Wednesday, November 25, 2009

Another day in the life of Pediatric Bone Marrow Transplant.

Ya know, the easiest way to navigate this Childhood Cancer road would be to stick my head in the sand, plug my ears and sing *lalalalalalalalala*.  It would.  I'm not wired that way, though.  Today is our offical nine month diagnosiversery.  Gregory was admitted on February 23rd and his bone marrow aspirate was two days later, on the 25th.  Nine months is just a drop in the bucket.  I've received bad news a lot these last few weeks.  For a while I was thinking that it's just a bad time, right now.  I'm beginning to change that line of thinking.  I keep getting bad news.  Which leads to a shift in my thought process.  Trying to accept, live with and be at peace with the idea that frequent bad news is part of all this.  How does one do THAT?  I don't have an answer and don't expect one to be forthcoming, anytime soon.  I could just check-out of this constantly growing community and wash my hands of it.  Can't do it.  It's not an option, for me.  There is a driving part of me that requires community.  A coming together of shared experiences, mutual understanding and support.  While I can't say to fellow cancer families "I understand what you are going through."  I can say "I get it.".  Every experience is unique, as unique as every child.  There is incredible comfort and security in being able to look another cancer parent in the eye and recognize the emotions that flit across the surface.  To be able to have a casual conversation about our experiences and not see the other person recoil in horror.  'Cause it is horrifying and before diagnosis, I would have recoiled like crazy.  To know that when I open my mouth the other person is not going to nervously redirect the conversation to something safer to discuss.  It's human nature to do this.  I get it.  Sometimes we all need SOMEONE to be present, listen and witness what we have to share.  THAT is why I stick around.  Not because I enjoy getting sucker punched with bad news, but because we need each other. 

While Gregory and I were in Seattle we met this incredible kid.  I say kid, but he was an adult.  18 or 19, I think.  The details get kinda lost, we met so many families.  Paul had survived Lymphoma, bone marrow transplant (I think.  I'm pretty sure, though.)  He received radiation as part of his treatment.  He develped Leukemia, secondary to radiation.  Not that there is a good leukemia, but he had the bad kind and needed another bone marrow transplant.  When we met he had already had his second bone marrow tranplant and was struggling with GVH and general "sickness" issues.  They had a really hard time getting his blood pressure under control and the medications he was on caused some gnarly insomnia.  He would roam the halls, late at night.  He had this really great t-shirt that said "Fuck Cancer".  My sentiments exactly.  We formed a friendship.  It's gotta be rough to be an adult, yet be in limbo.  He was treated at Seattle Children's with all the kids.  He left Seattle not long before we did and went back HomeHome.  Just this morning I received an email, letting me know that he had died Saturday night.  The details are sketchy, I haven't had a chance to talk with his cousin, yet.  It looks like he relapsed and was sick, too.  Fluid in the lungs and brain damage from infections.  ..............  I don't know what to say, next.  There really is nothing that helps.  My knee jerk reaction is to jump on my soapbox and BEG everyone to get active and seek funding for Pediatric Cancer research.  One of these days I will put together a page on "How you can help."  Not now, though. 

If you haven't heard already, we had the longest day, yet, at clinic on Monday.  We arrived at our normal 8:00 time and proceeded to get ready for blood draw and IViG infusion.  Well.......  we have been having troubles getting his central line to draw.  It flushes with ease, though.  Monday they could not draw any blood out of it, so we injected some TPA, thinking it was a clot somewhere and waited for it to work.  An hour later, no luck.  Doc was consulted and it was decided that we needed a line study to determine what was going on.  I have no idea what was going on in the hospital, on Monday.  Obviously Gregory's need for a line study was a pretty low priority.  We waited.  And waited.  And waited.  Then we waited some more.  And waited.  During this time we discussed his gut issues and decided to try a different "food" for his feeding tube.  We are now using Elecare, which is totally broken down.  Hopefully Gregory will absorb this food much easier, give his belly a chance to rest and recover.  He is being slowly introduced to this food.  20ml/hr for 10 hours, 40ml/hr for 10 hours.  4 hour break.  40ml/hr 10hrs, 50ml/hr 10 hrs.  4 hr break.  50ml/hr for 10hrs, 65mls/hr for 10hrs.  4 hr break.  65ml/hr for 20 hrs.  4 hr break.  (BTW~ There's 30ml in an ounce.)  I've already seen a significant change in his AM stool.  With less stooling, too.  Then again, he is receiving a significantly smaller volume.  The true test will come as the volume increases.  If this doesn't work, the next step is TPA, which is infused via his IV.  Bypasses his gut altogether.  We also discussed his incremental weight gain.  He's up another .2kilograms.  15.4 now.  His calorie intake has been consistent.  As we were discussing this, Gregory was curled up, laying down in my lap.  Doc asked me if this was common behavior.  It has been.  He hasn't been off the bed to often in the last few weeks.  Doc then attributed his weight gain to being sedintary.  Ah Ha!  Makes complete sense.  Thank you!  Finally around 2:30ish it was time for his line study.  They took us down to radiation and Gregory got to lie on this long skinny table that had an x-ray camera that could pass over his body, while taking "movie" x-rays.  There was monitors at the bedside that he could watch the pictures, while they were doing it.  They injected dye into both lumens of his central line and watched what it did.  It was really cool.  Meanwhile, he is totally chatting up the techs and they are getting a much needed kick out of it.  They had even brought down an Anesthesia nurse, just in case he needed something.  Nope.  Didn't need it.  She discovered this herself and looked and me and said, "Well, the only thing he could have had was Versed, anyway."  I looked at her and said "Nope.  He can't have Versed."  Gregory has a paradoxical reaction to Versed.  We didn't need her, but it was kinda nice to see a familiar face.  She has worked with us, before, during his other surgical procedures.  (side note:  I really wish they would look at his chart BEFORE seeing the patients.  Nothing like suggesting a drug that your child cannot have to instill a sense of security.  NOT!  Yes, yes, I know.  They would have consulted the chart before administering anything, but.......)  The test showed that he DID NOT have any kind of obstruction.  What it did show was that when you drew back on the line, surrounding tissue was being pulled up into the entrance, thus not allowing any blood to flow through it.  This could be due to several reasons, the line could have shifted or with his additional weight gain, it is causing the area to be compressed.  The only solution to this is to place another line.  Which means surgery.  Which means risk of infection.  Gregory is at a point where he does not NEED a central line for blood draws.  Yes, he does receive them weekly.  We CAN still use it for infusions.  This is good.  So.  He now has to have arm pokes.  Ugh!  After all this, we went back up to the clinic and waited for IV therapy.  They showed up and had to poke him in both arms to get the amount of blood we needed.  We are still doing weekly blood cultures, on top of all his other tests and it requires a substantial amount of blood.  It was traumatic and I'm sure our weekly visits are going to be filled with anxiety, now.  Argh!  Something I was desperately hoping to avoid.  Which means we certainly won't get an accurate blood pressure, anymore.  Monday's was up AGAIN.  134/75.  But came down, in the evening.  Gregory's threshold for IViG infusion is 400.  Doc has requested that we had IGg level results before transfusion.  If it was below 450, he would be infused.  Which meant we had to wait some more for results.  Results were 441.  Which meant he needed IViG.  Duh!  At this point the clinic was closed and we were shuffled over to the inpatient unit for his transfusion.  We were settled into our original room, 308, the room we had back at diagnosis.  After vitals, Tylenol and Benedryl, it was finally time to start the infusion.  It was 6:30pm.  The infusion went pretty fast, he slept through most of it and we were cut loose at 9:30.  Then the drive back to our Water Retreat and we were settled by 10:30.  All told it was a 15.5 hour day....... 

I feel like we are making small progress with Gregory's gut.  The next several days will be a challenge, though.  Daddy and the kids are coming out on Thursday and we will be having a Prime Rib Thanksgiving.  We are not a turkey loving family, but man do we love Prime Rib.  With Greogory's gut he is not able to eat a lot of table food.  I have even cut out dairy.  You don't realize how much you eat had dairy, until you can't eat it.  Today mom is coming out and I will have a chance to run to the store and pick up some Lactase so he can at least have some of what he loves.  (Chocolate MIlk & Cereal)  The family will be coming out again, on Sunday.  Curtis' birthday is next Tuesday and we will be observing it then.  It's just too hard to try to get together during the work/school week.  It's going to be a busy stressful few days for Gregory.  I just hope he weather's it well.  As always, time will tell. 

As you are all gathering with your families this Thursday (at lest those of you that are in the US or abroad and observe Thanksgiving.  AKA:  Travis) rejoice in your gatherings and be glad.  Make decisions that are good for you and your families, show your love to one another and remember those that are not able to be present.  Share memories and make new ones.  Remember too, that you don't need Thanksgiving to do this.  Everyday is an opportunity.  My greatest gift this year is Gregory's life.  The medical advances that allows him to still posess life.  Not just a mere being alive, either.  Happy Thanksgiving to every last one of you.  'til later.  Gotta jet.

Posted via web from MindiTheMagnificent

Sunday, November 22, 2009

Time is on my side. Says who?

This week has been so HARD.  So many things happening.  Things of which, I have no control or say in.  Sounds like life, doesn't it? 

 

This is my little pity party.  Please play along.  Thank you.  You would think that this part would be the easiest.  It's not.  It's just as challenging as all the rest, if not more.  Gregory and I have nothing but time, these days.  The daylight hours are far too short and I sleep far to little.  Noting but time to think.  Time to worry.  Time to contemplate.  Time to wonder.  Time to greive. Time to imagine.  There are so many families, families living with Childhood Cancer (Aplastic Anemia, too.) that are having such a rough time.  Gregory is OK, but could be so much better.  I've said it before, no matter what he COULD be experiencing, the reality isn't any easier. 

 

I knew we would be having peaks and valleys.  Living it is another story.  His GI Graft Versus Host is really giving him a hard time.  We started his B&B (Budesonide & Beclomethason.  Topical steroids) last Friday.  The only relief he has received is that he has less gas and no more stomach cramps.  He still has diarrhea (several times a day), is nauseated, doesn't have an appetite and now he is having breakdown in the diaper area.  Enough that his sores started to open up and bleed, today.  Which is not good.  An open wound in that area is ripe for infection.  It hurts so bad to change him that I've been too lenient with his diaper care.  Today I had to apply the smackdown and tell him how it was going to be done.  He does have a little bit of an appetite, but I'm afraid to let him eat anything.  Afraid that it will irritate him more and cause him more pain.  Which means I'm telling him "No" to most food.  Add to that, the fact that he puked out another nG tube, last night.  Which tells me his stomach is still really sensitive.  We had another power outage Friday night.  It went out about 11:30, scared Gregory.  He ralphed at 12:30.  The last several weeks, he has been feeling so off that all he wants to do is be close to me.  Preferably touching, laying in my lap.  He's been very sleepy, too.  At least for the last few days.  I've been wracking my brain, trying to figure out why.  Any change in his demeanor can mean something big.  He started blood pressure medication on Monday.  For the last several weeks his pressure has been elevated.  So, starting medication was a logical, evidence based, decision.  Home health came out today to place a new nG tube and before we started I asked her to take his pressure.  Thinking this was a possible culprit, I had withheld his blood pressure medication today, knowing I would be getting a reading.  Monday his pressure was 121/84.  Today it was 94/58.  Without medication.  I've been trying to think of a way to get more accurate reads.  I'm wondering if the early morning clinic visits are superficially elevating his pressure.  Yes, I could purchase a little hand held automatic device, but that's pretty expensive.  I asked home health if they would loan me a cuff and just teach me how to do it.  Manual reads are far more accurate, anyhow.  I already own a stethascope.  I use it to check placement of his nG tube.  Make sure it hasn't migrated out of his stomach.  (I do this by using a medication syringe inserted into the end of his tube, place the stethescope over his stomach and push air through the tube.  You can hear the whoosh of air as it enteres the stomach.)  We have clinic on Monday, along with an IViG infusion.  I'm hoping to get some help and answers for his GVH.  The kid needs some relief. 

 

All in all, we are doing good.  I've just had a few too many moments, lately, where the reality of all this is flashed before me in Technicolor.  Moments where we are going about our routine and I get a flash of "do you really realize what you are doing?  This is soooo not normal!".  Which is at constant odds with "He is doing so well, comparitively.  What are you complaining about?".  This cancer beast fractures families.  Throws everything to the four winds and keeps it there.  No matter where you are at on the continuum, you feel like an observer of what used to be.  There are parts that I really miss.  Yet, they are simple things.  Being with Larry, Curtis and AnnMarie, under the same roof, is the biggest.  Actually the only one, for now.  It doesn't get to me all the time.  Just in those Technicolor moments.  I know Gregory feels it, too.  When we ran to our HomeHome pharmacy to pick up a med, he recognized it and chatted about the neighborhood.  The very next morning, he sat up from waking and started yammering about "Nana's House".  First time he's done that.  He remembers, too.  I watched Mozart & The Whale, this week.  It was filmed in Spokane and not in the usual way where you see a glimpse of your hometown in a movie and go "Hey!  That was Spokane."  This entire film was entirely Spokane.  Gregory recognized Riverfront Park and the carousel and got teary eyed.  This week has been full of moments like that.  It's also been filled with plenty of love and tenderness, too.  Sitting here, snuggled up with him is beyond pleasant.  The other day he said to me, "Mommy.  I love you.  Really badly."  Said it again today, too.  Lately he has been sleeping curled up right next to me.  Like a little shrimp.  Nestled in any curve he can find.  He's even been wrapping his little arm around my neck, while he is sleeping.  While it is sweet as can be and I LOVE it, I can't help but wonder what is compelling him to feel the need to do this.  How is his little brain processing all this.  I'm realizing that he will not, magically, cross the one-year-post-transplant mark and emerge unscathed.  I knew he wouldn't, but seeing it is different.  All three of the OffSpring are going to require some pretty heavy hand holding and assistance.  For some time.

 

There are three families that are very heavy on my heart.  ParkerMaddyGregory H.  I don't have the vocabulary to express how I feel, right now.  What I can say, is that I don't know where to put, what I do feel.   They are having such a rough time.  If you feel it, please drop by their pages and drop a line.  I KNOW that every word makes a difference.

 

This is a pretty down post, but it's where I'm at, for now.  Don't send the troops and get all paranoid, though.  It's well in hand and we do have plenty of fun, giggly time.  As Larry says: "It is what it is."  And it is.  'til later, gotta jet.

 

BTW ~ 272 days since we started this.  195 days since we've been home.  164 days since transplant.

Posted via web from MindiTheMagnificent

Friday, November 20, 2009

Testing....1.....2....3......

Anything but THAT.

Yep.  Signed up for posterous.  Not quite sure how to use it, yet.  I think it is going to be grand, though.  Test.  test.  test.

Posted via web from mindithemagnificent's posterous

Friday, November 6, 2009

Labor & Delivery meets Childhood Cancer

I just finished The Business of Being Born and I need to write. I've avoided this movie. Like the plague. I've had numerous opportunities to see it. Due to my own birth experiences I could not watch this movie until I experienced something more painful. I could not watch The Business of Being Born until I'd experienced Childhood Cancer. That is how deep my feelings are in regard to my birth experiences.

I wasn't not a young new mother. I was 27 when Curtis arrived. I can't even call how they came into this world as births. I usually refer to their arrivals as being "surgically removed". I've had three caesareans. Curtis was a miniscule five days past my due date. I went the "regular" route for pre-natal care and delivery. I was not aware that I had another option. Inductions were normal and routine, in my mind. To be expected. Why wait if you didn't have to. I was so anxious to meet this little being. I love being pregnant. Love, love, love it. I am one of the lucky ones and never had morning sickness. The day Curits arrived, the doc asked me if I wanted to have a baby today. My response was a resounding YES! Induction with Petocin, they broke my water. Several hours later, it was discovered that Curtis was breach. Emergency Ceasarean. It happened so fast. Once he was outside he developed a pneumothorax. The lining of his lung separated too quickly with his first breaths and created a hole in his lung. He was rushed off to the NICU. As they were stitching me up, they told me he would be there overnight. Thankfully, it healed quickly and he was in my arms about 45 minutes later.

The group that my OB/GYN works for has a policy of once you've had a caesarean, always caesarean. I still did not know I had a choice. AnnMarie and Gregory arrived via planned caesarean. The time between delivery and in my arms was longest with Gregory. I spent quite a bit of time in the OR after Gregory was born. Larry took him to the nursery for his bath and all that stuff. I didn't find out why until after Gregory and I were settled into our room together. Gregory's placenta had adhered to my uterine wall. My doc had to scrape it out. One might say that I was lucky to have had Gregory via caesarean. Had he arrived vaginally, the placenta could have torn from the wall and I would have bled. A lot. Then again, if my uterine wall hadn't been cut into twice already, maybe the placenta would not have adhered?
Gregory ~ June 24, 2005
There is nothing I can do to change it. What's done is done. I've found some peace in my experiences. Sometimes though, it hurts. Deeply. I even feel robbed. Something was taken from me that I cannot replace. Even if I wanted another child, I can't now. The whole placenta thing messed with that. I would not have another child, now. Larry and I knew that when we had Gregory. I had my tubes tied with Gregory. The decision was already made and I am quite satisfied with the number of children we have. I still yearn to do it again. To do it "right". Every once in a while it crosses my mind that I have never given birth. What does that mean to me? Still trying to figure that one out. I do feel less of a mother. This is not the point in my writting where everyone clamours to tell me how much of a mother I am. I know this is not true. Doesn't mean I don't feel it, sometimes.

The things that bring me comfort is hearing my friends share their birth stories. I try to remember to ask my girlfriends for their birth stories on the day of their children's births. I do NOT watch birth shows on TV. Cannot do it. The Business of Being Born had me in tears of sorrow and tears of elation. Watching those brave, educated, empowered women deliver their babies. Babies born at home, babies born in birthing centers. Babies born the way nature intended for them to arrive. Yes, intervention is sometimes necessary. Not nearly to the degree that it is given, though. I am also encouraged that generations to come will KNOW they have a choice. Will have the information and tools available to choose how they want to labor and deliver.

Yes. Childhood Cancer is so scary that I was able to face my birthing fears. Not 100%. A little bit. It's a great movie, if you haven't seen it, watch it. Also, if you feel like it, tell me your birth story. 'til later, gotta jet.

I couldn't find an official video. The is Jane Siberry ~ Calling All Angels. It is hauntingly beautiful.

Thursday, November 5, 2009

More is on the way....

I have been importing my posts from Gregory's LiveJournal. I used LiveJournal for the 18 months before discovering that it just was not a good place for me to write. If you are looking for the missing posts, they can be found here:  http://thegreginator.livejournal.com/

They will all be here, soon.

Thank you!