Still in hospital

By | August 5, 2016

Dear friends,

Bram is still in hospital. During the last 2 weeks Bram has been ventilated. A sleep study showed that Bram’s CO2 levels were too high, he was not breathing enough and as a result his lungs are not properly inflating.
To counter this Bram will be ventilated during nap time and at night for the forseeable future. Laura and I have been trained and yesterday we completed the training to care for Bram with his ventilator. We expect Bram to be discharged on Monday, he will come home tomorrow for 24 hours to give it all a test run in the home environment. On Sunday evening Bram will return to have a final check up on monday morning before discharge.
Bram would not be Bram, so he took this all in his stride. He is already having more energy and is now finally able to get up in a sit and stay in a sit. It took him a year but he has finally managed it. A wonky balance won’t stop him and we can already see that he now wants to stand up……

Love,
Jeroen, Laura, Max and Bram

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Max’s birthday, Bram in hospital again

By | July 26, 2016

Dear friends,

Today 4 years ago was one of our best days in life. We welcomed Max in this world and started our biggest adventure in life…. Parenthood!
Our kids are everything for us and I am a proud father of Max and Bram. Today we celebrate Max’s 4th birthday together with his Scottish and Dutch grandparents at our home.

Unfortunately a family tradition is once again honoured. Celebrating a birthday with Bram in hospital. Bram was admitted on Sunday evening for a routine sleep study, which only lasts one night. However the results are such that after 9 months at home Bram is considered to be “unsafe” at home while asleep. Even with nurses looking after him. From today onwards Bram will have to be ventilated while asleep.
This will make his breathing safe again and hopefully mean that over time Bram will be able to live without extra oxygen and without his tracheotomy. Laura and I, as well as Bram’s nurses, will need training on how Bram lives with a ventilator. This will take a few days and until we are fully trained and have all the equipment delivered to our home Bram will have to stay in hospital.
So for the second year in a row we will be celebrating Max’s birthday together with Bram in hospital.
Although causing chaos in our life once again, we believe this is a way forward for Bram to be safe and hopefully overcome his respiratory problems.
But now it’s time to eat cake and celebrate Max’s big day.

HAPPY BIRTHDAY MAX!

Love,
Jeroen, Laura, Max and Bram

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Immunissations

By | July 7, 2016

Out with Bram for lunch.
Bram’s immune system is fully recovered from his cancer treatment and as a result he had his immunisations today which he missed out on last year.
And in a true hero style Bram slept right through it. 2 injections in his leg and Bram just sleeps. What a boy!

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Sea Life and upcoming MRI scan

By | May 25, 2016

Dear friends,

Today we took the boys to Sea life in Brighton. This was a present for the whole family from Max’s nursery. We had a fabulous day. Max was allowed to feed cabbage to the big turtles. We sat on a boat with a glass floor to see all the fish. And to top it off the boys received a gift bag each.

We missed days like this so much. It still is a huge undertaking to take Bram out on days like this, but it won’t stop us. Today was the perfect day to do this. It took our minds off things to come. Tomorrow we take Bram back to Great Ormond Street Hospital for another “routine” MRI scan. Although Bram is doing very well and we can see his progress every day these scans are absolutely nerve wrecking. We will have to wait a couple of days before the results come back. We can only hope Bram is still cancer free.

Please send him your positive thoughts, light a candle for him or pray for him, thank you.

We will let you all know when we have his latest results.

Love,
Jeroen, Laura, Max and Bram

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Disappointment

By | May 3, 2016

Dear friends,

Bram is back from hospital. Unfortunately not with the result we hoped for. Bram still has a tracheostomy. After a few days of step by step testing it is clear to us and the medical team Bram is not yet ready to live without his tracheostomy. Although disappointing for us and especially for Bram there are still a few positives. Bram has shown he can manage to live with a smaller tracheostomy than before, meaning he will be able to get some air through nose and mouth again. This is a positive sign for the future.

Bram’s medical team are now looking at what is needed for Bram to eventually be able to live without a tracheostomy. Over the next couple of months several medical professionals will have a look at him and come up with the best plan to get this to work for him as well as coming up with a plan how to deal with his oxygen requirements. With that in place we can hopefully try again in about 6 months.

This is not a setback for us, just not as much progress as we hoped. Bram is a fighter, and we believe he will eventually overcome this as well just as he has overcome so many hurdles in his young life. He has beaten cancer, his victory lap to overcome all other problems will just be slightly longer!

Thank you all for your messages of support over the last couple of days (and over the last year).

Love,
Jeroen, Laura, Max and Bram

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Decannulate 

By | April 29, 2016

Dear friends,

Another update on Bram.
Bram spent 3 nights in hospital earlier this week with a chest infection. He has mostly recovered and returned home yesterday. He is still making slow but steady progress in his recovery. 

Tomorrow Bram will be admitted to GOSH for a planned 5/6 day admission. His medical team are going to attempt to decannulate Bram. His tracheotomy is to be taken out. This is a stepped process in which Bram will have to prove he can safely live without the help of his tracheotomy. Currently there is no reason why This should not work, but the past has shown that Bram is not a standard patient. 

If he decannulates successfully this would be a massive step for Bram. Breathing through nose and mouth again, no more daily tape changes and monthly tube changes. Additionally it would enable air past his vocal cords. Bram should finally be able to make noise again. We can’t wait to hear his laughter or crying again and hopefully over time he will be able to learn to speak. We have missed his voice in the last 8 months. 

We have our fingers crossed for him. If anyone can do it it is Bram. Please pray for Bram, light a candle or send him some positive thoughts over the next couple of days. 

COME ON BRAM, YOU CAN DO THIS!

Love,
Jeroen, Laura, Max and Bram

One year ago

By | March 14, 2016

Dear friends,

Exactly one year ago was the worst day of my life.

After vomiting for nearly two weeks a CT scan showed Bram had a brain tumour, causing life threatening hydrocephalus. Bram was still lying in the CT scanner when a radiographer told me this. Shock, pain, fear were my initial reactions. But within seconds my brain went into overdrive. The radiographer invited me into his room to explain. But I could not do this alone. I had to tell Laura. Laura was waiting in Bram’s hospital room. While I made the two minute walk back to Laura I took a few deep breaths. How do you tell this???

That conversation I will never forget. After telling Laura, we promised each other to keep strong. Bram and Max would need us now more than ever. We would need each other more than ever. Our journey, but more importantly Bram’s journey had begun…..

The staff in East Surrey Hospital were fantastic. They comforted us as much as they could, sat down with us to explain the initial way forward and organised an ambulance for us to transfer Bram to St. George Hospital in London. They gave Bram his first dose of steroids, to relieve a bit of pressure in his head.

After arrival in St George’s we met a neurosurgeon who explained to us what exactly they had seen on the CT scan. The plan of action would be to insert a VP shunt (drain) and resect the tumour in the next couple of days. He also told us some brain tumours are curable, some are not and that we only would find out after the tumour is removed and tested in the lab.

After arrival on the ward we went to bed. Due to the exceptional circumstances we were both allowed to stay, and sleep with Bram in his room. That has been the last night Bram, Laura and myself slept together in one room. When we woke up it was the 15th of March……Bram’s 1st birthday. We were far from home, in a hospital, no spare clothes with us, no presents. The staff had made some birthday posters for Bram. I had to go to the hospital shop to buy Bram a birthday present. Not sure yet about his survival chances I wondered if this would be the last present I would buy him.

The medical team reviewed Bram and advised us that he would have to be transferred to King’s College Hospital. So we went with an ambulance again. Blue lights and sirens on. How many kids have done that on their birthday? That evening Bram underwent his first surgical procedure (15 so far), and a pressure relieving VP shunt was inserted in his head. This went well and Bram felt a lot better in the days after.

A few days later came the big day. Brain surgery to remove the tumour. We knew there were great risks attached to this. A small baby brain with a big tumour is difficult to perform surgery on. We hoped for the best, but were prepared for the worst. We said goodbye to Bram in the morning. Laura just outside theatre as she was too distraught, and I inside theatre where I held his hand and gave him a final kiss before he fell asleep. And than the wait started……

We were informed beforehand that there was no set time for these kinds of surgery. The surgeon would take as much time as he would need to remove as much tumour as possible. This would be followed up by a MRI scan to see if everything was removed before we would see Bram again. Bram was put to sleep at 08:45 in the morning. How to spend our day? We gathered our belongings and decided to go for a fried breakfast. We followed this up by a couple of hours sleep in the Ronald McDonald House where we were staying (and would eventually stay for 105 nights). We than went for a walk and had a coffee and bought some supplies at Sainsbury’s. Eventually we settled down on the couch in the Ronald McDonald House. We watched some TV, but more and more started to stare at our phone. This wait was horrible. By now it was 2000. Eleven hours had passed and still no news. On TV we watched a British cooking contest. Amazingly one of the contestants was called….Bram. And it did not look good for him at the beginning. He was the lowest ranked contestant and was the favourite to leave the show that day. But Bram impressed and survived the show. Was this a sign?

We could not wait any longer and decided to walk back to hospital and have a change of scenery. Before the end of the street, at 2115 we received the call. Bram was back from surgery, and on intensive care. We were asked to come to the parental room to meet with the neurosurgeon. Relieved that the wait was over, we were still scared….. Why did the neurosurgeon meet us? It turned out that he wanted to tell us himself that all had gone well and that the whole tumour was successfully removed. Minutes later we finally saw Bram again. Hooked up to a ventilator, and lots of medication. Big bandage on his head. An incredible sight. Bram was awake and moving all limbs and definitely reacted to our voices. What felt as the longest day ever was finally over.

A quick recovery from here and take him home in a few days. That was the plan…..but Bram does not adhere to plans as we would find out……

About a week after Bram’s tumour had been removed we got the results. And they were not good. Bram’s tumour was cancerous, called an Anaplastic Ependymoma. And surgery alone would not be enough to survive. He would need chemotherapy or preferably radiation.

To keep a long story short. Bram’s recovery was an absolute nightmare. He spend about 60 nights on intensive care, 15 rounds of surgery, problems with breathing, problems with his VP shunt, serious infections with MRSA, CRE, and CSF(brain fluid). He was severely breath holding at times if he would get upset, so much he would pass out and in one case even needed chest compressions. He underwent six weeks of chemotherapy, but the tumour regrew. More surgery to remove it. This time in about 5 hours. This got followed up by 30 round of radiation. Six weeks, Monday to Friday with a daily general anaesthetic.

And than came the 21st of October. Bram got discharged from hospital after 225 night and returned home with us. He has had two clean scans since and is making progress. He still has many health issues. He is unable to sit unaided, can’t stand or walk. He is unable to swallow, get fed with a tube in his stomach. He breathes though a tracheostomy, can’t make any noise. His eyes are squinted.

BUT he is still with us, he is improving every day. He has shown us that he is a very determined little boy. He is a supreme fighter and does not give up. He is remarkable in what he has achieved. We nearly lost him on a few occasions. He had to endure a lot. But he is still this happy boy with this infectious smile. He hardly ever cries, but laughs a lot. He is a smiling assassin. He will beat his cancer while smiling.

The last year has been extremely tough. Bram’s illness and all the stress were tough to handle. But we did. We kept it together. We have been with Bram on every step of his journey while not forgetting about Max. It is incredible how much a person can endure and how strong one can be.

Although tough the last year has given me a lot of positive things as well. so many positive moment I will never forget and which over time will outshine the horrible moments. My marriage with Laura is even stronger. We have dealt with this together. I can say that I am a better husband, a better father for Max and Bram and hopefully a better person as well.

I am very proud of Bram. He is such a courageous boy. So determined to overcome this all. He has shown us all that life is worth fighting for. To never give up. To stay positive and to always smile. Nothing is impossible for him.

Today was about remembering the last year. Tomorrow is one to celebrate. Bram turns 2 and we will finally have a birthday celebration for him.

HAPPY BIRTHDAY BRAM!
Love,
Jeroen, Laura, Max and Bram

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A lot of good news

By | March 1, 2016

Dear friends,

A very positive update this time.

After 14 days in hospital Bram returned home yesterday. His line is gone and the antibiotics have done their work.

Last Thursday Bram got transferred again to Great Ormond Street Hospital. That afternoon he had investigative surgery on his airway. The surgeons were happy with what they saw and plans are now being made to attempt to take Bram’s tracheotomy out in a couple of weeks. This is great news and would make our lives a lot easier. The surgeons also noted that Bram’s vocal cords are moving again. So hopefully he will regain his voice and learn to make noise and talk when his tracheotomy goes.

On Friday Bram underwent his MRI scan before returning to East Surrey Hospital where he stayed till Monday.

After a couple of very nervous days we heard back from Bram’s oncologist today. A clean scan!! We are over the moon with this and breathe a massive sigh of relief. He has been free of cancer now longer than than the first time. Very encouraging for his future.

Thank you for all your support over the last weeks (and year). We are proud and humbled that Bram has so many supporters.

We are now starting the countdown to Bram’s 2nd birthday (15th of March). Last year he had his first surgery on his birthday, the day after being diagnosed with a brain tumour. This year we will throw him a party. This special boy deserves nothing less. He is an amazing fighter!

Love,
Jeroen, Laura, Max and Bram