Just a few weeks ago my niece, Josephine Marie Wrenn, was a normal three year old, dancing on the “stage” (landing) of the stairs, lip syncing to Beyonce in the car, and learning how to read and write at daycare. Then she started experiencing unexpected gastro-intestinal issues of intermittent vomiting and constipation. Her blood and urine lab results were normal, and they couldn't find any good explanation for her symptoms. We were concerned, but a few extra tantrums and not wanting to eat broccoli are par for the course with a toddler.
A few weeks later Josephine was sitting at her pediatrician's office during an appointment for her little brother, Randall, when Dr. Sunny Bell noticed her voice sounded different than normal. Sensing something wasn't right, Dr. Bell called for a sedated MRI the next day and on Wednesday, June 6, 2018, my sister called me with the news that Josephine had a tumor about the size of a golf ball intrinsic to the medulla of her brain stem. While her husband was away on a business trip in California, my sister had to sit behind a curtain in an anesthesia “wake-up” room and learn her daughter had a large mass in the most critical part of her brain, the part that controls her heartbeat and breathing. I know how I felt getting her phone call, but I cannot fathom the crushing emotions of that moment for her. Without intervention, we were told Jo wouldn’t see her fourth birthday; in fact, she may have only had a few weeks left if we hadn't discovered the tumor.
To say that this news is devastating and unexpected is barely enough. Our family is reeling. For now, all we can manage is to hopefully not all succumb to a wave of desperation at the same time. And we’re actually kind of doing that. I think. Those of you who know my sister Casey know that her game face is STRONG, and I am already impressed with how she and Ryan have handled this situation, but this just isn’t something anyone can be prepared to handle.
Josephine is the first piece of my heart I let live outside my body. She is vibrant, loquacious, hilarious, and *the smartest* preschooler you could meet. Basically a mini Casey with plenty of extra awesome from my brother-in-law, Ryan. She is incredible.
As soon as you become a mom (or in my case an “Auntie M”), you have overwhelming moments of fear that something horrible will happen to this precious little life. And then you consider how rare the really horrible things are and you can push that worry away. But then sometimes, the absolute worst things DO happen, without warning. And what do you do then? We don’t know. You can see my sister’s posts that sum this up on Facebook — we don’t know what we’re doing in this nightmare or how to get out, but here we are.
While my sister was on the phone with me that Wednesday, Josephine was wheeled from the radiology department directly into Monroe Carell Jr. Children’s Hospital at Vanderbilt University and has been in-patient ever since. Originally, the oncology and neurosurgery teams thought Josephine was stable enough to conduct a craniotomy to biopsy the tumor to determine the best course of treatment. However, Josephine’s symptoms rapidly increased, causing the team to call off the risky surgery less than a day before it was scheduled. Surgery to install an access port was conducted the next day and radiation and chemotherapy were started the day following. Josephine started a six week radiation and chemo treatment course on June 14, 2018.
Caught completely off guard, Casey and Ryan have continued to be at her bedside in the hospital. With the tumor impacting her swallowing and breathing, as well as her walking and speaking, they have remained with Jo (rather than going back to work) because of the uncertainty of the progression of her symptoms and the delicate nature of the location of the tumor. Any swelling from radiation or continued growth of the tumor could drastically impact Josephine’s brain stem - the organ controlling heartbeat, breathing, and the transfer of information from the brain to the rest of the body.
Josephine is incredibly gregarious. She has never met a stranger and has befriended every nurse, doctor, care partner, and therapist who is part of her medical team. It doesn't take long to fall in love with Jo. Despite losing her voice from the tumor and treatment, she still talks incessantly as her family and friends struggle to understand her. The feeding tube in her nose and aggressive course of steroids to control the swelling have made her cranky, but not less independent or determined. She presses her own nurse call button for help, moves her own IV pole, and pushes her own medicine into her IV. She even occasionally steals syringes of saline out of nurses' pockets and then shoots her doctors with them! When asked, Jo will tell you she wants to be both a doctor AND a singer when she grows up, and we want to see that dream come true!
To learn more about Josephine and her journey, you can visit or subscribe to https://ItsJoTime.com or follow her mom, Casey Haugner Wrenn, on Twitter @caseyhaugner or Facebook. You can get in on the action by using #ItsJoTime as you join the conversation. Thank you for reading Josephine’s story. As Casey started chronicling the journey, we were asked by dozens of people “how do I help?” - so we decided to start this campaign. We are grateful for any help or contribution, no matter how large or how small. We feel your prayers and are floored by the amount of offers to help. It means a lot to feel a little less alone. If you feel comfortable, we encourage you to share the link for this campaign through your social media and personal networks. Even if you can’t contribute financially, the family needs prayers and well wishes as they battle brain cancer - a diagnoses without a guaranteed cure.
We will keep everyone involved in this campaign updated on the use of funds and Josephine’s progress going forward. If you have any questions or would like to help in a different way, please email us or sign up to provide a meal at https://mealtrain.com/20ydvm We are so very grateful for all the support!
If you need any further motivation, check out the pictures and videos of Jo below. I dare you not to smile.
Frequently Asked Questions
Who are you?
This campaign is led by a group of the Wrenn family’s closest friends, including Josephine’s aunt/Casey’s sister Meredith Alvarez (“Auntie M”), Ryan and Casey’s best friends, Drs. Brett and Sarah Parker, Casey’s Broad Academy classmate Adrienne Useted, and the Wrenn’s closest neighbor and porch drinking buddy, MacKenzie Lee Grant. We are based in Nashville, Tennessee.
Why are you raising money?
Medical expenses are debilitating and Casey and Ryan have such uncertainty with regards to the length and cost of Josephine’s hospital stay. We have to get started sooner rather than later. They already have dozens of x-rays, surgical procedures, a planned six weeks of radiation and chemo, and more than two weeks in the hospital on their tab, and they are just getting started. According to the Brain Tumor Foundation, the average cost of treating a brain tumor with “surgery, radiation and modern chemotherapy - along with hospitalizations and other costs - can exceed $450,000 in most parts of the country.” This is way more than any of us has in the bank! We figured if we could pool small donations together, we could give them some cushion to ensure Josephine would be taken care of, regardless of the chosen next-steps from her medical team or Casey or Ryan’s job status.
Is Josephine going to make it?
We don’t know. The good news is the tumor is completely contained in the medulla and NOT up in the “pons” (this is NOT a DIPG), which means her prognosis is most likely better than most brain stem tumor patients. For this, we are incredibly thankful. If the tumor is “low grade,” the chances of a cure are pretty good, and we are hopeful that the tumor responds to her current treatments of radiation and chemo and starts to shrink. If the tumor is “high grade,” and is very likely to return or continue to spread, Josephine doesn’t have much room left in such a critical location in her brain. If we can’t get a handle on the tumor, she won’t have long. Currently, her symptoms are being managed well and the medical team is hopeful that after the first course of radiation and chemo, they will be able to revisit the idea of a surgical biopsy to figure out the tumor’s histology and if needed, attack it with more targeted chemotherapy treatments. Regardless of the grade or characteristics of the tumor, it’s impacting critical bodily functions already, and Jo’s undergoing expensive treatments that are necessary for her to continue to live. As people who love Josephine (and the rest of her family) dearly, we want to be able to provide comfort and compassion to this amazing young lady in any way we can.
THANK YOU all for joining us in easing this incredible burden the only way we know how!
Can't get enough Josephine? See more pictures & videos at https://itsjotime.com/meet-josephine/