Saturday, May 28, 2011

Another trip to ABQ

Several weeks ago, David got his first blood transfusion in many years, as part of our efforts to get him cured of whatever disease he has.  The idea with the blood transfusion is to give his body something good to work with so we can see some growth and physical development.  He's very, very small for a 10 yr old- less than 3rd percentile, actually.  

When we first started with this program his hemoglobin was around 4.0 gm/dl.  Normal is around 11-13.  So, he's basically running with 1/3 the oxygen in his blood that he should have.  A week after his first transfusion, he was 8.5 gm/dl.   A week later, he was 6.6 gm/dl.  Since his bone marrow is producing blood, the destruction of this good blood may be occurring in the spleen, but the doctors need to rule out several other factors before we go removing his spleen.

Anyway, in order to keep his blood up, it was time for another transfusion and so, it was off to Albuquerque again.

Mom never misses a schooling opportunity!

It's a pretty easy drive of about 3.5 hrs to my mother's house in Santa Fe and we typically do that in the evening and spend the night there before going to ABQ in the morning.  David was actually looking forward to the transfusion because he gets to play video games.

The Wii one with IV in, waiting on blood.

This was his first time playing with a Wii and it took a bit to get the hang of it.  Before long, he was back to the slightly more familiar Xbox 360 and "Lego Star Wars".

The Video Zombie

There's a reason we don't have one of these devices and that is because they suck a person's brain out and replace it with a vacuum.  It takes 5 hrs for the transfusion and David can sit there with this vacuous expression on his face for the entire time!   Nevertheless, he got transfused and we headed home.

Sandyman, looking for another victim
 I did get to work with my new horse a little bit this week, for the first time since getting bucked off several weeks ago.  All I'm doing is saddling him and making sure he's used to the saddle.  I learned a few things about saddling and have been applying them. 

Short blog this week.  I'm just keeping everyone up to speed on stuff. 

Tuesday, May 24, 2011

Just Hanging 'round

We did some more rappelling practice recently.  I've been going down the cliffs in our NW corner but wanted to try an actual nest site cliff in preparation for the upcoming peregrine take.  Falcons don't always nest where I want them to, and you have to be prepared to deal with where they actually are, rather than picking a cliff that you like.  So, it was off to some cliffs on a neighbor's property.  My fellow elder and church member, Eric Armstrong, went along.  He's a physical therapist and, well, it never hurts to have a medically trained guy along when dangling off ropes on cliffs.

First, you gotta get to the cliff.

The view from the top.

Getting over the lip is usually the hardest part!

We picked out an old raven nest as a target.  The ravens have an active nest on this cliff, but it's around the corner and we didn't bother them.  I really thought there should be a prairie falcon on this cliff, but a look several weeks ago didn't show anything.  However, while hiking up to the top, a male prairie came overhead and checked us out.  Even though I'm after a peregrine this year, I think I'll swing back by here in early June and see if I can't find prairies, just for future reference.

Heading down the cliff.

At the nest- empty, but recently used.
This was a good exercise as I remembered how tricky it can be to ascend on the rope in a real situation.  Again, the rock I've been practicing on is flat and smooth and pretty easy.  The nest cliff was full of holes and out-croppings.  Holes are tricky because there's nothing to brace against and you spin and have to hold yourself up against the rope when ascending.  It's physically tiring.  Out-crops are tough because the rope lies flat on the rock and you can't get the ascenders under it.  I tried un-clipping one ascender and re-clipping it higher up on the rope, but then I realized that I was held to the rope by just 1 ascender and I didn't like that very much.  I made it back to the top (twice), but ascending over out-crops is something I need to work on.

Back at home, and a few weeks later, I wanted to try a few things with my shunt.  The shunt is a device that clips to the rope and can act as a self-locker.  When held open, the rope goes thru, but when released, it locks on the rope.  This allows you to stop and rest or to hang on the rope,  hands-free.  I've been clipping the shunt to my leg loop and I wanted to see how well that work out should I find myself upside down or in a bad situation.  We have an 8' tall storage container that's perfect for practicing.

Look Ma!  No hands!
Here's the shunt attached to my leg loop
 After hanging upside down a few times and even unclipping my descender and using just the shunt, I decided that I didn't like being clipped to the leg loop.  It held, but it really pull down on my leg and throws me off-balance.  So, I moved the shunt to my main harness loop:

Shunt (R) clipped to main loops
I liked this a lot better for several reasons.  The pull is on the middle of the harness, the rope is closer to the center of balance, it doesn't get in the way, and it just feels better to hold it centered than off on one leg.  So, this is the way I'll be running the shunt. 

As far as the actual peregrines go, we checked on them again and the female was still incubating, so we've got 2-3 weeks to go still.

News on David- results from the bone-marrow biopsy show that his bones are making blood.  That's good news.  There are still some tests to come back and then we'll see if there are toxins involved here or what else might be going on.  At this point, it seems that we've moved into hemolytic anemia territory where his spleen is the issue.  That also is good news because a partial splenectomy is a fairly safe and fairly successful treatment for hemolytic anemia.  But again, we're waiting on some tests.  In any case, the plan is use transfusions to keep his blood levels up until we get a more permanent cure.  He certainly has been happier and had a much better appetite since his 1st transfusion. 

Tuesday, May 17, 2011

Big Needles and Little Kids

We're back from another trip to Albuquerque.  Last week, David got a blood infusion to give him something to work with while we try to diagnose his problem.  The infusion was really helpful and he was more active with a better appetite than we've ever seen him.  This is only a temporary measure since the real goal is to get him making healthy blood on his own, but it was good to see what effect good blood would have on him.

This week we went in for a bone marrow biopsy.  The idea here is to find out whether or not his marrow is making good blood.  If it is, then it's probably his spleen that's the problem and a full or partial splenectomy might be the ticket there.  If the marrow is not making good blood, then we might be looking at a bone marrow transplant.  At this point, though we're just looking to see where the problem is. 

The patient with IV in place

Getting hooked up with monitors and all that

Post-Op Recovery

The biopsy involves sticking a pretty long ol' needle thru the upper butt into a hip bone.  Immediately post-Op, David was really hungry and demolished a granola bar, hot dog, and 2 Grandma's chocolate chip cookies.  That just held him until we left the hospital.  When then stopped at Cracker Barrel where he put down 1/2 of a chicken fried steak and mashed potatoes.  At our first stop, he ate a whole bag of M&M's and 1/2 can of green tea.  

He's pretty stiff and sore right now, but taking it like a trooper.  Oh, and pre-op, we did a CBC to see how he was doing with the infusion.  His hemoglobin was 8.0, up from 4.0 last week.  That's still 2/3 of what it should be, but definitely gives us an idea of how he might function with decent blood.  We'll do another CBC in a week to see how long the infusion "holds".  We'll also have results from the bone marrow biopsy in a few days. 

On the ranch, we had an interesting week.  We got 83 head of cattle in and B2 and I moved to pasture using our Grizzly 660 ATV's.  Grizzlys tend to overheat, esp when going slow and it wasn't a big surprise when B2's bike over-heated.   Her fan wasn't coming on and I figured it had gone bad.  But, driving down the road back to the house didn't cool the bike down.  The next day, I found the radiator empty and figured it boiled out.  I re-filled it and started the bike to let it heat up so I could watch the fan.  Immediately, coolant started coming out of an overflow tube which is designed to provide a drain in case of water pump failure.  If the coolant gets into the motor, it'll dilute the oil and cause catastrophic engine failure.  So, me and the boys tore the water pump apart- a dirty job which involves draining both coolant and water first.  Long story short, we found a cracked gasket.  This allowed coolant to seep past the seal and out the drain.  With all the coolant gone, the heat sensor in the radiator didn't turn out, thus the fan didn't come on.  This was a good lesson in troubleshooting as a small crack in a gasket at the bottom of the engine prevented the fan at the top of the radiator from coming on.  A lot of  people would've just replaced the fan.  I've got a brand-new pump coming, along with parts to rebuild the current one, which I'll stick on the shelf and use as a spare since we have 2 of these Grizzlies.

Tuesday, May 10, 2011

Bloody Business

We just returned from a trip to Albuquerque to the University of New Mexico Children’s Hospital.  David, as many of you know, is severely anemic and has been since birth.  After some testing and discussion in his early years, we decided to take a “wait and see” approach during which we’d try to implement good nutrition and care.  David’s 10 yrs old now and a recent blood test showed his various levels to be dropping.  For instance, his hemoglobin count was 4.1.  You can Google “CBC and hemoglobin” to find out just how low this is, but it’s basically about 1/3 of what it should be.  He also recently fell off the height/growth chart- he’d been holding right around the 3% mark, but dropped below that.  It’s a minor miracle that he’s able to function as well as he does.

So, it seems like it’s time now to get aggressive in treatment.  We went back to the same set of doctors and spent a good hour discussion strategy.  Our first need is to find out where his blood is failing- is it the blood itself or is the spleen destroying his cells?  In order to bolster him and get his CBC up, we decided to start a blood infusion program.  That should give him some good blood to work with and maybe allow some growth.  While he’s given periodic infusions, we’ll also be looking at his bone marrow, to see if there’s a problem there.  It’s possible that a bone marrow replacement program will produce some good results.  At this point, though, we just don’t know.

The area where we got the infusion is also where the cancer kids get their chemo.  There were 2 very young children getting "ports" changed and, based on their screaming, it didn't seem very pleasant.  Several older kids were getting chemo.  The nurses were very nice and really tried to make the kids comfortable- I'm convinced they've gotta be 8/10ths angels to work in that environment.  As for us, I’m sure we’ll be making some trips up and down I-25 over the next several months, years, or whatever.

A neat rainbow, ending right on our house!

The Patient trying to look morose
A hint of a smile creeps in

His true attitude takes over
Hooked up to the IV, getting blood
The view from the IV room
Playing video games.  The hospital does their best to make the kids comfortable

Saturday, May 7, 2011

A New Season Begins!

It’s been a busy couple of weeks here on the ranch.  I got the word that we were getting our first loads of cattle and so I hustled around getting last minute chores done.  Salt from town, pipeline full of water, our cake feeder back from loan, a few fences repaired, etc.  But, we got that all done and Tues, right around noon (they always come when we’re eating lunch), the first truck arrived.

The First Truck
Hey!!!  Lemme out!!!

The boys worked hard, of course.

Waiting to be moved to the pasture

The day was not, of course, w/out its share of surprises.  I had planned to ride my new horse- Sandyman- to put the cattle out to pasture.  He hadn’t been ridden in a month, but he’s a really gentle, well-behaved horse and I had done a little ground-work and saddled him, so I didn’t see any problem.  Brianna even gave him a little spin around the pens and all was well.   

B2 riding Sandyman, before The Incident
 After standing at the pens for awhile, it was time to go.  I checked the cinch and thought it a little bit loose, so I took it up a notch.  When I stepped into the saddle, he hunched up and then the rodeo started!  I rode out 2-3 bucks but it didn’t feel like he was going to stop.  Sometimes horses will hop a few times and settle down, but this didn’t feel like that.  So, when Sandy reared up, I took the opportunity to bail off the back.  I landed- WHAP!!! – flat on my back and, of course, flat on my head.  Fortunately, we were in probably the softest spot of the whole ranch and I was okay (although I was pretty sore the following couple of days!). 

After getting rid of me, Sandy kept right on bucking and that told us that it was a saddle problem.  Later on, our neighbor, Philip, came over.  He’s a good horseman and very quickly found a sore spot on Sandy’s right side.  Evidently, when I tightened the cinch, I caught a fold of skin there.  That was a new thing for me, but now I know to walk the horse after a cinch adjustment to check for pinches and to check both sides before getting on.  I’m just glad there weren’t rocks where I landed.    After all that, Sandy was his normal calm self and Brianna even rode him a little with her saddle and I sat on him again.  But he was sore, so I didn’t ride him that day, but instead,  I fired up an ATV and used that.  They still work pretty well, too.

On Thursday, we took David into town to the doctor.  David has severe chronic anemia and for the 10 years to date, we’ve been just watching him and waiting to see what would happen, with doctor visits every 2-3 years.   His last blood count, though, was the lowest its ever been and the bilirubin count was up, suggesting additional breakdown of his blood cells.  So, we made an appointment with the local doctor (another new one) and long story short, on Monday we’re off to Albuquerque to the Univ of New Mexico Children’s Hospital.  I’m thinking that a partial or complete splenectomy (removal of spleen) might be in order, but we’ll see what the doctors say.  In any case, I’m sure we’re going to be driving up and down I-25 to ABQ a few times this spring/summer.  And, of course, major organ surgery is never a light thing nor are the results guaranteed.  Nevertheless, we're optimistic.

Friday, it was off to look for peregrines again.  It’s been a month since our last trip and we were hoping to find nesting activity.  Plus I wanted to try out a new spotting scope that I bought recently.  In 2003, I bought a really nice banjo at Winfield- a Deering John Hartford.  I’ve played it a bit over the years, but in the past few years, my hearing has gotten worse and now it’s actually hard for me to hear the banjo.  You’d think that such a loud thing would be easy, but what happens is that my hearing aids shut down and then I can’t hear the high, non-sustaining sound of the banjo.  We’re just not playing much, probably never will, and I have guitar, mandolin, and bass to keep me busy.  At the same time, we’re stepping up our wildlife activities a little bit.  I have a decent spotting scope that I bought used in 1987, but it’s only decent and I was thinking about upgrading.  I have a friend who really wanted that banjo and so, with not a little regret, I offered it to him for the price I paid.  And then I turned the money right around into a very high ranked spotting scope- a Vortex Razor HD.   So, in addition to looking for falcons, I was looking forward to trying out our new scope and the real tripod that I bought with it.

Off to the field we went, meeting up again with a fellow raptor enthusiast.  The day was a success and we observed incubation at both sites we visited.  The scope performed spectacularly.  At home, comparing it to my old one, I was only sort-of impressed, but when it was put to work looking at cliffs… wow!!!!  I guess it’s like musical instruments- you often can’t tell much difference at home and it’s not until they get into an ensemble situation that the superior ones really shine.  In any case, we were looking at peregrine falcons at 60 power and that’s something I’ve never done before.  The old scope goes to 45x, but you can’t see anything there.  30x is really about the most you go before everything gets too fuzzy.  At 30x, the new scope is just barely getting warmed up.  At 60x, the new scope lived up to its name, being Razor sharp.  We were all impressed.  (Duh.... I should've stuck the camera up to the scope and taken a picture of the falcons!!!)

Angled eyepiece is really nice

Heading home thru Taos and Angel Fire, we stopped briefly at the Vietnam Veteran’s Memorial in Angel Fire.  I’ve wanted to stop here for a long time, but it was always too early or too late or windy or whatever.   But, we made it this time!  It’s a small but very nice place with an excellent library and display.  Glad we stopped.  Made it home right at sunset, having spent 14 hours and 400 mi in the field.  

Read it!

David loves helicopters

David and Dad in the memorial

Elk on the way home