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Firsts.

We’re experiencing several firsts these days. Of course, this is to be expected with a new baby.

Darby has finished her first month of existence outside the womb. Yes, we believe life begins well before birth, but that’s a topic for another time and place. She continues to grow, eat, sleep, make messes in her diaper, etc. As she is growing, she is becoming more mobile and routinely performs Houdini-like escapes from her miracle blanket.

What miracle blanket?!?!

We try to make sure she gets her fair share of tummy time each day. She’s getting better at holding her head up, but can only do so much.

So much for tummy time - I'm spent!

We’ve had several first visits from family and friends, from near and far. Some even brought us food (thanks, guys!). We feel truly blessed and fortunate to experience everyone’s generosity and encouragement.

Darby’s first Christmas season was a busy one, even though we didn’t go anywhere. See above – first visits from family. We had a house full of people for the better part of two weeks. Although we enjoy spending time with our families, we are also glad to have a quiet house again. Darby sleeps much better without the extra stimulation.

It got a little chilly for some of our guests, so we had our first fires of the season.

Ahhh, the comfort of a wood stove insert.

All our visitors were helpful in different ways – some cooked, some cleaned, some kept me occupied on house projects, and some even read to Darby!

Aunt Amy reads Darby's first story.

Other visitors were mindful of their own health and were careful to avoid getting Darby sick.

Papa Smith was feeling a little under the weather, so he took precaution.

Aunt Karis came to visit while my mom was here, and she brought Abby to meet her new cousin.

Abby wants a friend to play with...comma fool.

All in all, despite the busy time the last six weeks have been, we are again grateful for our family and friends. Here’s one last Christmas photo for the collectors out there.

This stocking wasn't hung over the fireplace.

In mid-December, we needed a babysitter because we didn’t feel comfortable taking Darby with us to my regular oncologist appointment. Since no family was visiting at the time, Darby had her first non-family babysitter: Chuck D. No, not that Chuck D!

Don't believe the babysittin' hype, yo!


This Chuck D!

Honorary grandpa status!

He reported that Darby slept the whole time, which was great news to us after a lengthy discussion with my oncologist. Is that an awkward segue? Whatever. My white count is up around 33k (normal: 4k-11k), with 93% lymphocytes. My platelets are down to around 75k (normal: 150k-400k). In the past nine months, my white count has doubled while my platelets have been reduced by half. In comparison, my white count was 88k when I was first diagnosed with CLL nine years ago. My lymph nodes are visibly more swollen as well. My oncologist feels that it’s a good time to start treatment again. We could wait, but why put off the inevitable? We have known for the last year that my white count was slowly but steadily increasing, and I would need treatment at some point. We just didn’t want it to be now!

So, I’m starting chemotherapy on Thursday with a new combination of drugs. In the past, I received the triple-threat FCR: fludarabine (Fludara), cyclophosphamide (Cytoxan), and rituximab (Rituxan). It was fairly successful, but Dr. Carroll is concerned about the long-term effectiveness of FCR. This time, I’ll be getting the Rituxan with a new-to-me drug called Treanda (bendamustine). Supposedly Treanda may have fewer side effects compared to the FCR therapy, but I’ll wait until after I’ve had it to espouse that claim. This treatment is shorter than the FCR therapy – it is administered over two consecutive days. The first day takes about five hours, and the second day takes about two hours. I’ll get between four and six cycles, spaced about four weeks apart.

Dr. Carroll also suggested that it may be a good idea to think about doing transplant again. We were caught a little off guard by this, even though it is consistent with what Dr. Sayegh (my former local oncologist) and Dr. Miklos (Stanford oncologist) said when we were thinking of doing transplant again in 2008. At that time, both docs said we should wait until I needed treatment, at which time we should consider doing transplant again. So, the thought of another transplant has been in the backs of our minds, but we were hoping for better circumstances. It’s hard enough adjusting to having a baby as two relatively mature and responsible adults, let alone caring for a baby during chemo and eventual transplant. We haven’t fully processed this information yet, so I’ll stick to the facts for now.

The good news is that I can likely have the transplant right here in Sacramento. The reason I went to Stanford in 2007 was that there wasn’t a transplant facility here. Since then, Dr. Carroll was recruited to Sacramento for the purpose of building a bone marrow transplant program. His 20 years of experience and credentials are impressive: He got his medical degree from Stanford, did an internship and residency at University of Chicago Hospitals, and fellowships in hematology and oncology at Johns Hopkins. Before he came to Sacramento, he was the director of the Clinical Leukemia Program and a member of the Blood and Marrow Transplantation Program at the University of Arizona Cancer Center. Before that, he founded the Blood and Marrow Transplant Program at the University of Texas Medical Branch. He was also on staff at the Bone Marrow Transplant Division at Johns Hopkins Hospital, and an Assistant Professor of Oncology at Johns Hopkins University.

We will take our time in thinking and praying through this decision. I have many thoughts swirling around in my head right now, and need to seek God’s direction. At the moment, I know I’m starting chemo this week. We’ll have to wait and see what happens. Please pray along with us as these decisions can at times seem overwhelming. We know that God is in control, but often struggle with trusting Him completely. This lesson is one we continue to encounter as we journey onward in our faith.

Darby is (has been) here!

It seems that my penchant for punctuality may be falling prey to the unpredictable schedule of a beautiful little girl named Darby. Almost two weeks have passed since she joined us on this side of the uterus, yet we are only now writing a new post to proclaim her arrival. Many of you have already seen photos and heard the birth details through other media, but we will include them here for the masses. I am leaving out some details in order to protect her from identity theft.

The stats: 4:41 a.m. arrival, 6 pounds 10 ounces, 19.5 inches long.

The story: Jen began having contractions around 9:30 on Saturday evening, so I promptly grabbed a pad of paper and my trusty Parker pen (Jotter ballpoint in stainless finish) to keep track. My Timex Ironman was up to the task of timing the contractions as they quickly went from seven minutes apart and relatively short duration to less than five minutes apart and lasting 45 seconds to a minute. After about two hours and a long hot shower, we called the hospital and they told us to come on in. Fortunately, Jen likes to be prepared, so our bags were already packed and waiting by the door, and the car seat had been installed for the past two weeks. I grabbed the birthing ball (nothing more than a repurposed exercise ball) and the camera, and we were off to the hospital.

The check-in process went smoothly, though the staff made an error on their paperwork despite our completion of the registration paperwork ahead of time. Literacy is important; stay in school, kids. Anyway, we got settled in our room and the nurse came to check Jen’s dilation status. We were surprised to hear that she was already dilated 6-7 cm! I called Jen’s parents to give them an update, since they were planning to drive from Lancaster to be present at the birth. Side note: Jen’s mom was an OB nurse for over 15 years, and we wanted her to share in the labor/delivery process. They got on the road at 1:00 a.m., but we were all not confident that they would arrive in time since Jen was already dilated so much.

Meanwhile, the contractions were coming on strong, but Jen was toughing them out. Throughout our childbirth classes, we heard the pros and cons of interventions such as inducement, epidurals, etc. We also had conversations with several friends about this topic, and one conversation about the reason for pain in childbirth was particularly noteworthy. As stated in Genesis 3, God increased Woman’s (the collective woman) pain in childbirth as a consequence of Adam and Eve’s disobedience and sin. Our goal was to have a natural childbirth since that is how we believe God intended us to experience it in a post-Fall world. We wanted to feel even a small amount of the pain that Jesus felt while He endured the punishment for our sins on the cross. We acknowledge that this may be a point of debate for some of you. After all, God has also given us medical knowledge and enabled doctors to provide excellent care and minimize discomfort. Isn’t an epidural the medical equivalent of grace? We don’t have the answers; our choice is our choice. We wanted a natural childbirth unless it became medically necessary to intervene. Please understand that our choice does not mean that we judge those of you who make choices different from ours; we are not better than anyone because of what we believe. If nothing else, we hope this is food for thought.

Enough theology for now…back to the story!

At around 3:30, Lisa (the nurse) checked again, and Jen was dilated to about 8 cm. Lisa wasn’t sure because Jen’s water had not broken yet. She suggested that Jen try to go to the bathroom. Little did we know that sitting on the toilet would put her pelvis in just the right position to force her water to break when she had a contraction while sitting there! At least there was no clean-up needed! When Jen got back into bed, Lisa checked her again, and she was at 9.5 cm. The nurses quickly called the doctor, and we started the hee-hee-hee-hoo breathing when contractions came again. For those who don’t know, that style of breathing is intended to help the woman avoid pushing when the peak of the contraction hits. And when I say “we”, I mean that Jen did the breathing while I coached her in different rhythms.

By the time Dr. S arrived and got her protective gear on, Jen was ready to push. After three contractions with pushing, there wasn’t as much progress as expected. Darby’s heart rate was dropping during the contractions, so the nurses put an oxygen mask on Jen and instructed her to breathe deeply to make sure that Darby got enough oxygen. Dr. S quickly assessed the situation and decided to use a vacuum extractor to get Darby out rather than waiting too much longer. On the next contraction, Jen pushed hard and Dr. S pulled Darby out, and it was clear why she wasn’t coming by herself: her hand was up next to her head as she was coming out!

At the moment of birth, I’ll admit that I was overwhelmed with emotion, and was so happy and excited that Darby was here! I was getting anxious when Dr. S brought out the vacuum extractor and put Jen on oxygen. I was able to compose myself long enough to cut the cord, and finally got to see Darby up close with Jen after the nurses cleaned her up a little bit and backed away from the bed. After my adrenaline rush wore off and I took a few photos of the placenta (don’t worry, I’m not posting them here), we made some phone calls to family to let them know the good news. Jen’s parents were in Modesto when I called, so they didn’t quite make it as planned. They arrived around 7:30 a.m., and after spending some time together in the room with Darby, we went downstairs for breakfast in the cafeteria. Note: the hash browns aren’t very good, and the Denver omelet has mushrooms. After breakfast, we went back up to the room for a while before Jen’s parents and I came home to take a nap. Hospital chairs aren’t good for sleeping, and the beds aren’t much better.

Darby didn't like her first bath in the hospital.

Jen’s mom stayed with her that night in the hospital, since Jen was in a double room without another patient. I was given the choice of staying, but I decided to get one last night of good sleep before Darby came home. Jen and Darby came home on Monday afternoon, and we’ve been adjusting our lives ever since! Jen’s parents stayed for a week, and helped out tremendously with meal preparation, laundry, diaper duty, and giving helpful advice to us as new parents. We have more family planning visits in the next several weeks, so we’ll be busy!

While Jen’s parents were visiting, we took advantage of the nice fall weather and walked around our neighborhood.

Fall colors.


So much for the lazy days of summer…

Poolside.


All that walking wore us out!

Grandpa Wilhelm and Darby took a nap in the chair, but Grandpa woke up first.


Darby is gradually warming up to her baths, but she is still a little uncertain.

Do I really need another bath?


She is already exhibiting a fine Smith trait.

Over the weekend, we had a special visit from DeAnna, who came to take some photos of Darby. DeAnna did some maternity photos of us, and we were glad to have her back. Some of her photos are below, and she has plenty more on her website.

We're raising her right...


Quietly sleeping...for now.


Happy parents!

Survey says….

It’s only early July, and we’ve had quite a bit of activity this summer! For those of you who like pictures, there are many.

In early June, we visited Kevin and Linda in their new town and new church. They live about 30 minutes from Calaveras Big Trees State Park, so we spent Saturday afternoon hiking in the South Grove, which I highly recommend over the North Grove if you really want to get into the forest. The weather was amazing, ranging from a sunny 70 degrees to overcast and raining. Along the trail, we found ourselves about 30 yards from a brown bear cub who was just foraging in the bushes. I didn’t have the camera out, so no pictures. The cub ran off, and after we waited quietly to make sure mama bear wasn’t coming to eat us (parents, tell your kids whatever you want about bears), we continued on the hike. Did I mention how big the trees are?

Jen tries to wrap her arms around the concept of how big these giant sequoias really are.

Jen tries to wrap her arms around the concept of how big these giant sequoias really are.

Recreating our wedding dance at Big Trees.

Recreating our wedding dance at Big Trees.

Kevin didn't get the memo...

Kevin didn't get the memo...

I’ve been playing in a co-ed softball league with some colleagues, and in our fifth game, I started out playing first base. Even though Jen will say otherwise, I did some stretching and warming up before the game. Apparently it wasn’t quite enough. As I did what any good first baseman would do and stretched to try to catch an errant throw while keeping one foot on the base, I heard a pop in my groin area and promptly fell down without catching the ball. I’ve had groin injuries before, but not this bad. The injury happened on a Thursday, and this bruise showed up on Sunday.

The bruise as it first appeared, 3 days after the injury.

The bruise as it first appeared, 3 days after the injury.

The week after that, we drove down to Santa Barbara for Jen’s sister Amy’s wedding. Amy is the youngest of the three sisters, so you can imagine Dad’s relief!

Whew...almost done with the third wedding!

Whew...almost done with the third wedding!

It’s much different when you’re just in the wedding and not the people getting married. You can actually goof off a little during rehearsal!

Gotcha!

Gotcha!

After the rehearsal, we headed to Amy’s then-boyfriend, now-husband Jim’s aunt’s house for a tasty meal of tri-tip. The baked beans were good too, and there was some other food, but I don’t really remember it.

Mmmmmm...tri-tip!

Mmmmmm...tri-tip!

After a week of hobbling around and a total of 13 hours driving to and from Santa Barbara, my bruise changed a little. I wonder if my low platelet count (99k at last visit about three weeks ago) has something to do with this?

The bruise after a week of interacting with gravity.

The bruise after a week of interacting with gravity.

We enjoyed a quiet 4th of July weekend at home. I took advantage of my holiday off work, and with the help of a few good friends (thanks to Sean V., Eric C., and Rob C.), finally got started on that shed I mentioned last summer by pouring concrete on Friday morning…and early afternoon. I’m pretty sure they made a mixing error and gave me too much concrete, because we had to scramble to build additional forms for places to put an extra 3/8 of a yard of concrete! Either that, or I just miscalculated how much I needed. Since we were pretty busy with that, I didn’t take any pictures of the process. More to come as actual construction begins!

On the actual holiday itself, Jen had to work. It was one of the two holidays that she signed up to work at the beginning of the year. We wanted a quiet (relatively!) evening at home, so we just had dinner alone and watched a movie, and briefly went around the corner to see the neighborhood fireworks.

Happy Independence Day!

Happy Independence Day!

Let’s see…what else? Oh yeah, Jen is about 21 weeks along now. We had an ultrasound today, and TJSJr. (XX) is developing just great. Our ultrasound technician happened to be the employee of the month this month, and we experienced no less than excellent service from her. I’ll add an image from the ultrasound tomorrow.

Jen at 21 weeks.

Jen at 21 weeks.

Tuesday morning edit: Ultrasound picture added.

Already sucking the thumb!

Already sucking the thumb!