Francesca Starts the Clinical Trial

 Since I know we have followers on here and across other social media platforms, I wanted to share the updates I posted about the clinical trial on Facebook. It was a challenging week, but Francesca was a rock star and I am so, so proud of her. I am home for a couple days and then heading back Sunday night for the week, with Amelia. 

Clinical Trial Diaries - Day 1: Francesca was a rockstar. We left Williamston at 6:30 a.m. and she was not impressed - her exact words were “oh man, it’s not even morning time yet.” Things kicked off at 8 a.m.:

• vitals
• blood draw
• ecg
• neuro exam
• a feel and function test
• eye exam

It wasn’t all work. We had a great tour of the hospital and found a lot of great superheroes who are almost as amazing as our Galacto Girl! The only meltdown was when we got back to the hotel and she was so frustrated about not being able to see because of getting her eyes dilated. 

I am in awe of my girl. She was full of smiles all day, rolled with some unexpected bumps and is still smiling while we watch a movie before bed. Tomorrow will be another long day - including a 90 minute MRI. Please keep the prayers coming. I definitely felt them today! And we appreciate all the messages we received. Love you all. 

Clinical Trial Diaries - Day 2: Today started out promising and is ending okay but the middle was rough. Francesca rocked her speech and language assessment and was amazing for the MRI. She had to lay still for an hour - I don’t know a lot of adults who could do it, but she was great. We got back to the hotel around 2 and Francesca was so excited to go swimming. But she thought the water was super cold and that made her sad. I think she was mostly crying because she was frustrated with herself for being too cold but still wanting to swim. She just sat on the window ledge behind the curtains in our hotel room and sobbed. Then I got a call from the doctor. It turns out Francesca has a UTI - which they found from the urine analysis they did. She is not complaining and doesn’t have any symptoms. It’s a long, boring story but ultimately the plan is to still give her the first dose of the trial drug tomorrow but then also start her on an antibiotic. Then she won’t take the trial drug again until after she’s done with the antibiotics. It’s the best course of action to treat the infection but make sure she is officially enrolled in the trial. Soooo after that news she really wanted to try the pool again. And she did great! We’ll be heading back to the hospital at 6:30 tomorrow morning. She’ll have to fast for a few hours in the morning which will be tough and she’ll receive the first does of the medication. Then it will be a long day of getting labs every 2 hours, until around 8 p.m. tomorrow night. Thanks for the continued love and support of our #galactogirls. 

Clinical Trial Diaries - Day 3: It was a long and uneventful but emotional day. Francesca got her first dose of the medicine (or placebo) at 7:40 this morning. A few hours later she started her antibiotic for the UTI. By the afternoon she was just over it. We both were. We left the hospital at 8 p.m. and returned to the hotel to the most thoughtful gift. Sara Armstrong had dropped off a gift basket with balloons from her daughter (Francesca’s friend), Wesley. As a side note, one of the things I always dreaded/worried about was sending Francesca to birthday parties because of her dietary restrictions. The first friend birthday party I allowed her to go to was Wesley’s. I remember feeling bad/like an inconvenience when I talked to Sara - but she was amazing and I knew our girl was in good hands. I appreciate you, Sara! It quickly went from a terrible day to the best day ever. (It was also helped by opening her “brave bag” from Dawn and family.) Because she’s not getting any more trial medicine until she’s done with the antibiotic, tomorrow’s visit will be quick and we hope to be home by lunchtime! Chris will take her Tuesday to her pediatrician for a urine recheck and if everything looks good she should start receiving the trial drug later next week. I can’t believe our brave girl will be 7 tomorrow. I am so blessed to be her mama.

Clinical Trial Diaries - Day 4: It was a quick visit this morning with a blood draw and visit from the doctor. The only pic I took was after coming out of the bathroom to find her across the hall in the office with the doctor and Jackie, the coordinator who had been amazing to us this week! We were home by 9 a.m. and she received the best birthday surprise - a loft bed made by Uncle Andy! I am so proud of this kid. It was not an easy week, but she did it (most of it anyway) with a smile on her face. And she’s been telling Amelia about all the things she can expect next week. Happy Birthday to the OG #GalactoGirl.

The Galacto Girls Join the Clinical Trial

 

Well, things just got real. We’ve been planning on enrolling the girls in the first ever clinical trial for a potential drug treatment for galactosemia for a few months now. Last week, we thought they would be going in August – after we return from our annual vacation in the U.P. Then I got a voicemail on Saturday asking if I could call them back, it was urgent. The direction from the sponsor was if we wanted to be part of the trial, we needed to come in yet this month. So, as of now (but things with this trial change a lot and quickly) I will be taking Francesca to Ann Arbor next Monday and staying until Thursday. Then I will return the following Monday - Thursday with Amelia. And then we’ll go on our vacation. (Insert wild laughter and hyperventilating here.)

So – a little background on how we got here. A few years ago, we learned some really exciting news – there was a drug company interested in developing a treatment for galactosemia. As a rare disease this was huge; companies don’t take interest in rare diseases like galactosemia. We had no idea what the timeline would look like or what it would mean for our galacto girls, but we were hopeful. When the clinical trial started, I was excited but didn’t plan to enroll the girls for two reasons. First, they are thriving. They aren’t currently experiencing any delays, so I didn’t feel the urgent need to get them on the medicine. The clinical trial was also taking place exclusively in Atlanta and the initial stay lasted around 7 days. I just couldn’t see how we could make the logistics work…until a couple months ago. Earlier this summer, they announced additional testing sites were opening, including one in Ann Arbor, Michigan – less than an hour from where we live. And they were enrolling in Part B, which would only require a 2-3 day clinic stay for the initial visit.

I knew then that we had to do it, for a couple reasons. First, we are a rare disease community – if we want to show the FDA that there is a need to get this potential treatment fast tracked and available for our kids, we need to show up for the trial. Second, while my girls don’t have any known impacts now, research indicates that over time they will be impacted – their bodies will continue to create galactose, and without a way to break it down – it will act as a poison attacking their organs and causing issues that could result in tremors, seizures or a host of other issues. I need to fight for my kids to have the best chance at a healthy life, and that means getting them on a potential treatment, as soon as possible.

So, what is the point of the clinical trial? Applied Therapeutics believes many of the long-term complications are created by galactitol. Galactitol only exists in people with galactosemia and occurs when aldose reductase changes galactose into toxic galactitol. (Huh? It’s confusing, I know! Watch this video for a better explanation: https://youtu.be/U_uInPTBmLA.)  Anyway, the medication they are testing has been shown to lower the amount of galactitol in participants without raising the Gal-1-P (amount of galactose in the blood). Currently they are wrapping up Part A, which is determining the correct dose for each of the three age groups. (Ages are 2-6, 7-13 and 14-17).

As participants in part B, the girls will receive the medicine (or could be given the placebo…it’s a double-blind study so we won’t know what they get until the end of the trial) and go through extensive multiple-day testing (think MRI, EKG, blood work, speech and language, eye exam and neuro testing). After the initial clinic visit, a nurse will do home health visits at 30 days and 60 days. Then we will return to the clinic at 90 days. After that they will receive monthly blood draws (at home) and we will return every 6 months for 1-2 days of testing, until the end of the clinical trial.  

The galacto girls had their initial blood test to confirm their diagnosis and provide additional necessary medical information in early June. And we had been waiting for next steps…until I got the call over the weekend.

So, yes – I’m panicking. I honestly don’t know how I’m going to make it through the next few weeks. It’s a huge time commitment. It’s a sacrifice. It’s hard to watch the girls go through the anxiety of the blood draws. But it’s even harder to think about a future with no treatment, with no hope of mitigating the deficits they will most likely experience over time. It’s for a better future – for our galacto girls and all our friends with galactosemia.

And yet, nothing is promised. Will the medicine work? Will it really make a difference and reduce the long-term complications? I have no idea. But we are showing up for our small but mighty rare community. And if it doesn’t work – we’ll be ready for the next opportunity. Because my girls deserve to live the best possible life, even if it means long days, sleepless nights and discomfort for a short time. That is what I am going to keep telling myself – when I start to doubt that it’s worth it, when I want to quit, when the tears come (from both me and them, probably), when it seems like they can’t take another needle poke. It will be worth it. Maybe not today, maybe not in a year or even two– but eventually, if it helps with the complications, it will be worth it. And even if it doesn’t – we will know we did everything we could while we wait for a successful treatment.

So, if everything happens as currently planned, I’ll be taking Francesca on Monday, July 12 and staying until Thursday, July 15…which happens to be our sweet girl’s 7^th birthday. Not the best way to celebrate, but it is out of our control. Then I will return the following week with Amelia. Please keep us in your prayers over the next few weeks. I’m not sure how we’re going to do it, but we will. Because we can do hard things.

GLOW: Galacto Girl Style

As we approach our second GLOW: Galacto Girl Style event (virtual this year) I thought it was probably a good time to look back at last year's event. 

This year will definitely look much different since we won't be GLOWING together in person, but I'm still excited about the awareness and funds we can raise. 

So, a look back: Last year was our first year participating in GLOW -  an amazing fundraiser started by my friend Brittany in Tennessee in honor of her daughter Ansell, who has Galactosemia. Our first event was a huge success starting with two different news crews interviewing me two days before the event. We had 74 people attend the event and between the registrations and donations team GLOW: Galacto Girl Style raised over $2,000. 

Because I'm not what you would call an avid runner (okay, probably could have omitted the word "avid") - we went with a "MOVE" event. There were stations where attendees could move their bodies and their minds. Attendees played basketball, walked laps, did yoga and also colored, played board games and learned about Galactosemia. The day was so much more than I could have expected or hoped for! 

We held the event at our church, South Lansing Christian Church (and hope to gather in person there again for a future event!) The morning of the event I attended church and was so moved by one of the songs, which was so appropriate for that day and our Galactosemia story. Here is part of the Facebook post I made: 

“Great is your faithfulness...you never change, you never fail, O God.” He has been so faithful to me and our family - I may forget that sometimes or question it in moments of weakness, but it’s not that He isn’t faithful - sometimes His timeline just doesn’t match up with ours. And that’s because His plan for us, our life and our family is so much bigger than we could imagine. 

And at the end of the day, after everyone left and we had locked up, I sat in the prayer room at church and thanked God for His faithfulness, for all of you and for my husband and my girls. Navigating this medical condition was not something I could have ever imagined but I would also not change it for anything because that would mean changing my girls and I would never want that. And I asked him for strength and wisdom to keep being the mom my girls need me to be, even when I’m not feeling particularly strong. I know He will continue to be faithful. We are blessed.

GLOW: GALACTO GIRL STYLE 2021 - register today!

So, looking forward to this year - it's not how we would prefer to have the event, but it is what makes sense as we make our way through this pandemic. We can still make memories, get some exercise and learn something new. And most importantly, we can still raise awareness and funds for our Galactosemia community. 

For those interested in joining our event, you can sign up here: https://runsignup.com/Race/Register/?raceId=68674&eventId=450216&fbclid=IwAR1nL4syGZsdTrDVlWbTQz4elaUSVY97L76MuWbx-77DtduJ5GJJnpXz4l4

Make sure to register as a virtual participant and then say yes to joining a team and join GLOW: Galacto Girl Style. You will receive a glow in the dark t-shirt and mask for every registration. The money from registration goes to benefit the Galactosemia Foundation. You must register by Feb. 10.

For the details on our specific event - check out our Facebook event: https://fb.me/e/1PD20D6P5

We will start with a Facebook Live event at 10 a.m. - after that, it's up to you, but we ask four things:

1. MOVE - Get active! Do yoga, take a walk or have a dance party - whatever sounds like fun!

2. LEARN - We will share some great new resources available and other information so you can learn more about the disease our Galacto Girls live with, every day.

3. EDUCATE - Help us spread the word about Galactosemia and why it is so important to raise funds and support research by posting information about Galactosemia and Rare Disease Day on your social media.

4. SHARE - Post a picture on social media of you/your family GLOWING on Feb. 28! Use any or all of the following hashtags: #GalactoGirls #glowforgalactosmeia #rarediseaseday

P.S. Newscasts covering our event last year available here: https://www.wlns.com/news/galactosemia-what-is-it-family-shares-story-of-daughters-rare-disease/ and https://www.wilx.com/content/news/Williamston-mom-raises-awareness-of-rare-disease-day--568350051.html

And then there were two...Galacto Girls

Well, two days before the twins turn 2, seems like a good day to introduce Galacto Girl 2.0 (and Dairy Queen) to the blog. (Oy...life is clearly a little busy). But here goes...

We knew there was a chance one (or both) of the twins would have Galactosemia, so when they were born we put them on Soy Formula and waited for the Newborn Screen results. From the moment they were born Amelia had oxygen/breathing issues, so I didn't even hold her. I heard two babies cry,  I heard reports of two "good size twins" but it took me a little bit to realize I only had Baby B on my chest. I finally said "Where is Baby A" and that's when Chris (or someone) told me she was having some breathing issues and was on Oxygen. 

I didn't think much of it at the time in relation to Galactosemia, but I probably should have - that is exactly how things started with Francesca. Amelia was taken to the NICU and Annabelle was able to come in the room with me. The next few days were a roller coaster - but a familiar one. Amelia's white blood count was low and there was something showing on her lungs (likely fluid), so they put her on an antibiotic. One thing would get resolved (coming off oxygen) and then another thing would pop up (IV for possible infection). Then her blood sugar was off. I'm not sure after which "new" issue I realized it, but I remember saying to my mom "If we have another Galacto Girl, I'm pretty sure I know who it is." If you look back at one of my first blogs about the Seven Day Eternity - these were all issues that Francesca had. Francesca was never put in the NICU though - when she was born Sparrow had a "Special Care Nursery" and she was there. I was able to hold Francesca from the beginning. That was not the case with Amelia - she was in an incubator and hooked up to all kinds of stuff. I didn't get to hold her until the day after she was born.

And then of course this time we had the added complication of my C-Section, so I was in more pain and not as mobile as I was with Francesca. It made for a stressful and scary time. I think the scariest (and most infuriating) moment was when Dawn and I went to the NICU to see Amelia and they were putting an IV in HER HEAD. She was screaming, there were two nurses and NO ONE was saying anything to me. I was terrified, I had no idea what was happening and I was helpless watching my baby scream. I soon learned her IV in her arm had gone bad and the head is one of the best places for babies - BUT no one told me that at the time. As you can tell, I'm still a little bitter.  I understand they were just doing their job but a little communication would have been nice. Anyhoo....

On day three we got the results. Chris had just left to see Amelia in the NICU and I was pumping, when a doctor knocked on the door. Results were in - Amelia had Galactosemia. Annabelle didn't. I was prepared for this, I knew it was a possibility but it still felt like a punch in the gut. I cried, a lot. How in the hell was I going to handle one baby with galactosemia and one without. It seemed very scary and overwhelming.. And yet, I was also relieved. Relieved Annabelle (who at this point I was already calling "Annie" and constantly singing "Sweet Annie" by Zac Brown Band to) didn't have it and relieved to know that was likely the reason behind all the issues Amelia was experiencing. 

Amelia was discharged from the NICU and we were able to have the girls together for the first time and a newborn photographer came in and took pictures. With most everything resolved, except Amelia's bilirubin, we were able to go home on May 15, with a light therapy blanket for Amelia. 

As we settled in at home we started figuring out the formula situation. We purchased color coded name bands for bottles (blue for "anna blue belle" and orange for "agent amelia orange.”  I have no idea guys - I was tired, and it made sense and stuck!) We also bought two Dr. Brown formula pitchers - one for soy formula, one for dairy. Over the course of the next few months there would be several times I would dump a formula container because in my sleep-deprived state I wasn't totally sure if it was soy in the soy pitcher or dairy in the dairy pitcher. 

The first metabolic appointment was at lot less scary and overwhelming than with Francesca. I didn't cry all the way home and although I still had moments of anger, sadness and uncertainty - I knew we could and would handle anything the condition threw our way. 

As the girls started to develop, Amelia (Galacto Girl) hit the major milestones before Annabelle. She rolled first, crawled first, cut teeth first, walked first, talked first. If Annabelle would have been the one with Galactosemia I would have definitely thought it was the condition. I guess it made sense, she was "Baby A" - the first to be born, I guess she had to keep up the signature "Baby A" by being the first at everything! But it was just the case of kids developing and hitting milestones at different times. You notice it a lot more when you have two to compare. We do have Early On coming for visits monthly to watch for any delays, but at two years old, Amelia continues to exceed expectations. 

We knew they weren't identical since one had a genetic condition and the other didn't - but they also didn't look identical. As they got a little older I had a couple moments of panic. I remember a time around their baptism that I started freaking out about getting them mixed up or other people mixing them up - and I labeled their diapers. 🤣 That lasted about a day. And of course when I went back to work and the nanny started I worried about her mixing them up, so I wrote down all the differences (Amelia had more hair, Annabelle was smaller, etc.)

Everything is still color coded. The name bands are now around sippy cups instead of bottles; Amelia has green sippy cups and Annie has blue and dishes are coordinated the same. Other than Vitamin D milk, Annabelle is eating what the big girl eats which means dairy-free mac and cheeze, pizza, etc. Some day we'll introduce her to the real stuff (and with our luck she won't like it), but for now with how they share and drop food, it's just not safe.

Francesca and Amelia are our Galacto Girls and Annabelle is our Dairy Queen. When I was pregnant with the twins, Francesca was obsessed with "Baby B" and that continued until recently. Now she is more drawn to Amelia, who is a little more loving toward her sister than Annabelle (who we lovingly refer to as "bulldozer baby"). Recently the twins started interacting and playing together more; it's fun to watch. It will be interesting to see how relationships develop and change as the twins get older. Of course the twins will have their bond but I expect Francesca and Amelia will also have a special relationship because of galactosemia. It's bound to be a fun (and exhausting) adventure. We hope you'll continue it with us. And I'll try to be better about updating the blog!

Galacto Girl Goes To Preschool

Galacto Girl Goes to Preschool? Well that doesn't seem right. Didn't I just do a blog post a couple months ago about Galacto Girl going to daycare? Oh that was a year and a half ago? Alrighty then...

So, September 5 Francesca had her first day of all-day Preschool. It was less than two weeks after we decided to see if it was even a possibility.

Chris and I had talked in passing a couple times about the fact that we should look into it. But it wasn't until less than two weeks before school started that I made the call. It was mostly prompted by my frustration and discomfort with daycare. While they have been wonderful to FJ and good about her dietary restrictions - there had been a lot of turnover with both the teachers in the rooms and the director and assistant director. I understand that turnover happens, but it felt like all the people who were there when FJ started - the people who really loved her and were aware of the Galactosemia were gone. And it was exhausting and worrisome wondering if the new teachers were up to speed and if the directors really understood the condition. So, it was a combination of that and the fact that I knew she was getting attached to her friends at daycare and it would be harder for her to leave in another year - I made the call.

They returned my call on Monday and said because they had just had a family withdrawal - they had one open spot. Sure felt like a "God thing." And that was just the first of many. We arranged for Chris to pick up the necessary paperwork and when he was at the school to pick up the paperwork the teacher was there. He was able to talk to her and explain FJ's Galactosemia. Then a couple days later my mom took Francesca for a walk to play at the park and see where she would be going to school. As they were reading the sign on the door a woman came to the door and asked if they needed anything. My mom explained Francesca was going to be starting Preschool there. It was Francesca's teacher - so she was able to meet her.

The only person who wasn't going to meet the teacher before school was mama. I was going to be out of town for work for a few days. During that time Chris would take FJ to the orientation and have a one-on-one meeting with the teacher. I struggled with a lot of mom guilt, but I had work commitments and I knew I would be there for the first day of school, which was the most important thing. 

The night before she started school I began to panic. I wanted to make sure they had information that explained FJ's condition. There were a few "teachers' guides" and other information online but most of them were for kids who had known delays, which she doesn't at this time, or very complex info. So it was a late night - but I created an overview document that explained the condition, FJ's journey, delays we were watching for, restricted foods and then a page of approved and not approved snacks, based on their calendar. Lunches wouldn't be a problem because she would bring her own lunch but some of the snacks were definitely off limits, so I made sure to cross off everything FJ couldn't eat and highlight the items she could, on the monthly calendar.

Francesca was super excited to start preschool. She would be going on Monday, Tuesday and Friday

all day (8:30-3:30) and then to after care until 6. She would still go to my parents' house on Wednesday and Thursday. We explained that she wouldn't be going to daycare anymore but she would have new teachers and meet new friends. She told us on several occasions that she was excited but "might be a little scared." Me too baby, me too. The first day drop off went very well. Francesca didn't cry at all...and mama mostly held it together. I worked from home that day and at 3:45 we got an email from her teacher with the subject "accident". Turns out our potty trained girl had pooped her pants during rest time...and she was wide awake.

Okay...probably just nerves and the new routine. Right? Got another email on Friday the first week - Madame Poops Her Pants had made a return - pooping her pants during rest time. What in the actual?! I was really afraid we were going to get kicked out. We talked about it with her and reminded her she needed to tell her teacher or an assistant when she had to go potty, she said she understood. LIAR LIAR PANTS ON FIRE (and full of poop). So, on Monday I refresh my email about every 3 seconds around the time we would get the poop alert - and finally we do - to let us know that she didn't have an accident. WOOT! I remember how when she was little and was constipated we would joke about a "poop party" when she finally went. I didn't ever think I would be having a "no poop party" when she was three. But, here I was - damn near ready to throw her a party for not pooping her pants.

But then Tuesday came. This was a little different because we didn't get an email from the teacher about it, in fact Chris did get one that said she didn't have an accident. But when I went to pick her up she was in different pants and I had a suspect stinky plastic bag to take home. Gagsville. So, I ask FJ when she pooped her pants. "I didn't poop my pants!" was the reply. "Well, I have a stinky bag of your clothes and some poop marks that tell me different." "NO MAMA, I DIDN'T POOP MY PANTS" - great Madame Poops Her Pants is now also a big fat (and angry) liar.

When she went back on Friday (today) I didn't have high hopes, mostly because I knew she hadn't pooped since Tuesday. And I was right...another email about her pooping her pants during rest time. NOW I'M PANICKING - it's week two and there is no improvement. How long can I keep telling myself that it is because of the new routine?! And although I don't remember seeing anything about kids needing to be potty trained, I know that is usually a preschool prerequisite. So, I reply to the teacher and pretty much apologize and ask if she's going to get kicked out. A response comes a few hours later - she has some ideas for what they can try over the next couple weeks and no, she's not going to be kicked out. SHOOOO - a huge sigh of relief for this mama. Her teacher mentioned maybe she doesn't like going with all the other kids in the bathroom - which hadn't really dawned on me but Chris noted that the bathroom at daycare was only a single stall, she didn't have to worry about others being there. Maybe that's the issue. So the teacher is going to wait until all the kids are down for rest time and then take her and see if that makes a difference.

I have to be honest. I've said a lot of prayers in my life - but I never expected to beg God to help my child not poop her pants. But here we are...on the third night (or more) of that prayer. And this is a doozy of one for him to take His time answering. I'm hoping next week is better and sooo thankful her teacher has been wonderful and understanding.

Overall the communication with the teacher has been amazing. Aside from the "your kid pooped herself again" emails, she also let us know a couple times when snack changed and Francesca was able to have it - or an email to tell us on the days when she couldn't have snack, what they substituted based on the allowed/not allowed list I provided them. It has all been very reassuring.

So next week will be week three. Really hoping it will be a poop-in-the-toilet-not-in-your-pants kind of week, but only time will tell. In the meantime, if anyone has any tips to help Madame Poops Her Pants, I'll take them. Also, I can't wait to show her this blog on her high school graduation. Unless she's still pooping her pants, then it won't be so funny.

A Letter to Myself - July 15, 2014

This is the time of year when Timehop and On This Day Facebook memories and pictures bring back the sadness, fear and uncertainty we experienced three years ago. We still face uncertainties including possible learning disabilities (yes, I know she's doing great now - but the galactose will continue to build up in her body and and could still cause long term challenges) and premature ovarian failure, among other things. But we have an amazing kiddo that I wouldn't change for anything - including her Galactosemia diagnosis. As Francesca's birthday approached I kept thinking of things I would have loved to know three years ago. So, I wrote a letter to my July 15, 2014 self.

Dear Me,

Things are about to get really scary. When your skin-to-skin time is cut short, it will be just the beginning. You will question if you'll ever bring your daughter home. You will feel incredible guilt
when you return to the nursery after breastfeeding Francesca only to find out  the very thing you thought was sustaining her would kill her. You will think you want to go home for a night only to make your husband turn around and take you back to the hospital because you would rather spend the night sharing a room with a stranger (divided only by a curtain) than spend the night at home, away from your baby. You will experience an emotional roller coaster that will include times of peace and hope and times of extreme sadness, fear and anxiety. But know this, your baby will be okay, you will be okay.

Don't push your friends away. There are a lot of people who love you. And you need them. Reach out, ask for their prayers, cry with them. Let them come visit. After spending a couple days not talking to anyone about the situation - you will feel so much relief when your best friend comes to meet Francesca and you get away for a couple hours. People you haven't talked to in years will reach out to offer prayers and provide support. It will help. You will still remember who they were and be grateful 3 years later.

Be wary of what you read on the Internet. You will read A LOT. And most of it will be really scary - because it is worst case scenario. You will find good things too; A blog about two healthy girls with the condition, a Facebook group full of supportive people who have been in your shoes and will offer advice and support, and information about the conference that happens every two years (and is actually taking place in Florida while you are scouring the Internet for information about the condition). But there will also be out of date information, including dietary guidelines. And there will be conflicting information. And there will be a lot about worst case scenarios - read it, know it is a possibility and then move on. It could happen, it doesn't mean it will.

Be prepared for information overload. You will be terrified and anxious leading up to the specialist appointment. At the appointment you will meet with several different people who will provide so much information you will feel like your head will explode and you will never remember everyone and everything. You will leave feeling exhausted and overwhelmed. You will cry all the way home and not want to talk to anyone. Your husband will hold your hand and share in your grief. These appointments will not always be this way but your husband will continue to be your rock - strong when you are weak, positive when you are negative, patient when you are not. You will make a great team. (I realized as I'm typing this that I probably don't tell him that enough. Thank you, Chris! xoxo)

You will learn more than you thought possible during the first year. The first time you go to buy baby cereal you will call the dietitian in the aisle of Kroger to make sure it is safe because there are a couple ingredients you won't be sure about. You will be near tears because you're overwhelmed and think you'll never figure it out. And this will not be the last time - you'll put all of the dietitians phone numbers (3 to be exact) in your phone and will call them frequently as your child ages and is introduced to new foods. But, you will learn a lot - quickly. By the time she is two you will be able to easily read a label and spot unsafe ingredients. You will learn that the allergy statement is the first place to start and what to look for - but also know to read the ingredients, just in case.

Stay positive and pray. This child is the best thing you have ever made. Enjoy her. Don't spend your life worrying. Nothing good comes from worrying about something that might never happen. And if it does happen, it won't help to have wasted days, months or years worrying about it. You will have good days and bad days, days filled with anxiety but more filled with hope and joy. Pray. Know that even when the future seems scary and uncertain for you, it is not for God. He's got this. Remember, Francesca is a child of God, and He doesn't make mistakes. She is exactly who He meant for her to be. Find peace in that and walk by faith.

Love,
Me

p.s. I might also include - you're not going to completely change your diet, removing all dairy, and get super skinny like you might think. You will make simple substitutes (dairy free butter, bread, marinades, etc.) when they are available, but for the most part you will put the cheese and other dairy ingredients on the side and teach Francesca from an early age what she can and cannot have and to ask if something is "safe" for her, before she eats it.

Celebrating Galacto Girl on Rare Disease Day, and Every Day

It's Rare Disease Day - the perfect time to give an update and celebrate our Galacto Girl. We had our appointment with the Metabolic specialist the beginning of November. As always, they tested her Gal1P, the amount of galactose in her blood. They want the number to be under 4. It had been under 4 for the last couple appointments so I was hopeful. This time it came back right at 4. They aren't concerned because she is doing so well and said it could have just been what her body was producing that day and not related to anything she ate. They didn't recommend a recheck so we will get it checked at her next appointment...which won't be until next fall. We only have to go back yearly now. Yay!

We also found out her Vitamin D is low. Not surprising since our strong-willed sassbox refuses to drink any kind of milk substitute (coconut milk, almond milk, soy milk...we've tried them all). The doctor prescribed chewables for her but trying to get the prescription filled has been a nightmare. Insurance wouldn't cover it because she's not over 65. Then I found out it was like $6 for the prescription so told them to order it and I would pay out of pocket. Then they couldn't find it in the amount the doctor was prescribing. After several trips and calls to the pharmacy, I finally gave up and went shopping. After trying Whole Foods I found them at GNC. Brought them home and....she hates them. GAH. I called the Metabolic clinic back and asked for drop recommendations. So, I will be ordering those  and hope they do the trick to get her Vitamin D where it needs to be. Other than that, the appointment was great. She is great. Just the same caution of "delays usually don't show up until around school age."

We often talk to FJ about being a Galacto Girl and having Galactosemia. It's a struggle to figure out how to make your two and a half year old understand that although sharing is very important - she cannot share food if someone offers it to her. I know it will be easier as she gets older but we will continue to have the conversation.

And then there are things she definitely understands...like how to turn our own words on us. So we often say "that's not safe for you" or "we have to make sure that's safe." Well a couple weeks ago miss smarty pants was eating her dinner and decided she was done. She pushed her plate away and looked at me and said, "No mama. Can't. It's not safe for me." :/ AHHHHHHH. I assured her that her mama would never give her something that wasn't not safe for her. Oh boy...we're in for it.

In other news - Francesca will be having tubes put in her ears next Wednesday, March 8. In the last year she has had a couple double ear infections and several single ear infections. At a recheck for the last one the doctor found that although the infection was cleared up there was still fluid in her ears. We went back two weeks later and it was the same, so they sent us to a specialist. They said her hearing is probably impacted to some degree, so hopefully the tubes will help. I know it's a simple procedure but am still anxious, of course. Prayers are appreciated!

She is a rare kid - in more ways than one (I mean, have you met her parents? Especially her dad...) but I wouldn't change her for the world. She is by far the best thing I have ever done.

Conference Recap

Five months after the conference seems like a good time to post an update. Whoops. Let's see if I can remember...

The conference was much like I expected. There were times I felt very hopeful and other times that I felt lost and terrified. But overall, it was a wonderful experience.

We met a lot of great people and learned a lot of tips for managing the condition. Two of the sessions stand out to me. One as a high and one as a low.

The low: Premature Ovarian Insufficiency. Bottom line, most women with Galactosemia (80-90%) have POI in some form making it unlikely (but not impossible) to have children. They said the best chance of a woman with Galactosemia to get pregnant is to do IVF with donor eggs because they have lower egg count. With that said, I know research is continuing and we have years before we have to really think about that.

The high: A presentation by a mother of two boys with Galactosemia about the importance of self esteem. She talked about everyday events that can be challenging for our kids and the importance of helping them believe in themselves so they can rise to any challenge. She also gave some great tips such as putting green and red stickers on all the food in the house - that way if a family member or babysitter comes over, they will know what is safe. It's also an easy way for the child to know what they can and can't have. She also talked about the importance of having the kids start asking questions and talking to the chef when you're out to dinner, at an early age. This will allow them to learn what questions to ask and how to explain the restrictions since as she said, some day mom won't be with them. It was also encouraging to later hear from both of her sons who are in college and doing well.

We also got to meet Dr. Fridovich-Keil who does Galactosemia research at Emory University. I had enrolled Francesca in a study with her lab so it was great to meet her and learn more about the research. We also enrolled FJ in another study.

FJ celebrating her birthday at the conference

One session has really stuck with me. A mom shared her story of refusing the newborn screen. As I have talked about before, the newborn screen is the reason Francesca is with us today. She was diagnosed because of the newborn screen - a simple heel poke - at 3 days old. I learned that there are people who actually petition against the newborn screen. The presenter shared her story of being approached by a nurse who claimed the newborn screen was a violation of privacy and it would allow the government to have the child's DNA. After talking with the nurse and not being aware of any genetic issues in their family, she signed the Parental Refusal of Newborn Screen. After her son was born her nurse (different nurse than previously mentioned) encouraged her three different times to get the newborn screen. After the third time, she agreed and because of the test found out her son had Galactosemia. Thankfully it was caught in time and he is now a healthy 7 year old. Her story made me realize I need to be a vocal supporter of the newborn screen. I need to share my story. I hate to think about what could have happened if we hadn't done the newborn screen and it is heartbreaking to me that people would advocate against a non-invasive and potentially life-saving test.

Apparently she thought it was okay to take
all the balloons, since it was her birthday!

The speaker also shared the poem "Welcome to Holland" - written by a mother of a special needs child. I've also read other special needs parents talk about why they don't like the poem. Personally, I really related to it. It left me in tears and still does.While we have been very fortunate so far and Francesca is not experiencing any delays, we know we could still have a long road ahead of us. And it's not what any parent expects or wishes for. It reminds me of when I blogged about how everyone tells you to have a birth plan but also warns you it might not go as planned but no one tells you your after birth plan might not go as expected.

We learned a lot at the conference. We met some new friends but didn't meet as many people as I had hoped. It was hard because they had activities at night but they started at the same time as FJ's bedtime so we didn't attend them.

The next conference is in 2018 in Denver, Colorado. We'll definitely be flying to that one. Oh - that's another thing I learned - driving to Georgia with a toddler is a questionable decision. Actually, the drive there wasn't the problem, but when we were driving through the mountains on the way home and FJ was screaming "OUT...I WANT OUT" at the top of her lungs, I briefly considered strapping myself to the roof of the car. Instead, after we were out of the mountains Chris frantically searched for the nearest park, which we immediately went to and let Francesca play before continuing the drive.

I'm looking forward to the 2018 conference and am currently brainstorming some fundraising ideas we can do to support the cause. Stay tuned.

FAQs According to JLS

As we shared Francesca's diagnosis with people we began receiving a lot of questions. I've compiled a list below.

Q. Will she grow out of it?

A. No. It is genetic. Her body does not produce the GALT enzyme necessary for breaking down the sugars in dairy.

Q. How did she get it?

A. Both Chris and I are carriers. Which means we both have a working copy of the gene and a non-working copy. We both passed on the non-working copy to Francesca.

Q. What are the chances our other kids will have it? 

A. There is a 25% chance they would have Classic Galactosemia (like FJ). There is a 50% chance they would be a carrier (like Chris and I). There is a 25% chance they would have no form of it at all (if Chris and I both passed on the working copy of our genes). And yes, God willing, we will have more children. If I'm being completely honest, when we first learned about the diagnosis I thought we were going to be one and done. But after some time and talking to Chris, I realized I want Francesca to have a sibling and if she ever asked me why she doesn't, I couldn't imagine telling her it was because of the condition she has. 

Q. Since they caught it so early does that mean she won't have any long term issues?

A. No. While it is a blessing it was caught so early and we were able to avoid damage to her organs, it does not necessarily mean an obstacle free life. Her body produces Galactose, the very thing that she does not have the enzyme to break down and therefore there will be a build up of it in her blood. This build up is what can cause the potential problems. It could be years before we know what kind of long term effects she will have, if any.

Q. What are the possible complications?
A. Cataracts; Learning disabilities including:speech and language difficulties, fine and/or gross motor difficulties, and difficulty with math or reading; Neurological Impairments including: gait, balance, and fine motor tremors; Premature Ovarian Failure - they will start testing her around 9 years old; Speech Disorders. 

Q. Is there a medicine for it? How is it treated?

A. No, there is no medicine. The only current treatment is diet. She cannot have any type of dairy or foods containing galactose. Galactose is found in many processed foods so reading labels will be key.  Many fruits and vegetables contain galactose but they don't restrict them because the health benefits outweigh the risk.

Q. How often does she go to the doctor?
A. She sees a metabolic specialist in Detroit every 3 months. When she turns 1, we will start going every 4 months. Every visit they draw blood to see the level of galactose (Gal1P). They want the number to be under 3.5. Her last visit (December) it was 4.6, so not as low as they want. Considering it was 85 when she was born, we're heading in the right direction. She also sees a pediatric eye doctor every 3 months. So far her vision has been great and the eye doctor has no concerns.

Q. What can't she eat?
A. Anything that contains dairy (milk, cheese, sour cream, butter, yogurt, etc.) Thankfully there are a lot of dairy free versions of these products available (and I am making lists). She also cannot have Whey, Sherbet or Organ meats (often displayed as "meat byproducts" on labels - no problem there...ick).

Q. What can she eat?
A. Since her diagnosis she has been on Soy formula. As for baby food, she can have all fruits and vegetables. As I mentioned earlier, they do contain small amounts of galactose but the benefits outweigh the risks. She will be allowed to drink soy milk, almond milk, rice milk, etc. Legumes used to be restricted but aren't anymore. Our clinic still does not allow garbanzo beans (chick peas) because of their high galactose content. Some clinics/doctors vary in their restrictions.

More info: http://galactosemia.org/PDFs/UnderstandingGalactosemiaDietGuide3.pdf

The Seven Day Eternity

When I was pregnant I kept hearing and reading that I should have a birth plan. I leaned over to Chris during our hospital tour and said "my birth plan: get this baby out...and give me drugs." I also read that you shouldn't expect your birth plan to go off without a hitch. What I wish someone would have told me was to not expect my "after birth plan" to go off without a hitch. In our birthing classes the nurse talked multiple times about how once the baby was born they would put her on me for two hours of skin to skin time and then we would try to breastfeed, and she would stay in the room with me. Why didn't anyone tell me that might not happen?

Day 1 - July 15
Francesca Jo was born at 6:26 a.m. and they did put her directly on my chest. I stared in awe, we took pictures, and for a few minutes things were perfect, we were right on track. Then things changed. Drastically. They were worried about her labored breathing and after calling additional people in the room to examine her, they took her to the nursery. She was put on oxygen, did a
chest x-ray and ran blood tests. The chest x-ray showed haziness, they said it could just be access fluid from birth but they would treat it as worst case scenario (pneumonia). And she had to stay in the nursery until her oxygen levels went up. The test results also showed she had low blood sugar. When they tried to feed her, she was unable to keep it down so they started gavage feedings. By the end of the day 1 our baby girl was hooked up to oxygen, had a "club" hand for the IV and had a tube down her nose for the gavage feedings. It was a rough day for all.

Day 2 - July 16
A new day, full of so much promise. They were removing the tube to try and breast/formula feed. If she kept the food down and her blood sugar levels stayed normal, she would be able to come in our room. If. If. If. They did a repeat chest x-ray and the fluid had cleared up. One step in the right
direction! But...white blood cell count was still low, so she would be on antibiotics for another 24 hours. Her blood sugar was also still low. Another night in the nursery.

Day 3 - July 17
One step forward, two steps back. That's what it started to seem like. Every time we would get one issue on the right track, something else would surface. On day 3 that something else was her bilirubin. Her blood sugar was good so they were going to start weaning her off the IV. But the elevated bilirubin meant she would need to go under the lights and could only come out for 30 minutes to eat. Considering we already had limited time with her since she couldn't be in my room, this was heartbreaking. And I was supposed to be discharged. How was I going to go home without my baby? Thankfully they had empty beds and said I could just stay in the room. There would be no more vital checks, no more free food, but I would have somewhere to stay so I didn't have to go home without Francesca, for now.

The good news was, with her being off the IV she could come to my room to eat. It was our first glimpse of freedom, but I knew I had to be quick because the lights were waiting. I felt hopeful but sad as I took her back to the nursery. Little did I know everything was about to change. As we entered the nursery one of the nurses was on the phone. It was Francesca's doctor, and he wanted to talk to me. "Everything is okay," he said, "Francesca is fine..." I wasn't sure I was believing that. Then he continued..."but the newborn screen test showed that she tested positive for something called galactosemia, her body does not have the enzyme necessary to break down the sugars in dairy." He explained that it was treatable by diet and we were very lucky to find out so early because many babies die before they ever know something is wrong. Then he said something that rocked me to the core, "stop breastfeeding immediately." I had just experienced so much joy from having her in my room and breastfeeding her. And then I realized an act I was so excited about and thought was giving my baby life was poisoning her. That was a lot to wrap my head around. I took some notes and headed back to my room to share the news with Chris.

Honestly, at this point I wasn't feeling terrible about it. The doctor made it seem like since we caught it so early, it would be fine. She just wouldn't be able to have dairy and other foods that contain galactose. Didn't seem so bad. Only, that was the simplified version. We soon found out there was much more to it. Damn Google. Chris started to relay the information to me, I didn't want to hear it. Things like "learning disabilities", "liver failure", "premature ovarian failure". At this point I pretty much went silent. Even my best friends weren't hearing from me. I felt bad but I wasn't ready to talk about it. It made me sick to think about. Why? Why was this happening? My mind started to race, and so did my heart. I started feeling like an anxiety attack was around the corner. Thankfully, I had not yet been discharged. The nurse brought me some meds to help me relax and sleep. It was still a pretty restless night.

Day 4 - July 18
This day is pretty much a blur to me. I cried a lot, I remember that. She was still under the lights for most of the day so I couldn't see her much. By that evening her bilirubin was better and her weight had went up a little bit. And I was finally ready to talk, my friends needed to know and I needed them- so I made some phone calls. Small steps.

Day 5 - July 19
It was never ending. The worst roller coaster ride of my life. Some of her blood tests came back concerning. Specifically her ATTP level which could indicate a clotting issue. Immediately I went back to what the doctor said when we found out about the galactosemia, "some babies bleed out and you never knew anything was wrong." This can't be happening. Thankfully, it wasn't. But they were concerned and did a scan of her head to rule out a brain bleed. They checked her liver panel and that was perfect. Her bilirubin had stabilized. But we weren't going home until they figured this out. What was this, set back 583?

I had to leave the hospital. As much as I appreciated the room, I had to get out. Thankfully the hospital has an "Ellison room" for moms to stay overnight when they had been discharged but their babies hadn't. I reserved one of the beds (two in a room, divided by a curtain) and Chris and I headed home for a little bit. Big.Mistake. It was awful. Walking into the house filled with Francesca's swing, Francesca's pack and play, Francesca's books. And no Francesca. I lost it. It wasn't right to be there without my baby. It wasn't the plan. And I started to fear I would never bring her home, that she would never experience any of the things waiting for her or the dreams I had for her. It was probably my darkest moment; all I could do was cry.

We stayed long enough to take showers, have some food and pack new clothes and then headed back to the hospital. There was nowhere else I wanted to be. And once I had Francesca in my arms, I felt better. The only time I really felt at peace was when I was holding her. It was hard to look at her and think she was anything other than a perfectly healthy baby girl.

Day 6 - July 20
Her bilirubin was back up, so back under the lights she went. They came to take her blood to recheck the ATTP and couldn't get it. She was screaming. And they were talking about repoking. Tears

Dear Jesus, I'm ready to go
 home from the hospital now.
Praying you can make it happen.
 Love, Francesca

streamed down my face, I had to walk away. Finally they called a nurse from the NICU. I couldn't help but be concerned when she came in. She had to be 75. My mom reassured me that meant she had lots of practice and here's where I apologize. She was great and got it on the first try. But the results still came back elevated. They had the hospital hematologist come and evaluate Francesca. She told me she was concerned about the level but didn't see any signs of internal bleeding. She also told me that the results can be skewed by a hard blood draw. HELLO, that is all they have had. She mentioned an artial stick but they don't recommend using that method with someone who might have a clotting disorder. I was losing my patience. The kid's blood is clotting before they can get it out. Doesn't really seem to have a clotting problem to me!

I went back and forth about going home for the night. I decided to stay. I wanted to go back to the room and have a good cry. But when I got there someone else was staying in the other bed. I felt uncomfortable and called Chris, I decided to go home for the night, or so I thought. In tears I met him in the lobby and walked out to the car. We had not even gotten on the highway when I told him to turn around. I couldn't leave her, even if it meant sharing a room with a stranger. I think Chris was somewhat relieved. And I was so thankful to have an understanding husband who immediately turned around, no judgement about my 46 mind changes in 20 minutes.

Day 7 - July 21
Her bilirubin was down after spending the night under the lights. Since they couldn't get a free flow for the ATTP test they ended up doing an artial stick; she clotted fine and the results came back normal. Liver panel was good. (Liver function is a concern with galactosemia) The doctor came in to see her and after looking over the test results and talking to the hematologist and the specialists at Detroit, everyone was in agreement. It was time for Francesca to go home. I couldn't believe it. The last few days had been so frustrating and filled with so much uncertainty and false hope and now - we were going home! I called Chris and told him he should come soon. When he asked why I replied, "because we need a car seat to take our baby home." We walked out of the hospital about a week to the minute Chris and I had arrived after my water broke. Jesus had answered Francesca's prayer (and ours)!  But we knew this wasn't the end of the roller coaster journey. With a condition like Galactosemia, it was likely just the beginning.

Welcome to The Adventures of Galacto Girl

Our daughter, Francesca, was diagnosed with Galactosemia three days after she was born. It is a rare genetic metabolic disorder, and by rare I mean 1 in 40-70,000. We owe her early (and potentially life saving) diagnosis to the newborn screen they do in the hospital.

After doing a little research and reading articles, blogs and personal stories I knew I would soon be joining the ranks. Francesca Jo (FJ) is now four months old and she is perfect. I still have a lot to learn and know there is potentially a long, difficult road ahead of us but I am learning to enjoy every day for what it is.

Early on I told myself I would allow time to grieve for this scary diagnosis and uncertain future but then I would spend my energy being thankful for every day instead of worried about what may be around the corner. Because really, what's the point of worrying about

something that might never happen. And if it does, it won't help to have wasted days, months or years worrying about it. I do pretty good, but still have some hard days. I just want my baby girl to have the best life possible.

So, I will be keeping a blog about our Galacto Girl.  Maybe it will help someone else and I know it will help me. You're invited on this crazy journey with us. The good, the bad, the ugly. It will be the Adventures of Galacto Girl. Sounds like a super hero, right? Well, after the fight she put up during her first week of life, she could be one. All we need is a cape.

Learn more about Galactosemia: http://galactosemia.org/Understanding_Galactosemia.php