Friday, May 30, 2014

Wrestling with Monkey

Roscoe loves his monkey pacifier. We got it during his first visit to UCSF and he's kept it ever since. At first we thought it was just a gimmick, but then we realized how helpful it was. It's been so helpful that we bought a backup (a giraffe) in case his monkey gets dirty or lost.

The monkey gives him something to grab onto and let's us position the pacifier so it's held into his mouth a little more firmly. Most of the time, he just plays with the monkey like this video shows below. To me it looks like he's wrestling with the monkey and the monkey has him pinned.

Lately he's been shoving the arms or legs into his mouth and chewing on the fuzzy parts, instead of the pacifier. We're not sure if this is him experiencing new textures or starting teething, but whatever it is he likes it.

As a bonus, today he passed the 10lb mark on an official weighing. He gained an average of 2oz each day this week, and when that happened last week much of the weight ended up being water weight. We'll see if this weight gain can be sustained long-term.

Thursday, May 29, 2014

Kids Don't Deserve This

Kids don't deserve to be sick. If one thing resonates with me after watching Roscoe struggle in the hospital for almost 8 months now, it is that kids don't deserve to be sick or deal with major problems. During the time when we've been in the NICU we've seen many babies come in and be poked with needles and subjected to surgeries to repair their brokenness. We've seen a baby leave with Down Syndrome and we've seen one baby in Roscoe's room struggle and then disappear (death). All of this is not fair to these kids.

We come in for most of the day, but some things Roscoe has endured without us. For instance, I came in on Monday after he'd had blood drawn from his arteries and found two needle marks on one wrist (shown below) and one needle mark on the other wrist (not shown):

I didn't see him cry, but I know that he did. We heard from the nurse that the blood clotted when they drew it from his wrist artery on one side, so they had to let him calm down and try again. I've been there before when they draw blood and it isn't nice to experience, but I know he's better if we are there to comfort him. He's been in the hospital for over 30 weeks now, so averaging two blood sticks in his foot each week (they were much more frequent early on) that's 60 blood samples from his feet with a pin prick.

Roscoe has it rough, but there's always someone who has it rougher. I just can't help but think about how unfair it is that the 1st floor and 4th floor of the building where he resides are filled with children who are sick and don't deserve it. Elsewhere there are entire childrens' hospitals full of children who are suffering with illnesses and ailments that they don't deserve.

You might say to yourself, "It's not fair that anyone gets sick" but I can't really agree. As adults or teens we are responsible for ourselves and we do lots of things to get ourselves into trouble. We do damage to ourselves by eating poorly, abusing substances, avoiding exercise, practicing dangerous activities, and filling up with stress. Then we harm our bodies even more by trying to take shortcuts (like pharmaceuticals or surgery) to get ourselves back in good health. Even if we live the healthiest life we can, we still deserve the problems we get. After all, we sin.

We might not be the worst person on the block, but we've all done some things wrong. We've said mean things, lied, lusted, hurt others, and neglected to do the good we know we ought to do. We might try to make up for some bad things we've done by doing some good things, but that's like trying to uneat some ice cream by chasing it with a salad.

I think about this quite a bit as I sit near his bed and watch people walk by outside his window:
When I see someone stroll by outside this window and they are in a wheelchair or carrying an oxygen tank, I think to myself that they probably did something to deserve it. I fully accept that I may be wrong, but the thought still crosses my mind. Oxygen tank? That guy probably smoked too much. Wheelchair? That person probably ate poorly or was lazy. Limping? They probably were doing something stupid.

I realize how hypocritical this is: that I am judging others, something which in itself is wrong to do. I try to correct or muffle these thoughts, but they still come instinctively. In fact, some day I will be shuffled along on a gurney or wheelchair and someone may look at me in the same way, trying to surmise what I did to rightfully deserve this physical retribution.

The point still remains: kids don't deserve it. No matter how you look at the situation, it isn't fair to these kids. They haven't sinned. They haven't abused themselves. They haven't done anything wrong. Yet still, they suffer and fight for life more than some life-long drug addicts do. It isn't fair.

At this point I'm forced to choose my worldview. I can look at the world as a place where bad stuff just happens pointlessly to collections of atoms, and there is no rhyme or reason to it all. Some people just get the short end of the stick and that's too bad. To me this worldview makes things even bleaker, because it leaves my child suffering with no meaning or empathy behind that suffering.

Instead, I am compelled to look at the world through the eyes of our creator. Though sometimes I may want to deny his existence because he does not immediately give me an answer to my questions of "Why is this happening?", I cannot deny that he's there. I see him everywhere, in every part of his creation. The design of the human body, the resiliency of life, the clockwork of creation just screams that he is behind it all.

The fact that the world's most highly-trained doctors can do little more to "fix" a person than to try to stimulate the body's natural growth process loudly speaks to the existence of the body's designer. The doctors can cut, stitch, observe, apply ointments, and inject medicines and nutrients, but that is about all they can do. They cannot heal a scar, grow new pathways, or assimilate, distribute, and utilize nutrition throughout the body. They cannot create a replacement lung from scratch. They cannot weave Roscoe a new heart.

To think that these doctors are the ultimate hope of fixing Roscoe is the equivalent of relying on a shade-tree auto mechanic with nothing more than duct tape and a screwdriver, while denying that the car ever had teams of engineers and testing behind its design. I am not trying to belittle the doctors' skill or intelligence, because they have been compassionate towards Roscoe with his ultimate healing as their goal. However, when we see healing occur we need to give credit where credit is due. When someone uses duct tape to fix a car, give credit to the man for the creative patch fix, but give more credit to the designer who created a car that is resilient enough to run properly with such a patch in place.

There is a certain reassurance in the fact that God can empathize with my experience. After all, when I look at the scars in my son's wrists, I know that God sees scars in his Son's wrists as well. Those scars are there because of me. He saw his Son fighting for life and suffering punishment that he didn't deserve. That doesn't make my son's suffering any easier for him to endure, but it does reassure me that God knows that kids don't deserve this.

Big Smile

This video is a follow-up to the previous blog post. It's a longer video that shows Roscoe entertaining himself by playing with his tongue. As a bonus, there are also some huge smiles that are sure to bring one to your face as well. Enjoy!

Wednesday, May 28, 2014

Entertaining Himself

Roscoe does a good job of entertaining himself. Something we've noticed as he'd grown is that he'll start initiating actions instead of waiting for something to come along and please him. Now this doesn't mean that we'll walk in and find him reading to himself or building a LEGO structure, but it does mean that he is starting to learn that if he's bored he can do something about it. We still have to help quite a bit in getting him started, but we can see mental baby steps happening.

Here he is watching some overhead toys that dangle above him.

And then he got distracted when daddy said something.

This shows a view from the side, as he watches the stuff hanging overhead. Between the two stuffed animals (bugs), there is a plastic mirror that's shaped like a sunflower. Occasionally he'll get really captivated by what's in the mirror whether it's him or just the blanket or a wall. The mirror amplifies any movement in the overhead string, so it's the first thing to move.

The video below shows him playing with his tongue. Part of me thinks that he's convinced he's got a fish in his mouth and he's trying to pull it out while it flops around!

Tuesday, May 27, 2014

Reading Books

Roscoe got some new books when his aunt and uncle rolled into town this past week. The books are called Hello, Animals and Hello, Bugs. They are filled with high-contrast images of animals and bugs with a single foil color, along with funny sounds that each one makes. Roscoe really loves these books and they've quickly become some of his favorites to look at and have read to him. Alisha often gets him to smile really big with certain bug sounds like "buzz, buzz" or "scuttle, scuttle". Here are some shots of her reading him the animals book during the good part of last Saturday:

I've started reading through the Rhyme Bible with Roscoe. He likes the rhyming sounds and pictures, and I'm sure that over time the stories will start to sink in. On Saturday we made it through the entire Old Testament in a single sitting, and on Monday we read about half of the New Testament.

Roscoe's breathing was very steady yesterday on bubble CPAP of 6L/min at 45% oxygen. He seemed calm and once again his normal self. His weight was 9lb 9oz, mainly because he had gotten rid of 5oz of fluid in a single diaper on Saturday. I suppose that a good portion of the big weight gains he'd had were due to retaining fluid, rather than building muscle and bone.

I thought it would also be fun to include some pictures that I forgot to post from several weeks back, before he was put on the CPAP full-time. Rachelle took these while Alisha was holding Roscoe and I'm sure entertaining him very thoroughly:

Roscoe sure loves his momma!

Monday, May 26, 2014

Doing Better

We will be swapping out time between the hospital and family barbecue today, so this post will be short. Roscoe seemed to be doing much better yesterday, back on bubble CPAP. He started off the day at over 50% oxygen, but ended it around 40-45% and very stable. He was back to his usual playful self. We spoke with the doctor and she said that the wetness in his lungs was probably brought on by his chronic lung disease (BPD) and agitated by the added breathing support. The plans are to keep him on bubble CPAP for a while so he can remain stable.

"Thanks for praying for me, everybody!"

Sunday, May 25, 2014

Good Day Turned Sour

Roscoe just can't seem to keep a break when he catches one. After the roller-coaster for the past few days, I was surprised to come in Saturday morning and find Roscoe on the Vapotherm machine at a lower pressure than he'd been on in weeks. I asked the nurse and she said that the doctor who we'd met with to talk about his long-term plan had reduced the breathing support in response to seeing how Roscoe had suffered with added breathing support. Needless to say, I was overjoyed to see his face and to see how calm he was:

Roscoe and I played around, between him dosing off for small naps. He made full use of his NICU jungle gym full of toys:

Overnight the doctor surmised that the added breathing support was causing him issues (evidenced by increased lung patchiness on successive x-rays), so he decided to back off of the lung support even further than we anticipated. He planned to leave Roscoe on Vapotherm @ 4L/min until Monday when he'd do another blood test to check Roscoe's CO2 levels.

Over the past week, here is what his lung support has looked like:
   May 18: Bubble CPAP @ 6L/min
   May 19: Bubble CPAP @ 6L/min
   May 20: Bubble CPAP @ 7L/min
   May 21: Bubble CPAP @ 7L/min
   May 22: BiPAP @ 5-10L/min
   May 23: Bubble CPAP @ 5L/min
   May 24: Vapotherm @ 4L/min
   May 25: Bubble CPAP @ 6L/min

By comparison, we have never had them change his breathing support this much in such a short time span. For most of the day, we were greatly relieved because he seemed much more relaxed and we could see his face for longer than a single 30-minute span. Roscoe's personality seemed fully returned as he flashed huge smiles at the nurses and even talked back and forth a little bit.

I sent a text message to Tifany and Caleb, who is are town for the next two weeks. I left them know that his mask was off for at least the next two days, so they should come if they wanted to see lots of his face. Thankfully, they came and got a good amount of time with him.

Roscoe stayed comfortable and playful for most of the day, with his oxygen requirements at around 40-45% for the middle part of the day. Around 5pm he started needing more oxygen (in the 55% range) and then by 7pm he was up at 60%. We didn't think much of this, since we assumed he just had a full belly. Often when his belly is full it gives his lungs less room to breathe, so he needs more oxygen.

Thankfully his regular night nurse returned today and noticed him breathing extra hard. Around 9pm she listened to his lungs and said they sounded "wet". If his lungs were too wet, it would explain why it was more difficult for him to breathe and why he needed more oxygen.

Alisha put him to sleep and returned home while I made dinner. We usually eat dinner now around 10pm, because Roscoe doesn't go to sleep until 9pm. While we were eating dinner at 10:30pm, the doctor called and said that Roscoe's oxygen requirements had escalated to 75%, so they checked his CO2 and it was at 90. Looking back at his CO2 trend, Roscoe never had a CO2 measurement higher than 80, so this was very concerning. They planned to put him back on bubble CPAP to make his breathing easier, give him a diuretic to get rid of the excess fluid, and then re-check his CO2 around 2:30am.

I remember waking up around 3am and 4am, but didn't stay awake long enough to call in. At 5:30am I woke up enough to call in and speak with one of his regular morning nurses. She said he got rid of 5oz of fluid in a single diaper and he seemed stable on bubble CPAP @ 6L/min with 50% oxygen. We were thankful that he is once again stable, but we aren't sure where this leaves us.

Hopefully the coming days will provide some clarity and stability. We are thankful for all of the prayers and support we have received from everyone around the country. It is an encouragement to us that we have such a great network of people concerned about the health of our little boy. We know that as long as you continue to fill God's ears with your prayers, he will listen. For some reason God has not interceded to the point that Roscoe is home stable, but we know that he is listening and that he understands ...

"'For my thoughts are not your thoughts,
neither are your ways my ways',
declares the Lord" - Isaiah 55:8

Saturday, May 24, 2014

Improvements and Weight Gain

Roscoe had a much better day yesterday, but still isn't back to normal. The good news was that when Alisha came in the morning, his personality had mostly returned; he was happy and playful like usual. The nurse who had him Thursday and Friday said she noticed a huge difference in his energy level on Friday. His heart rate and breathing rate were slightly less, but they were still much higher than usual. The doctors did another x-ray and found moderate negative changes from yesterday (added patches of poorly functioning lung tissue), which they attributed to the added pressure of the BiPAP machine.

The pulmonologist lowered Roscoe's breathing support pressure from 7L/min to 5L/min, because we first noticed the heavy breathing when he went from 6L/min to 7L/min this past Tuesday. Unfortunately, Roscoe did vomit/spit up last night again. I spoke with the doctor and she was confident it was likely a residual effect of his lungs recovering.

In the videos below he was playing with us in his little virtual jungle gym of sound, toys, and sights. We were trying to get his right arm flopping back and forth how he sometimes does when he gets a good hold on something:

I just realized that we haven't posted his weight in a while, which is a shame because he's been steadily gaining weight since they started using his feeding tube to standardize the amount he's taking in. Here has been his weight at the past few weigh-ins:
   May 16: 9lb 3.4oz
   May 19: 9lb 7.1oz
   May 21: 9lb 11.7oz
   May 23: 9lb 14.6oz

This is a very good trend for Roscoe to be on, because historically for his entire life he's gained a little over one pound each month. With this trend, he'll roughly gain 2-3 pounds in a month! As he puts on weight, he will gain and store more energy, which will support his lungs and give him reserve oxygen when he needs it.


Now that he's neared the 10lb mark he has graduated from "newborn" diapers to "size 1". Looking around at the constant growth God affords the trees, bushes, and even weeds around us, I never knew it would be such a concerted effort to get a baby to grow, but God has blessed him.

Friday, May 23, 2014

BiPAP Mask

The doctors did a blood test on Thursday and found Roscoe's CO2 back up at 77. Since he's been getting large variations in the test results, the doctors decided to try out a CO2 monitor (similar to his current O2 monitor) so they can get a constant reading of his CO2. Since it's a less common monitor, they are going to validate the accuracy by measuring the CO2 at the same time when they take get blood test results. If the monitored CO2 value reasonably matches the blood test CO2 value, then they'll consider the CO2 monitor to be sufficiently accurate and will use it from now on.

They doctors also felt that Roscoe's CO2 might benefit from added breathing support, just to get the number stable into the mid-60's. They tried changing him to a new machine and mask called a BiPAP. This machine is the pediatric version of what some of you might use at home when you sleep to prevent apnea.

After a period of hating the new mask for about 60 seconds, Roscoe got rather used to it. It blocks his vision more than the old mask, but it has the added benefit of being softer gel material and appears to be made more for long-term use. I liked the mask more too, because the nozzle at the front is able to rotate (unlike the fixed bubble CPAP mask nozzle). This let me transition him from laying down on my chest to sitting upright much easier, and it also let me hold him with his back against my chest when I couldn't do that alone on the bubble CPAP.

Despite how much we both liked the new mask, as you can see in the videos above he was rather irritated. Some of the irritation was the rough day he had been having, due to what Alisha and I think is a sickness (click here to see the other blog post about his rough day). Part of the irritation came from the added pressure of the new machine.

The bubble CPAP was giving Roscoe a constant pressure of 7L/min (increased from 6L/min just 3 days ago). The new BiPAP machine would give him a constant pressure of 5L/min, with forced "breaths" at 10L/min at a periodic interval determined by the machine settings. Roscoe's body didn't like the new machine.

After he slept for a while on my chest, I laid Roscoe back down in his bed before his feeding. Before each feeding, the nurse checks how much food is left in his stomach. Typically this amount is between 0-5mL (meaning he digested all of the food), but this time it was 26mL. On top of that, after he got his next feeding, he vomited up (twice) about 20mL of it onto the bed. Luckily he was laying sideways and both the nurse and I were by his bedside when it happened. The food was undigested, so it didn't look like a stomach bug.

Throughout his rough day his oxygen requirements had been much more touchy, meaning that when he cried his O2 number would drop much more quickly than it had previously. This was another reason why Alisha and I suspect that he has an illness, because his body is using its reserve energy to fight the infection, rather than to store oxygen.

Roscoe's oxygen requirements on the new machine kept increasing and increasing. They started him on 5L/min of 100% oxygen and as he became frustrated or moved the requirements gradually increased to 10L of 100% oxygen, with his O2 measurement still sitting in the low 90's range. By comparison, just less than 2 months ago he was on 100mL/min of 100% oxygen and ready to come home, so this was an oxygen requirement increase of 100X.

I had a frustrating bout with the respiratory technician around 9pm. The new BiPAP machine kept triggering an alarm that said Roscoe was having an apnea, even though his monitors on screen showed he was breathing. The respiratory technician was convinced that it was merely a leak in the new mask, so he kept pushing the mask harder into Roscoe's face (even pushing the mask into his eye) with no pacifier in his mouth. Roscoe started screaming since his woke him up from sleeping. After I saw that he was doing this longer than a few seconds, I pushed his hand out of the way and put Roscoe's pacifier in his mouth to calm him down. Then muttered something about his lack of intellect under my breath as he walked back to the machine. It is incredibly frustrating to see someone value their machine setting more highly than your child who is supposed to benefit from that machine.

We had already called the doctor to the bedside to discuss why Roscoe's oxygen requirements were increasing, and so I explained that the vomiting and increasing required oxygen hadn't been necessary just 3 hours prior when he was on bubble CPAP. They changed the new machine settings from BiPAP (which varies from 5-10L/min) to CPAP (which gives constant 7L/min) and Roscoe calmed down and his oxygen requirements returned to "normal" (for that day).

I stayed until a little after 10pm as Roscoe slept in his bed to make sure he was okay. I also wanted to make sure that the respiratory technicians would do as little messing with him as possible, since he was now stable. When I left, they were planning to move him back to the bubble CPAP machine so that the BiPAP wouldn't keep having the apnea alarm and so the bubbles on the CPAP would be indicating that Roscoe was getting the breathing support he needed.

Rough Day

Roscoe had a pretty rough day yesterday. He wasn't his happy self all day and his breathing and heart rate were both much higher than they usually are. Usually when he is sleeping, his breathing (white number) is 25-30 and his heart rate (green number) is 105-115 like this:
However yesterday, his numbers were much higher while he was sleeping (see the image below). When he was awake or even drowsy, his heart rate ranged from 170-190. The image below doesn't show it, but his breathing rate was often around 70+ breaths per minute.

His heart rate was 30-40 points higher than usual and his breathing was much shallower and more labored. Alisha pointed this out to the doctor and he ordered an x-ray to take a look at Roscoe's lungs. They saw more patchy areas than were on his last x-ray about a month ago, which indicated that his lung function was worse. The two possible explanations he gave were that his BPD (chronic lung disease) has gotten worse or that he has a respiratory infection (like pnemonia).

Alisha and I are convinced that Roscoe has a sickness or infection of some kind, due to the drastic change in his mood and vital signs. Surprisingly, his body temperatures have still been normal. The doctors will do another x-ray today to see if his lungs look any different after just one day, and if they do then that would indicate an infection.  If this is an infection, then he would be started on antibiotics and they would send a culture to the lab to identify the virus.

In addition to all of this going on for our little guy, they tried changing him to a BiPAP mask which didn't go so well. Click this link to see another blog post of him on that new mask and breathing support. It only lasted about 5-6 hours before he was back on the bubble CPAP.

Wednesday, May 21, 2014

Roscoe's View

If you wondered what the view is like from Roscoe's crib, here's what he sees most of the time:
Now of course this isn't all he has to look at. He also has his mobile, some hanging toys, a jingling frog, momma's face, and any cheerful nurse who happens to walk by. Then sometimes he'll get a visitor to entertain him, like his grandpa did a few Sundays ago:

When he gets bored, we'll sit him up in the Bumbo chair and face him out the window. We've done it previously because he likes watching the trees move with the wind. Now that he's got the CPAP mask on his face, it keeps our hands free so that we can keep his mouth closed (so air doesn't escape before it hits his lungs) and his CPAP mask tubes at the right angle. He's a handful and he doesn't even realize it!

Tuesday, May 20, 2014

During the Day

While I am at work, Alisha is at work too (taking care of Roscoe). She keeps him entertained and makes sure he's happy. Roscoe always has a nurse nearby, but he's started being more selective with how he's held and what he wants his caretaker to do. His regular (primary) nurses know him really well, but they can't work every day and so when he's with an unfamiliar nurse it is good to know that Alisha is there with him.

During the day, she will send me text messages with pictures of what they are both doing. For instance, here's a picture she sent of Roscoe looking at himself in the mirror:
I wonder if he remembers what he looked like 1-2 weeks ago, when he looked at himself in the mirror without the CPAP mask on his face? Here is another picture she sent when he was sticking out his tongue at his morning primary nurse (Rena). As you can tell by the big smile on his face, he really likes her. She has bright red/orange hair and a voice that makes him giggle. One of these times we'll catch a giggle on camera, but it's difficult since he has to be in the right mood and he laughs at her more than he does at either of us.

Occasionally I'll get pictures of Roscoe eating:

Or even great news like this: It is a follow-up blood test that the doctors ran today, which shows his CO2 level at 63! This was wonderful news because his prior reading was 77, which was a big disappointment.
His next CO2 reading will be on Thursday, so we are hoping for a good reading again. The pulmonologist increased his breathing support to a pressure of 7L/min (from 6L/min) in an attempt to make his readings more consistent.

Monday, May 19, 2014

CO2 Trend

This morning, Roscoe had his 3rd CO2 measurement since he's been back on more breathing support with the bubble CPAP. His first two measurements (64 and 68) were taken from the small capillary veins in his foot, so they can tend to be higher than the actual value. This morning's measurement was taken from his arteries, so it is more accurate. We were hoping for a lower value. I specifically prayed for "58", but the measurement came back at 77. This is one of the higher readings he's had (higher is worse).

The pulmonologist gave us the chart below when we had a meeting about a week and a half ago. The chart shows his CO2 readings over time, correlated to changes in his breathing support.
I put "lightning bolt" markers where his breathing support was changed. For the start of the graph, he was primarily on bubble CPAP with some short periods on vapotherm (like he is right now). At the first lightning bolt, he was changed to vapotherm-only. At the second lightning bolt, he was changed to a non-pressurized nasal cannula to prepare for going home. At the third lightning bolt he was changed back to vapotherm when they learned he couldn't go home. Then at the solid line ending of the graph (the day we had the meeting), he was changed back to bubble CPAP. I added additional markers to show his readings since the chart was printed.

At this point we had hoped to see a downward trend starting, since he's receiving additional breathing support. The amount of oxygen being pushed into his lungs has been increased from 100mL/minute to 2100mL/minute (6L/min at 35% oxygen). What is extremely frustrating to Alisha and I is that he is on greatly elevated breathing support now, but his readings are indistinguishable from those in late March when he was on minimal nasal cannula preparing to come home. On Saturday the doctor on call said that if his numbers stay in the mid-60's then they are comfortable with that. I'm not sure if they'll react to this single reading of 77 and elevate his breathing support once again, or if they'll give him time to get another reading.

Saturday, May 17, 2014

007 Baby

This past week, I was thinking that Roscoe has quite a bit in common with James Bond. At first that sounds a little confusing, until you look at the facts:
  • He has different women (nurses) always coming into his life, fawning over him, and then being replaced by another
  • He is surrounded by high tech gadgets like sensors, machines, and other specialized equipment
  • Headquarters is constantly monitoring his vital signs for optimal performance of their multi-million dollar investment
  • He is always encountering exotic (stuffed) animals like his pet giraffe and monkey
  • He is sometimes referred to by his code number (medical record number) rather than his name
... and lastly, he wears a tuxedo. This is the story of Roscoe Bond:

One day, Roscoe was enjoying the ambiance of a small coastal village in northern Italy. He sat in the shade, sipping his milk (shaken, not stirred). Just then, Roscoe received an urgent message from headquarters. "Bond!" the voice began, "We need you in Cairo. The prime minister has been kidnapped and they are demanding a truck-load of gold as ransom". The voice continued to explain, "They want a big truck load. Not like a small pickup truck that's barely filled with gold, but more like a large dump truck where it's so full that it's spilling out the sides. I don't know why you'd fill a dump truck with gold, but that's what they are demanding. Get to Cairo as fast as you can!". The voice crackled to a stop.

"I need to get to Cairo, but how?" thought Roscoe Bond.

Roscoe Bond boarded the next plane to Cairo, of course being eyed by the stewardesses for the duration of the flight. He awoke as the plane touched down in Cairo. It was night and he needed to locate the prime minister. There was only one villain who would be capable of such a feat: BigFace. Roscoe Bond knew that if he could find BigFace's lair, he would be able to save the prime minister. But time was short. He stopped a suspicious looking character on the dark streets of Cairo:

"Excuse me, sir ..." Roscoe began, "would you happen to know where I could find BigFace?"

The dark, looming individual responded, "Absolutely! I really appreciate you speaking so kindly to me so I'll gladly offer up that information. In fact, I will drive you there!" Roscoe was pleased. The man continued, "Usually people think that I'm such a suspicious, dark figure that they should speak meanly to me and threaten me until they get what they want. I don't like people like that, but I like you because you are kind".

Roscoe had made another valuable ally on the mean streets of Cairo. The man drove Roscoe Bond through back alleys, winding roads, and up a dark hill. The man stopped the vehicle near a door, covered by hanging vines, that led into the belly of the mountain. Roscoe had reached BigFace's lair.

Roscoe Bond studied the lock that secured the door to BigFace's lair.

"I know!" Roscoe Bond said to himself, "I will use an exploding key." Roscoe removed the exploding key from his bag of special gadgets, inserted it into the lock, and waited. 

BOOM! CRACK! FIZZLE! The door dislodged and he snuck inside.

Roscoe Bond made his way stealthily down a damp hallway. The echo in the hallway got deeper and deeper. Just as his foot reached the last stable section of floor, Roscoe realized that in front of him was a huge pit.
"Whoa! I almost fell right into BigFace's trap!" Roscoe muttered to himself as he regained his breath.

It was dark so he couldn't see into the pit, but from the smell in the hallway, he knew the pit was filled with alli-tigers. The alli-tiger was a cross-breed that BigFace developed. BigFace's favorite animal was the tiger, but its face was too small, so he cross-bred it with an alligator. The result was a menace that even Roscoe Bond didn't want to tangle with.

With a single leap, he bounded over the pit and safely onto the other side.

As Roscoe continued to explore BigFace's lair, he turned a corner and was surprised by an evil henchman. The henchman had a rifle and was already pointing it in Roscoe's direction. "Hands up!" the henchman barked in a gruff voice.

Roscoe complied with the demand as he contrived a way to escape.

With Roscoe's hands raised, the henchman reached toward his waist and grabbed his radio. Roscoe Bond knew that he was going to notify BigFace of Roscoe's capture, which would spell the end for the prime minister. Roscoe Bond couldn't let that happen.With reflexes that only extensive training and good nutrition could provide, Roscoe quickly flung a powerful strike toward the face of his captor.

The strike found it's mark.

The henchman reeled back in pain and dropped his gun to the floor. Roscoe Bond threw the gun into the alli-tiger pit. The henchman once again fumbled for his radio, so Roscoe knew he had to act quickly. Roscoe Bond flung the henchman and his radio into the alli-tiger pit as well. The only sound he heard was the crackling of the broken radio. He moved on, winding his way through dark passages. He had to find the prime minister.

Without warning, Roscoe stumbled upon a large room.

In the center of the expansive room was the prime minister, tied to a stainless steel chair. Roscoe surmised that BigFace used stainless steel furniture because the high moisture content in the air would have certainly eaten away at any steel or wood furniture over time, regardless of quality. Yes, stainless steel was the only sensible option. BigFace was an evil villain, but he wasn't a fool.

Roscoe pondered to himself how he could free the prime minister safely,
as BigFace was undoubtedly lurking nearby.

As Roscoe walked cautiously toward the prime minister, BigFace jumped out from behind some complex machinery. BigFace was very strong and his face was at least 2.4 times larger than any other man's face. He was a formidable foe for Roscoe Bond.

As BigFace rushed toward him, Roscoe shouted, "Stop it BigFace, you don't need to do this!".

BigFace continued his assault, but Roscoe blocked every punch and bite that BigFace used to try to harm him. He knew BigFace wouldn't give up, so Roscoe Bond put all of his remaining effort into a single kick and threw it toward BigFace.

The kick landed and BigFace toppled like a poorly stacked Jenga tower.

With BigFace's plan thwarted, Roscoe Bond untied the prime minister and led him safely out of BigFace's lair. As they exited, the lair inexplicably detonated and collapsed. Roscoe Bond and the prime minister hopped into the vehicle with Roscoe's newly found ally and they sped toward safety.

Roscoe had saved the prime minister!

Roscoe returned to his homeland, but because of the secrecy of his operation he was not given a hero's welcome. As he returned home and entered his lavish apartment, Roscoe threw his keys onto the nearby table. On the table was a handwritten note from headquarters which read "Job well done, Roscoe". He knew that this wasn't his last assignment and wouldn't be his most difficult.

After all, he is Roscoe Bond.