Showing posts with label HgB. Show all posts
Showing posts with label HgB. Show all posts

Wednesday, April 29, 2015

when cancer came (part two)

when cancer came (part one) {here}

I called our family doctor first thing on Wednesday (April 9th, 2014) morning and got an appointment for 12:10pm. The timing was perfect as I could drop the older boys off at their weekly homeschool group class and then go straight to the doctor. That morning there was a meeting for parents about the upcoming changes from the provincial government for the 2014/2015 school year. While the older boys went off to activities with the other kids, Jax stayed close to me for snuggles during the meeting. He received several sympathetic looks from staff and other moms at the meeting. I mentioned my concerns to a few friends after the meeting and they affirmed my decision to pursue bloodwork. Most agreed with me that his complexion looked pale, another friend thought he looked yellow. One friend sent me on my way with a hug and a quick prayer for courage, peace, answers.

While talking with our family doctor, I mentioned my concern about leukemia being the cause of his symptoms. I told her about Debbie. She assured me that leukemia is rare, is not hereditary, and that it was highly unlikely to be the cause. Yet she readily agreed to run bloodwork (at my request), to set all our minds at ease. 

Right from the doctor's office, I took him to the hospital lab for bloodwork. He was a champ! I don't think he even cried, just a flinch at the needle pinch. The boys and I completed our day in town and headed back home. Jax played with the boys next door and made himself a smoothie with Sharon.


At about 6:00pm, the phone rang. Paul answered. After a moment he said "Oh, hello Patricia." And I knew. She asked Paul if I was with him. We went into our bedroom and closed the door, our doctor on speakerphone between us. She said that Jaxon's bloodwork had come back and that it showed his hemoglobin was frighteningly low. (Hgb should have been easily over 100, and it was at 40.) She said "I know I said that this is likely not leukemia, but these are the kind of numbers we see in leukemia." Our stomachs dropped. Voices gone. Tears came. She told us that she had spoken to the pediatrician on-call at the Duncan hospital who agreed that he needed to be assessed quickly and thoroughly. She told us to meet Dr. Z in the emergency department at 8:00. She said that we would not have to wait long to be seen, to tell the triage and registration desk that we were getting a "direct admit" as per our family doctor and would be seen by Dr. Z. At that time I didn't know what "direct admit" meant, now I do. It meant we had a very sick child who needed immediate attention, and we wouldn't be going home anytime soon.

We called Frieda and she immediately started the 90-minute drive to our house. I grabbed my pillow and Jaxon's, as well as his cozy blanket, and maybe a blanket for me. I couldn't think of anything else to take. I must have taken his slippers. He wore big orange rubber boots out the door. He, or maybe the other boys, asked why I was taking pillows and blankets. I said it was because we might be there for a little while and I wanted to make sure we'd be comfy. We fumbled around the house for a bit, I have no idea what we did. I don't think we had supper. Finally, we just decided to make our way into Duncan (25-minute drive). We sent Max and Marty next door to play and eat until Frieda could get to our house to take care of them for the night. I probably called my mom and my sister to let them know what we were doing. I had talked to my sister that day about my concerns, I don't remember if I had told my mom anything at that point. Maybe my sister filled her in?
Updated details from my Mom ...Our phone rang at about 6:45 pm on April 9, 2014. Because it was a Wednesday we had finished supper and I was likely hurriedly cleaning up before the people arrived for Bible Study. It was Laurel-Anne, I think you had asked her to call us. She told me that you had recently been having concerns about Jaxon's health leading to a visit with your family doctor that day. She told me about the call to you at home less than an hour earlier, about the "frighteningly low hemoglobin," and the appointment with the pediatrician in Duncan soon to take place. She also said that you had phoned her to learn about E's anemia after his viral infection.
I went to tell Dad, and as we hugged each other, he asked, "does that sound like leukemia to you?" I answered, "yes." Ten minutes later our friends arrived for Bible Study. We began by telling them what had just transpired and prayed together for your visit with the pediatrician and whatever was to follow.
You were able to phone us at about 10 pm after the visit with Dr. Z and knowing that the helicopter was arranged for the next morning.
I think Laurel-Anne phoned your brothers and families too.
When Dad and I prayed together before falling asleep (yes, I think we did sleep), we determined that we would choose to trust the sovereignty of God. 
When I had heard our doctor mention the name of the pediatrician we'd be seeing, it sounded familiar to me but I couldn't quite place it. We got to the hospital in plenty of time for our 8:00 "appointment". 

Although he was feeling crummy, he was still full of beans and smiles and lovies.
On the way into the ER there were some paramedics hanging around in the ambulance bay and they used some choice words in their conversation just as we walked by. I turned and gave them the stink-eye and carried on inside. As we were sitting talking to the registration clerk, one of the paramedics came in and gave Jax a stuffie. Compliments of Shaw, but still ... I appreciated the sentiment.  Jax would need that buddy over the next few days.
I saw a nice lady come in through the main doors, and as she chatted with someone else in the waiting room before flashing her lanyard to open the door into the ER, I knew why her name sounded so familiar. She had volunteered at our camp a few summers earlier, and she and I had chatted a few times. I don't know if I knew at that time that she was a pediatrician. A few minutes after she went in, Jaxon's name was called. I don't remember if we were seen by a nurse first, or if Dr. Z just came right in to start her examination. 

My darling! What yellow flesh you have!
Dr. Z listened to the history of Jaxon's illness, now hearing it from the perspective of knowing what his blood was telling us. We told her about Debbie. Knowing that his hemoglobin was so drastically low brought much greater urgency to find out why he was still so unwell. She affirmed that it could very well be a viral suppression of his bone marrow, but she did not rule out the fact that it could indeed be "that big scary thing that we really hope it isn't." Further bloodwork would tell us what course of action to take. She prepared us for the fact that he may need to be transported to Victoria or even to BC Children's in Vancouver for further testing. A transfer to Victoria seemed scary enough, knowing that BCCH was a possibility was absolutely mind-blowing. I don't know if she consulted anyone in Victoria, but she did get in touch with the oncology department at BCCH. They told her what blood tests to order. The lab tech came in while Dr. Z was out of the room and commented to us on the vast number of tubes needed to collect all the blood that was to be analyzed. Not helpful, lady. Not helpful. But thanks for doing your job.


Popsicle prize!
After x-ray tattoo prize! Daddy's damp, leaky eyes.
Dr. Z was in and out of our room several times to talk to various people and back to us. She came in to say that BCCH wanted to see him first thing the next morning, and that we'd be going over on the first ferry the next day. When she came in again and said that BCCH wanted him to be FLOWN over the next morning, we were stunned. Again Dr. Z reminded us to hope for the best, but assured us that if it was indeed something big, bad, and scary ... we'd be okay. We could do this thing. The fact that SHE was the pediatrician on-call that night, the way she spoke to us about the serious nature of his illness, the way she cared for us and encouraged us ... we are so very grateful.

We were moved upstairs to the peds ward to settle in for the night. I don't remember any of the names or faces or much of what happened at all. I scrounged around the parent kitchen for something to eat. Digestive cookies and apple juice never tasted so good. Paul went home to gather more clothes and things for me and Jax.

Earlier that week, he had come to me to show me something amazing! "Mom! Look, I can see my heart beeping!" I looked at his chest and indeed I could see his heart beating. Knowing nothing about normal resting or active heart rate for a child, I thought how cute it was that he noticed it. I told him "that's great, it's doing it's job!".  Upon exam in the ER his resting heart rate was noted to be about 132 bpm. Too fast. Because of his severely depleted hemoglobin (the part of the blood that carries oxygen around the body), his heart was needing to work extra hard to sustain his major organs. Several people commented in the early stages of diagnosis that if an adult had such an alarmingly low hemoglobin, we'd be flat on our backs and feeling debilitatingly unwell.


Despite the smiles and "thumbs up", he was really annoyed by the oxygen tubes in his nose. I had to put it back on several times as he knocked it off. One clever nurse adjusted it to go down to his nose from the top of his head, not up from underneath his chin. That worked much better and he finally drifted off to sleep.

I didn't sleep much. I waited for Paul to return with whatever he could think of from home, and I watched this little monitor tell me what his heart rate was (red) and the percentage of oxygen in his blood (green - "sats"). Because his hemoglobin was so low and not doing its job, the extra oxygen he received did the work, and did it well. He stayed on the oxygen all night, and his heart rate and sats remained stable. I found some cookies and milk for myself in the parent kitchen.
Paul came back around 1 or 2 am and snoozed for a bit on the pull-out chair in our room while I snuggled with Jax. The plan was for him to drive our car over on the ferry with our big bag of stuff while Jax and I caught a ride in our own private chopper. Paul caught the 5:45am ferry and got to BCCH before we did.

when cancer came (part three)

Saturday, May 3, 2014

Clinic and other stuff

Jax had his second-to-last BCCH clinic appointment yesterday. He received his final (for now) dose of Vincristine. His blood work showed an excellent report, indicating that healthy cells are returning which can only happen when the diseased cells are lessening.

Here's my Facebook update from yesterday:

Today brought us another Oncology Clinic appointment. Jax received his final dose of Vincristine (chemo) for the Induction phase of treatment. His blood work looks great, really great! His ANC (Absolute Neutrophil Count - google it for more info!) is at 1.31, which means his risk of infection is much lower than it has been in the past 3 weeks, when it dipped as low as 0.27. Both Metric and Imperial measurements are used to calculate blood counts. ANC of 1.31 is within the 1000 range, and is considered "minimal risk of infection". When his HgB count was 40 at diagnosis, others would call it 4. As the ANC increases, it indicates that there is less disease in his blood.

We have a whole week off of appointments! He has his final Induction appointment on Thursday May 8, when he will have a lumbar puncture and bone marrow biopsy (after the "sleepy milk", of course). If all results indicate that he has indeed responded appropriately to treatment, we should be able to return to the Island on Friday or Saturday. We expect to do most of the next phase of treatment (Consolidation) in Victoria.

We have a whole week off of appointments! He has his final Induction appointment on Thursday May 8, when he will have a lumbar puncture and bone marrow biopsy (after the "sleepy milk", of course). If all results indicate that he has indeed responded appropriately to treatment, we should be able to return to the Island on Friday or Saturday. We expect to do most of the next phase of treatment (Consolidation) in Victoria.
And Paul's:
Today we had our second to last visit to BCCH for this initial stage of induction for Jaxon at which the doctor told us, after looking at his blood counts, that we could safely go to a public place with Jax because his ANC's were above 1.0. The fact that his ANC's are above 1.0 means there is room in his bone marrow to produce good white blood cells which means Jax is responding very favorably to the treatment. The next phase (6-7 months) will have various stages of 4 and 8 week treatment mini-phases within it. Each phase will continue to be challenging as Jaxon's body responds accordingly. Please continue to pray for Jax, for us his parents and for Max & Marty too. Your continued support is always encouraging. 

We had a busy day yesterday.  After clinic, we spent several hours at Metrotown, arranging a new cell phone plan for both of us. Paul hasn't had a cell phone since we moved to the Island, just an iPod for texting and emails. With all the traveling back and forth and all the arrangements that he needs to take care of from here or at home, it became clear we needed to get him a phone. We found a great deal with Fido and although it took several hours, we are all set up for easier and reliable communication.


Jax snoozed in the stroller most of the time we were at the mall. I found a few sales and got a couple clothing items I've been needing. Toward the end of our errands at the mall, Jax started telling us "Let's go already! I want out of this mall!" On the way back to RMH he started feeling really icky. He says his tummy feels "bad". Hard to know if it's pain or nausea. After some time spent with his head in a bowl, we gave him half a Gravol. He slept for 16 hours, woke up to pee and give his breakfast order, and is resting again now. Big day yesterday. He hadn't napped for a few days so I guess he's got a lot of catching up to do! He was happy to hear my answer when he asked if he would need a poke today ... Nope! No pokes for lots of days!