Saturday, April 30, 2011

Hospital stay #3

Well Isabelle has been having fever, head aches, body aches, fatigue, and nausia for the past few days. We originally thought the head aches were from her RBC being so low, which is why they transfused her earlier than they were going to. (red blood count) Yesterday on the way to the clinic, she threw up all over herself. Abel did not have a change of clothes, wipes, or anything. He stopped at Walgreens and bought wipes and an extra large tshirt to put her in while he cleaned up the mess. He broke our umbrella stroller because when he went to leave he backed up and ran over it, lol. I wish I was there to see it. At the clinic Abel said Isabelle seemed to be feeling fine, no fever or anything. They needed to give her a second dose of antibiotics since she had been having a fever. (Just as a precaution) Abel got home at 1 and left for work around 1:30.

As soon as he left Isabelle was in quite a bit of head pain. She just wanted to lay down and whenever she moved she would cry and grab her head in pain. I checked her temp and there was no fever. I gave her some tylenol and an hour later I checked her temp. and she had a low-grade fever. The tylenol also did not seem to do anything for the pain because she was still having a lot of it. I called the doctor and she told me that I should take her to the ER as a precaution since she was having, so much head pain and fever. Abel came home from work to help me. I got to the hospital around 7, Isabelle threw up in the car, so I had to change her. She was having a hard time standing because her legs were in pain, her head was in pain, and she was wobbly. They put us back in the childrens waiting area, which she is NOT supposed to be in. The nurse was like can you guys wait here for a couple minutes. I was like no its not really ok, I don't want her in here. The nurse ran out and they moved everyone around in the ER to get us a room by ourselves. I don't know how well the room was cleaned with all the hassle, but I can only do so much. The nurse we had was an idiot and was driving me crazy. When it was time for Isabelle to get her night chemo the nurse just squirted it back into her throat and she immidiatly threw up. (We had to give it to her again, we waited a half an hour)

The doctor on the ER side said they spoke with the oncology doctor on call and they wanted to keep us overnight for observation since she had been throwing up. The throwing up in the ER was completely the dumb nurses fault. She did have a fever all night. It got up to 102.3 and thats with her being pumped with tylenol every 4 hours. We were moved at around 11 to the oncology side and Isabelle had to be woken up for height, weight, and a bunch of other things that they were supposed to do while we were down in the ER, but didn't. She cried the whole time until her special male nurse Amil came in to do blood pressure. As soon as she saw him, she started getting giggly. He asked her if he could take her bp on her arm and she giggled, "no you have to do it on my leg." She then put the sheet over her legs and was like, "you can't find my leg, you can't find my leg, giggling." When he put it on her she started giggling that it tickled. It was sooo funny how she went from being dead tired and cranky to flirting.

This morning she woke up with a low-grade fever of 100.3. About 10 am she started feeling really good and she started running around. When the dr on call cal in, Dr. Chang, she practically sat on his knee and was telling him what he needed to check on her. He said she looked good to go and that it was probably just a reaction from the ARAC chemo. With cancer patients they have to always assume the worse and they gave her another dose of antibiotics before we were allowed to leave. It took forever to discharge her and as soon as we got home, around 2, she wasn't feeling good again. I gave her more tylenol. They said call if she gets a fever again because I may have to bring her back. We will see how the night goes.

Thursday, April 28, 2011

4/28/2011 Fever

Today Isabelle woke up with a fever of 100.6. We called the clinic and they told us to bring her in as soon as we could. They drew up a blood culture, checked her blood counts, and gave her some tylenol. Her red blood count was low as they already knew, so they went ahead and gave her a transfusion. They decided to do this today instead of waiting until Friday as planned because she was experiencing the symptoms of having low red blood counts. (fatigue, crankiness, and headaches) With every patient that has a fever in the clinic they give antibiotics 2 days in a row, so they gave her some this morning. Her white blood count was 6700 which is very high. (could be her body fighting off an infection, allergies, a virus, or pretty much anything)

Side effects from her push chemo are flu-like symptoms and she is getting a very high dose. She had a fever, her body was aching, she has a rash, and she was fatigued. (all side effects) We were at the clinic all day and afternoon. Abel had to call out of work and by the time we got home it was dinner time. Isabelle was so exhausted she fell asleep and we had to wake her up to eat. She has barely eaten anything all day because she has been feeling so yucky. She had a fever of 101.4 at 6 pm. This morning she was also feeling very nautios and threw up a few times.

Isabelle has an appointment at 9:15 am tomorrow for more chemo, she needs a second dose of antibiotics (it is given IV over 30 mins), and then they will deaccess her port. Hopefully she will feel better tomorrow. It has been an exhausting day for everyone.

Tuesday, April 26, 2011

4/26/2011 procedure

Isabelle's procedure was at 10:30 this morning which sucked because she could not eat or drink for 8 hours prior. (Which for her she went to sleep at 8pm) I really need to get her more cds for the car trip because she only has 2 cds that she likes and it is such a long drive. (they're like Disney mix cds and she only likes a handful of the songs on there) As hungry and thirsty as she was today she was in a great mood. They were late doing the procedure and it didn't even start until 11:30. She was talking the whole time it was going on, even under the anesthesia. I guess that is just going to be the normal for her.

 Her white blood count actually went up to 2700, which they weren't expecting. (which is awesome!) Her red blood cell count is still really low and they are going to do a transfusion on Friday. They are going to try to wait until then because they are "booked." They were telling me if her energy level goes down dramatically and if she starts getting headaches to let them know and they will go ahead and give her one earlier. Since we are going in everyday for the rest of the week, I'm not overly concerned about it. 20 minutes after the procedure was done, she was able to eat and drink. We left at 1, so it was a lot shorter visit than last week. They told me the reason for the longer visit last week was she got an additional chemo last week that she needed to be observed for a while. After this week we get a 2 week break where she will only have to go in Tues. to be put under for chemo. Then they will start on the 4 days a week chemo in the clinic again.

When it was time to go, Isabelle actually did not want to leave the clinic. She wanted to go and play. Instead we went to the Disney store and she picked out a doll there. She is in love with Mulan and Tangled right now. Shang, Mulan's bf, is her favorite right now. She picked him out at the Disney store and when she got home she was sad because she didn't have Shangs gf Mulan, lol. I didn't even think about getting her too, so I guess that will be another day that we get her.

Her appointment is at 3 tomorrow, 3 Thursday, 9:15 Friday and then 12 on Tuesday. The Tuesday appointment sucks because shes getting a procedure done and she will have to spend half of the day with nothing to eat. Brutal.  Overall she is doing great! She threw up twice this morning, but thats really the only nausia she has had this entire week. She had so much fun during Easter and it was nice that her counts were high enough that she could actually participate in different activities.
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This is the area at the back of the clinic where the art therapist comes in and plays with the kids.
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This is where the toys are. This picture was taken last Friday.
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Her hair is growing back, but the doctor said that it will fall out still because of the VinCristine chemo that she is going to continue to get.
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This was her waiting for the doctor to come in to do the procedure. She was watching Strawberry Shortcake on the tv.

Friday, April 22, 2011

Week 1 over

The past few days of clinic visits have been a hassle. The drive is horrible and the traffic even worse. Isabelle is completely over the chemo that is a push in her tube. The saline that they flush her tube out with before and after they put the chemo in gives her mouth a gross taste and she hates it. Today we saw the doctor and her white blood count is down to 1,800. The doctor said that she can still go out, but to be careful around Mondayish because her counts should be really low by Tuesday. Her red blood count was kind of low and the doctor thinks she will need a transfusion by Tuesday. They gave her an Easter basket at the clinic full of goodies which helped keep her mind off of the gross taste in her mouth. The deaccessed her port and gave her a bandaid.

It took a whole 2 hours to get home from the clinic today because of bumper to bumper traffic coming back from DC. We arrived at the clinic at 12:45 and left at 2:30. We got home about 4:30 which was dinner time. Thank goodness someone had made us food that way we didn't have to waste any money on buying something on the road and trying to feed the girls. The main problem with Isabelles appointments are that they have been in mid-day which leaves no time to go anywhere really while her counts have been up. Not to mention the weather has been rainy and today it was cold. We were able to go to Chuck E Cheese for about an hour before we had to leave to the clinic. Next week she has her procedure appt. on Tues. at 10:30 (which sucks because it is so late and shes not going to be able to eat or drink), Wed. and Thurs her appts. are at 3, and Friday her appt. is at 9:15.

Tuesday, April 19, 2011

First day of Consolidation phase

Our appointment was rescheduled from Friday to Tuesday because there is a shortage of chemotherapy drugs nation-wide. So today we our appointment was at 8:30 am. When we got there they accessed her port and checked her blood counts. Her white blood cell counts are at 2,570!!! That is a normal range, so the doctor said that she can go pretty much anywhere and no special restrictions until Friday! (thats when they are going to check her counts again.) They went up so much because she's had such a "big" break from the chemo. I'm so glad that she gets to see the Easter bun!! Hopefully it will be nice weather so we can actually go to the park with other kids! The doctor said by next Tuesday her blood counts will be on the way back down again from the chemo and she will be on restrictions again.

Her procedure went well. It was very different from the past procedures in that I was in the room with her the whole time, it was done at the clinic, and different anethesia (fenanyl and versed ,one is a pain med. that causes drowsiness and the other is the sedative)They told me that most kids go right to sleep. Isabelle laid on her side while they put chemo in her spine, but chit chatted the whole time. During the whole procedure she did not stop talking once, her eyes were open, but she seemed as though she were seeing double. The doctor said they're not usually, so awake seeming. The procedure took about 15 minutes and was done as she laid on her side. The doctor injected the chemo into her spine, while the nurse made sure Isabelle didn't move around a lot on the other side. 15 minutes after the procedure was complete Isabelle wanted to get up and move around, but they said she had to wait a whole 30 minutes.

After the procedure we went to the back area where Isabelle had to get fluids to hydrate. They then gave her the chemo that is just a push in her tube. We had to stay until 3 because they had to make sure that her kidneys were going to be ok and had to push a certain amount of fluid through her system. They said this was to make sure the stomach lining and kidney lining did not get too irritated by everything. They had to keep track of her urine while we were there, so I kept having to put gloves on and catch it in a cup. At one point there were 7 or 8 doctors/nurses in the hall having a little meeting in the hall. Isabelle noticed it immediatly after she went potty and she had to get their attention. She said, "Excuse me, everyone, I went pee pee and its right here for you!!!!" They all laughed, clapped, and cheered for her as she walked back to where we were sitting so proud. While we were there I don't think she stopped talking once. She was very hyper and at one point I was chasing her around with her IV pole trying to make sure she didn't yank her port line out!! I was glad that she was feeling so well. There was an art therapist there that also helped Isabelle paint and color. She really enjoyed that. A few times at the clinic she put her hat on and became upset. She told me that I can't look at her bald. (We normally take the hats off once we are in the clinic) She doesn't seem comfortable taking her hat off in front of other people who don't have hair loss.

As far as the chemo shortage, the only thing it affects is their protocol. Any chemo that has to be pushed in her port line has to be administered there and can not be given at home. She has to go in Wed. and Thurs. at 3 to get her "push" and Friday at 12:45. Abel still has to giver her the pill chemo everyday.

Mercaptopurine or 6 MP- This is the chemo pill Abel has to give Isabelle at night. It has to be given on an empty stomach, at least 1 or 2 hours after food. We can not give it in citrus or dairy products. She basically has to have the pills crushed in apple juice or water. The most common side effect with this chemo is low blood counts.

Cytarabine or Ara-C - This is given 4 days a week with a little syringe push in her port. Common side effects are nausia, vomiting, loss of appetite, diarrhea, low blood counts 1-3 weeks after treatment, and mouth sores.

We went out to eat to celebrate this evening and when she took her hat off in the restaurant, she put it back on a few minutes later. I don't think she felt comfortable, but I don't think she noticed anyone staring at her. It wasn't so much the adults, but the kids. The adults would kind of look and then immidiatly shy away and tell their kids to stop staring. Isabelle hasn't wanted to wear any wigs because they kind of scare her. Her favorite hat is her strawberry shortcake hat. 

Friday, April 8, 2011

Consolidation Phase

Well today we were supposed to start the consolidation phase of Isabelle's treatment. Her ANC (total white blood cell count) wasn't high enough for them to begin. (They need her at at least 750, she was at 280) They want us to come back next Friday and they think her counts will be fine by then. We pretty much drove to the clinic and drove home. The good thing is that we have a week off! They did explain a little bit about this phase. It is a period of six months, broken into 3, 2 month sections.

In this first 2 month period she will be going under every Friday, as I explained before, to have chemo put into her spine. Abel will give her Cytarabine  "ARAC" chemo every Sat. and Sun. (That is the one that goes in her tubes with a syringe push) Monday we will go to the clinic and she will get deaccessed and more chemo.

She will be on an oral chemo called Mercaptopurine "MP". They are pills that we will have to be crush. She will be on this chemo from the first day that we begin this new phase, till the 15th day. She will then have a break and restart it from day 29-42.

She will get a chemo called Cyclophosphamide "CPM" on day 29. (administered IV at the clinic) On days 15 and 43 she will be getting a chemo called PEG-asparaginase which is also administered IV.

Isabelle has been feeling great with minimal side effects from the chemo right now. One of her eyes has been drooping pretty drastically. The doctor said it was a side-effect of the VinCRISTine chemo that she got 2 weeks ago. The doctor also said that most likely will go away with time. She has also had some leg pain as well, but has been a lot more active.

Her ANC is still very low so there will be no Easter egg hunt at Ida Lee this year,  no mall visit to see the Easter bunny, and no flower festival either. At least she is doing well and thats all that matters.

Monday, April 4, 2011

Remission

Well the doctor called with the results from Fridays biopsy/labs and Isabelle is considered in remission. That means shes right on track to start her 4 days a week chemo. We will still have about 2.5 - 3 years of treatment to get rid of the cancer fully. They say once she hits the 5 year mark since the diagnosis she is considered cured.

Friday, April 1, 2011

Day 29, Hopefully last day of the "Induction" period

Cranky girl, on the way to Fairfax
Well the day started off nice and early. The Horaces' and the Beisels' picked up Sabrina at 6:30 a.m. and watched her for us. We left the house around 7 a.m. to make it to Isabelles 8:45 a.m. appointment at the clinic. From the moment Isabelle woke up at 6 a.m., she started asking for something to eat and drink. I knew right then and there it was going to be a long day. (She couldn't eat or drink until after her procedure) They accessed her port and checked her "levels". Her white blood count was 290, which is the highest it has been. (Normal is 2500) They said from here on out, that her counts should be going up because she is off the steroids now and the kind of chemo she is getting is different.

The doctor went over a game plan, before we went to the hospital for the procedure regarding her chemo. If her results Monday are where they should be then she will start the next phase. This means every Friday for the next 2-3 months she will have to go in for a procedure where she will have to be put under to get chemo in her spine. They will leave her port accessed with a little tube in it and we will have to give her chemo at home through a syringe on Saturday and Sunday. We will also be giving her oral chemo on those days as well.  Monday we will have to take her to the clinic to get chemo and have her port de-accessed. So a total of 4 days a week she will be getting some kind of chemo. From my understanding, these types of chemo don't have as strong of side-effects as the ones that she has been on. They will teach us about them when we go to the clinic next Friday. We will also have get the prescription while we are out there.

Her procedure went very well. She was super cranky. A combination of not sleeping well, being thirsty, and being hungry really had her in a mood. They took forever it seemed like to get her ready and they gave her the anethesia at noon. It was so sad because as she started getting loopy she started screaming, "mommy pick me up, mommy!" I hugged her and spoke to her, but you could tell that she was almost out. It was so sad. They gave her extra medicine, so that she wouldn't throw up after the procedure because she normally throws up a lot from the anesthesia. She woke up and she was cranky, but she was hungry and thirsty. She had no problem holding down the bread and water that we brought for her. They did a spinal tap, took bone marrow, and gave chemo in her spine. She has a big bandaid on her back and it doesn't look as bad as it did last time. Her platelet counts are higher now too, so thats probably why. We were able to leave the hospital around 2:30. Since we've gotten home she ate some rice and she's been laying down because she is wiped out. She is in good spirits though!

Waiting for her to wake up after her procedure.As soon as she woke up she wanted to eat. She was starving!


"No mommy, you can't go potty!!"  This is after we were discharged and we were about to leave.

Shes at 32 pounds right now, which she started at 36. She has gained some weight though because she was lower last week. (I don't remember what it was.) Hopefully everything will continue to go up and we find out Monday how many cancer cells are still in her body.