Shrinking

Things have gone very well over the last few days.  It is so nice to see Madeleine laughing and interacting with other people.  Her counts have pretty much recovered and she is off of all medicine except for her blood pressure meds and the nutritional support (TPN) that she gets through her line.

She had a CT scan done yesterday because her doctor wanted to know if the chemo was having any effect on the tumor.  I was pretty sure that I did not want to hear the results of the scan. We've had nothing but bad news for nearly a month and I couldn't face more of it.  When I asked one of the doctors what the results were this morning he said that he didn't know yet but that he wasn't expecting too much change since it had only been one cycle of chemo and normally they don't even image until after two cycles.  He did say that he was very pleased with her clinically - she is walking well (if not far, yet), she is peeing on her own without residual, her appetite is somewhat back, and her counts recovered quickly.  I ran into him later in the hallway and he told me that he was very happy with her scan and that it showed that the tumor is shrinking!  I don't know how much it is shrinking yet because we don't have the final report with the measurements and all that but he said that it appears that it is coming off the renal arteries, and shrinking in size.  Also, the fluid in her lung is less than what it was on the last x-ray.  This is great news!!

We just signed the consent for cycles 2 &3 of chemo.  These cycles shouldn't be as difficult as the first one was.  Once she has recovered from cycle 2 we will go to Denver (pending insurance authorization) for a stem cell harvest.  This is a process where they will extract her healthy stem cells from her blood, and then freeze them.  The extraction is not painful, and they will most likely use her broviac line.  Somewhere down the line she will get an extremely high dose of chemo that will wipe out her bone marrow.  The harvested stem cells will then be put back into her so that she can continue to make blood cells and platelets.  This type of stem cell transplant is easier to endure since it is using her own stem cells rather than those from a donor.

On Thursday Madeleine will have a surgery to have a G-tube placed.  This will allow her to "eat" even when she can't or won't.  The current nutritional "food" that she is on cannot be used for more than a few weeks.  This will be better anyway since the TPN typically has to run 24 hours (meaning carrying around a pump constantly), and with the G-tube we may be able to only run it at night while she is sleeping.  She can still eat normally when she feels like it.  So, they are slowly weaning her off of the TPN and we are trying to increase the foods that she eats by mouth.  Yesterday she ate 6 sushi (veggie) rolls as well as some other things.

Another awesome thing is that we may be coming home soon!   Of course, we have to come back on Monday or Tuesday for cycle #2, but a weekend at home, together, would be amazing.

One of the perks of being a cancer kid (ha) is that Madeleine gets to have a wish granted through the Make a Wish foundation.  Originally she discussed wanting to go on a Disney Cruise.  However because she is not currently able to travel (the fluid in the lung thing means no air travel - although hopefully that is resolving itself) we spoke with her about doing something locally.  Our social worker gave us some possibilities and Madeleine has chosen to have an awesome playhouse built in the backyard complete with trampoline and zip line.  Apparently this can be built at any time we just need to pick a date.

It's hard not to feel optimistic when we have received such great news.  Everything I said in the last post is still true, and she still has a huge uphill battle to fight to get rid of this thing.  It is nice, however, to feel like we are winning the first fight.

                                                               With her new wig.

Relapse

I am assuming that everyone that reads this already knows what is happening.  I will not pretend that I have some "audience" out there that has been waiting 2.5 years since my last post here for an update.

We had a good run there.  I didn't update for years because there was nothing to update.  I had the same complaints, worries, and concerns as every other mother out there, and that was nice.  It was nice to not have cancer be a part of our everyday lives.

However, here we are again.  As of this post Madeleine has been inpatient at UNM for 25 days.  Early this year we learned that the tumor was growing.  A biopsy told us that it was 99% ganglioneuroma (the benign form of neuroblastoma).  We celebrated.  Madeleine had to have surgery to remove some of the tumor that was compressing her nerves and causing her pain and weakness.  After the surgery we celebrated again, thinking that this was the last surgery, the last hurdle.  Six weeks after the surgery things started to go bad.  The pain returned, Madeleine had no appetite and was losing weight, and she couldn't walk more than a few feet without crying.  An MRI showed that the tumor had been growing aggressively. It was given a label:  Relapsed neuroblastoma, stage IV.

There is disease in her knees and in her bone marrow as well as the primary tumor that has grown up her spine and into her chest cavity.  The tumor is encasing her renal arteries and aorta causing her blood pressure to be very high (this is now under control with medicine).  There is involvement in her left lung, and perhaps her bladder may be somewhat compromised as well.  There was also a spot on her pelvis which was surgically removed and biopsied.

Madeleine is now recovering from some high-dose chemotherapy (doxorubicin, vincristine, and cyclophosphamide for those that have asked) - her oncologist went off-protocol and started her on what would normally be cycle #4 of chemo to attack this thing as fast as possible.  Her white blood cells are slowly rising.

A few days ago it was discovered that she had fluid in her left lung, and it was drained after she started having some respiratory distress.  The fluid is blood and neuroblastoma cells.  The tumor has invaded her lung and is causing a bleed.  Subsequent chest x-rays show that the fluid continues to accumulate - although possibly not as fast as it did previously.  This is currently the most serious and pressing issue.  We will speak with the surgeon hopefully this weekend to see if anything can be done surgically. 

Madeleine's chances of surviving this thing are not good.  Stage IV relapsed neuroblastoma offers a very poor prognosis, coupled with this bleed in her lung is even worse.  She has perhaps a 25% percent chance, but that number is pretty nebulous as this is an extremely unique tumor (or so we are told over and over again).  This has all happened so fast. 

She will not, unfortunately, be leaving the hospital any time soon.  If the lung can be stabilized then we will remain inpatient through the next round of chemo which is coming up fast.  After that the plan is to get her to Denver for a stem cell harvest.  They don't do this at UNM.  All of this also sort of depends on the results of an MRI that I believe she will have next week.  If the tumor has continued to grow in spite of the intense chemo than it may be best to stop treatment altogether.

For now, Madeleine's appetite has returned and she no longer has any nausea.  She is smiling and joking and sort of back to her old self.  For today, we will hang on to this.  We can only take this thing one day at a time.  

New Digs

We are no longer Californians. And that feels strange.

But, I really like it here.

We moved on New Years Eve. I flew with the girls, and then rented a car to head up the hill to Los Alamos. At the time, New Mexico had just experienced a huge storm, with way below freezing temperatures. When we got to the hotel it was somewhere around nine degrees. Nine! Coming from San Diego, where it's always around 70, this was a huge shock.

Ryan definitely had the most difficult journey. He drove, with Humphrey dog, and it took about 18 hours because of road closures due to the storm. He had been sick before the trip, but thought that he was on the mend and well enough to drive. Somehow he came down with bronchitis during the trip and barely made it to the hotel that night.

When we first arrived:
Madeleine was beyond excited to go out and play in the nine-degree weather. That lasted about two minutes.
It took a long time for our furniture to arrive, a week, so we camped out in the hotel for a few nights, and then eventually moved into our new house. Check out these icicles on the kitchen window!

Ryan was off work for a couple of weeks, so we were able to take some day-trips to Taos, Santa Fe, and Bandelier National Monument.


On the way to Taos.

This picture doesn't do this justice, but this is Valles Caldera, a volcanic crater. It really is stunning. They have cross country skiing, snowshoeing, hunting, and a bunch of other things there. There is even a half-marathon at over 8,000 feet. I'd like to consider it, but just don't think I'll be able to train for it by June.

There are our neighborhood resident deer. We see them every couple of days, just walking down the middle of the street in front of our house, or jumping the fence in our neighbor's backyard.

So, we're settling in. Haven't made any friends yet, but have started to scope out the places with other moms and kids. We're looking at a preschool for Madeleine next week, as well as dance classes in Santa Fe. She's obsessed with ballet lately.

Laurel loves her jumpy!

Ballerina girl.

Long time

I can't believe that it has been about six months since my last post! The fact is, I'm not really sure what to do with this blog. Now that Madeleine's tumor is stable there isn't much to share in terms of medical updates. We recently saw the neuroblastoma specialists in LA, and she was happy with Mad's recent scans and doesn't see any need for further biopsy at this time. She still has to be monitored, as the tumor is still active.

We also have to watch out for secondary effects from the chemo that she received, such as secondary cancer, problems with infertility, etc. My biggest fear is that Madeleine won't be able to have children. I worry about this all the time. It was very reassuring to hear that with the amount of chemo that she had, her doctors don't think that infertility will be an issue. There is still a likelihood that she could have some sort of secondary problem, but from what we've been told she may just beat this thing without any issues...except for a couple decent scars, and a weakened right leg...but I'll take that.


In OTHER life news however, there is a fair amount going on. In August Madeleine became a big sister:She loves her little sister, Laurel, and is surprisingly a big help to me.


Madeleine has been enjoying her dance class:


And logging in some beach and friend time:


Shortly after Christmas we are moving to New Mexico! Ryan got a good job at the National Lab in Los Alamos, and we are looking forward to getting out of fast-paced Southern California. We will definitely miss our San Diego friends, but I think this will be a good move.

Preschool

I just dropped off Madeleine for her first day of preschool. She is so excited. She wasn't worried at all, and was ready for me to leave the second we got there :)

In the picture above you can sort of see her new AFO brace on her right leg. She's had it for a couple of weeks and is still wearing it, so I guess that's a good sign. The brace is to help straighten out her foot so that she doesn't roll onto the inside of her foot so much. We've noticed a lot of improvement in her walking, jumping, and running even before we got the brace, so she's continuing to make accommodations for that weaker right leg.

And now I have three glorious hours to myself!

Medical update

Madeleine's recent MRI shows that the tumor is stable and there hasn't been any growth for the last six months! This is great news. Her VMA/HVA levels continue to be high, which means the tumor is still active (but not growing). We have been told that these levels can remain high for years, so while we'd like to see them dropping, we aren't very concerned about this.

The stable tumor means that we now get to do MRIs every four months (instead of every three) and urine tests every two months (instead of every month).

Madeleine's cancer diagnosis also means that we were able to secure free cord blood banking for baby #2 - a huge savings for us, not to mention the potential life-saving ability of cord blood. I am 31 weeks and feeling great!

Recent pictures