Days 36 & 37

K and Jax before clinic

Nothing much to report -which is a good thing.  K had clinic yesterday and her blood counts are still good (ANC 5,000+).  Yesterday she finally got to go to Build-A-Bear and made two adorable creatures.  She also got an extra treat of lunch at Rainforest Café, where I made them wash down our chairs and table before we sat down (yes, I’m still germaphobic).

Last night K started her 6mp and of course she gave dad a hard time about not eating for 2 hours before/1 hour after.  I escaped to a much-needed hot yoga class so dad was on duty after 7pm. 

Dad, Grandpa & K 

Today dad was home with K. Dad worked a bit from home and then they had fun doing some arts and crafts with K and grandpa.  Maddox went to work with mom and spent part of the morning modeling HIP’s spring fashions on Channel 7: http://abclocal.go.com/wls/video?id=8575276&pid=8575178#global  Maddox hung out with Christina post segment, I guess she is more fun than mom.  Thank you Christina!  

K’s spirits are up so hopefully this weekend will be a good one!

Day 35

YAY - we are low risk!

Today was the day we got the news we were praying for.  Kennedy is officially LOW RISK!  This is the doc’s first low risk case falling under the new treatment protocol.  He seems excited about it and a passionate doctor can only mean good things for K.  There are two completely different treatment protocols for low risk determined by COG (Children’s Oncology Group). One protocol is LR-C and the other is LR-M (see a summary of both below).  We were randomly selected for LR-M.  The good thing about LR-M is that she will not be treated with any cyclines and no more Peg so the side effects shouldn’t be as severe and long term effects won’t be as risky.  The bad thing about LR-M versus LR-C is that there are (6) 3-day hospital stays for higher doses of IV Methotrexate, the first being next week.  This treatment plan also means no spinal tomorrow – YAY.  There is a 97% cure rate with this protocol.  Here that?  97%!  It is still a 2.5 year chemo program but 97% outshines the next 2 years!!!!!

K and Sofia painting

The plan for tomorrow is to go to clinic and have blood drawn.  This will help the doc determine the dosage for next week’s Methotrexate.  This means we get a quick port pokey and blood draw.  If she’s feeling good, we will be off to Build-A-Bear for the bears we owe her.  Tomorrow she will also start oral chemo Mercaptoupurine (6MP).  The tricky part about this med is that it can’t be taken with food or dairy so getting it down will be our new challenge.

During our meeting with the doc, we also learned her neck/head pain and weekend nausea was probably due to the spinal tap/infusion and that caffeine may have been a quick fix.  Now we know…

Maddox and Molly

So although I should be dancing around, all I want to do is run away.  Despite the good (GREAT) news of the day, I came home to a sick little monkey and I spent the evening rubbing her belly and cleaning puke (yes, again) off the bed.  When I came home from work, Sofia came over for a play date with K.  It started off well, we painted birdhouses but about half way through, K complained of nausea and stomach pain. Sofia spent the last 20 minutes hanging out with Molly and Maddox while Kennedy laid on the couch to have her tummy rubbed.  After a nice warm bath and a 10-minute nap, K threw-up.  This time I called the doc just because I KNEW it wasn’t chemo related.  No fever.  Doc thinks she either overate something that didn’t agree with her or has a touch of the tummy bug.  He’s not worried but didn’t have a quick fix like caffeine for this one.

Maddox being a good big
brother

K started feeling better after throwing up so Maddox fed her some rice (trying to earn some good boy credit after a breakdown earlier).  Dad and Grandpa are off cleaning out the travel trailer…getting closer to selling it.  Hopefully the rest of the evening will be uneventful.

Oh and our canine friend Jaxon is now back home.  He spent the past 2 weeks with Grandpa but K really wanted me home so he has been pardoned.  Yet another child to care for.

Low-risk: Patients are randomized to 1 of 2 treatment arms.

Arm I (LR-M):

Consolidation therapy (19 weeks): Beginning one week after completion of induction therapy, patients receive vincristine sulfate IV on days 15, 22, 78, and 85; methotrexate IV over 24 hours and IT methotrexate on days 8, 29, 50, 71, 92, and 113; leucovorin calcium orally or IV on days 9-10, 30-31, 51-52, 72-73, 93-94, and 114-115; dexamethasone orally or IV BID on days 15-21 and 78-84; and oral mercaptopurine on days 1-133.

Maintenance therapy: Patients receive vincristine sulfate IV on days 1 and 8; oral dexamethasone BID on days 1-7; oral methotrexate* on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, 78, 85, 92, 99, and 106; and oral mercaptopurine on days 1-112. Courses repeat every 16 weeks. Patients also receive IT methotrexate on days 1 and 85 (courses 1 and 4), day 57 (courses 2 and 5), or day 29 (courses 3 and 6). Patients then receive course 7 comprising vincristine sulfate IV on days 1 and 8; oral dexamethasone BID on days 1-7; oral methotrexate on days 1, 8, 15, 22, 29, 36, 43, 50, 57, and 64; and oral mercaptopurine on days 1-70. Treatment continues for 2½ years (timed from the date of diagnosis). [Note: *Patients do not receive oral methotrexate on the days that they receive IT methotrexate.]

Arm II (LR-C):

Consolidation therapy (4 weeks): Patients receive vincristine sulfate IV on day 1; oral mercaptopurine on days 1-28; and IT methotrexate on days 1, 8, and 15.

Interim maintenance I therapy (8 weeks): Patients receive vincristine sulfate IV and methotrexate IV over 2-15 minutes on days 1, 11, 21, 31, and 41 and IT methotrexate on day 31.

Delayed-intensification therapy (8 weeks): Patients receive dexamethasone orally or IV BID on days 1-7 and 15-21; vincristine sulfate IV and doxorubicin hydrochloride IV over 1-15 minutes on days 1, 8, and 15; pegaspargase IV over 1-2 hours on day 4; cyclophosphamide IV over 30-60 minutes on day 29; oral thioguanine on days 29-42; cytarabine IV over 15-30 minutes or SC on days 29-32 and 36-39; and IT methotrexate on days 1 and 29.

Interim maintenance II therapy (8 weeks): Patients receive vincristine sulfate IV and methotrexate IV over 2-15 minutes on days 1, 11, 21, 31, and 41 and IT methotrexate on days 1 and 31.

Maintenance therapy: Patients receive vincristine sulfate IV on day 1; oral dexamethasone BID on days 1-5; oral methotrexate on days 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78; oral mercaptopurine on days 1-84; and IT methotrexate on day 1. Courses repeat every 12 weeks for 2 years for girls and for 3 years for boys (timed from the start of interim maintenance I therapy).

During the Maintenance phase of therapy, health-related quality-of-life (HRQOL) measures, parent‘s perception of child‘s health vulnerability, fewer missed days of school/daycare by patients and work by parents, and peripheral neurological functioning may be compared in children receiving different vincristine sulfate/dexamethasone pulses frequencies to systematically assess the impact of treatment.

Blood samples may be collected periodically for research studies and patients may complete quality-of-life surveys periodically.

After completion of study treatment, patients are followed up periodically for 10 years.

Day 33

This morning it was hard to leave the house.  K was a bit nauseated and I went to work leaving her on my bed with bucket in hand, I felt awful.   I left my phone number and Gene’s phone number with K and she finally figured out how to use the phone all by herself. 

Gina and K cooking

The first call was to tell me her neck pain returned and she wanted Tylenol.  I told her to look at the clock and if she still had the pain in 10 minutes, to call me back and I would have Gala give it to her.  Instead she called dad back in 10 minutes and he arranged the medicine with Gala.

Thankfully, the rest of the day got better. Molly came over to work with K on her writing and she wound up painting Kennedy’s and Maddox’s face.  Kennedy had a butterfly mask and Maddox had “Go Bulls”. 

I met with the Red Cross today and we are working on setting up three blood drives at the HIP: one in May, one in June and another in September. I also caught up on some projects I had put off and overall had a good day.

Dad and Maddox at the Bulls game

Dad took Maddox to a Bulls game tonight thanks to his boss Jolie (thank you!).  It was a great time for them to bond and Maddox really needed some one-on-one dad time.  Gina came over to play with K for a few hours and we wound up making cookies, playing a game and creating jewelry.  Around 8’ish Kennedy started feeling queasy so I walked Gina home across the street, gave K a bath and put her to bed.  I finally sat down for dinner at 9 – long, long day!  I miss my boys.

Day 32

Last night remained bad until about midnight.  Finally K was able to keep down some Zofran and she felt normal and was giggly until around 1am until she finally fell asleep.  We were afraid sleep wouldn’t come for her since she slept all day and felt so awful.

K woke up okay but then complained of severe pain in her spine, near her neck.  Again, no fever so we gave her some Tylenol.  After eating a little for breakfast, she was nauseated again so we gave her Zofran and that seemed to help.  She jumped in the shower and hung out there for about an hour.  After all the pukeys yesterday, chocolate ice cream no longer works as a good mixer for her meds so we’ve switched to mint chocolate chip and were able to get her meds down.

Kennedy and Emily and their puzzle

Stephanie came by today with Emily for a play date.  We made cookies, dyed eggs and worked on a puzzle.  It was a nice afternoon and K kept up nicely.  It was nice to see her interact with someone her own age.  She wasn’t as social as she normally is and it took forever for her to actually talk to Emily but finally, they played like kids should.

Grandma came by later and helped me complete my kick of ultimate organization.  Something has gotten into Gene and me, we have started organizing and cleaning like crazy.  I guess it makes us feel we can control something since we feel like we no longer have control of anything.  Gene was installing shelves and cleaning his workroom and I disassembled and reassembled both kid’s rooms along with the basement playroom.  Getting closer to finishing, one more weekend I think.

Grandma and the kids dying eggs

Maddox came home around 7pm from his night with Alek.  They went everywhere – swimming, the movies, out to eat….and the list goes on (thank you Jane, very much!).  It was nice to see Maddox so happy.  As awful as we feel for not spending time with him, we know we can’t compete.  When K is sick like she was the last day and half, the house needs to be quiet.  We know he tries so hard to get our attention but we are so preoccupied, it is hard to give him the feedback he deserves.  It’s also not fair to him to keep him cooped up at home asking him not to be a wild, crazy and fun kid.  Being out and about is the best place for him until the chemo side-effects wear off (hopefully over the next day or so).  

When Maddox came home, K was feeling pretty good.  We all dyed more eggs, he read to us, we read to him and he crashed from exhaustion.  Later in the evening, K complained of the neck pain returning and some nausea so she had another dose of Tylenol and Zofran.  Another big change is that she barely eats, dinner consisted of rice and a piece of bread.  What a change from only a few days ago.

Gene and I both have work tomorrow so K will be with Gala.  Hopefully Thursday's chemo will wear off and K will have a happy, fun and pain-free day.

Day 31

K sleeping off the pukeys

It’s funny how when Kennedy is giggling and acting normal, we forget how sick she is and that cancer has invaded our home.  Today we have been reminded.

We never made it to Build-a-Bear yesterday since she was so exhausted.  Instead, Mom, Dad and Kennedy took a nap while Maddox played at Riley’s house (thanks Kim!).  At night, she ate super light and passed out early.  She was super fatigued and not herself.

This morning K woke up with severe leg pain. Since she didn’t have a fever, we gave her some Tylenol and the pain subsided.  She ate breakfast and went back to bed.  Maddox and I went to the Y for our classes and stopped at the store on the way home to pick up some “K” essentials.  When we got home, Gene was dealing with pukeys.  K had thrown-up all over our bed.  She threw up so much, it went right through our mattress. She was feeling awful.

Gene put her in her bed and brought her some gingerale.  I tried giving her Zofran (for nausea) but that all came back up within 15 minutes.  She finally got a little rice down and we spent a half hour reading her Cinderella.  Dad and I took turns staying with her.  At one point she watched a bit of a movie and colored. Eventually K and dad took a nap and I fell asleep in Maddox’s room. 

Thankfully, in the midst of all of this, Jane picked up Maddox for a play date/sleepover with Alek (thanks Jane!).  I asked her to come early so we could focus on K without him feeling left out.  He left at 12:30 this afternoon and we miss him already.

Now we wait.  We wait for her to feel better.  We wait for her test results and we wait to learn about her new protocol.  793 days to go. 

Day 29 & 30

Yesterday was great.  We made cupcakes, jello jigglers and cookies.  K received a ton of baking supplies 2-days ago (in addition to my Target run) so baking was the theme of the day.  We took a nap around 12 and returned to cooking.  She was exhausted all day and also went to bed at 7pm.  I was worried her exhaustion meant her blood counts were low and that she might need a transfusion again.

Last night I spent a few hours at a neighbors house after K went to bed.  Usually I am overwhelmed with a group of people around but not last night.  It was nice to get out and it was the first time I let down my guard.  It was nice to laugh.

Today was the day they tested her bone marrow for percentage of blasts (cancer cells) and it was also the day she couldn’t eat all morning.  She actually woke up at 2am super thirsty and I cheated by giving her a big gulp of water.  We got up, gave her the dex (steroid) with a swish of water and then that was it until after the procedure. 

K and dad waiting for the procedure.
Grumpy face says "I'm hungry"

Post procedure "I feel weird"

The procedure was scheduled for 10 am and thankfully she didn’t need blood or platelets but they still didn’t start until 11.  She was not a happy camper and was miserable about food.  Thankfully all went well. 

It’s hard to sit and rub her head knowing needles are going into her back.  Since her eyes are open while she is under the twilight anesthesia, I couldn’t cry but wanted to.  I didn't want K to see me cry, even though she was “under”.  Dad got the procedure view, luckily I was by her head and didn’t see a thing.

Now we wait.  We should know on Tuesday her risk level.  Doc will let us know on Wednesday the next course of treatment.  Thursday is another spinal.

We came home and took a nap.  The plan is to head to Buld-a-Bear this evening.  Her blood counts were awesome so we can take a trip to the mall.  We still can’t take her to the movies (per the doc) but wide-open spaces are OK.  Still trying to figure out this rationale but I’ll venture out.  

Maddox has a nice busy weekend planned.  He has a play date this evening, swimming tomorrow morning, followed by a sleepover and yet another playdate on Sunday.  Lucky kid.

Day 28

Today went well. Gene and I both went to work and K stayed home with Gala.  I got a total of two calls from home.  The first one was from Gala to see if she could paint Kennedy’s face with the face paints someone got her to decorate her soon-to-be-bald head (K was begging).  I said “yes” of course, is there any other answer?  The second was a call from Kennedy to tell me Maddox called her “stupid”.  I guess this was another good day. 

I also had great luck today with the American Red Cross for a blood drive (LifeSource is still ignoring me).  Someone at Loyola passed my information along to their Red Cross contact and the woman called me back, super excited about our blood drive proposition.   We meet next week so I will keep everyone posted on the dates (if you want to donate).

I took my lunch at Target today and bought a bunch of spring treat accessories (molds, cookie cutters, etc) for my date with K tomorrow.  I also got finger paints and large sheets of paper – tomorrow will be messy!

It feels good to blog about nothing important.  It means K is feeling well and my emotions are under control.  One more full day until clinic.

(Wrote this yesterday but was too tired to log on and post)