Thursday, December 31, 2015

The Year in Review

I have never been one for resolutions, but at the end of 2014, I did conjure up the idea that 2015 was going to be the 'year of simplification', and ironically, the idea held true all year long. Most of the time, the idea of simplifying efforts and focusing only on the important issues happened as a result of circumstances, rather than a conscious effort that I had to periodically remind myself of at specific calendar milestones.

Late in 2014, I had decided to dissolve my LLC at the end of the year, which I had established back in 2011. Trying to juggle residential projects on the evenings and weekends became very overwhelming at times - with the economy gaining momentum, in turn fueling homeowners' desire to expand or renovate. In our area, the houses are older (typically 50-75 years) and smaller, which has produced a steady surplus of work for me over the years - at times, more than I could handle. The original notion behind the LLC was to do projects for families and patients with special needs, but in retrospect, only a small fraction of work was actually coming from that idea. As the company moved forward, a majority of projects came from non-special needs referrals from past projects, the neighborhood, friends, and family. I ended up finishing off my last renovation in early 2015 and officially closed the books to focus on my day job. This was a huge step toward simplification.

Later this year, I also stepped down from my position on the board of directors for Bleeding Kansas, which is a non-profit group organized for the purpose of getting medicinal cannabis legalized here in the State of Kansas. Unfortunately, trying to devote additional time to the cause had become too much and I frankly felt guilty, for not being able to contribute to the level of other members on the board. There are some extremely devoted people here in the state, who are politically tied-in and driven to see that legalization becomes a reality. I am forever grateful for their efforts and they deserve someone who is capable of devoting as much to the cause as they are.

In terms of medication simplification, Sarah and I have always tried to have a 'less is more' attitude toward Mira's pharmaceutical trials, thus we tried a Lyrica wean at the end of 2014 and into 2015. If you read back in some of my prior posts in January of this year, you will come to realize just how much of a disaster it was. Mira was miserable, so we ended right back where we started. We did however, successfully wean Vimpat over several months in the fall, just finishing it up at the end of Novemeber. We still hold steady with this idea of keeping the pharmaceuticals to a minimum, as Mira has a horrendous track record with them. Ultimately, in exchange for the Vimpat, we are just getting settled in with fluoxetine, which right now, seems to be helping quite a bit. Yet, I do think her recent improved demeanor is a result of a combination of changes, which I will get into later.

The loss of her toy has been the most significant change we have made all year. Call it simplification, call it necessity, or whatever you like, the fact that we had to take her toy away from her permanently, has been bittersweet. It personally makes me sad, when you consider the fact that she has played with that toy nearly every day for the past 8+ years. We have heard that noise and those lights, nearly every day in the house since 2006. We have had a long relationship with it, from hunting high and low on Ebay countless times to snag reserves, to conjuring up new ways to keep it strapped to her easel, to burning through literally hundreds of Duracell AA batteries. In browsing prior posts, it appears we had been flirting with the idea of taking it away, since April of this year. It finally became so overwhelming for her, triggering seizures every time, that it had to be put on the shelf, permanently. Another strange and sadly nostalgic step toward simplification I suppose, but a step nonetheless.

While we did pursue a few testing avenues for Mira, most of it was ongoing and residual efforts from her being in a few genetic studies from years prior. We did move forward and received results from some testing from a CEP (Comprehensive Epilepsy Panel) through GeneDx, which yielded a heterozygous mutation in her TPP1 gene, which is apparently irrelevant, since she still has one functioning gene. I have read that even heterozygous issues are sometimes implicated in epilepsy, even following up with the idea with her neurologist, who is communicating with the genetic specialists at Children's Mercy. I also had the idea, back in February, that Mira should be tested for GAMT and a few other isolated metabolic screens throughout the year. Her levels turned out to be right on target on all of the tests, thus we put all of those ideas to rest as well. Other than routine neurology and endocrinology visits, this year has been fairly quiet on the testing front. Mira is still enrolled in the whole genome study at the hospital, but there won't be anything to report, unless they identify an issue in the future. Should something relevant to Mira's situation surface, they will queue her DNA up for testing, but it is all happening behind the scenes and we would be notified accordingly.

Simplicity does have its limitations. Throughout 2015, we have continued to battle with Mira's irritability and that's not not to say that we have been trying or that we have completely surrendered. I did a substantial amount of research on just irritability, particularly in regards to chemicals in the brain and how they affect depression and pain, which led me to serotonin. I have always had this idea that Mira's fussy demeanor has something to do with a deficiency of some sort in the brain, thus went down a rabbit hole of research regarding Pyridoxine Deficiency (for the third or fourth time) and thought it seemed logical to do a trial of B6, about mid-year. Pyridoxine is supposed to raise serotonin levels in the brain - just one of 150+ different functions in the body. We did see some fantastic results, about 45 days into the trial, where Mira became consistently vocal and animated, even keeping seizures to a minimum. My optimism eventually waned as she slipped back into her familiar neurological patterns. I still think there is something to this however and after discussing options with her neurologist, we opted to put her on an SSRI, which ended up being fluoxetine. It's too early to tell whether it is effective or not, since it has only been a month.

So what has changed over the past year? At first glance, looking at everything at a global level, it is difficult to tell. Mira still has seizures, she is still irritable, and we still don't have any solid options remaining in regards to helping her in either one of those departments. The State of Kansas is no closer to legalizing medicinal cannabis (thanks to one single person, Mary Pilcher-Cook, who is a atrocious senator and a horrible religious hypocrite), which would create a potential avenue for us to explore. We still continue to contemplate moving to a legal state, while serious at times (heavily researching Colorado and even taking a trip out there) to half-joking comments (such as, 'f*^k this, let's just pack up and move everyone to Los Angeles so we can all be outside most of the time') when Mira has a rough week. I still continue to read, research medical options and ideas, write the occasional letter to The White House, and hope that something, someday, might help Mira have a better quality of life.

However, if you look at everything on a micro level, Mira has had more good days than bad, at least lately (meaning over the past few weeks). In perusing old posts, I found it alarming just how many poor days Mira has had over the course of the last 12 months - how many wailing, inconsolable days she has had. It has always been a viscous cycle of seizures, sedation, and irritability, but a few things are starting to change, just within the past month. Since we have permanently retired her toy, Mira has had more positive days than usual - I haven't seen any morning myoclonics for the past two weeks, which is something. I am convinced that there isn't one single, solitary medication, therapy, diet modification, or natural remedy that will control Mira's seizures, but rather a combination of changes that will help. Over the past two weeks, we have made some fairly drastic changes with her - removing the toy, fully weaning her off of Vimpat, and added an SSRI. The optimistic side of me is hoping that some magic combination might help - the pessimistic side of me continues to chant a familiar mantra, which is 'the more things change, the more they stay the same'. Only time will tell.

Thank you all for continuing to read and follow Mira's blog. It is nice to know that we are not in this boat alone and that we have wonderful family, friends, and support around the world. I wish you all of the best for 2016.

Tuesday, December 29, 2015

Mostly Happy, with a Chance of Seizures

Something strange has been happening with Mira for the past several days - she has been happy, nearly the entire time, since I last posted. Up until this morning, she hasn't had a big seizure (which I will get into later), but what has been most noticeable, is her quiet and subdued demeanor. She hasn't necessarily been overly energetic or excited, just content and going with the flow. Most days, Mira has objected to something every day (often multiple times or all-day long), whether she is hungry, tired, or whatever the issue may be - she would certainly vocalize her opinion. The past few days however, she hasn't really fussed once, about anything. It has been a little surreal. We have been running around shopping, eating out, and even headed down to Union Station to see the trains, and Mira didn't complain a single time. Even with all of the noise, transfers in and out of her chair, and having her sleep schedule thrown off some, she has been very chilled about it all. She has been a real trooper these days. She did wake up this morning and had some strange repetitive movements - they didn't look like seizures, but they eventually led into a big tonic-clonic. We couldn't exactly tell what they were, as she kept groaning and sort of almost laughing at times, but she kept doing it every 4 or 5 seconds. The cycle of moaning and flexing/tensing her muscles repetitively, went on for about 45 minutes, then ultimately went into a big seizure. We have seen similar episodes (particularly this year we have seen an increase) but this episode seemed different than the others. She ended up having another big seizure right after lunch. Other than the 2 tonic-clonics, she is still having these random, quick lightning jerks throughout the day. They last just a second, almost like startle reflexes - she is having maybe 10-20 a day that I can see.

Saturday, December 26, 2015

Uneventful, Yet Very Positive and Active Day

Mira did another 180 degree turn again today, staying happy as can be all day long. Not 24 hours prior, she was wailing at the top of her lungs and today, she was all smiles. She has been all over the map for the past week, so we never know what to expect when she gets up in the morning. She was full of energy from the second she woke up, flapping her arms, vocalizing, and kicking her feet. She took a few catnaps throughout the day and each time, woke up scanning the room and kicking her feet. Mira even withstood some errands in the afternoon and getting rained on, as we had to sprint back to the car on our last trip. In her chair, she kept doing this cycle of leaning forward, putting her legs up on the front of her seat, then slowly slouches down under her lap belt, which usually gets her wedged down so that the belt ends up around her stomach. We typically leave her chest harness off about 98% of the time, only using it when she is on the bus or in a really crowded place where we are concerned about her lunging forward and hitting something. Even when she has the harness on and the lap belt is nice and snug, she can still manage to slouch her way down toward the end of her seat. It's much easier to keep the belt loose, so that we don't have to unlatch it, pull her back up, then redo it every time. Either way, she still has to be re-positioned back in the chair - she only does this when she is really active, like today. Her volatile demeanor these days is definitely keeping Sarah and I on our toes. We shall see what tomorrow brings!

Friday, December 25, 2015

Merry Christmas!

If you would have asked me yesterday how I thought our Christmas was going to unfold, I would have most likely pasted together some optimistic adjectives, based on Mira's spectacular day. She was happy and content, focusing on people at times that came in the room, and even braving an after-dinner van ride to go and see Christmas lights on the Plaza. She was alert and happy the entire day, not fussing once. Today however, she was singing a completely different tune. Much like earlier in the week, she was wailing, irritable, crying, and just not wanting to do anything. She spent most of the day in her bed, since she hated being in her chair, every single time we tried to put her in it. We tried to keep her involved in the festivities, which mainly involved cooking, but she wanted no part of it. She didn't sleep much, but did have a serious appetite throughout the day. No seizures or any seizure activity all day, but plenty of crying.

The boys were up at 6:00am and were ripping open presents within 30 minutes. Having to sit an entire half-hour always seems like an eternity to have to wait when you are a kid. I need to have at least one cup of coffee in my system before I can properly function, and the boys were eager to help me moving in the right direction. Mira was not interested in being a part of the gift opening, voicing her disapproval very loudly right off the bat, so she ended up back in her bed. We tried throughout the morning to rouse her interest in something, whether it be racing around the house, listening to music, or having a bottle. It was far too cold to go for a walk, so unfortunately, Mira's choices were limited. Despite Mira's fussing, we managed to have a nice Christmas. Sarah replicated much of her spectacular Thanksgiving meal, while substituting a small chicken for a turkey. Turkey is overrated anyway, so we mixed it up. Once you have had a taste of stuffing in November, it gets you craving it again by the time Christmas rolls around. Thankfully, there are plenty of leftovers - the gift that keeps on giving. We ate mid-afternoon and were basically semi-comatose within an hour, all sprawled out on our respective couches and chairs. I hope everyone had a nice holiday or a great day in general, wherever you were today!

Wednesday, December 23, 2015

Seizures and Bad Timing

It became apparent what had been bothering Mira for the past few days and it was definitely something neurological. She continued her pattern of becoming irritable soon after being out of bed, but today, she erupted into a big tonic-clonic right after breakfast. She followed it up with another one about 2 hours later. We let her recover after the first one, so we figured we would try and get her out of the house to run a few errands, but as I was transferring her from her chair into the van, she went into an involved seizure and for the first few seconds, I didn't realize she was actually having one. She started curling into a fetal position the second I lifted her out of her chair. Having a 70+ pound child in your arms who suddenly goes rigid and shifts their weight all to one side, completely throws off your equilibrium. It was just bad timing, as she lunged forward into the seizure, the instant I was lifting her to put her into her seat in the van. It caught me off guard - not so much so I thought I was going to drop her, but enough to have me work hard to bring her back to baseline and get her situated in the van, just temporarily so she was stable and sitting somewhere. For a second I considered just turning around with her and putting her back in her chair, but my first reaction was to pick the path of least resistance. This second seizure lasted about 45 seconds. Needless to say, Sarah and I divided our errands and conquered them individually, while one of us stayed home with Mira.

Tuesday, December 22, 2015

A Whole New Level of Cranky

We aren't exactly sure what was going on with Mira all day today, but she was extremely irritable. This morning she was fine for a brief moment in her chair, but her mood turned sour for the rest of the morning. An hour later, it progressed into a full-on wailing at the top of her lungs, with intermediate whimpering and sobbing, for the entire morning. She finally quieted down right before lunch time, then took a nap for over four hours. Yes, a four hour nap. She finally woke up before dinner, had a repeat performance of wailing and crying for another hour or so, then when back to bed. She has been drinking plenty of fluids all day, doesn't have a fever, and no other visible symptoms, but obviously, something was seriously bothering her. She isn't constipated and her hands and feet were fine. No big seizure activity at all - some isolated 'lighting' jerks on occasion, but nothing else. She wanted nothing but to be back in her bed - no racing around the house or even walking around.

Sunday, December 20, 2015

The Winds of Change

Mira had a much better day today - a drastic change from yesterday. She didn't have a ton of patience after breakfast, but then again, that is pretty much the norm for her. She drank a fair amount and wanted to be back in her bed. Apparently, she didn't get enough sleep, because she ended up taking a 2-hour nap shortly thereafter. We only went for one walk today, which Mira was super excited about - kicking her feet and vocalizing most of the way down to the store. It was incredibly windy outside, so we didn't end up going out after lunch, but Mira didn't seem to mind. She was content hanging out with us watching a little football and cleaning up the house. She was really only fussy in the morning for a bit and then once late after dinner, but both times, it was very brief and probably because she was tired.

Saturday, December 19, 2015

Just Keep Walking

Mira has been irritable again today and the only remedy for her crankiness is going for walks. She was in a decent mood this morning for a few hours, but right after lunch, she ramped up the irritability. We went for our first long walk, down to the post office and the grocery store, then came home and she took a nap. After she woke up, she was cranky again and wanted nothing to eat, so we went out on another excursion, just around the neighborhood. We seem to do a fair amount of walking on the weekends, to try and break up her boredom or whatever is ailing her. It's always fun to track steps on my phone - after finally checking it late today, it seems today was an active day. Counting some errands this morning, I ended up at around 20,000 steps. Fortunately, the weather was tolerable and we were able to get outside and actually go for a few walks. It was a little chilly at 50 degrees, but we bundled Mira up and she was very enthusiastic about being outside in the sunshine. I'm crossing my fingers for similar weather tomorrow.

Friday, December 18, 2015

Rough Week Ending

Mira has been really off the last few days, riding the roller coaster up and down, irritability wise. She has been having really big seizures at school too - one Wednesday and one on Thursday, both in the afternoon, both around the same time. Despite not having the toy, she is still having seizures, which isn't a surprise, I suppose. We haven't seen any involved tonic-clonics at home for nearly a week, but obviously, her toy is not the primary issue. She still finds a way to have seizures. The last three days, she has come home from school either sleepy or irritable, sometimes both. Today was her last day at school until after the new year, but it wasn't a good day - she was fussy off and on for the entire morning and by the time she got home, she was a wreck. She must have been having stomach woes because she is having a ton of BMs lately too. Just a whole lot of poop - not sure where all of this activity is coming from (or whether it's the most riveting topic of discussion for her blog), but it's just reality. I hope this isn't a preview of what to expect for the next 17 days at home, as we are all destined to lose our sanity. There are some days I wish we lived somewhere warm, where we could at least occasionally shatter the inevitable cabin fever we will all soon experience, by getting outside and take Mira for a walk or something, just to get outside in the fresh air. Kansas City weather doesn't always cater to our needs - 25 degrees one day, 60 and raining the next day. Time to move to southern California for awhile.

Tuesday, December 15, 2015

Toy Withdrawal

Mira has been very up and down today. She was irritable when she woke up - no seizures and not even any myoclonics that I could see - just fussy. She has had a few 'lightning' jerks throughout the day, but hey were very brief and random. Her teacher said she had  good day at school - she was even giddy with excitement when it was time to go out for recess. She tolerated the Kidwalk at school and overall, had a decent day. This afternoon at home however, she has been on a roller coaster. At times she was wailing, with tears streaming down her face. She definitely misses her toy and is going through withdrawal not having it for the past few days. It's going to be a long road ahead.

Sunday, December 13, 2015

Rain and Sleep

It has been raining heavily here all day. which usually means one thing - our basement will flood, which it did, in full force today. We live in a 60+ year old ranch house, with foundation walls that leak like a sieve. It is a steady flow, never more than just surface water in a few corners of the house, but enough to be a headache. We put an addition on the house back in 2009, which doubled the size of our current footprint, but we built it with a crawl space foundation, in order to save money. It has not leaked a drop. Our existing foundation however, leaks through the walls, the floor, and everywhere in between. It has become a recurring problem when it rains heavily, which there isn't much we can afford to do about it right now, accept channel the water from the corners to the basement floor drain, and keep everything protected and off the floor. The basement is not finished, so there isn't much down there but storage bins. After 16 years of dealing with this, 2016 might be the time to fix it, if we can afford it. Being an architect, I sort of know what our options are from a structural standpoint - it just comes down to the level of invasiveness we want to take on and how much money do we want to pour into trying to remedy this.

With the rain comes sleep. Mira spent nearly the entire day, sleeping. Today was Day 1 without the toy and Mira voiced her objections a few times, but for the most part, she was completely out of it and in her bed. She woke up after a late lunch, had a few bottles, then went back to sleep. She did the same thing around 6:30pm, stayed up for about an hour, drank a few more bottles, then wanted back to bed. She wasn't up for racing around the house or for just hanging out in the living room with us.

Saturday, December 12, 2015

The End of an Era

All good things must come to an end. I was happy to give an update earlier with Mira not having any seizures for almost a week, mainly due to her not having her toy. As the week progressed, Mira became increasingly irritable, until we reached a breaking point and ultimately, gave it back to her. Much to my amazement, she didn't have a seizure the first two times we returned it to her. That was short-lived. The past several times we have re-introduced the toy, her myoclonics became more pronounced with each exposure, and in turn, prompted us to limit her time with it, the moment we felt things were becoming too intense for her. Everything came to a head this morning, when we gave her the toy and she instantly erupted into a huge seizure. Following the seizure, she was completely off for the rest of the day - clammy hands and feet, sweating, and tons of drooling. Unfortunately, the pattern has become so consistent and established over the past 6 months, that she can no longer play with the toy at all. We are forced to retire it permanently. I cannot believe we have reached the point in this journey where we have to keep something from her that has brought her so much entertainment and joy for the past 8+ years.

Wednesday, December 9, 2015

Caving to the Fuss

Typically, I am starting off every post with Mira's daily seizure count and frequency, but for now, I have nothing to report in terms of seizures. Mira has not had a major seizure since last Friday and not since we started the fluoxetine. She has had some brief morning myoclonics, but nothing more. However, with every medication alteration over the past 10+ years, there always seems to be a negative side to every positive checked box. Mira has been very irritable over the past three days - fussy at school and fussy at home. My first reaction was to chalk it up to the fluoxetine, but I think (and hope) it is something else. I think she misses her toy. As I posted on Sunday, there is the expectation from her that once she is settled in her chair, that toy needs to arrive in front of her on a silver platter (aka her tray) within the first five minutes or there will be trouble. She loves that toy.

Having gone 5 days without the toy and having to deal with a lot of fussing and anxiety, we relented late this afternoon and gave it back to her. I was expecting her to immediately launch into a seizure, but rather unexpectedly, she played non-stop for almost 90 minutes, without so much as a twitch. Mira was balling her eyes out and the second Sarah turned on the toy, her crying came to an immediate, abrupt stop. She stared at it with her mouth open as though she couldn't believe what she was hearing. Focused and determined, she gazed at it for a solid 30 seconds before reaching out to start playing. Five days is the longest stretch she has gone without that toy since it was first introduced to her in therapy, more than 8 years ago. I hope this isn't an isolated reintroduction with it, but history has proven that the toy is a consistent seizure trigger for her, which is the reason we took a break from it in the first place. After playing for 90 minutes solid, I gave her a bath, put her back in front of it, and she continued to play for another 20 minutes, but she was visibly worn out from playing. We will see if giving it back to her will help tomorrow. For tonight, it was the toy for the win.

Sunday, December 6, 2015

Interesting Day

Today was day 2 of starting the fluoxetine and day 2 for keeping Mira's toy on the shelf, thus it was an interesting, mixed day. Mira woke up having some subtle myoclonics, but they didn't last very long - only while I was getting her changed and dressed. She was in a fine mood for about 30 minutes in her chair for breakfast, but then became pretty fussy. I think there is this pattern that she has been accustomed to for so long, thus an expectation that she is going to have her toy in front of her. Disappointment sets in once she realizes it isn't coming. So, I put her back in her bed for about an hour, then a cycle of fussing, drinking bottles, racing in her chair, and going for walks in the neighborhood began, for the next 6 hours. Finally, about 4:00pm, she completely clammed up. She was in her chair, as calm as can be, just looming around the room. It was really strange. She was scanning the room, rubbing her hands together, not making a peep. She sat while we cooked and ate dinner, still not making a sound - wide awake and alert, just not objecting to just chilling out in her chair, hanging out with us. After dinner, I gave her a bath, which usually sends her into a tailspin of irritability, but she continued to be quiet as can be, still not opposing to anything she was subjected to, even the hair washing, which she typically gets really upset about. It was certainly an odd day, like a light was flipped on with her late in the afternoon. She went from needing to be constantly entertained, to being extremely chilled, just going with the flow. Other than the brief myoclonics this morning, she didn't have any other seizures the rest of the day, which makes 2 consecutive days without a tonic-clonic, which is fantastic! If she can't get used to not having the toy and if we can try to keep her busy with other distractions, while perhaps crossing our fingers with the fluoxetine, I hope we might see a significant reduction in seizures.

Saturday, December 5, 2015


We started Mira on fluoxetine today, which we thought was logical choice, seeing as we could keep an eye on her over the weekend. It is a once a day dosage and has a very long half-life, yet we were told that she would fairly drowsy the first few days. It takes a few weeks in the system to reach its potential efficacy. Starting her on fluoxetine was going with the hope that an SSRI might help her irritable disposition, which is something we deal nearly every day with Mira. I suggested trying it with her neurologist at her last appointment, to address her mood,  but also based this idea on the studies and trials I had read, which used SSRIs for seizure control - fluoxetine in particular. There are numerous abstracts regarding Dravet and SSRIs as well and if anyone is interested, you can search for them through PubMed. One of the more current (very generalized concept on it) is located here.

Mira did not have any seizures today, mainly because we kept her toy from her all day. She wasn't too happy about that, as she a few irritable spells and wanted to spend as little time as possible in her chair, after realizing she wasn't going to play with it. Each time we took her out of her bed, she lasted less than 15 minutes in her chair before she got upset. She did spend a fair amount of time napping and sleeping, but nothing out of the ordinary, especially for the weekend.

Friday, December 4, 2015

The Toy Hiatus

Jonah spent another day on the couch, but slowly broke out of his shell by the afternoon, even wanting to play some hide and seek after dinner. He didn't eat much all day, but finally had a reasonable amount to eat at the table. Eli continued to have chills and sweating throughout the day, taking several showers to try and cool off, when he was warm. By the end of the day, he seemed as though he was turning a corner as well. I hope this round of viruses is short-lived and really hope Mira stays clear of it. Mira was the only one who went to school for a full week, while the boys ended up getting another extended weekend, right after a 5-day stint for Thanksgiving break.

Speaking of school, Mira had a decent day at school again today, which was a nice turn of events from her irritable disposition earlier in the week. We have given some serious thought about abandoning her toy permanently, as it is triggering a seizure, every single time now. Six months ago I would have never through we would be at this crossroads, taking away the one thing that she truly engages with consistently. Unfortunately, it has become a real problem. This morning, she became fussy, probably because she was bored in her chair, so I tried the toy, and of course, she had a massive tonic-clonic within the first 10 seconds. It's too much of a gamble and it's heartbreaking to keep it from her, but it is too much stimulation and consistently a trigger for her now. We are going to take an extended hiatus from it and see where this all goes.

Thursday, December 3, 2015

1 out of 3

This week was fairly uneventful, up until this morning. After dinner last night, Jonah kept complaining that his stomach was bothering him, but couldn't elaborate much on exactly what was bothering him. At the same time, Eli was complaining that his head hurt and wasn't feeling well. They both went to bed at their respective bedtimes, then each woke up this morning to different ailments. Jonah had an upset stomach at some point during the night, as he threw up on the side of his bed, yet didn't bother to wake us up to help him - he just went back to bed. Eli woke up to chills and a fever of 102.3. Needless to say, they both stayed home from school, resting on the couch and taking it easy. Jonah hardly ate anything all day, but was able to catch up on a fair amount of Curious George episodes before dinner, then had another vomiting episode before he went to bed. We kept him up for awhile to make sure his stomach was a little more stable and to express to him the protocol for feeling ill in the middle of the night - please wake us up! Eli continued to shiver from chills on the couch, but his appetite remained intact, as he downed an entire pizza in less than 10 minutes at dinner. Ironically, Mira was the only one who went to school today. No fever, no vomiting. However, as history has proven, it's just a matter of time before the rest of us catch whatever stomach and/or flu-like bug(s) that are now floating around the house. I am crossing my fingers I don't get hit, as I have to travel to Canada again the beginning of next week.