Showing posts with label symptoms. Show all posts
Showing posts with label symptoms. 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)

Sunday, April 12, 2015

when cancer came (part one)

Do you know how to boil a frog? The theory is that you don't drop him into a pot of boiling water because he'll just jump right out. Instead, you put him in cool water and gradually bring it to a boil. Because the temp slowly rises, he doesn't realize what's happening and we all know how that would end for a frog. It was the same with the clues Jaxon's body was giving us that something wasn't right inside. We didn't see the external indicators as much because he was with us all the time. But for those who didn't see him every day, the signs were much more obvious. 

Starting near the end of March 2014, around the 28th, Jaxon had a cough and cold. I noticed that he had been tiring more quickly than he usually would. He'd come to me during the day for extra hugs and snuggles. Looking back, I think he was feeling fatigued but of course he didn't know how to express that and I didn't see it as anything to worry about. His cold symptoms didn't seem too bothersome. He had hives a few times, which was not a surprise as we had discovered in January that he sometimes gets hives when he's fighting a virus. He had some low-grade fevers now and then, but nothing alarming.

I took him to our family doctor on Tuesday April 1st, just to see what she thought. She said that he probably had the same crud that so many people seem to have at that time of year. She said his cough sounded just like many others she had heard over recent months, that it might linger for a few weeks but that he'd surely bounce back. Looking back on the summary of that appointment, I see that she noted he looked pale and subdued. The hives were consistent with his previous reaction to a viral illness. I hadn't been giving him any Tylenol or Advil since he didn't seem "that bad". She said to give him Advil every 8 hours for a day or so to see if he'd perk up. I kept him with me while the boys went to their weekly St. John Ambulance first aid class that night. Since he had a touch of cold and cough and wasn't back up to full energy, he was happy to stay with me. I had a previously booked appointment with our family doctor for myself the next day, Wednesday 2nd.  Jax was with me again and she commented on how he looked so much better than the day before and he was likely well on his way to recovery.  That night we had a Camp Family Dinner. Other than mild cold symptoms, he seemed fine to me. That night our friend Chris took one look at Jaxon and instinctively asked him if he was okay, if he needed to lie down, if he was going to throw up. He saw that Jax looked really pale, told me that he thought it looked like Jax was about to pass out. I appreciated his concern, but didn't think there was much to worry about and still assumed Jax was just getting over something. We had just seen the doctor the day before and she seemed confident nothing was seriously amiss. I don't remember much about the next several days, just that he was still tired and not his usual self. 

These next details are fuzzy for Paul and I, but this is the best we remember it. On Tuesday (8th) afternoon, Paul took the boys to drum lessons. Max had drumline practice and it was Jaxon's turn for his 15 minute lesson with Drum Teacher Conor. Marty hung out with Paul. At 4:45 when Max and Jax came out of their lessons, Drum Teacher Dustin commented to Paul that Jax looked really unwell, and reminded him how important it was to keep sick kids away from the group lesson as illness can spread so quickly on the team. We were still of the belief that he was just getting to the end of whatever viral bug he had and that he was no longer contagious. Paul then called me at home to see if I should call the doctor back to maybe get Jax in for bloodwork before the end of the day. I called the office but they were closing for the day, and told me to call at 9am the next morning for a same-day appointment. At 6:30pm on Tuesday the older boys went to their St. John Ambulance class. As Jax still wasn't feeling top notch, he spent that time with Paul after they dropped the other boys off. One of the SJA leaders mentioned to Paul that Jax really did not look well, and asked if he was sick. That's when the first red flag really broke through our "he's fine" bubble. Paul called me and suggested that I call his Mom to ask for her perspective on what to do next. We thought he might be anemic as a result of this viral sickness he had going on. That happened to my nephew several years ago when he was about 2 and a half. A viral illness can trigger a suppression (like a 'stop work order') of the bone marrow. It's a temporary condition that usually resolves. That's what we really hoped it was, and figured that must certainly be the answer. But we also had a nagging suspicion / fear / dread that his symptoms could very well point to something much more serious. 

Debbie:
Paul's older sister was diagnosed with leukemia (A.L.L. - the same as Jax) when she was 7 years old. Paul was only 4 at the time so he doesn't remember much about her three years of treatment. We've heard bits and pieces from Frieda and Deb over the years. I called Frieda to tell her about Jaxon's illness and the comments we'd been getting from other people, and to ask her about what Debbie's symptoms were before her diagnosis. Deb had some swollen glands, bruising in unusual places (abdomen) and petechiae on her chest. Her bloodwork revealed a low platelet count, while the other components of her blood looked ok. Although we didn't have bloodwork results to look at yet, Jax didn't have any of the symptoms Deb had so we felt reassured.
Debbie, recently returned home from initial treatment in Vancouver.
Age 7 (or maybe 8) in 1982. Bunny snuggles.
Deb & Jax meeting for the first time in June 2009. He was about 6 months old.
Deb celebrated her 40th birthday the same week that Jax was diagnosed.
Frieda agreed that a follow-up call to the Dr. would be a good idea, to insist we get bloodwork done, just to put our minds at ease. It was probably 'nothing' ... but we were not naive to the fact that it could be 'something'.