Way back on December 4th, we discovered that Katie was neutropenic. At the time, our biggest hope was that she would be out of the hospital for Christmas. Eight weeks later, she has finally recovered from her nuetropenia, regained a functional immune system and can resume the life of a normal and healthy 3 year old child. Blood tests at Fletcher Allen today showed that Katie's ANC, which had been only 220 last week had climbed to 1040. Anything above 500 would have been great. 750 is the minimum to restart her chemotherapy. Over 1000 is absolutely great! Of course, with numbers as good as that, the at home chemotherapy began again tonight. She received her first pills just before bed, but I digress.
So what did she want to do to celebrate the return of her immune system? She wanted to go to a book store. We went to Barns & Noble. She navigated the aisles of books for nearly an hour, picking up this, and thumbing through that, and the entire time, talking to anybody she came across. In the end, she decided to buy nothing, but she insisted that she was happy. She got what she wanted finally and what she wanted was to just be around people.
As it so happens, she requested a very special outfit last night when we were laying out clothes for today. She wanted to wear a beautiful red dress with red tights and shiny black shoes so that she could show it off to everybody at the hospital. She spent the day posing for doctors and nurses and had to take her coat off to pose for perfect strangers in the book store too. She was in her glory and I am glad that I was there to see it.
Tomorrow, she could finally go back to day care to play with other children again. But as luck would have it, her day care is closed tomorrow so she will spend one more day with her grandparents. She has enjoyed spending time with her grandparents, but she is eagerly awaiting Monday morning.
Thursday, January 29, 2009
Sunday, January 25, 2009
All Tests Are In
Since I express some feelings in this blog post, I wish to point out first that I, Rick Kelley, Katie's dad, am the one writing this entry and not Amy, her mom.
The remaining test results from Katie's bone marrow are in. There is still no sign of cancer and the tests revealed that her cells are maturing as they should be. To say that information was a relief is an understatement. Further blood tests also indicated that Katie's antibody count was low. Her count was 420 but I foolishly didn't ask what normal counts should be. Her ANC dropped again too. She was just over 500 Monday, but by Thursday she was back down to 220. However, in an effort to boost her immune system and fight off her cold and her virus, she received her first IVIG (Intravenous immunoglobulin) Thursday. We have been asking for Neupogen for some time to help boost Katie's immune system, but we didn't even know another option was available in the form of the IVIG until two days before Katie received it. I can't tell you exactly why one option was chosen over the other option, but I can tell you that I am glad that something was done.
Today, several days after the IVIG, Katie is feeling better. She is currently suffering from Laryngitis, and her swollen voice box is making it difficult to breathe, but she had that problem before we went to Fletcher Allen on Thursday. The doctors checked her over and told me to call if it got worse. It was bad Thursday night and Friday night. I was up a lot those two nights, checking on her to make sure that she was still breathing okay. Luckily, it never quite became bad enough to take her back to the hospital. Last night, she slept better and breathed easier and today it is a little better than that.
We are still fighting the battle to heal her lips but we are winning. I don't know if the IVIG is helping at this point or if the continued heavy use of the Medicated Blistex is working wonders all by itself. Her lips look normal at this point, but if she lets us look under her top lip, a sore is still hiding there. However, this last remaining sore doesn't seem to be causing her any pain and she will let us lift her lip up to apply the Blistex directly to the sore. The remaining sore is not a nasty, white hole surrounded by angry, red flesh any more. It is only slightly off-color and there is no redness surrounding it at all. She even brushed her teeth all by herself tonight before bed, which is quite an accomplishment since teeth brushing has been a real battle these last couple of weeks because of the sores on her lips.
Her spirits have been good and her energy has been great. She played around the house all weekend with her brother - running laps from room to room and climbing stairs and sword fighting in between coloring, painting, and just being a kid. It would have been nice to spend more time with her while she was feeling good this weekend, but I had a lot of work waiting for me and it kept me busy all weekend. She played around me as I sat at my computer for hours on end. Since Friday after work, I created and published a new website for a company that I work for our of St. Johnsbury, and I wrote two college papers for a course that I'm taking as part of my Master's program. I am very pleased with myself for getting that done, but I am sorry that I missed another opportunity to play with my children. Unfortunately, weekends spent working are pretty common place for me when my college is in session. There isn't time to do the work any other time.
The remaining test results from Katie's bone marrow are in. There is still no sign of cancer and the tests revealed that her cells are maturing as they should be. To say that information was a relief is an understatement. Further blood tests also indicated that Katie's antibody count was low. Her count was 420 but I foolishly didn't ask what normal counts should be. Her ANC dropped again too. She was just over 500 Monday, but by Thursday she was back down to 220. However, in an effort to boost her immune system and fight off her cold and her virus, she received her first IVIG (Intravenous immunoglobulin) Thursday. We have been asking for Neupogen for some time to help boost Katie's immune system, but we didn't even know another option was available in the form of the IVIG until two days before Katie received it. I can't tell you exactly why one option was chosen over the other option, but I can tell you that I am glad that something was done.
Today, several days after the IVIG, Katie is feeling better. She is currently suffering from Laryngitis, and her swollen voice box is making it difficult to breathe, but she had that problem before we went to Fletcher Allen on Thursday. The doctors checked her over and told me to call if it got worse. It was bad Thursday night and Friday night. I was up a lot those two nights, checking on her to make sure that she was still breathing okay. Luckily, it never quite became bad enough to take her back to the hospital. Last night, she slept better and breathed easier and today it is a little better than that.
We are still fighting the battle to heal her lips but we are winning. I don't know if the IVIG is helping at this point or if the continued heavy use of the Medicated Blistex is working wonders all by itself. Her lips look normal at this point, but if she lets us look under her top lip, a sore is still hiding there. However, this last remaining sore doesn't seem to be causing her any pain and she will let us lift her lip up to apply the Blistex directly to the sore. The remaining sore is not a nasty, white hole surrounded by angry, red flesh any more. It is only slightly off-color and there is no redness surrounding it at all. She even brushed her teeth all by herself tonight before bed, which is quite an accomplishment since teeth brushing has been a real battle these last couple of weeks because of the sores on her lips.
Her spirits have been good and her energy has been great. She played around the house all weekend with her brother - running laps from room to room and climbing stairs and sword fighting in between coloring, painting, and just being a kid. It would have been nice to spend more time with her while she was feeling good this weekend, but I had a lot of work waiting for me and it kept me busy all weekend. She played around me as I sat at my computer for hours on end. Since Friday after work, I created and published a new website for a company that I work for our of St. Johnsbury, and I wrote two college papers for a course that I'm taking as part of my Master's program. I am very pleased with myself for getting that done, but I am sorry that I missed another opportunity to play with my children. Unfortunately, weekends spent working are pretty common place for me when my college is in session. There isn't time to do the work any other time.
Wednesday, January 21, 2009
Some Preliminary Good News
As you may know, Katie had some bone marrow samples taken again this last Monday. Normally a bone marrow sampling for Katie consists of a single bone marrow aspirate from one hip. However, Monday, the doctors took bone marrow aspirate from both hips and they also did a bone marrow biopsy. Due to the extra medical attention she received Katie was a little more sore coming out of this procedure than she historically has been.
The bone marrow was extracted at around noon on Monday, and at 2:30 on Tuesday the doctor called me at work with the preliminary results. I am happy to report that when Katie's bone marrow samples from Monday were compared to those just a couple of weeks ago, the doctors were able to observe her cells maturing normally just like they are supposed to. In addition, they did not see any signs of leukemia cells in the sample. I am happy at the news, but I am also trying not to be too excited about it. The bone marrow samples will still undergo sever more tests and be looked at by many more people, and any one of them may report something that I don't want to hear, but for now things look good.
On another positive note, Katie's ANC on Monday had climbed substantially and was at 520. If that number is a sign that she is recovering and not just an abnormally high spike, we will soon be back to something closer to normal.
Tomorrow, Thursday, Katie has to return to Fletcher Allen for a follow-up appointment. We are hoping that more news has come back from the bone marrow and we are hoping that her ANC has climbed even higher. Her infection seems to be almost over, but her lips still look pretty bad. The sores left a lot of damaged tissue and her lips are cracking as they heal - leaving her with blood stained teeth several times each day. Her lips are still sore to the touch and putting any kind of lip balm on them is still a challenge unless she is sleeping. She also has a nasty sounding cough that she managed to pick up from her brother and it wakes her up at night. I think her throat hurts from coughing but it is hard to tell. For now she is sleeping soundly, and when she wakes up in the morning we will be headed back to Burlington.
The bone marrow was extracted at around noon on Monday, and at 2:30 on Tuesday the doctor called me at work with the preliminary results. I am happy to report that when Katie's bone marrow samples from Monday were compared to those just a couple of weeks ago, the doctors were able to observe her cells maturing normally just like they are supposed to. In addition, they did not see any signs of leukemia cells in the sample. I am happy at the news, but I am also trying not to be too excited about it. The bone marrow samples will still undergo sever more tests and be looked at by many more people, and any one of them may report something that I don't want to hear, but for now things look good.
On another positive note, Katie's ANC on Monday had climbed substantially and was at 520. If that number is a sign that she is recovering and not just an abnormally high spike, we will soon be back to something closer to normal.
Tomorrow, Thursday, Katie has to return to Fletcher Allen for a follow-up appointment. We are hoping that more news has come back from the bone marrow and we are hoping that her ANC has climbed even higher. Her infection seems to be almost over, but her lips still look pretty bad. The sores left a lot of damaged tissue and her lips are cracking as they heal - leaving her with blood stained teeth several times each day. Her lips are still sore to the touch and putting any kind of lip balm on them is still a challenge unless she is sleeping. She also has a nasty sounding cough that she managed to pick up from her brother and it wakes her up at night. I think her throat hurts from coughing but it is hard to tell. For now she is sleeping soundly, and when she wakes up in the morning we will be headed back to Burlington.
Friday, January 16, 2009
QPD: Naked Soccer
I will admit it: I have been really edgy lately. I am tired of the madness. I know that we have a lot to be thankful for and that our situation could be much worse. Katie feels fine. But I do want some peace of mind and a return to the joys of Maintenance that we experienced this Fall. I want neutrophils. I want my kid to be a kid. I want us to do kid things.
We think Katie is a champion kid, of course. She is a dress up queen and a dancing fool. She loves art projects and books and dolls. She doesn't let much get in the way of her own personal celebration of childhood. We continue to look for ways to support her efforts, as illustrated by one of my recent Questionable Parenting Decisions (QPDs). I thought I would share thed Naked Soccer story:
Katie has a Nerf soccer ball, and she often plays with it at home. She insisted that we had to bring it to Burlington, and I relented, despite the difficulty of fitting it into my purse, which was already full of all her other favorite goodies. (How many children bring Dora lunch boxes full of Play Doh to the Children's Specialty Center? I would guess that there are a lot of them!) Anyway, after a port access that was nothing short of traumatic--the nurse was great, but Katie just panicked--and a terrible movie (the Barbie version of the Dickens classic A Christmas Carol--yikes), Katie decided that it was time to play soccer. She scampered about the infusion bay clad only in Strawberry Shortcake underpants, pink toenails flashing as she kicked the ball while directing the nurses she had drafted into a very bizarre soccer league. ("You stand by your chair, and Mommy will stay here. I'll be the other part of the triangle.") "Only Katie," I thought. I probably should have dressed her. I probably should have spared the nurses. We were noisy. We were dangerous. We added chaos to the proceedings in the infusion bay. We interrupted traffic in the hall. I let it all go. I let her play. I encouraged her, actually, because she was having fun.
This was probably not my best parenting moment. I should have set some boundaries. Katie will read this story many years from now and wonder why I let her zip around naked in public. I let you cause chaos, Miss Katie, because you were happy, because you relaxed for a few minutes in the midst of a long day, because for once you forgot about your port and ran around with both arms at your sides, laughing and smiling. For the record, it was worth it, and I would do it again. I'm just sorry I didn't get a picture.
We think Katie is a champion kid, of course. She is a dress up queen and a dancing fool. She loves art projects and books and dolls. She doesn't let much get in the way of her own personal celebration of childhood. We continue to look for ways to support her efforts, as illustrated by one of my recent Questionable Parenting Decisions (QPDs). I thought I would share thed Naked Soccer story:
Katie has a Nerf soccer ball, and she often plays with it at home. She insisted that we had to bring it to Burlington, and I relented, despite the difficulty of fitting it into my purse, which was already full of all her other favorite goodies. (How many children bring Dora lunch boxes full of Play Doh to the Children's Specialty Center? I would guess that there are a lot of them!) Anyway, after a port access that was nothing short of traumatic--the nurse was great, but Katie just panicked--and a terrible movie (the Barbie version of the Dickens classic A Christmas Carol--yikes), Katie decided that it was time to play soccer. She scampered about the infusion bay clad only in Strawberry Shortcake underpants, pink toenails flashing as she kicked the ball while directing the nurses she had drafted into a very bizarre soccer league. ("You stand by your chair, and Mommy will stay here. I'll be the other part of the triangle.") "Only Katie," I thought. I probably should have dressed her. I probably should have spared the nurses. We were noisy. We were dangerous. We added chaos to the proceedings in the infusion bay. We interrupted traffic in the hall. I let it all go. I let her play. I encouraged her, actually, because she was having fun.
This was probably not my best parenting moment. I should have set some boundaries. Katie will read this story many years from now and wonder why I let her zip around naked in public. I let you cause chaos, Miss Katie, because you were happy, because you relaxed for a few minutes in the midst of a long day, because for once you forgot about your port and ran around with both arms at your sides, laughing and smiling. For the record, it was worth it, and I would do it again. I'm just sorry I didn't get a picture.
Friday Update
We survived the rest of the week but just barely. Josh did end up staying home from school on Wednesday. He still had a fever when he woke up in the morning, and he was coughing. He and Katie both stayed with their grandparents, and they enjoyed the day. Katie was animated and energetic, and the sores were improving. We thought we were making progress...but we were also distracted by other commitments. This week was midterm exam week at school, and Amy and I have been very busy.
Thursday found us in Burlington. Katie had an appointment with Dr. Bradeen and crew at Fletcher Allen, and she met an infectious disease specialist. We hoped he would be able to identify this thing that Katie is fighting. Unfortunately, we still don't know what caused the sores, and her ANC remains very low. The sores on her face have cleared up for the most part but her lips are still quite sore and the focus of a lot of attention. Her energy levels ebb and flow from day to day but that may be based more on how well she sleeps the night before than on anything else. She has a lot of nightmares now, and she wakes up at least once every night crying out about something she is afraid of at the hospital. Last night it was the finger pick.
Another bone marrow extraction has been scheduled for this coming Monday, 1/19/09. The doctors are still edgy about the possible causes of the absence of neutrophils, so they want to compare this next bone marrow sample to the last one to see how things have changed in the last couple of weeks. They also want to send another sample off to John Hopkins for a more detailed inspection, which of course means they are still looking for signs of cancer. The roller coaster emotional ride never seems to end.
To top things off, my mom called school late this afternoon as Amy was working on some grades. Katie had a fever. We went home for an ear thermometer and changes of clothing. We were convinced that the other shoe was about to drop. It was a tense and quiet ride to Newport. As it turns out, the fever was gone by the time we arrived, and Katie provided the clue we needed to determine what had caused her temperature to rise. She told us that she had had a headache and that she and Grandma had fixed it with some juice. Our old friend blood sugar. Grrrr. The good news is that we are home for now and have some time to wrap up grades before making the trip on Monday, which is a vacation day. It is a relief to end the night at home and not in the ER.
Thursday found us in Burlington. Katie had an appointment with Dr. Bradeen and crew at Fletcher Allen, and she met an infectious disease specialist. We hoped he would be able to identify this thing that Katie is fighting. Unfortunately, we still don't know what caused the sores, and her ANC remains very low. The sores on her face have cleared up for the most part but her lips are still quite sore and the focus of a lot of attention. Her energy levels ebb and flow from day to day but that may be based more on how well she sleeps the night before than on anything else. She has a lot of nightmares now, and she wakes up at least once every night crying out about something she is afraid of at the hospital. Last night it was the finger pick.
Another bone marrow extraction has been scheduled for this coming Monday, 1/19/09. The doctors are still edgy about the possible causes of the absence of neutrophils, so they want to compare this next bone marrow sample to the last one to see how things have changed in the last couple of weeks. They also want to send another sample off to John Hopkins for a more detailed inspection, which of course means they are still looking for signs of cancer. The roller coaster emotional ride never seems to end.
To top things off, my mom called school late this afternoon as Amy was working on some grades. Katie had a fever. We went home for an ear thermometer and changes of clothing. We were convinced that the other shoe was about to drop. It was a tense and quiet ride to Newport. As it turns out, the fever was gone by the time we arrived, and Katie provided the clue we needed to determine what had caused her temperature to rise. She told us that she had had a headache and that she and Grandma had fixed it with some juice. Our old friend blood sugar. Grrrr. The good news is that we are home for now and have some time to wrap up grades before making the trip on Monday, which is a vacation day. It is a relief to end the night at home and not in the ER.
Tuesday, January 13, 2009
Two Kids Sick!
Katie's struggle with this virus continues. For the past three days I have been applying medicated Blistex lip ointment to her lips and a little to the sores on her face. The sores on her face are looking much better. They have dried up and the red areas around them are shrinking. Her lips are looking a little better too. However, during a close inspection of her lips tonight I found another new sore on the underside/inside of her top lip again. This one doesn't seem to bother her as much as the previous ones and she did let me touch it to apply a little Blistex to the outside of it. I'm curious to see how this one will progress now that the other sores seem to be getting better.
Josh is also sick tonight. This morning he complained of a headache, but we thought it was from lack of sleep since Katie had woken everybody up last night during a bad dream. In her dream she was screaming and saying "Don't take me to the hospital!" None of us got much sleep last night. Tonight, as we were putting Josh to bed, Amy noticed that he felt warm so she took his temperature. He has a fever of just over 100 and he is complaining of the headache again. We'll keep an eye on him through the night and see how he's feeling in the morning. Maybe my parents will have two kids on their hands tomorrow...
Josh is also sick tonight. This morning he complained of a headache, but we thought it was from lack of sleep since Katie had woken everybody up last night during a bad dream. In her dream she was screaming and saying "Don't take me to the hospital!" None of us got much sleep last night. Tonight, as we were putting Josh to bed, Amy noticed that he felt warm so she took his temperature. He has a fever of just over 100 and he is complaining of the headache again. We'll keep an eye on him through the night and see how he's feeling in the morning. Maybe my parents will have two kids on their hands tomorrow...
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