Before the dawn..

... It's always darkest, before the dawn...
I've faced a few dark times in life too, a story not uncommon to all.. Losing my Dad suddenly 2 weeks after my wedding.  Being told that we had miscarried our second son (now a spritely beautiful 3 year old!).
But I'm not sure anything could've prepared me for the last week and a half.  I've had health scares, back issues, appendicitis.. They're easy - drugs/surgery, treatment, recovery..
I got home Monday week ago and noticed a few odd spots on my right arm - like freckles, but blood red.  Didn't think too much of it - had I brushed up against something? It wasn't until I noticed the same spots on my left arm a couple of hours later that I thought it might need some attention. Adelaide has a great GP connect program, who come out to your home after hours, and not thinking it an emergency I called.  A hour or so's wait and the Doctor arrived. He took a good look, had a look inside my mouth as well.. Said that there are a "few things it could be, but as you're not feeling unwell, I'll just write a referral for some blood tests in the morning, and we can go from there - follow up with your regular clinic".   Satisfied, I sussed out the earliest and nearest place to get the tests done on the way to work and went to bed.
The morning after, I woke up with dried blood all around my mouth, and black spots all over my tongue. 
Being the duck in an emergency (calm on the surface, paddling like mad underneath!) I went to Sarah, still sleeping and about to get up to get the boys ready as normal, and told her she needed to get up now, and get Cooper in for an unscheduled childcare day.. Groggy, she wondered what was going on.. It didn't take her long when she woke up and saw!!
Kids in, and off to Flinders Emergency, it didn't take us long to be called through.   It's all a bit of a blur as you could imagine, but I remember a great agency nurse getting me comfy in their recliners (they had a bay with 4 in there,  I thought it was a cool alternative to a bed and good use of space!) A young English doctor came and took a look, his demeanour remained calm while talking about some scary possibilities!  The poor agency nurse put a jelliecoe needle in my arm to give me fluids, etc.. And blood went everywhere!  It wasn't until blood results came back that we learned why that had happened, and it certainly wasn't the nurse's fault!
From there I remember a steady stream of Doctor's coming in - some to examine and offer specialist advice, others cause they'd heard a pretty cool case had come in!  Doctor's also felt that my spleen was slightly enlarged, confirmed by ultrasound..
After a while I was transferred to my own room in the haematology ward.  It's a bit scary up there - most patients I encountered actually had things like leukaemia and other terminal situations. It wasn't hard to maintain perspective on the seriousness of my situation - for the most part I felt fine and knew I'd be getting out soon enough!
The Doctor's believed I had what was called idiopathic Thrombocytopenic Purpora (ITP) , for which the treatment is high doses of prednisilone steroids, iv immunoglobulin (iv ig) and Trans examic acid - the first 2 suppress the immune system to allow the body to develop the platelets, the last helps in case of bleeds.   The iv ig can only be had 3 times, and the acid only for a week.  After a day my platelet count jumped from 0 to 4, after another day to 5..
Thursday was a hard day.  The diagnosis of ITP came reasonably early as the most likely.. However,  it's a big word that really only says 'you have a low platelet count and we don't know why'.  I was tested for HIV and Hepatitis, and Thursday I had a biopsy and bone scraping taken from my hip, under sedation.  I was nauseous in the waiting area and they were nearly going to postpone, but I think it was just a combination of the medication I was on and the stress of the last couple of days catching up with me!  The preliminary on the biopsy came back as okay the day after, but I was also then told that it wasn't a very good sample.. So again I was still waiting for a cause while doctors treated the symptoms.
We've generally acquiesced to requests of any way we can help in the medical profession - we had student doctors accompanying our obstetrician for both our boys, it's happened with gp clinics, etc.. Word had gotten to the Gastrointestinal doctors of my interesting case, and as they were in the midst of preparing for exams, I was asked if I would be willing to have 4 doctors do an abdominal examination under exam conditions as practice.  Agreeing, Saturday morning saw me popped into a wheelchair and taken to the clinics.  Some slightly over and under-enthusiastic doctors poked and prodded.. 2 failed the exam, 2 passed but not with flying colours! But it was all learning and teaching and an opportunity for them.   Once finished, they called to get an orderly to help me back to my room,  and a waited for a little bit.. But feeling bored and in a wheelchair I attempted to make my own way back to the ward! I got to the lift, and a floor before mine one of the orderlies from my level was returning from a break, and helped me back to where I needed to go..
And this is where the story took another interesting turn.  I arrived back on my ward to find that my single room was needed for a more critical patient and I was moved into a shared room!  Having completed what I could have of my IV IG the day prior,  I was advised that my platelet count had actually dipped again, and had dropped to 4, but the morning blood test had shown that my immune system had also turned on my red blood cells.  I was anaemic and slightly jaundiced, and it explained a bit more about why it was such an effort to wheel myself around in the wheelchair!
My enlarged spleen came up again - earlier that day it had been the secret little test for the doctors doing their exam practice - could they find it?  Splenectomy was discussed, but it was interesting - being a teaching hospital, they do a lot of role play, what if, what then, and in that process the weekend consultant said that while their maybe some benefit to a Splenectomy, there were risks attached, and they've found that in some cases ITP can go into spontaneous remission within 12 months, with or without the Spleen being removed.  The odds of Splenectomy fixing were about 65%, but combined with the new information on my immune system attacking my red blood cells, it dropped to about 50/50.  It was really at this point that the length of the journey ahead began to sink in for me.
Gradual progress was made, with my platelet count reaching 10, and though my red blood cell count wasn't where it should be, my bone marrow was compensating, and making more than enough new baby red blood cells.   I still felt flat but improving. 
To further rule out anything nasty, the doctors ordered a Ct scan, to check my lymph nodes.  This became pretty scary too - we were already waiting on the final biopsy report, and the doctor had said over the weekend that the jelly they'd taken from my hip wasn't the best of samples, and they hoped they found get what they need from the scraping.  But it wasn't until the Ct scan that the big C word was used.   It took me a while to tell even Sarah that they were testing for that, because even the thought of it scared me.  The same sonographer that had done my earlier ultrasound did my Ct scan, which included the contrast dye that has some interesting side effects (including making you feel like you've wet your pants!).. And so began what was probably the longest wait of the stay in hospital.. It was already bad enough not knowing what was the cause, but fearing the cause could be really sinister wasn't fun!
Finally the results came back on all and sundry showing nothing that wasn't already known - enlarged spleen, slightly enlarged liver but no cancer or lymphoma.  The relief was palpable.   My blood test returned a platelet count of 16 Monday, and by Tuesday it reached 26 - 20 being the safe level before going home was an option! 
The Doctor's then discussed vaccination against coccus infections in case of emergency Splenectomy and kept me in for another day.  I was told that pending the blood test results from that day, I may be able to go home, and after 9 days inside, I was somewhat keen to leave!  I spent the day anxiously waiting, and finally was advised my platelet count was 48 and I could go home! Red blood cells still a little low, but safe acceptable. 
The feeling of walking outside into the sunshine was incredible!
To single out people from the hordes that helped Sarah with the boys and food would probably leave me missing someone, but to all and sundry from the bottom of my heart, thank you.  To those who came to visit, thank you.  Whilst facing a scary medical journey, I knew that I was in the best place being taken care of in the best possible way, I knew that I wasn't home doing my role there,  and that was hard to contemplate.
So the road ahead.. The term ' Evans Disease ' had been bandied around in the last few days I was in hospital, which is a fancy way of saying I have ITP and Autoimmune Haemolytic Anaemia (the immune system attacking my red blood cells).   I remain on high doses of prednisilone steroids, and pending regular blood tests and platelet counts could remain on them sometime.  Hopefully I'll know more in a week or so when I go back for a clinic appointment.
The challenge at the moment is work.  It's going to be a while before I'm physically able to work, and whilst I'm grateful that I live in a country where we have a social security system, even experts recognise it's far below the level it needs to be.  Ideally I'd love to find something I can do from home with flexibility around managing how I'm feeling, but that may not be possible.  With 2 boys and another on the way, it has added another level of stress at a time when many families are already not coping.  We have been provided with so much food and meals that have been fantastic and one less thing to worry about, but we also have bills to pay that I can't pay with food.. ;)
So I only ask that if you are in a position to help, first seek God for what He suggests, and then get in touch.  Our heart is that we don't want people to give what God hasn't ordained.  But if He has, then we are grateful.
Thanks for reading!