team passed around a football last year for the players to sign and give to Oliver during his transplant. It was such an amazing gift! We went to the first home game while we were there this past weekend and it was so much fun! You bet we will be watching the games every Saturday this fall (win or lose)!

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At the Nebraska game with 90,000 other fans!

3. Outdoor Adventures. Nebraska is also probably the last state you think of when brainstorming outdoor adventure ideas BUT we found so many great things while we were there! We camped at Mahoney State Park, which is phenomenal because it has stunning views perched over the Platte river, hiking trails, horseback riding, water park, camping, cabins, frisbee golf, and even outdoor ice skating in the winter.  We took advantage of the 131 miles of paved and crushed gravel bike trails in Lincoln (most of them off the roads!). We went ice skating during the winter, horseback riding in the beautiful plains, and saw the unique beauty of the plains as we road-tripped to Colorado and Chicago.

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Nebraska has gorgeous sunsets!

4. Entertainment! There are so many big-name performers that come to both Lincoln and Omaha since it is kind of an island of big cities in the Midwest. We regret not attending the Elton John/Billy Joel concert while we were there, but we were able to see Broadway shows like The Lion King, West Side Story, and Joseph and the Amazing Technicolor Dreamcoat while we lived there. Hamilton is coming next year and I’m halfway tempted to make a trip out for that since parking and hotels are so much cheaper and more accessible than Seattle!

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Nebraska is beautiful in winter too!

I know I’m biased because I have such fond memories of living in Nebraska, but you should definitely put it on your bucket list if you haven’t. It is such a fun place!

Eliza’s diagnosis, treatment, and prognosis: 1 year in

DIAGNOSIS:

I’ve written in other posts about NF1 and Eliza’s optic glioma, but I wanted to write a post explaining how we discovered Eliza had an optic glioma (along with NF1), what her treatment options were, and what her long-term prognosis looks like as far as we have understood what we have been told by our care team. Maybe this will be helpful or encouraging for another NF1/optic glioma family! I know when Eliza was diagnosed I was googling like crazy other optic glioma stories!

Eliza was born completely healthy via C-section due to being breech in December, 2015. She was a healthy baby that slept and ate great! We moved from Nebraska to Washington when she was 7 months old. Her new pediatrician noticed a couple café au lait spots and mentioned that she should be tested for NF1. She also thought Eliza was delayed in her gross motor skills and a few other things. I really dragged my feet and I even changed pediatricians because I thought she was really going overboard with all the referrals she gave us to go all the way to Seattle when she seemed completely fine to me.

Eliza, 3 months before diagnosis. (Age 2.5)

Our next pediatrician also mentioned seeing a pediatric neurologist to check for NF1 and recommended that Eliza do a little bit of physical therapy to help her learn to walk since she was not walking or standing by 12 months old. Eliza finally learned to walk around 20 months. Physical therapy did help quite a bit with her strength!

We spent a whole day driving to Seattle to see a pediatric neurologist with Eliza to check for NF1 and the results were…100% inconclusive. I was really frustrated at this point because I thought there was NO WAY Eliza had NF1 after googling it, especially since I had the same café au lait spots that she did and I didn’t have NF1 (spoiler alert: I do). She recommended seeing a pediatric ophthalmologist to check for any eye symptoms and coming back in 6 months for another evaluation.

I drug my feet even more but we finally saw the pediatric ophthalmologist in Bellingham. They were trying to get Eliza to read an eye chart in a MIRROR at age 2 which was almost comical. The whole appointment seemed like a waste of time. That doctor did recommend that we go back to Seattle Children’s to see another pediatric ophthalmologist since one of Eliza’s eye nerves looked slightly elevated, but she also said this was normal in a lot of cases.

By this point I felt like I was just going from appointment to appointment, referral to referral for no reason – paying $200+ for each specialist visit with no one giving concrete info. Again, Eliza seemed COMPLETELY normal to me. Fast forward 3 months and we were back in that pediatric ophthalmologist’s chair being sent to Seattle Children’s ER. Turns out the doctors were right and I was wrong.

TREATMENT

Once Eliza’s optic glioma was diagnosed with an MRI under general anesthesia we met with the pediatric ophthalmologists. They confirmed NF1 and referred us to the brain tumor team at Seattle Children’s. Our doctor said when optic gliomas are discovered, they usually just monitor them with MRIs first before jumping right in to chemo. Because Eliza’s eye bulged out so fast they decided to treat it with chemo right away to avoid further vision damage. The doctor assured us this was a BENIGN tumor (meaning it would not spread to other areas of her body) but it was growing so it could cause damage in the area that it was growing.

The “gold standard” in treating optic gliomas caused by NF1 that has been used for years and years is a combination of Carboplatin and Vincristine. I’ve seen on other NF1 pages that this isn’t always the first course of treatment across the country, but that is what our providers chose. Eliza had a port placed under general anesthesia – once her port was in we would need to take her to the ER any time she had a fever for as long as the port was in to rule out central line infection.

One of Eliza’s many ER visits for a fever (when she still had hair!)

In the big scheme of the cancer world and chemo, Carboplatin/Vincristine seems relatively mild. The major side effects that the doctor discussed were hair loss, appetite loss and nausea, constipation, and neuropathy (nerve pain). We did foot stretches every night to help with any neuropathy but Eliza never really seemed to complain about nerve pain. She did lose most of her hair, but was never completely bald. She did lose her appetite and had to take nausea medication pretty often. She almost needed to have an NG (feeding) tube placed in her nose but she just barely skated by without one. There are very few long-term side effects of this chemo.

Eliza started Carboplatin/Vincristine on September 7, 2018. She started with “induction” chemo where she got infusions over 1.5 hours every week for 10 weeks then started 5 weeks on/2 weeks off cycles. These cycles are numbered officially by days, not weeks. This was supposed to last for about a year but in December her eye swelled up way worse than it had been before even though her MRIs showed the tumor was shrinking. Her doctor switched her to 8 weeks of Avastin since they thought her eye bulging out was a result of inflammation around the tumor area. She got Avastin infused every other week for 8 weeks. The Avastin worked wonderfully and her eye swelling went down to look almost normal again. It was also around this time that the ophthalmologist said Eliza was most likely permanently blind in her right eye.

Eliza’s eye protruding, Christmas 2018

After her 2 months of Avastin, Eliza went back on her Carboplatin/Vincristine cycles. It was around this time that the rest of her long hair fell out. Unfortunately, in May she developed an allergic reaction to the Carboplatin and broke out in hives all over during her infusion. They had warned us this could happen so their plan was to premedicate her with Benadryl and steroids and run the infusion over 3 hours instead of 1.5 hours. She was able to handle this for a few weeks until she had another hives reaction despite the Benadryl and steroid premedication.  If they would have kept giving her Carboplatin every week her body would continue to react more and more and eventually she would have trouble breathing so they decided to stop Carboplatin/Vincristine and switch to Vinblastine, a cousin drug that studies have shown works equally as well.  She now gets Vinblastine once a week through her port IV access and it only takes about 5 minutes to administer the medicine. Vinblastine seems to have less side effects than the Carboplatin/Vincristine did for Eliza. The one side effect we did see is that the new chemo affects her white blood cell count quite a bit more so her immune system is quite a bit more compromised with her new chemo than the old one.

Eliza with her port accessed

PROGNOSIS/FOLLOW-UP

Eliza will finish her Vinblastine treatment in October. She will continue to have MRIs every 3 months for two years. After 2 years she will have MRIs every 6 months for another year. Next, she will have yearly MRIs for 2 years. If everything is stable at that point they will only do an MRI if some symptom shows up, otherwise she will be done with MRIs!

As far as I understand, once chemo is done for Eliza, there is a 33% chance her tumor(s) will start growing again and a 67% chance they will stay the same/shrink on their own. Hopefully she will never need treatment for the optic gliomas again, but if she does they will start a newer drug called a MEK inhibitor which is just a pill. These drugs seem promising but just have not been around for as long as the IV chemo treatments so the long-term effects of them have not been studied quite as long.

Eliza does not seem to notice being blind in one eye. She once even asked me which eye was my “light eye” and which eye was my “dark eye” since she has a “light eye” and a “dark eye.”

She will continue to be seen by her NF1 doctor every year to monitor for any other NF1 related things that could come up. She sees the ophthalmologist every 3 months right now and that will also space out to every 6 months and then to every year along with her MRIs. Worst case scenario, Eliza could go blind if her tumors grow, but the doctors are extremely optimistic that her vision will stay where it is at.

There are a lot of unknowns with NF1, but they really don’t worry me too much…maybe they should more, but the fact that I have NF1 and have had no issues makes me optimistic that Eliza can have a full, healthy, normal life! Eliza has adapted to having chemo and going to the doctor incredibly! She was so scared and would scream the first few times she had her port accessed, but now she hops in the chair like a champ! She is a beautiful, funny, happy little girl and I just love her so much!  

Our Favorite Vacation Spot

We just got back from a weekend in Whistler! Oliver’s doctor gave us the okay in June to take him to Whistler and we have gone three times this summer! We actually went to Whistler on an already-planned trip the day Oliver was officially diagnosed with leukemia last year. It was the first place our doctor let us take Oliver for vacation (they have a helicopter ambulance on standby for the sports injuries that occur…which would also work for transporting a post bone marrow transplant fever patient if need be). Whistler has been a place where we can get away from daily life and especially hospital life and be out in nature.  Here are 3 reasons why Whistler is our #1 favorite vacation spot!

  • Price! You can do Whistler basically as cheap or as expensive as you want. Seth has tent camped at Whistler several times for $13 a night. Bring all your own food, the gas to get there, and that’s it! Or on the complete opposite end of the spectrum you could stay at the Four Seasons Resort in a suite for $1000+ a night. Our favorite way to stay is at a VRBO or Air BNB where you rent a house/condo for a couple nights. This is especially great if you have a group to split it with. This past weekend we stayed in a 2 bedroom/3 bathroom condo close to the village with all my siblings. We were able to cook our own food and have our own space while still being able to hang out in the common area whenever we wanted!
  • So many things to do! It seems like you could never run out of things to do in Whistler! Just like lodging, you could spend no money or piles of money depending on your style. There are TONS of free paved biking/walking trails, cross-country mountain biking trails, and plenty of hiking trails! Again, on the total opposite end of the spectrum you can take a 12-minute helicopter ride for $179 per person. There are a lot of adventure options like zip lining, bungee jumping, downhill mountain biking, gondola rides, etc. if you want to spend some money. Whistler Village is really fun to walk around in and there are a lot of good options for food and shopping!
  • Location and People! Whistler is only about a 3-hour drive from Bellingham. We have Nexus passes – which I totally recommend if you go to Canada very often! They cost $50 for 5 years and kids are FREE! They also get you TSA pre-check if you fly. The Nexus passes definitely speed up your border crossing! The 3 hour drive up the Sea to Sky Highway is gorgeous! The diversity of people in Whistler is exciting too! There are people from literally all over the world, especially from Australia and various countries in Europe. We were talking to four guys from Dublin, Ireland in the hot tub on Saturday night!

Hopefully I’ll do more posts in the future about specific things we love doing in Whistler but overall we just enjoy making family memories there! We have mostly spent time in Whistler during the spring/summer/fall but it is best known for its winter skiing/snowboarding. We haven’t spent a ton of time up there in the winter yet but we hope to in the future!

Roc Solid Foundation Playground Surprise!

Each cancer diagnosis at Seattle Children’s is paired with a social worker to help navigate housing, FMLA documents, etc. In June, our wonderful social worker emailed me and said an organization reached out to her offering to build a play set for Oliver and Eliza in our back yard! We said we were definitely interested, especially since Oliver is not supposed to be around crowds or public places (like park playgrounds) for a year after transplant!

Seth and Eliza measuring the yard

Roc Solid Foundation emailed me and set up “build day” to be August 9. I did not fully understand what a big coordinated project it was until the day arrived! They told us they would pick us up in the morning with a limo, build the play set in about 4 hours, then bring us back to reveal it!

Roc Solid sent us this box a few weeks before the build.

Volunteers flew in from all over, including California and Virginia. There were local volunteers helping too (including a motorcycle gang called the No Name Riders!). The build was sponsored by Wienerschnitzel so they had representatives fly from Los Angeles! The group showed up at our house around 8:00 a.m. the morning of August 9. A limo picked us up (along with my mom-in-law, sister-in-law, my two sisters, two nieces, and nephew) at 8:30am and took us to breakfast! We ate breakfast, then the kids got to pick out a toy at Walmart, followed by playing at a park for a little bit. Nothing like taking a limo to Walmart!

Founder Eric sending us off in the limo.

The whole day was so surreal. It was the BEST DAY EVER for our kids and we hadn’t even gotten home to see the playground yet! At 12:30 they took us home and met us at the front of our house, giving the kids blindfolds. We walked the kids to our back yard where we took off their blindfolds and showed them their new play set as the volunteers cheered!

Breakfast while they build

The kids were excited to see their playground and a little overwhelmed! They warmed up to it quickly and were nonstop playing almost right away. They have spent hours playing on it already and will use it for years and years to come. Wienerschnitzel served a lunch to the volunteers, friends, and neighbors that came to celebrate.

Taking off their blindfolds! (PC: Matthew Roland, BBJ)

The founder of Roc Solid Foundation, Eric, is a pediatric cancer survivor. He presented us with a framed picture that read: “What Cancer Cannot Do: Eat away peace, corrode faith, destroy confidence, shatter hope, kill friendship, silence courage, reduce eternal life, shut out memories, cripple love, conquer the spirit. Cancer is so limited.” I couldn’t hold it together as Eric said that Oliver and Eliza could grow up like he grew up to make a difference for other people. It was such a special day and a huge bright spot after some really hard times this year.

Cheering for the kids!

King 5 News from Seattle did a story on the playground build. I linked the video here. One strange thing is they used a picture of a girl that was NOT Eliza, but they said she was Eliza. The girl in picture they used was completely bald and had a feeding tube…Eliza never had a feeding tube and she also never went completely bald, just lost her long hair. She must not have looked sick enough for their news story, which is so bizarre.

So excited! (PC: Matthew Roland, BBJ)

It was so humbling to see a group of complete strangers come together and volunteer their time and effort to give this gift to our family. This past year we have seen some of our scariest, loneliest days of our lives so far; but we have also seen outpourings of love and generosity like this. We have felt love and support beyond anything we ever could have imagined in a situation like this. We have seen answers to prayers and miracles. There are a lot of really, really hard things in this broken world but we also get to see glimpses of grace and we are so incredibly thankful.

The AMAZING group of volunteers! (PC: Matthew Roland, BBJ)

What is a Bone Marrow Transplant?

Like in some other of my “medical type” posts, I first want to say that I am not a doctor and not an expert in cancer or bone marrow transplant! I had no clue what a bone marrow transplant was or why someone would need one before Oliver was diagnosed. This is a summary of what a bone marrow transplant is and why Oliver had one!

Oliver during his induction chemo before his transplant admission

When Oliver was diagnosed with JMML they told us without a bone marrow transplant he would not survive. We had to sit through several conferences where they went over what a bone marrow transplant was along with the very serious long-term and life-threatening risks involved. We had to sign mountains of consent forms before they started treatment.

Oliver after one of his pre-admission bone marrow biopsies

Oliver was given a variety of extremely high dose chemo during the days leading up to transplant day which killed the cancerous cells in his bone marrow. The immediate effects of the chemo and having no immune cells included vomiting, diarrhea, open sores in his mouth and digestive tract, the worst bleeding diaper rash you could possibly imagine, and complete loss of appetite. It also was very hard on his kidneys, liver, blood vessels, and other organs in his body. Once the new stem cells started producing their own cells, his body started to heal.

Oliver’s actual transplant that flew from Europe!

There are three sources that the cells for bone marrow transplant can come from: bone marrow, peripheral blood, or umbilical cord blood (collected from a baby’s umbilical cord after it is born). Doctors determine what type a person needs depending on a variety of factors. Oliver was given a peripheral blood transplant meaning his donor donated cells in a similar way to giving blood (only with more steps involved). His donor did not need to have surgery to take bone marrow out. The cells were given to Oliver in his central line (an IV placed in his chest during treatment) on transplant day.

Oliver was hooked up to this IV pole 23.5 hours per day

Be the Match is an organization that helps with matching people for bone marrow transplants. Their website has a lot of information about all aspects of transplant. Everyone under age 44 should join Be the Match! It is free to join! They send you an envelope with a q-tip in it to swab your cheek and you just mail it back! Donating to someone would mean literally saving their life.

Oliver and Eliza were not allowed in the same room for over a month because of isolation rules.

They were able to find a 10/10 match for Oliver! Not everyone is able to find a bone marrow match – it ranges from 19% to 80% depending on ethnicity according to bethematch.org. Oliver’s bone marrow donor came from somewhere in Europe (we heard either Germany or England but we aren’t totally sure). The person donated and they put the bag of transplant cells right on a plane and flew it straight to Oliver in Seattle! We hopefully will be able to find out who Oliver’s donor was two years after his transplant. Oliver was in the hospital for 42 days during transplant. (He also had a 4 week hospital stay for chemo prior to transplant). We had to stay locally in Seattle for 100 days after transplant. We are so incredibly thankful for the complete stranger that donated their cells for Oliver’s transplant!

Oliver’s feeding tube and central line

Transplant is a long slow recovery. Oliver had a feeding tube in for 5 months after transplant because he completely lost his appetite. He threw up every single day for over 40 days straight. He can’t be in public places, dig in dirt or sand, swim, be around animals, or a lot of other things for a year after transplant while his immune system recovers.

HOME after Oliver and me living in Seattle for 6 months!

Another complication of transplant is something called Graft vs Host disease. This is where the new transplant cells attack the person’s body because they recognize it as something foreign. This can show up as a variety of things but commonly includes skin problems, liver problems, and gut/digestive problems. These complications are usually treatable but can be very serious and need to be treated early. Oliver has not had too much graft vs host disease but it can happen up to two years after transplant most commonly.

One of many clinic appointments post-transplant

The transplant will make Oliver more susceptible to other cancers for the rest of his life. He will require long-term follow up on other body systems for the rest of his life as well. Hopefully because Oliver was so young when he went through transplant he will forget the hard parts and someday will understand that despite his long term side effects, we made the only decision we could for him in choosing this transplant.

Look how GREAT Oliver looks today!

Camping at Larrabee State Park

We packed up the kids and took them camping this past weekend! It had been almost a year since we had done an overnight camping trip! We typically try to do at least a 7-day car camping trip each summer but this summer has been a little different because of Oliver’s bone marrow transplant.

Oliver has a LOT of rules to follow for one year after transplant including no digging in dirt/sand, no touching lake/ocean/hose water, no crowded public places, no daycare/school, no being in the sun without massive sun protection…the list goes on and on! The doctors said camping was ok as long as we kept him off the dirt as much as possible and away from rummaging through ferns/other plants and away from crowds!

We probably wouldn’t have taken him camping 4 or 5 months after transplant but since we are 7 months out from transplant his immune system has had more time to recover and we were comfortable taking him. One year after transplant he will have all his restrictions lifted!

We decided to choose a location that was close to us in case any sort of emergency came up. (Both kids still need to be at an ER within an hour if they get a fever). We went to Larrabee State Park without a reservation but luckily there was someone that did not show up so we got a spot!

We had never camped at Larrabee before. Overall I would probably rate Larrabee State Park a 2/5 for a camping place.

Pros:

  • Close to home
  • Nearby beach access (about 1/2 mile)
  • Nearly no bugs
  • Fun playground for kids
  • Picnic and open grassy areas
  • You don’t need a Discover Pass if you are camping overnight but you do need one if you are just visiting for the day.

Cons:

  • It cost $32 per night for a basic tent site which seems a little high.
  • There is a train that goes through the park and blows its horn all night long. We were about as far from the train as you could be so it didn’t bother us too much but if you were close it would definitely wake you/kids up!
  • The garbages were overflowing and the bathrooms had running water but no hot water. Normally I’m not too picky about bathrooms and garbage but when paying $32 it seems like it could be a little better!
  • We had TERRIBLE neighbors. This isn’t really the park’s fault, you can have bad neighbors anywhere but they were loud, smoking cigarettes and weed, openly drinking hard alcohol (which was allowed), constantly swearing, and had kids and a dog running all over the place including into our campsite a couple times. They stayed up at least until 1am loudly talking. We have kids that are GREAT sleepers but if they would have woken our kids up I would not have been happy!

Modifications we made for Oliver included bringing lots of hand sanitizer and baby wipes, letting him play in the tent with toys while Eliza went to the playground with Seth, and having him sit in our lap or his camping chair instead of following Eliza around.

Overall we have had better luck with national parks than state parks as far as overnight camping but we were extremely happy to be able to fit in at least one tent camping trip this summer!

6 Tips for Day Hiking with Toddlers

The Pacific Northwest has an unending supply of outdoor activities for all ages! Day hikes are an easy way to get out in nature with kids. We have learned a few things by trial and error taking our kids (now ages 3.5 and 1.5) on day hikes!

1. Make sure kids are WARM! This is the #1 mistake we have made! You are way warmer when you are the one doing the hiking effort vs just being carried in a backpack. We love toddler Columbia fleeces for spring/summer weather and REI packable down coats for fall/winter.

Eliza’s second time cross country skiing

2. Brings lots of SNACKS! Not enough snacks/food is the #2 mistake we have made! Applesauce pouches and goldfish crackers have saved the day more than once. If kids are warm and fed it eliminates 90% of the complaining.

3. Use a good CHILD CARRIER! We typically use an Ergo when the kids are less than 6 months old and switch them to a solid child backpack after that. The child carriers have lots of pouches for snacks, water bottles, sunscreen, etc.

4. Start with SHORTER hikes, it helps to have a way out in case you do have to carry a crying toddler for over a mile (you bet we have done that!).

5. Encourage KIDS to walk/explore. We have been really surprised how far our toddlers will walk on their own – even uphill! We may be moving at a snail’s pace but the kids have a blast. We love Keen sandals for kids hiking!

Eliza leading the way in the Hoh Rain Forest

6. Just get out and DO IT! Kids are going to have meltdowns at home and they are going to have meltdowns on hikes…as long as they are warm and fed there are a similar amount of meltdowns either way. Because we started taking the kids outside when they were really small they generally don’t bat an eye when we take them out now…in fact they love it!

Snack break before a hike!

What is Neurofibromatosis Type 1?

First, I am not a doctor or a geneticist so this is a simplified version of Neurofibromatosis Type 1 (NF1). If you want real medical information, talk to your doctor! The information I have is from doctors, genetic counselors, and ctf.org. The Children’s Tumor Foundation (ctf.org) is a wonderful resource for NF1 and helps fund a lot of research!

I have been diagnosed with Neurofibromatosis Type 1 through genetic testing and Eliza and Oliver have also been diagnosed. I was tested after both kids were diagnosed. There are three types of Neurofibromatosis (NF1, NF2, and Schwannomatosis). NF affects 1 in every 3,000 people which is actually relatively common!

All three of us have Neurofibromatosis Type 1!

The main indicator of NF1 is multiple café au lait (light brown/birth mark) spots on the skin. I have 6 café au lait spots and no other symptoms. Many people with NF1 also have neurofibromas (benign tumors) on or under their skin. About 50% of people with NF1 have learning challenges. In more rare cases people with NF1 can develop benign tumors in their brain or on their optic nerves (Eliza!). NF tumors are usually not cancerous but can sometimes cause issues if they push on important body tissue (like Eliza’s optic nerve). There are also other rare complications that can occur such as scoliosis, high blood pressure, and delayed or early puberty.

Oliver getting leukemia is NOT a typical manifestation of NF1. He had a double genetic mutation – first the NF1 and then a second mutation that caused him to get JMML. Less than 1% of people with NF1 will develop leukemia.

NF1 is autosomal dominant which means since I have NF1 our kids had a 50% chance of getting it. Either you have it or you don’t, there is no such thing as being a “carrier.” 50% of the time NF1 is a spontaneous mutation and 50% of the time it is inherited from a parent. Unless serious complications from tumors occur, those with NF1 have a normal life expectancy.

Oliver’s largest cafe au lait spot on the left side of his back

There is a huge range of how NF1 can manifest. Some people never even know they have it, some people (like Oliver) have serious complications from it. While not always the case, most tumor growth happens in early childhood and during puberty. Eliza will get 3 month MRIs for a few years and then as long as the tumors are stable they will be just once a year.

There is no way to predict how it will manifest, even within the same family. There is currently no “cure” for NF1 since it is a genetic condition but there is a lot of research being done to find new ways to treat issues that may arise.

We met with Oliver’s NF1 doctor a couple weeks ago and she said something to me that made me furious. (Although at the time I just kept it inside…I didn’t realize until later the meaning of her words). I mentioned a family member of mine was getting tested for NF1 so they could be ready to watch out for signs of NF1 in their children if they had NF1. The doctor said “oh yeah, and there is genetic testing you can do on fetuses so that if they do have NF1 you can choose not to keep the pregnancy.” I HAVE NF1!! It was basically like the doctor was telling me I shouldn’t have been born and that my two kids should not have been born. I wouldn’t trade my kids for the world. They have not had the easiest life so far but they are happy and they are LOVED and they are children of God. No one is guaranteed a life without struggle. We live in a fallen world and there is suffering but that does not make my kids’ lives one bit less significant than a child born without NF1.

The world is a better place with this little guy in it!

Honestly, I feel like my kids will be stronger for having gone through these trials.  I obviously would not have chosen Eliza to have an eye tumor or chosen Oliver to have leukemia but through these struggles we have seen answers to prayer, miracles, and people pouring love on us like you could not believe! We have been blessed and humbled through everything.

Please comment if you have any questions about NF1! I really barely knew about NF1 before the kids were diagnosed but I know a whole lot about it now

Two Kids Diagnosed in Two Weeks: Story of Diagnosis

Summer of 2018 was awesome. We had two healthy kids and did a 10-day car camping trip through Mt. Rainier and Olympic National Parks. We did family bike rides, were loving our second summer in the house we bought…Seth even said at one point “I don’t think life can get any more perfect than this.”

July, 2018

At the end of August we noticed Eliza’s right eye sticking out a little bit further than her left eye. I thought maybe she had hit her head or something and I hadn’t noticed. We took her to our pediatrician who sent us to a Bellingham ophthalmologist on a Friday. After looking in Eliza’s eye at her optic nerve, the ophthalmologist sent us straight to Seattle Children’s ER. We stayed in the ER until 3am when they sent us home with instructions to come back on Tuesday for an MRI under anesthesia.

Pre-op for Eliza’s first MRI

We were already planning on going to Lake Chelan that weekend so after the ER we slept in a Lowe’s parking lot and drove the rest of the way to Lake Chelan in the morning. My parents met us there with Oliver. It was very smoky and hot in Chelan. On Tuesday we drove back to Seattle Children’s for Eliza’s MRI which showed she had benign but growing tumors on the nerves of her eyes. The one on her right eye was already fairly big and causing her eye to bulge out. At the same time they diagnosed her with a genetic condition called Neurofibromatosis Type 1.

Earlier in the year our pediatrician had referred us to neurology at Seattle Children’s because he suspected she might have Neurofibromatosis Type 1 because she had several café au lait (brown freckle) spots on her body. We met with neurology and they said they weren’t really sure if she had it or not and since I also had the spots and had no issues, they would just wait and see. The ophthalmology team referred us to the oncology clinic. The oncology clinic is a place you never ever want to end up as a parent.

We met with a brain tumor doctor who told us that Eliza would need to have surgery to have a port placed so she could get weekly chemotherapy for a year to try to shrink the tumors behind her eyes. The chemo had a 33% chance of shrinking the tumors, a 33% chance of them staying the same size, and a 33% chance of them continuing to grow. (Spoiler alert: they have been shrinking!)

Our pediatrician called us that same week when he found out Eliza was diagnosed with NF1 and optic gliomas and wanted us to follow up with lab work on Oliver. At Oliver’s 9 month well-child visit his iron was low. Oliver was put on iron drops and we repeated the test a few weeks later. Oliver’s white blood cell count was high but he also had a cold at the same time so we thought it was just from that. Our pediatrician had us get more lab work on Oliver and it showed high white blood cell counts again and extremely low iron. He referred us to the oncology clinic at Seattle Children’s but also said the labs didn’t look like typical leukemia so he wasn’t sure what it could be. Oliver was acting like a totally healthy kid as far as we could tell.

Oliver at 11 months old

On September 6, 2018 Eliza had surgery to have her port placed. We were given binders of information and met with several nurses about how to care with a child with cancer. On September 7, 2018 (my birthday by the way) Eliza had her first chemotherapy treatment. Right after her chemotherapy treatment we went to meet with Oliver’s oncologist. Our pediatrician had said Oliver’s labs didn’t really look like leukemia so we were SHOCKED when the doctor told us that Oliver’s labs looked like he had an extremely rare and aggressive form of leukemia called Juvenile Myelomonocytic Leukemia (JMML) that has a 50% survival rate. The doctor specifically told us not to google JMML (which is the first thing I did when I got back in the car). This type of leukemia happens in less than 1% of kids that have NF1 due to a secondary genetic mutation. The only potential cure for JMML was a bone marrow transplant (at the time we had no clue what that involved).

Eliza’s port surgery scar

We went from thinking we had two perfectly normal healthy kids in August to having two kids diagnosed with a genetic disease and both needing to go through chemotherapy. It was really overwhelming but our family, friends, and church rallied around us to figure out how we would spend the next 6+ months separated as a family. The oncology team at Seattle Children’s is truly amazing and our family is so incredibly thankful for them!

Even through all the difficult times of the past year we have seen so many answered prayers. The kindness and generosity of family, friends, and strangers is something we will never be able to repay. I know we had hundreds…probably thousands of people praying for our family. We felt so loved and supported and we continue to feel so much love and support from everyone around us. THANK YOU if you prayed or helped in any way!

September 9, 2018(2 days after port placement/diagnosis)