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When she suffers a stroke, 12-year-old Cheyanne Coxen's eyesight becomes so terrible she cannot see well enough to tell you how many fingers you are holding in front of her face.
You must understand that, in order to comprehend the joy that filled the lives of the Polson girl and her family last weekend. You must also understand that, sometime in the next six months to two years, the strokes that keep happening more frequently and rob Cheyanne of her eyesight and more, the strokes that all the doctors and medicines in the world cannot stop, are probably going to rob her of her life. Only then can you even begin to imagine how special it was for a 12-year-old girl to be able to see across a room. As her parents and sister and nurse watched, Cheyanne's eyes lit up and a smile spread across her face as the Disney characters entered. Cheyanne could see and identify them all: Mickey Mouse, Snow White, Captain Hook, Eeyore, Donald Duck, Pluto and more. "It was amazing," says Maria Gurreri, a registered nurse at Missoula's Community Medical Center who accompanied the Coxen family on Cheyanne's Make-A-Wish Foundation vacation to Disneyland last weekend. "It may sound corny to people," she goes on, "but it was so emotional for me and her parents to see her so happy. I mean, she's had such a rough time. After a stroke, you can hold fingers a foot away from Cheyanne's face and she can't tell you how many you're holding up, and here she could see who was who from all the way across a room." It was a room she almost didn't get to be in, on a trip that almost didn't happen. After Cheyanne was diagnosed with MELAS following the initial strokes that began a year ago - MELAS is a very rare and fatal form of dementia whose initials stand for mitochondrial myopathy, encephalopathy, lactic acidosis, and strokes - her mother Angie started looking into getting her daughter to Disneyland through the Make-A-Wish Foundation. Angie sent a request to the foundation's national headquarters, where it apparently got lost in the shuffle. But a social worker at Community Medical Center told her to redirect the request to the Alaska, Montana, northern Idaho and Washington chapter of the foundation. Things moved quicker after Missoula Make-A-Wish volunteer Adrienne Dussault got involved, and the trip was approved. There was only one problem. "They said they would arrange nursing care down there, but my husband and I didn't feel comfortable with that," Angie says. "It would be a nurse who didn't know Cheyanne and might not know a lot about her syndrome. We asked if we could take our own." The obvious choice, Angie says, was Gurreri, who happened to be on duty a year ago when, after the first stroke, Cheyanne was flown by helicopter from Polson to Missoula. "I was the nurse who admitted her when she was very first diagnosed, and I've happened to be the nurse on duty when she's been admitted several other times," Gurreri says. "We've gotten quite attached to each other." But bringing in an outside nurse threw the trip into a bureaucratic nightmare. The state of California dragged its feet on recognizing Gurreri's Montana nursing license, which had to happen for liability purposes before the Make-A-Wish Foundation could finalize the details. Meantime, every new stroke - Cheyanne has suffered a dozen in the past year - set the 12-year-old back. Her physical condition deteriorates with each one, and the windows where Cheyanne would feel well enough to travel were getting fewer, and further between. "The alternative was Disney World in Florida," Angie says. "Florida said we could bring Maria with us. But it's a very long flight, and so much farther away if something were to happen." Then, one day, the phone rang at the California Board of Registered Nursing. Gov. Arnold Schwarzenegger was on the other end of the line, and told the staff there to get the ball rolling, and rolling now, so the little girl from Montana could head for Anaheim with her nurse from Community Medical Center. It didn't take long after that phone call. Cheyanne Coxen was going to Disneyland. Who contacted Arnold Schwarzenegger on their behalf? "We have no idea," Angie says. "We asked the social worker, and she said maybe Maria Shriver (Schwarzenegger's wife) had something to do with it, maybe her mother (Eunice Kennedy Shriver) had a hand in forming Make-A-Wish or something. But we don't know." Angie, husband Doug, daughters Candace (13) and Cheyanne - not to mention Maria Gurreri - boarded a flight for Los Angeles a week ago Friday. "I was prepared for it not to go well," Gurreri says. "Cheyanne is so fragile." But it was a success from the get-go. The pilot on the flight invited Cheyanne to roll her wheelchair into the cockpit for the pre-flight check. After Cheyanne had taken her seat, the pilot announced to the passengers they could expect a safe and pleasant journey, because Cheyanne made sure everything had checked out before takeoff. The family and nurse stayed at a Howard Johnson's across the street from Disneyland. Last Saturday and Sunday, they hit the theme park early and had VIP passes that let them cut to the front of the line on all the rides. Cheyanne says some of her favorites included Pirates of the Caribbean and It's a Small World. She didn't go on fast-moving or jolting rides. The family would go-go-go until Cheyanne got tired, then retreat to the hotel to let her rest, and return at night when the Magic Kingdom was lit up. "She was giggling like I've never heard her giggle," Gurreri says. "Mentally, she was so excited. I was cautious, because I was there to intervene if she suffered a seizure or a stroke, but it never happened. I think she was so looking forward to this that it rallied her physically." The rides were great, but it was meeting the Disney characters that made the trip so special. "The day before we went she told me, 'Mickey Mouse isn't real, you know,' " Gurreri says. "I told her, 'We'll see.' " You couldn't wipe the grin off Cheyanne's face when she finally met the mouse. "All she could do was stare and smile," Gurreri says. "She told him, 'Tell Minnie hi for me.' " But she'd meet Minnie, too, and dozens of others, over the two days. Disneyland has a special lounge for the terminally ill children who request trips to the park through the Make-A-Wish Foundation, and Disney characters stop in regularly to say hi to the kids who are taking a break from the action. The two days were perfect, Angie Coxen says. There was too much to see to do it all in one day, but anything more would have taxed Cheyanne too much. On Halloween 2005, Cheyanne Coxen came home from trick-or-treating early, complaining of a horrible headache. Angie and Doug took their daughter to the doctor, who put her in St. Joseph Medical Center here. "She was acting like she couldn't see us," her mother says. "She didn't know where she was, or who we were." The doctor ordered an MRI. Incredibly, the test showed the 11-year-old had suffered a stroke. That's when Cheyanne was put on a helicopter for Missoula. The doctors at Community Medical Center who examined Cheyanne had heard of MELAS and consulted with a neurologist before ordering the blood tests and muscle biopsy that would show if the genetic disease was the culprit. The results were sent to the Mayo Clinic, and the diagnosis was made. It's a genetic disease that Angie, who doesn't suffer from the syndrome, passed on. Tests have showed that Candace, Doug and Angie's other daughter, is also a carrier. "It's very progressive," Angie says. "There is no cure for it, there is no stopping it, there is no treatment for it." When she's not undergoing another episode, Cheyanne is awake, alert and these days more than happy to tell visitors about her trip to Disneyland, either from the hospital bed in her room, or from the wheelchair that lets her hang out with her mom in the living room or kitchen when Cheyanne feels well enough. Cheyanne was only able to attend school two days this year before her symptoms forced her to stay home. In the year since the first episode, nausea and vomiting have been steady companions of Cheyanne. She's lost all interest in eating, and is kept alive through a feeding tube. Her weight has dropped to as little as 37 pounds during the ordeal - she lost 12 pounds in a week after one of her strokes - but was back up to 43 pounds when she made the trip to Disneyland. When she has them, the migraine headaches are so severe not even morphine can control the pain anymore, her mother says. "The strokes keep happening, and they're getting closer and closer together," Angie says. "She's definitely in the later stages, and we just want to keep her comfortable and out of pain as much as possible." They've watched their little girl suffer so much in the past year, and have made the gut-wrenching decision not to resuscitate when the time comes. But thanks to the Make-A-Wish Foundation, there will be wonderful memories associated with Cheyanne's final months. "Nothing in the last year has happened by Cheyanne's choice," Maria Gurreri says. "Nothing, except Disneyland. You have no idea how much it meant to her."
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