Last Night Home...

... and when I say home, I mean the Ronald McDonald House. Tomorrow at 11:00 am, we admit Bella to the hospital, and she will begin her treatment immediately. I met today with our social worker, Janet, who is AWESOME, as well as a representative from a volunteer group called Care Partners. They assign a volunteer to the family for the entire journey who is kind of at our disposal. Laundry needs doing? They're on it. Groceries? No problem. Hang out with the girls while I play soccer? Easy. Support, baby support. It's all about having enough support to counteract the immense increase in stress on the family, both individually, and collectively.

Ali's craft work while I met with Janet

Last, but not least, I met with Dr. Wagner today. He's the head researcher on this trial and quite the guru in curing incurable diseases. He is great. No ego whatsoever. We spent an hour going over all the risks and benefits of the trial for one last time to make sure we are clear about what we are getting ourselves and Bella into, and realistically what can we expect to get out the other side.

How to keep a 4 year old preoccupied...

His tone was more measured than in January regarding promise for the protocol being a possible cure. Today, her referred to it repeatedly as "A first step." That really wasn't that cool to hear the night before we're admitting our daughter, but, 6 months have passed and a lot has happened since then. The hard truth is that out of the 10 transplants that precede us (number 11 gets transplanted in three days, and we are number 12), 2 died, and 1 experienced graft failure, but miraculously grew his/her own white blood cells back. That isn't supposed to happen, so that patient is really lucky to be alive. That leaves 7 other patients, and their results range quite a bit in terms of reduced acuity of the disease. So, when you are on the front lines of a new treatment, anything's possible. We accept this and are frankly grateful that Bella is only 12 months old and participating in this rather than 12 years old. We do know that for the majority of the 7, there has been improvement in their skin. How much ranges the entire gamut.

The master artist at work in her shop...

Let me try to break down succinctly if I can what is going to happen. Here's the deal: Bella is going to receive 8 days of intense chemotherapy to effectively clear out her own bone marrow, and completely eradicate her body of any immune system whatsoever. Then, she'll have a day off, and following that day off, the docs will pull bone marrow out of Ali's hip bones, and through a simple blood transfusion, give it to Bella. Now, the idea is that Ali's marrow will start producing stem cells that will turn into new blood cells, and a new healthy immune system. But more than this, the stem cells go to the skin, where the area of injury lies, and these stem cells start to generate new skin cells as well as blood cells. This is where this trial is the first of its kind. Normally, BMT is done for cancers of the blood, where the injury is in the blood and marrow. Not with Epidermolysis Bullosa. The stem cells somehow "know" that the skin is where they are needed so they home in on the wounds and generate healing previously never seen in the patients.

So, this means that all the areas of injury on Bella's body currently will potentially get an infusion of healthy new skin so that these areas no longer blister and wound as easily in the future. Here's where it gets interesting: What about the areas that have no wounds? Well, they aren't included in the equation. Somehow, the trauma sites send out a signal calling for back-up, so to speak, but the uninjured areas have no reason to send that signal (yet) so the stem cells don't go. However, once a site injures for the first time (anytime after transplant), the stem cells will then get in gear and head to that site to increase healing.

We brainstormed about several different subtleties about this disease, and during the conversation, what struck me was that Dr. Wagner is so far down in the trench... literally into the micoscope, with this particular protocol, that he hasn't yet delved into other more global questions about EB that surface when you theorize about what is next AFTER this. At one point, I suggested what I see as a future evolution in treatment, and he looked at me point blank and said, "I never thought of that!" That was fun. Brainstorming with Dr. John Wagner. Sweet.

How to make sure your kid doesn't take a header off the bed while you pee...

So, tomorrow begins the year-long walk down a very dark tunnel to emerge out the other side with a brighter future for Bella. I say year-long, because realistically that is how long it will take her immune system to be back on line firing on its own cylinders. Until then, we walk a dangerous road, hoping to avoid graft failure (Bella's blood attacks Ali's blood), Graft verus Host Disease (Ali's blood attacks Bella's), and infections as best we can.

This is where that time-honored struggle of control kicks in again. How to do everything possible, fight every battle, take every necessary step, and yet KNOW that it is totally OUT of our control while we weigh decisions that APPEAR to demonstrate that we ARE in control... what a conundrum. I like the phrase, "God is in the results business." We are in the process business. If we just do the best we know how, then turn it over to God, it's really the only way to manage any sanity throughout this. This is when I am grateful for my Faith. See, my faith is of my own volition. It is not anyone else's faith. Others may believe similar things I do, but at the end of the day, I CHOOSE to have faith. No one gives it to me, and no one can force it upon me. Consequently, no one can take it away from me either. It is literally my own creation, and since it is such, I create a faith that empowers me, strengthens me, inspires me, motivates me to get out of bed and face my terrifying fears head on. Without this asset, I wouldn't have the ability to get out of bed in the morning. The fear I am experiencing going into tomorrow is far beyond anything I have experienced in my life.

So, what do I have faith in? What do I believe?

I believe Ang's and my love for each other deepens every day we walk through this together.

I believe that Ali's character deepens every day she is Bella's big sister.

I believe that Bella knows exactly why she is here. She just smiles blissfully at us while we labor over her bandage changes as if to say, "ah, yes, this is why I chose YOU... because I KNEW you would do a good job with me."

I believe that I will be pushed past what I thought I was capable of and thus know myself as enhanced, increased, and upgraded from my previous image of my self.

I believe that Bella will inspire many, many more people, and that this was her plan all along.

I believe that God has the answers, and I believe that I ask him pretty good questions.

I believe that one day, Bella will look back on all this and say, "Yeah, I was born with this rare skin condition, but when they brought me home from the hospital, it went away."

What do you believe in?

The Night Before Work Up...

...and all through the house,

not a creature was stirring,
not even Ali.

She was successfully run into the ground this afternoon at my friend Logan's house. For those that may not remember, one of my good childhood friends from little Redding, CT (home of 7,000 when we lived there) relocated out here and is a researcher at U of M and actually works with Dr. Wagner. Logan invited us over to his house for a BBQ to welcome us back and give us some good midwestern lovin' (read: lots of food) before "it" all begins tomorrow. He also invited another friend of his and his family. Logan's friend Mark is also a guitarist and songwriter, and is a prolific songwriter for Songs Of Love (www.songsoflove.org).

I happen to be on their newsletter list after meeting the founder, John Belzer, over email a few years back at the end of my music therapy degree. Essentially, his mission and mine are the same. I say, "Heal the Planet with Music." He says, "Give a Song today, Change a Life Forever." Think we're on the same wavelength? I can't remember who introduced us, but we are kindred spirits, and Mark is one of the early and more prolific songwriters for Songs Of Love. To date, he has written over 40 songs for kids or teens going through intense physical or emotional times. The healing power of music comes in many shapes and sizes.

Anyhow, it was a wonderful day, there were 5 kids running around playing and having a ball, 7 adults enjoying each other's company, and 1 baby discovering her talents on the keyboard....

Man, she took to that thing like a fish to water. It was AWESOME. By the end of the day, we "borrowed" the princess keyboard from Ellory, Erin and Logan's little girl, then hit Target looking for our own. Well, we found something even better...

wait for it...

wait for it...

That's right (Sara, eat your heart out), it's a Plex Keytar from Yo Gabba Gabba and it is AWESOME.

What a great way to go into this week. Totally connected to Family, totally connected to Friends, totally connected to Faith. Thank all of you who have emailed and commented in the past couple of days with your prayers and intentions. You KNOW they made all the difference a year ago. You continue to hold us up and keep us strong as we enter this strange bubble of BMT. We know we do not travel into this alone. We have our Three F's; (Friends, Family, Faith) they literally have all shown up this weekend to send us into the clinic tomorrow morning feeling totally supported. Thank you.

Epidermolysis Bullosa can be looked at as a cruel disease, but when I look at it, I see so much love, faith, and generosity from near and far, from old friend to new acquaintance, I CANNOT see anything but blessings all around us. This is not to say there isn't pain, stress, grief, anxiety, fear, exhaustion, and everything else that comes along with this debilitating disease. TRUST ME, the cost is ever-present. However, if that is all I looked at, I'd miss the gifts. The real gift? Having the choice to choose what to look at in the first place. For that, I am most grateful.

Tomorrow begins Day 1 in the clinic. Labs, consultations, tests, etc. from 9-3. We'll share much more tomorrow night. We go in your hands, in God's hands, and in each other's hands. I've never felt more proud to be the husband to my wife and the father to my children than tonight. Why? We are ready. We are as ready as we can be for this, whatever it may bring. We are ready, and we are not alone. What else could we ask for? Life is Good. God is Good. Amen, and Amen.



Good Night.

Happy Easter!

Well, we've made it to Easter, and we have so much to be thankful for. We spent Saturday at Grandma's and Grandpa's house with Bella, Ali, and their uncle Steve and aunt Dina and cousin Wil, and new baby cousin Molly. It was a beautiful day, and the older kids had an easter egg hunt and the babies, well, they did their thing as babies. Eat. Sleep. Lounge. You know, the good life!

Ali Delighting in the Easter Egg Hunt

On the book front, we are excited to announce our featured partner for the month of April, MUSIC TO HEAL. Music To Heal is a non-profit organization that funds music therapy programs in children's hospitals in Southern California, including CHOC, where Bella has spent 17 days this year, including her first 12 on the planet. Please read up more about them on our Featured Partner page! I had the opportunity to provide some training to their volunteers last week and they are just a great young organization full of life, passion, and a giant heart.

On the wound care front, things have been going very well for the most part, until today. We had our first sign of a possible Pseudomonas infection in one of Bella's wounds. When I took off one of her dressings, the underside of the dressing was neon green, a color we have never seen on her. Immediately, Ang thought it might be Pseudomonas because after reading about it in a number of other EB blogs and websites, she remembers that is was described as characteristically blue-green, bright green discharge. The interesting thing is that the wound itself didn't look at all infected. I guess the dressing (Mepilex Lite) must have wicked it all away from the wound? Still being relatively new to all this, we cleaned the site twice, but bactroban on it, and covered it this time with Mepilex Border Lite. We'll check it daily to keep cleaning it. I read on one site that Pseudomonas is antibiotic resistant, which if that's true is a drag. We'll be starting to add vinegar to subsequent baths to upgrade the cleansing campaign.

On the Transplant Front, we are officially beginning Bell's "work up" on Monday June 14 in Minneapolis, MN. It will be about two weeks of consults and tests, and then Bella would be admitted to the BMT Unit approximately on June 28. Ali will have her stem cells harvested around July 5th or so. Of course, these dates are approximate, but we are full steam ahead go for the 14th. Ang, Bella, and I will return to MN later this month to finalize lodging, then I'll drive the minivan packed the week prior to the 14th and Grandma and the girls will fly up that weekend. My goal is to have us unpacked and moved into wherever we end up by the time they arrive for the smoothest transition for everyone. I'm really looking forward to driving to MN alone! The last long distance trip I took alone was from CT to AZ in 1995 and it was the quietest 7 days of my life. I felt like I stepped off the planet for a week and just hung out with God. I didn't hurt that I had no radio in my car. We'll see if I choose to crack out on a bunch of books on CD or go for the monastical journey again. Which do YOU think it'll be?

How come I don't get to collect Easter Eggs???

Can I just also share my fears with you real quick? These are things you can pray for as we prepare for this journey. I know that these are just my own fears, but they linger and fester, so I would like to turn them over to you collectively to pray for. Thanks! I worry about Bella and how she wrestles so violently in bed when falling asleep. How's that gonna go with a Hickman line in her chest? I worry about Ang having to focus on her job in a new city each day while her baby is going through such an ordeal, and how much that will weigh on her. I worry about how we will keep Ali happy given I'll be in the hospital room 24/7 and Ang will be working full time. I worry about how I am going to keep my sanity in that hospital room for 50 days straight on little to no rest daily.

Thanks for taking those off my shoulders. I am reminded that this has always been beyond my control, and all of these fears are from me wanting to know how it's all gonna turn out before it happens. I am reminded of the quote, "God is in the results business." I just love trying to take back control over the outcome of everything in my world. Oh, man, that is mentally exhausting, though. Thanks.

I have to take a minute to publicly gush about Ali. Ang was away on biz this past week, and in the past, Ali would seize the opportunity to really out me through the ringer while mommy was away. Well, whatever it was, she has currently gotten it out of her system, and has just been an ANGEL with with Bella and me. I think I gushed about Ali last post, too, come to think of it. She's just been amazing.

Okay, outta here for now. Please go read about our new partner, MUSIC TO HEAL. They are very inspiring, especially because the founder is just starting his third year in med school! Get to know them. They rock. I am just so inspired by both these guys and PUCK as well, and thrilled to be making a difference in the world with them, albeit small here in the beginning. At least we're doing SOMETHING.

Happy Easter to you all and good night.

We're Back Home!

Well, we are back home from snowy, cold Minneapolis. We had a BLAST! First off, after you've lived in extreme temperatures ( like Phoenix ), extreme cold isn't any different than extreme hot. You know as you are walking out the door that you are about to be slapped with a temperature your body won't like and can't tolerate for very long without being properly prepared. The nice thing about the cold is you can bundle up. In the desert, you can't "bundle down" to cool off, you just dehydrate and burn to a crisp. However, in the desert, you don't have to shovel heat, either.

okay, enough about the weather.

On to... the GOOD STUFF...

We met with the good Doctor John Wagner. Here is his title off his business card:

Director, Pediatric Hematology/Oncology/ Blood and Marrow Transplantation

Scientific Director of Clinical Research, Blood and

Marrow Transplantation and Stem Cell Institute

The University of Minnesota has been doing Bone Marrow Transplants (BMT) since the sixties. They are the leader in the field, and he's the head hancho. His Curriculum Vitae is quite impressive, yet, he doesn't have the ego that you would expect. He's a researcher, and a teacher. So, when he explained what he is accomplishing in this clinical trial, I could see the wheels spinning in his head. He has a child-like passion for what he does. What does he do? In his words, "I cure incurable diseases."

That rocks.

So, we spent 2 hours together where he presented his results up to date, then answered all our questions. I had two pages of questions for him, but admittedly, when it came time for Q&A, he had already answered most of my questions in his presentation.

We talked about so much, it's honestly hard to recall specifics. Also, I can't talk about the results of the research as it is currently being peer reviewed for possible publication. What I can say is that we feel extremely confident in him, and in the U of M staff. He has broken into uncharted territory with his research. Don't go around using the word "cure" as it would not be appropriate at all, but you can say that his results have never been done before with an EB patient.

We told him we were going to Columbia U. to discuss their "reduced intensity" BMT clinical trial as well. He gave us a few questions to ask and shared his honest thoughts about their multi-site trial that has just gotten rolling. Columbia will get their moment in court to "sell" us on why their trial is better, but Dr. Wagner is really the guy they are trying to imitate. He knows more about BMT for EB than anyone on the planet, so they have their work cut out for them to convince us to go to NYC instead of MN. Having said that, we're adamant about going and doing our due diligence. Leave no stone unturned.

Metaphorically, I wish there was another way to rebuild the engine without having to strip it down so far. However, when Dr. Wagner explained that they have successfully done BMT on FETUSES IN THE WOMB because you can be BORN with cancer, I realized that it's simply a point on a line... a line of treatment where researchers are looking for new, less invasive ways to treat these diseases, but have yet to make the breakthrough that will ultimately leave this treatment in the history books. So many other breakthroughs HAVE occurred in so many areas, it is simply a matter of time. However, here we are NOW, and not 5, 10, or 20 years from now. Lucky for us we ARE here now, not 5, 10, 20 years ago, when there was NO chance for an RDEB kid to have a shot at living a "normal" life.

The trip was especially fun because we got to have dinner with one of my childhood friends, Logan Spector, who is a pediatric epidemiologist at U of M. He's been there for almost 10 years now and knows and works with Dr. Wagner. He invited us to his home and we met his wonderful wife and two children. We also met Lonni Mooreland, who is the mom of patient #2 of the trial. Unfortunately, little Sara passed away due to complications from a weak heart; a condition she had since shortly after birth. She and her husband, Jay, are the ones who have started PUCK, a charity to raise money for Dr. Wagner. www.puckfund.org. Check it out. We will be partnering with PUCK with the release of Bella's book in the very near future. Anyhow, It was nice to connect Lonni and Logan since they both work with Dr. Wagner. Also, Lonni and Jay have moved to MN recently, so it's always nice to know someone new in town. The most tender moment of the night was when Lonni was leaving.

She said, "Thank you for inviting me, Tim. I was surprised you even wanted to meet me."

It dawned on me that she felt that we wouldn't want to meet her since her daughter died in the same study we are considering our daughter for. Somehow, it might scare us or remind us of the danger of the study. What I am reminded of is the sad fact that ANOTHER EB child passed away last week, bringing the total to 4 since December 1st. This disease claims its patients in far more ways than through experiments to find a cure.

I couldn't believe what Lonni said; that's the last thing I would think. Thanks to working on the Grief and Loss Retreat with my colleague Mauro and my Mom, I was able to quickly share with her how tough the grieving process is in our "afraid-of-death" culture. I was able to validate her experience and reinforce that the insane feelings she is having are in fact normal. It is our "feel-good-all-the-time-at-all-costs" culture that is totally insane. We are so completely cut off from the experience of death that we don't have a clue how to handle it.

She just looked at me, a little incredulously, as if to say, "You actually GET IT." Then, she said, "Thank you, I feel like I had some therapy tonight!"

By the way, U of M mascot is called "The Gopher." Wanna know why? Because just about the entire campus is connected by above ground skyways and underground tunnels. The farthest we walked outside the whole time was from the car to Logan's front door. No lie. Applebee's delivered breakfast to our door each morning. Starbucks was located in the lobby, and the hotel was connected to the medical center. Add Valet parking, and we hardly felt the sting of the cold. I did leave my Starbucks in the car Wednesday night by accident and here's what it looked like the next morning...

Ice coffee, anyone?

Anyhow. We feel great about U of M. If this is our path, it will probably happen this spring/summer. We don't want to wait. EB is too dangerous. Also, the younger the patient, the better the chances. This is our year! We know there will be much in store for us, but we genuinely had a good feeling up there in Minneapolis; a feeling that said, "We can do this."

Thanks for being there with us. We felt you.

Thanks to Grandma and Grandpa for watching Ali and Lucy as well as for donating their miles for plane tickets.

Thank you to Aunt Marie and Uncle Tom for their INCREDIBLE contribution.

Thanks to our friends at Harbor Christian Church for their generous contributions as well.

Thank you, God, for delivering us to and from MN right in between nasty storms. Thank you for Dr. Wagner, and thank you in advance for Betty Ann, the financial counselor at U of M, who will be getting full inpatient and outpatient approval for us from our new insurance provider (we pray!)

Friends, Family, Faith.

Always remember the Three F's. We are so blessed to be lifted up by all three simultaneously. That is not always the case in life. You are blessed to remember to lean on any one at a time, but three, we are very blessed, indeed!

God Bless You All,

Good night.