Friday, September 16, 2016

He has not forgotten us


My Mama shared these words, or something similar, in the early days after Jaxon's diagnosis. They've been forefront on my mind today. 

This morning brought frightening news from a fellow pediatric leukemia family - a reminder that there is no "good cancer" for a child to have. Their news of a relapse could be the very same for us at any time.

This afternoon we learned tragic news from a family we know through our camp, homeschool, and church communities. They are walking through the dark valley of the sudden loss of an adult son and brother.

For several days this week I have been supporting and praying for a friend who has a very sick little boy ... and there are currently more questions than answers about what's going on in his body.

Tonight as I watch my babies sleep, 
I'm holding to the promise that our God is with us. 
He has not forgotten us. (link)

Tuesday, June 28, 2016

one - year - countdown!

Jax finished DEX for this month yesterday. This morning, moments after eating a huge bowl of Mr. Noodles, he came to tell me he was still hungry. 
I listed off some options, to which he replied 'no' for each. Then I suggested 
a grilled cheese sandwich. He paused ... "No. But you almost got me with that one Mom!" After another pause ... "Actually, you did get me with that one. Yes please!"

Perfectly timed with the start of our one-year countdown until the anticipated end of treatment date (June 11, 2017!), our boy was honoured by his baseball coach with this ...


He thoroughly enjoyed playing ball once again 
and is eager for next season to start!



I took this screenshot of my countdown on June 11. 
We have completed 2 years and 2 months of treatment/recovery 
from A.L L. Now less than 1 year remaining!



It's an odd feeling. Many oncology parents agree that the official end of treatment is a time of very mixed emotions. For many, the end of treatment marks the start of increased anxiety, worry, and fear. As long as Jax is receiving chemo, we have a significant level of assurance that the Leukemia will stay in remission. Once we stop the oral, IV and spinal chemo regime ... The "safety net" is gone. It's the end of treatment but the beginning of questions like "Did he get enough?", "Did it work?", "Will it come back?".  At this point I don't tend to dwell on those thoughts. They are questions with no answers. Like my Mom said when Jax was first diagnosed ... It is in situations where I understand the least that when the sovereignty of God matters the most. We trust that He will carry us safe to shore - however that may play out. 


Even at his monthly IV chemo appointment last week, in the words of a fellow oncology mom ... "Leukemia didn't bother us much!" We are so very grateful that the most intense parts of his treatment are over, and that he is responding well to treatment. We have daily reminders that this is not always the case. 

Here is our beloved Anne doing her thing. 

These two bros got plenty of screen time to pass the hours while we waited for bloodwork to be processed, meds to arrive, meds to be checked, meds to be administered and monitored. 

Anne was the designated chemo giver that day since these two ladies ...


... are not allowed! 

This was the last day we'd see both of them before their maternity leaves begin. Steph, on the right, was working her last shift. Sarah hopes to work a few more weeks before her baby comes but we'll be in Vancouver for our next chemo appointment so we won't see her. 

So much love for these ladies for their roles in our small but mighty pediatric oncology clinic in Victoria. ⭐️💕🎗

July 19 will mark DAY 1 (of 85) of CYCLE 8 (of 11) of Long-Term Maintenance. We travel to BCCH twice a year to check in with our top docs. That was supposed to happen in June but we extended it by a month to coincide with our summer holiday plans. More on that in another post. 

Wednesday, March 30, 2016

Day 720

I forgot to add his ANC in the top right screenshot - it was 2.5.
Day 720 of Jaxon's recovery from Acute Lymphoblastic Leukemia. Almost 2 years into this ordeal, I'm still surprised to learn that some people think he's all done and finished his treatments. Not so! He continues with a cocktail of daily, weekly, monthly and every-three-months chemo administrations (oral, IV, spinal) as well as steroids for 5 days each month (plus several days of steroid hang-over). Every month his blood counts are checked to make sure the ALL remains in remission, and to make sure he is receiving the right dosages of chemo. This month his white blood count is a bit higher than preferred, but we suspect that is because he has some symptoms of a viral illness. If he has no cold symptoms and high counts again next month, his chemo dose will likely increase. If all continues to go according to plan, the anticipated end of treatment is mid-June 2017.

Monday, February 29, 2016

Rare Disease Day


When Jaxon was diagnosed with Acute Lymphoblastic Leukemia almost two years ago ... it was the darkest day of our lives. Paul and I mourned the news, grieving that there was no easy answer to our questions of "why?" and "how?" and "what if?" and "what now?". Not long after the news of his diagnosis, I was struck by a thought of gratitude. We had learned WHAT was making him so very sick and we knew that there was a thorough and highly effective strategy for treatment. The reason the diagnosis of Jaxon's type of Leukemia has gone from 100% mortality rate to 85% expected long-term survival is because of research. Childhood cancer (collectively) is not rare, though many sub-types are extremely rare. Although A.L.L. has become the most optimistic of childhood cancer diagnoses, (some call it "the good one" - no. such. thing!), cancer in general is the reason for the most disease-related deaths of Canadian children. Lots of kids get A.L.L. so there are lots of opportunities to study it and to improve treatment for it. But there is still so much to learn and improve for the treatment of all childhood cancers. Due to low numbers of kids getting rare types of cancer - funding for research is minimal.
On Jaxon's diagnosis day I thought of my friend who had been taking her young daughter to multiple specialists for several years, trying to get an explanation for her frightening and mysterious symptoms. Their family was living under the shadow of uncertainty for an agonizing length of time. Although we were facing a lengthy recovery time for Jaxon with the potential for complications at any time, I remember feeling grateful that AT LEAST we knew what this was and somebody knew what to do to help. Not every parent in similar situations has this in their favour.
Some would say that cancer is every parent's worst nightmare. I don't fully agree. Yes, cancer is heinous. There is absolutely no denying or minimizing or sugar-coating it. Diagnosis and treatment of Leukemia has been OUR family's most difficult struggle. For many of my friends - more rare and aggressive and recurring pediatric cancers have brought devastating physical and emotional effects and death - painful beyond comprehension! For others, a rare disease causes unrelenting symptoms for which there is little to no relief. The prospect of a shortened life expectancy, endless watchfulness or progressive debilitation is excruciating for the families who love a child with a rare disease.
Whether it's a common/well-known disease or a rare one, a chronic illness or an acute crisis - I believe the worst prospect any parent faces is that of losing their child, or watching their child suffer or having to cope with significant difficulties and not being able to do anything to relieve the burden. It could be Leukemia or Ewing Sarcoma or a hundred other sub-types of pediatric cancer or a traumatic brain injury or Wiskott-Aldrich Syndrome or Spinal Muscular Atrophy or Eosinophilic Esophagitis or severe allergies/asthma/eczema or Epilepsy or Congenital Heart Defect or Opitz Syndrome or Denys-Drash Syndrome or Hypophosphatasia ... or ... or ... or ...
The severity of one experience does not diminish the impact of another illness or injury or difficulty faced by another family.
My friend said to me the other day "There's no such thing as 'other people's kids.'" It could happen to anyone. We all need the support of others. I am honoured to journey with families like these in their most difficult trials, just as they and others have done for my family. I raise my voice to support them through awareness to bring about more meaningful research toward better treatments and cures. I will take them a meal or a cup of coffee. I will give blood. I will say "yes" whenever possible when asked to donate money to support a family in need or a local children's health initiative. I will ask others to do the same.

Saturday, February 6, 2016

this is the face ...


... of a very unhappy boy!

Jax started coughing a really harsh dry cough on Monday morning. We already had an appointment at our clinic in Victoria for later that afternoon so I wasn't too concerned. He just had a dry cough and no other questionable symptoms. He handled his ventolin and inhaled antibiotic really well and we made our way to Jeneece Place for the night. He had a good night and we went to his chemo appointment as planned on Tuesday morning. It was a long day with an LP and IV chemo. Nurses and Doc listened carefully to his chest and it was all clear, so they advised me to just watch him carefully as the week went on, especially after his Dex wore off early next week. (Dex elevates his white blood count, so once the elevation wears off, viral illnesses can become more intense.) The cough lingered and then on Thursday he started having a stuffy nose. Since he's always more sensitive and moody while on Dex, adding in the illness has made him a very grumpy bear.

Friday night he hardly slept at all. Coughing non-stop. Ever since he was just little, he tends to cough so hard that he vomits. That's been in full force this week too. Yuck. He was so miserable last night, and we couldn't give him anything to help him feel better, since Tylenol is a no-go for someone with a VAD. We can't give it because it can mask a fever which could lead to missing out on catching a bacterial infection. A bacterial infection can be very dangerous for someone who is immune-suppressed. 

Because his VAD line goes directly into his heart, 
we have to take fevers very seriously. Every time. 

He begged for the morning to come so he could get out of bed and lay on the couch. He finally napped late this morning but when he woke up I could tell his temperature was significantly elevated. I had checked a few times through the morning and he was always within normal range and this time when I checked it was 39.4. I've never seen his temp go that high so I jumped into flight mode. I grabbed a few things, put Emla (numbing cream) on his port and got him packed up to go. Paul had taken the car into Lake Cowichan so I called him to get home right away. He swooped in and helped me get everything ready to go and called the hospital to let ER know we were on our way. 

Once we got there he was seen by triage right away and his temp was a bit lower but hovering very close to the threshold to begin what's called Clinical Order Set - Fever and Neutropenia Protocol. Long name with a bunch of steps to take for a chemo patient with a fever. We were soon given a private room and nurse and doc saw him right away. His temp was still so very close to the magic number that they decided to begin antibiotics. He got some tylenol and codeine (supposedly has cough suppressant properties), chest x-ray (looks good), and first dose of prophylactic antibiotics to cover any bacterial infection that may be brewing. He was seen by the pediatrician on call, who agreed with the ER doc that it's a standard cold virus but protocol would continue until blood cultures have been 48 hours to show any signs of infection.

The nurses decided not to use his VAD port for drawing the bloodwork. I was happy they didn't want to access his port unless necessary, but not happy about having to tell Jax that he'd be getting an arm poke without any numbing cream. He agreed to it on the promise I gave that the lady knows what she's doing and it wouldn't be as bad as he anticipated.

It was bad. 

She missed his vein the first time and spent a minute re-aligning to try to make it work, but to no avail.  The plan after that was to give Jax a break, put Emla on the other arm, and have a different tech come attempt the IV. 15 minutes later that happened and she got it on the first try.

Not long after that we had to get going with accessing his VAD. Sadly, the Emla I had put on it at home 3 hours prior had lost its potency so he felt the pinch on that one also. 3 pokes with very little numbing is hard for a boy who usually doesn't have to feel much from pokes. 

As grumpy as he was, he was rocking some totally rad bed head.


Once the meds kicked in he started to feel much better.


We're thankful this didn't happen in the middle of the night, thankful that this is a rare occurence for us (only his third fever since diagnosis in April 2014), and thankful it seems to be viral and he'll come through just fine. Many oncology patients and their families spend countless days and nights in the ER and admitted to hospital, dealing with serious infections and complications from the powerful medications used to attempt to restore these kids to health. I just found out that our little buddy Marek was in ICU for 9 days this past month. That could just as easily have been our situation.

As I write this he's been asleep for about 2 hours with just a few coughs. In a strange twist ... now that I'm actually allowed to give him Tylenol to make him more comfortable (because he's already getting antibiotics and blood cultures have been drawn) ... he's refusing to take it. He did accept a Gravol though, so there's that. I can tell he's having a good sleep because he's doing the cute little sigh-coo thing that he does when he's sedated for his LPs.

After his LP on Tuesday, in his loopy state, he said "That was fun! That was the best back poke ever! Mom - you have FOUR eyes, TWO noses TWO moufs ... and ONE CHIN." (Yay, just one chin!)


Friday, January 1, 2016

S I X T E E N


This number is significant today for a few reasons. 


It's a new year - 2016. Hard to believe that 2015 has already passed us by. So many emotions as we continued on our path through cancer-land, and the new people we met and stories we heard along the way. This community of parents and children is unlike any other I have known. I am honoured to know these families and to share in their victories and heartbreaks.


I realize it's been a long time since I've posted any actual updates. I guess the main reason for that is that everything is going according to the plan! Jaxon continues to have monthly appointments. I've made a blurb on the side bar to describe what his current treatment protocol dictates.

In November Jax had his S I X T E E N T H lumbar puncture (spinal tap) under sedation. If everything continues to go according to the plan and protocol, he will have about 6 more before the anticipated end of his treatment in June 2017. We are well aware that everything going according to the plan is something we should not hold onto too tightly. 

We have now been in Long-Term Maintenance for just over one year, approaching Day 57 of Cycle 5. While much of the time we carry on with regular life and it could appear as though he is "cancer-free", that is not the whole picture. We are ever vigilant to watch out for potential exposures to illness. What is a minor, common, viral or bacterial infection for a child with a healthy immune system ... can rapidly become dangerous for someone like Jax who is immune-compromised. 

The dosages of the oral chemo he gets every day (and extra on Thursdays) are calculated based on his absolute neutrophil count (ANC). They want his ANC to stay between 0.5 and 1.5. Since beginning LTM in Dec. 2014 his ANC has stayed perfectly where they want it. At his last appointment in December, it was elevated above 1.5 so he got a minor increase of his Thursday chemo (methotrexate). He was also at the end of a viral cough/cold, so that could explain his elevated ANC. Since he had been hovering close to 1.5 for several months and then jumped to 2.3, they decided to see how he handles an increase. At his appointment on January 6th we'll find out if the dosage will stay the same or will be adjusted. Some kids run really high ANC all the time and are constantly seeing meds increase, some run really low and are on low percentages of meds. If the standard dose is 100%, some will get closer to 150% and some only 10%. Each kid is different, and the treatment protocol is designed to treat each patient according to their blood counts. He takes his 6MP first thing in the morning, and then has to wait one hour before he can eat or drink anything other than clear fluids. Some days, the wait is easier than others. 


Dex. Ooooooohhhh, Dex. 

Steroids are a powerful cancer fighter. I don't know why or how they work, but they do. Younger kids in cancer treatment take dexamethasone. Older kids and those who don't handle Dex well take Prednisone. They are taken for varying stretches of time all through treatment. Jax had 28 days at the very beginning, 2 stretches of 7 days (with 7 days off in between) in the most intense part of his treatment, and now takes them 5 days every month. Along with Dex comes mood swings, hunger, anger, hunger + anger = HANGER (it's a thing), agitation, short fuse, food cravings and aversions ... etc. The side effects are the most intense while he's taking the meds, and they can last up to a week afterwards. Even when he's not 'under the influence', I see some effects. He often tells me "I just don't know what to DO!" He said once "I wish I could go back to before I had cancer because I used to always know what to do and now I don't know what to do!" I think it's a restlessness and that's the best way he knows to explain it. Knowing he's hungry but not knowing what to eat. Fixating on something to eat but then not wanting it after he finally gets it. It's a tricky balance to navigate his mood swings, knowing that he is battling a chemical force. We work hard to extend grace while at the same time, ensuring he doesn't learn behaviours and carry them into his regular life. Roid Rage is no joke, and it has a mighty impact on many days of our life. 10-14 days of the month ... we tread lightly.

I found this perfectly worded quote online:

We still have to pay close attention to his body temperature. If he spikes a fever over 38.5* we need to get to the hospital immediately to begin IV antibiotics and find out if a bacterial infection is causing the fever. He could go septic very quickly if there is an infection in his port / line / bloodstream. 

I don't think very much about his monthly bloodwork until we get close to his appointment day. I don't dwell on the possibility of relapse, but as any oncology parent will tell you, the nagging thought is never far away. Remission is a wonderful place to be, but it can go sideways at any time. We remain hopeful that his body will continue to respond well to the treatment with minimal long-term side effects. 


At our appointment at BCCH in December he had an evaluation with an Occupational Therapist. He is part of a study group that is monitoring the effects of Vincristine, the IV chemo he gets every month. I don't have the results of her findings yet. He did the same tests after the first month of treatment.  She was short on time so couldn't complete all the exercises, but I'm hoping we can get that done when we go next time.
She was wearing protective gear because he had a cough, and she didn't want to pick anything up and pass it on to other patients and staff. It was the very end of the cough and no one was really concerned he was contagious, but the precautions must be taken.
It was lovely to be at RMH just before Christmas. The Grand Living Room is lined with about a dozen fully thematically decorated trees. The second night we were there, RMH had arranged for a bus to take families to Canyon Lights at Capilano Suspension Bridge. We had a great time, despite the rain. The ride through the city in the big, tall, fancy charter bus was probably just as exciting for my little country bumpkins.


I got to deliver some soft cozy hats made by my friend Jenny and her grade 4 students. Sweet Samantha picked one for herself and had a hard time deciding which of her many friends to give the others to. Jenny just gave me another bag full of hats to share around. She had made one for Jax when he was first diagnosed and it was such a perfect gift. She actually sent two for him in different sizes. We kept one and gave the other to Kaynan, the little guy we shared a room with our very first night at BCCH. 



Jax and Marek are 3 years apart in age but have a special bond as they were both diagnosed with leukemia on the very same day. We met in the halls of 3B. His Mama Amanda holds a very special place in my heart and we keep close tabs on how each other and our boys are doing. The boys follow the exact same treatment schedule. They travel to BCCH/RMH every month from their home in Whitehorse. We see them every six months when we go to our required appointments at BCCH. It should be noted that it's faster for them to drive to the airport, fly to YVR, drive to RMH ... than it is for us to drive to the ferry, cross the water and drive to RMH. 

Intermittently over the past year, Jax has had signs of blood in his urine. Just a few streaks one time and a slight pink tinge half a dozen other times. It's always been just once and then all is normal. No pain, no fever associated with the blood. Way back in the first month of his treatment, it was thought he might have a kidney stone, but nothing has ever been definite. Ultrasounds and x-rays have been inconclusive. Because of this he has had a few nephrology (kidney) and urology appointments both in Victoria and at BCCH. Again, all very mysterious as to what could be causing these random episodes. His kidneys seem to be happy and healthy with no lumps or bumps or kinks or cracks. We expect to just wait and see if any more symptoms occur and his team of docs will decide where to go from there. 


The wait to see the nephrologist was excruciatingly lengthy. 90 minutes after our appointment time, we met this lovely gal from Sydney, Australia. She's a resident, or medical student, or something. Can't remember. She went over his history with me and gave him a thorough once-over. Once she and the top doc looked at the ultrasound pics from the day before and reviewed his urine samples ... they sent us on our way. Poor bubs was super hungry as I let him sleep too long and he had that one-hour wait before he could eat. I had only brought a few snacks and the Dex was talking to him about ALL THE THINGS he wanted to eat. I wish I could remember this lady's name, she was great with him. She couldn't believe how strong he was, beating her twice in an arm wrestle. He could believe it.



This is my friend Sondra and her boy, Lucas. He is S I X T E E N


He was diagnosed with Leukemia this week. My heart aches for this dear family as their lives have taken this unexpected and frightening turn. I pray, with hope, that he responds well to treatment and can get back to the business of being 16 sooner than he could have thought possible after such an upheaval. They face the same three years of treatment that we are in the midst of (some different medicines because he is older), but his prognosis is very good.