Wednesday, May 27, 2009

Emily's Wednesday, still moderately neutropenic

Emily had her labs today and her ANC is still pretty low, around 580 which is moderately neutropenic. That means we have to keep our eyes open for fever ever more than normal. Haley has been sick with a cold, so there is that risk that Emily will get it and then have issues. So far things have been going fine though. She still has some sniffles and a little cough. Overall her attitude has been up-beat and she has been going to school. Today she went on a field trip to the Tech Museum in San Jose. Her class took the light rail to get there, she was really excited about it.

They are going to continue Emily at %75 dosage this week. They are talking about changing her over all dosage if she can't get back to %100 here. They explained to us that Emily has not gone 1 full cycle (roughly a 3 month period) without having to have at least some reduced dosage, so a total reduction might be needed. We are going to hear more about it next week.

We don't have anything else planned medically this week, and will probably take it easy over this coming weekend.

Wednesday, May 20, 2009

Emily's I.V. chemo went well. 275th post in the blog.

This is the 275th update to Emily's blog. Wow it's been a real journey hasn't it? I went back and re-read the the first two months, and there were some things in there that I almost don't want to remember. Actually I am really happy with the blog, it's given me a chance to express how I feel and to also feel all the support of the people who are following Emily's courageous battle with cancer.

The picture above was taken tonight at Open House at Country Lane School.

Today went well. We had I.V. chemo, labs, and a physical exam. The Exam came first, and Emily checked out on all the things they check her for. A typical exam starts with any question or concerns we have. Then they ask Emily a ton of questions, ranging from how she is feeling to what she is learning in school. Then they get her up on the exam table and they check the sites in the body where we all have a lot of lymph nodes. The neck, stomach area, pelvic area. They listen to her lungs and heart. Then she has to take at least 4 steps on her heals and 4 steps on her toes. The heal and toes exam is to asses neuropathy which the Vinchristine can cause. Early on in treatment you'll remember Emily couldn't walk and needed a wheel chair, neuropathy was the reason for that. It's a side effect of her chemotherapy. Today she checked out fine, like she has for the past several months.

After the exam we get moved into the Day Hospital, which is a part of the ! North Unit. Here is where they take Emily's blood sample and give her I.V. chemo. She has a really good vein on her left hand that we save each month for the I.V. needle. Our nurse did a great job getting her vein on the first try. I think these 1 North nurses are amazing they have to stick kids with needles all day, and they do it so well. The hardest part if accessing the vein and once that is over the blood sample and Chemo go really quick. Today we hung around about 10 minutes after the I.V. because Emily got a visit from a dog that was in the clinic today to help brighten up the kids day. When the pet therapy animals are on site, you can sign up for a visit, which we had done.

Stanford/Packard are really quick with the lab results, the Cancer ward has their own lab which really expedites things. By the time we drove home we had a voice mail with the results. Emily's blood levels were good and they moved her from %50 dosage up to %75 dosage which makes us really happy! let's hope she can stay away from colds, she really needs to stay on higher doses, that even got brought up at her exam today.

Saturday, May 16, 2009

Day in SF

We went up to San Francisco today and it turned out to be a really good day up there. We drove up after breakfast and a slow morning at home. It was around 90 degrees with no wind in San Francisco which is very unusual, it was almost too hot. We took the girls out on a ferry ride to Saucalito in the afternoon, which is just across the golden gate bridge. It was a really nice day to be out on the bay, maybe the only slightly cooler place today, it was so hot. We spent a little time in Saucalito, and then caught the Ferry back to the Ferry building in S.F. We had dinner in the ferry building and made our way back home. The girls had a great time, and so did Tracy and I.

Emily is feeling great and her cough is all but gone. She has a ton of energy, and she's always having fun with her little sister. This coming Tuesday she will start her 5 days of Prednisone. On Wednesday she will have her I.V. chemo and her exam from her doctors.

Thursday, May 14, 2009

Emily's lab results and an ask for donations for research.

Emily had her labs drawn yesterday. It was a tough lab draw for her as her favorite phleubotomist wasn't on call. They were able to get their sample of course, it was just hard emotionally for Emily. Stanford does a great job at continuity of staff for their patients so you really notice when someone is missing.

Her lab results were good, putting her ANC near 2500, which is in the range we want it. However remember that's in the range, but only on a %50 dose of chemo. That means Emily is still working on getting over her virus. Per the protocol she needs to stay on %50 dosage for one more week, and then we will step up to %75 dosage for 2 weeks and then finally back to %100 dosage in about a month. It's understandable why they need to keep the dose reduced, but it's also really frustrating that we need to. If you read the literature on being cured and reduced risk of relapse, it's important to be on %100 dosage as much as possible, and the past 2 months she has rarely been able to take that much. As much as anyone tells me things will be OK, I know too much at this point to not worry a bit about this. Next week is Emily's prednisone and IV chemo treatment on Wednesday.

Many of you may have received an email from me this week, for those of you who did please excuse the repeat ask here. A friend of mine is riding the Leukemia and Lymphoma Society Team in Training ride around Lake Tahoe in early June. He is doing it in honor of Emily and I am trying to help him with fund raising. The money raised goes to fund important medical research for Leukemia and Lymphoma. It's important, maybe people in the future won't have to go through what Emily has gone through. I can say as a parent, a %70 cure rate is OK but certainly not high enough for Tracy and I not to constantly worry. Please donate to Mike's cause if you can. We'd love to see some donations made in honor of Emily. Here is the link to donate, any amount you can.

Monday, May 11, 2009

Emily just deals with it

I forgot to include this story when I posted last night.

Yesterday afternoon I took Emily and Haley to the park to play. They were playing together in the sand pit, and after a few minutes two other girls came up and started playing next to Emily. About 5 minutes later I heard one of them say to Emily with a very mean face, "Your hair looks like a boy's haircut." Emily responded very directly to her by saying, "That's because I have cancer." The girl responded back, "What's that?" and Emily replied "It's a disease I have that could kill me, and the medicine I have to take made my hair fall out, but it's growing back now." The girl didn't really know what to say, and Emily looked over at me, trying to make a smile and shrugged her shoulders and continued to play. A few minutes later Emily was playing with the girls who had been making fun of her.

I am so proud of her for sticking up for herself, and ultimately not backing down and running away, but instead befriended them. I asked her on the way home how she felt about it and she said that the girls had apologized while they were playing and she thought they were nice. I don't think I'd have the guts to do anything close to that when I was a kid, I remember crying because someone made fun of a shirt I wore once, and to think of Emily dealing with being bald and now with short hair is just a testament to how strong of a person she is. I constantly learn from her.

Sunday, May 10, 2009

Emily seems to be getting better

It looks like the reduction of chemo, taking it easy, and finishing the course of anti-biotics is paying off, Emily's cough is much, much better. it's not completely gone, but she's not coughing herself to sleep anymore. She finished her medication for pneumonia last night and now is just on her reduced chemo dose. She will be having her blood checked this Wednesday and we will find out if they will increase her dose. Emily is looking forward to getting back to school tomorrow.

This weekend was Mother's day and Emily was really excited about it. She and I went shopping for Tracy on Saturday and Emily wanted to get her a bottle of perfume. This morning we gave it to Tracy and Emily and Haley "helped" make her breakfast. The original plan was to serve it to Tracy in bed, but she got up before Emily so we just had it at the table as usual. Tracy had to work this afternoon and evening so we only had Tracy home for part of Mother's day.

Wednesday, May 6, 2009

Cough returned vigorously last night, chemo reduced, chest X-Ray

The past two nights Emily hadn't been able to go to sleep because her persistent cough had returned, and it was/is getting worse. This really made Tracy and I concerned that the pneumonia either wasn't getting better, or even worse that something else was going on. Today was her lab day and we insisted that Emily be seen by her NP and or Doctor after her lab draws.

First result from the blood test is Emily is borderline neutropenic with an ANC level of 540, which is about as low as you can get without having to cut chemo dosage all together. Starting tonight she will be a on %50 dosage. That's discouraging because she's been on so many reduced doses in the past 8 week, and ideally patients need to be at %100 dosage. There isnt anything we can do about this, but hope she starts to get better so we can just be on full dosage for the summer. From here we will probably be on %50 dosage for 2 weeks, then %75 for two weeks and then finally and hopefully back to %100 dosage. It worries me that this keeps happening.

After her labs she saw both Dr. Link and Karolina or NP. She sounded clear but they wanted to do a chest Xray to see if the pneumonia was clearing up. What they told us was if the pneumonia had gotten worse, or was the same as it was in the ER the other week, they would probably switch her to another antibiotic. However, the great news was her pneumonia was much smaller than it was a week and a half ago when we were in the ER, so the antibiotic is working. Her cough is just something we need to live with, and try not to worry about. Given the extra exam and chest Xray, Tracy and I can both rest assured that she's OK.

My opinion is the cough is related to the pneumonia but since she dropped to near neutropenia her defenses are too weak to fight the cough, so reducing her chemo SHOULD help with the cough and allow her immune system to kick the pneumonia and cough to the corner. Let's hope that happens. So while it's hard to reduce the chemo from a cancer point of view, it's probably a good thing holistically. It's all related. Blood cancer is so tough to manage, isn't it? I haven't talk with Tracy about it, but I think we may want her to stay home from school at least for tomorrow to get her levels back up.

Monday, May 4, 2009

Emily is back in school, getting better every day

We thought Emily's cough is to the point where we could send her back to school today. She is only coughing at night, and even then it's getting less and less frequent. She had some apprehension about going back today after a full week off, but once she got there, I am sure she is doing fine.

Her energy level is pretty good, however she and I went for a walk to the shopping center on Saturday for some coffee and hot chocolate. On the way home she had to stop and sit several times. I do this walk with her a lot and it was unusual for her to take so many breaks. Then about 20 minutes after we got home she came to me and said "daddy remember you asked me to be honest with you if I am ever not feeling well?" to which I said "yes, sweetie what's wrong" and she said, "I am having a hard time catching my breath." I was worried but since I knew she had pneumonia, it was probably the reason. She also complained about cramps on her left side, which I also nervously passed off as the pneumonia. Her cramps come from time to time, and really scare me every time she reports them. The reason they scare me is before she was diagnosed she complained of really bad cramps, which looking back were the formation of her tumors. Cramps can be normal, so it's one of those things that I try not to worry about, but knowing what I know, it's hard not to.

This week she will have a lab draw on Wednesday and right now that's the only thing that is scheduled medically. She remains on %100 dosage of her Chemo.

Friday, May 1, 2009

Emily is still doing great

Emily has been home from the hospital for 2 nights now and she is still doing great. In fact she has bounced back to her normal self almost completely. Her cough still remains from time to time in the night, and last night she coughed so hard she woke us up, but after some water and a little talking she was able to go back to sleep. Tracy was a little concerned about the cough so we called the clinic today to report it, but they assured us that Emily was on the right dose and this would just take a little while to clear up. When the cough is all gone she can go back to school, hopefully on Monday but we'll just have to wait and see one day at a time. During the day the cough is pretty much non existent though, which is a large improvement over the past several weeks. Looking back, she had had the cough for a while leading up to the pneumonia diagnosis. She is really bored having to stay at home and wait this out. Even though the swine flu is very over blown in the media, any flu is bad for Emily so we are keeping her away from crowded places for that reason too. So on this rainy day it would have been fun to go to a movie, but a movie theater full of people is one of the last places you want to be if you want to avoid a virus.

Last night Tracy and I went out on a "date" while Grannie and Grandpa Steve stayed home with the girls. We had a really fun night out together, having some drinks and then a nice slow dinner up in Mt View. Tonight will be the first night in many that we aren't going anywhere and all the family is home, which is really nice too. It's the first time in a long time on a Friday night I am looking forward to doing absolutely nothing.