Clinic Day #23

November 25, 2009

I wish I had taken a picture. Lily, Tanner’s friend who also has ALL, was at clinic today. She, Tanner, Sara (the child life specialist), and two other little girls sat around a table in the middle of the clinic and played UNO. Tanner and Lily were accessed, with tubes hanging out the bottom of their shirts. One of the other kids had an IV pole. It was such a normal scene in the middle of an abnormal situation and was testament to the fact that kids will find a way to be kids, no matter what is going on with them.

When we were getting ready to leave, Tanner and Lily sat next to each other in infusion chairs to remove the sticky patch placed over their ports to keep the needle stable. Lily casually said, “Tanner, do you need some Remove? I have some you can use.” Tanner took the little packets and then both of them pulled up their shirts and began rubbing the pads along the patch to try to loosen the sticky stuff. They each worked for a couple of minutes getting the patch off, then Lily unceremoniously pulled her own needle out and handed it to her Mom while Tanner asked if I would take hers out instead of waiting for the nurse. She looked so impressed that Lily took her own needle out and I told her it must be because Lily is eight. “Ohhhhh,” Tanner said, as if that made perfect sense. It was hilarious and reminded me that there are good moments to be found in even the most challenging circumstances.

We were so hoping to find out Tanner’s neutraphil counts had risen to at least 750 today so we could spend Thanksgiving with John’s family, but it just didn’t happen that way. Tanner’s counts had gone up just 60 points since last week and were at just 440. Anything below 500 is considered severely neutrapenic and as Tanner’s nurse said, “I wouldn’t risk it if it were my daughter.” That was all I needed to hear.

Tanner was really disappointed. She burst into tears right there in the clinic and cried several times on the way to the car. But, as always, she found a way to be happy. She and I are going to cook Thanksgiving dinner together tomorrow – something we have never done and she is very excited about. Anyone who knows me knows I don’t “cook” so much as “heat,” so cooking with Mommy is a real treat.

As always, people are so kind to us. Lauren, in John’s office is bringing us a fried turkey, my friend Kim is supplying a pumpkin pie and Ashley is giving me some of her cranberries. That leaves a couple of side dishes for Tanner and I, which I am capable of.

Hopefully, Tanner’s counts will continue to rise and we can start Long Term Maintenance next week. It wasn’t really expected that they would be any higher than the were today; this is just part of this phase of treatment and why they give the kids two weeks off chemo for counts recovery. She probably bottomed out on Sunday or Monday and has just started to climb. No big deal if they aren’t up high enough to start next week, we’ll just wait another week. But, the sooner we start, the sooner she will get to the point where we can have a little more freedom. Freedom is more valuable than gold and diamonds to us right now.

I’m off to blow the dust off a cookbook or two.

Love,
Beth

A Long Day at the ER

November 22, 2009

Since Thursday, when we went in for clinic and Tanner’s hemoglobin was so low, we’ve been keeping a close eye on her for signs that it was dropping even further or that it was producing symptoms that made her uncomfortable. After asking me to take her to bed at 6:30 last night, she woke up this morning with a headache and was very washed out looking. We decided not to wait until tomorrow to take her to clinic, so John took her to the ER around 11 am.

They arrived home at 9 pm with fresh blood and platelets in her system, tired, but with rosy cheeks and red lips. Her hemoglobin had dropped down to 6.6 from 7.2 on Thursday (anything under 8 is grounds for a transfusion, but Tanner was not showing any symptoms then so we decided to wait) and her platelets were down to 28 (normal is somewhere around 300). So, two bags of platelets and one bag of blood later, she should be feeling a lot better. Her neutraphils have, thankfully, not dropped from Thursday, so hopefully those have bottomed out and will start going back up so she is less vulnerable to infection.

We weren’t surprised or too upset that she needed a transfusion; it’s almost expected during DI and Tanner has really been lucky that this is only her second transfusion since diagnosis. We’re just thankful that she hasn’t caught anything while her immune system has been so compromised the past few weeks.

The anemia didn’t slow her down a whole lot this weekend. Saturday, Jessica, our friend, babysitter and petsitter extraordinaire, came and played with the kids all afternoon while John and I cleaned out the attic and garage and went to lunch together at Puckett’s in Lieper’s Fork. We were playing at the elementary school playground next door to the house when Jessica got there and Tanner never slowed down until Jessica left. They danced, played wii, and pretended all the day long. I think Tanner was just happy to see someone else but John, Jake and I. It’s been a while.

After John and Tanner left for the hospital today, I shaved Jake’s head. He wanted to look like Daddy and Tanner. All those little curls in the trash can. He loved it, though! I thought it was so cute that he wanted to look like them.

Jake's new hairdo

Jake's new hairdo

It looks like it will be another “keep to ourselves” kind of week… at least until Wednesday when we get our next counts check. That will let us know whether we can see John’s family for Thanksgiving or whether we need to keep it simple here at home with just us. It would be great to see John’s family, but either way will be fine; the way I see it, we have a lot to be thankful for.

Love,
Beth

Clinic Day #22, the Last Day of DI !!!

November 18, 2009

photoWhat a day! We celebrated extra large thanks to the kindness of so many people. We started by going to clinic in our Bye, Bye DI !!! t-shirts. The nurses and doctors loved it. We busted into the clinic in full celebration mode and it was great to start the celebration among our cancer compatriots. Everyone in clinic congratulated us and it was actually really fun to go today – lots of hugs all around.

Tanner’s counts, as expected, were very low all around. Her neutraphils (big infection fighting white cells) were at 380 (to give you an idea of how low this is, I had some blood work done last week and mine were at 6,000) so her immune system is every bit as compromised as we suspected it might be and we are very glad we’ve kept to ourselves lately. What we were surprised by, however, was her low hemoglobin level at 7.2. This is the lowest that Tanner’s level has been since diagnosis. I told the doctor before we got counts that there was no way she needed a transfusion because her energy level was crazy. With a hemoglobin level of 7.2, she should have gotten a transfusion, but because she hasn’t been showing symptoms, we decided to wait and see if she recovers on her own or if she starts showing fatigue, blueness or shortness of breath.

I didn’t even notice how low her platelet level was until we got home and she had a little place on her head where she scratched herself. It was bleeding just a little and I put some Neosporin on it. Fifteen minutes later, I noticed it was still bleeding and I thought, “Uh oh.” I checked her platelet level and sure enough she had gone from more than 300 last week to only 58 this week. Yikes! A bandaid solved the problem, but it’s a little weird.

It remains to be seen whether her counts have bottomed out or whether they will come down yet some more. We go back in on Wednesday for counts to see if we can celebrate Thanksgiving with John’s family or if we need to stick to ourselves at home.

This afternoon, we had a surprise visit from Tanner’s friend, Lily, and her mom, Larisa. Lily is 8-years-old and, like Tanner, has ALL. They brought a video and a congratulations card; they know what a milestone it is to get to this point.

Tanner and I sat at the kitchen table and read post after post from Friends of Tanner and Tanner Time. She was so happy to hear from you all. In a way, I think it was the first time she began to understand that this day was a big deal.

IMG_1291After some crazy dancing to our new Roger Day CD, we heard Daddy come home. He brought pizza and a cake and we sat around the table eating pizza and laughing about our day. Then, John got a text message that said, “special delivery on the front porch.” OH MY GOSH!!! It was a party in a box! It was a huge box, decorated on the outside with a huge balloon bouquet, a beautiful flower arrangement, cards, party hats and blowers, a party mix CD, and best of all, a piñata!!! It was from two families who have been such rocks for us. These are the girls who just show up when you need them and who are so thoughtful I know I will never be able to repay them.

So, then the party was on! We ate cake and whacked the heck out of the piñata and let them eat candy after just having huge pieces of chocolate cake. It was a day without description. A day that cancer could not take from us. A day we lived without regard to what comes next. The perfect day.

Thank you all so much. You made a little girl and her family very happy today.

Love,
Beth

Bye, Bye DI !!!

November 18, 2009

IMG_1286It’s here. Tomorrow is the last day of DI… the last day of the most intensive part of leukemia treatment… the last day before we enter LTM (Long Term Maintenance)… a day we have been working towards for six long, grueling months. I can’t believe it’s here.

We’re celebrating. I made t-shirts for Jake, John, Tanner and I and we are going to wear them to clinic tomorrow. I think we are also going to pass out something to the staff – I’m not sure what yet – maybe donuts? — to thank them for making this journey with us and for, literally, being our saviors.

John is picking up a cake on the way home from work tomorrow so we can celebrate with a special dinner. Depending on how her counts turn out tomorrow, we may invite some friends, but it’s not likely; we expect her counts to be low.

So, here’s how our friends and family can celebrate with us. Send a comment to Tanner congratulating her on the last day of DI. I want her to open up Tanner Time and Friends of Tanner and see how many people love her and realize what a big accomplishment this is.

We’ve really been celebrating all week. We’ve been visiting playgrounds and stopping by church to drop something off and getting to see the whole church staff (aka wonderful friends) and giving them hugs. Tanner got to spend the day with Aunt Beth today at her house (I think it must have magical properties the way our kids plead to go there) while Jake and I played some mean wii Star Wars. We’ve just been finding ways to remember how great it is to feel good and have the energy to have fun.

Yesterday was a great day. In fact, it was a ROGER DAY!!! Roger Day is a children’s recording artist who is big time at our house and he was so nice to stop by and bring Tanner his newest CD, Brain Freeze. It’s AWESOME!!! If you’ve been following our story long enough, you might remember that Roger came to our house back in July to have a small concert for a handful of kids and we had the best time. He is a great entertainer and a great person and he made my kids’ day.

Tanner and I in our new hats

Tanner and I in our new hats

We had another visitor yesterday as well. My friend Pat dropped by with hats and chicken noodle soup… the perfect combo. She had seen this adorable pink fuzzy hat for Tanner and brought it for Tanner and a hat for me, John and Jake, too. What a nice surprise. When she left we noticed a little gift bag on the front porch that contained an envelope full of cards from a 1st grade class at Tanner’s school. There were pictures of each child on the card and Tanner loved reading them and remembering all her school friends. Then, John came home with two new wii games sent by a long-distance friend who has recently relapsed with lymphoma. Mind boggling to think they thought of us when they have so much on their own plates.

It’s a lovely world where hats, chicken noodle soup and Roger Day all show up on the same day. Help us celebrating a life worth living tomorrow.

Love,
Beth

The Struggle

November 16, 2009 We continued our quest for uncrowded playgrounds today… neighborhood playgrounds are almost never occupied, just in case you ever need to isolate your kid who still feels good enough to play! Today we went to Liberty Downs playground in Brentwood. We had a contract on a house in that neighborhood when Tanner was diagnosed, which we let go, of course. It’s one of my favorite neighborhoods, though. The whole thing feels like a beautiful park.

They have a nice playground next to a beautiful lake and a little stage where they hold neighborhood events. There is lots of space for running and some beautiful trees, so it’s one of our favorite spots. Today, though, it almost proved too much for Tanner.

To get there, you have to park at the top of a hill and go down the grassy slope to the lake and then down another steep hill to the playground. As soon as we got out of the car, Tanner cried out in pain – her left leg. She wanted me to carry her, but I encouraged her to walk, hoping it might work itself out. It was most likely nerve pain, combined with some pretty marked muscle loss from the most recent steroid bout. She limped down the hill with a grimace on her face, but seemed to be moving a little better at the bottom. She began running, which is once again a real struggle for her. She can do it; it just looks very awkward and like she is running against a current that keeps her from getting anywhere very fast. Her legs don’t seem to really cooperate with the will behind them and her head jerks and bobs with the effort of trying to get her body to do this simple thing that she would like to take for granted.

She fell twice while trying to kick the soccer ball. I had to lift her up into and out of a low fork in a tree she would have scaled easily before the leukemia. She struggled mightily, and with typical Tanner resolve, to get up the “rock wall” on the playground that Jake climbed up in seconds. She fell again, dancing on the stage and scraped her ankle. And, finally, when we left, she had the two big hills to face in order to get back to the car.

Normally, I would have given her a piggy back. I’m all for using play as therapy, but she was beat from an hour of hard play and it’s about 125 yards, mostly uphill. But, I had two soccer balls and some coats to carry. So, I put my hand under her upper arm to help support some of her weight up the first hill. She worked so hard. At the top, she stopped, hands on her knees, to rest. She looked back at the hill, panting, and said, “Corinne could just run right up that hill.”

Corinne is Tanner’s best friend and Tanner is right; she could have run right up. She is strong and athletic and full of energy. While I would pit Tanner’s energy against almost any kid, her physical strength has waned to the point that I wonder whether she will ever fully recover from the damage the drugs and the steroids are doing. Her upper legs are so thin, she looks like one of those starving kids in Africa; there’s no muscle there.

She has never fully gained her physical strength back after the first round of steroids back in June. She gained a lot back, mind you, and surprised me with what she was able to do. But, it was never normal. Now, this second round, combined with the 10-day stint in the hospital, has put her almost right back where she was before. I worry what the five-days-a-month of steroids that she will take for the next year and 10 months of Long Term Maintenance will do to her. Theoretically, she has the rest of her childhood to get strong again, but I still wonder what 2 ½ years of not being able to use her body to it’s fullest will do long-term. Not to mention the possibility that the long-term steroid use can cause avascular necrosis, or bone death, which can have a permanent debilitating effect (one of our leukemia friends is dealing with this now).

It’s scary and seems unfair, but I try to remember this: someone (I don’t remember who) told me that they knew someone who had leukemia when they were young and that it was a miracle this person survived at all, because leukemia at that time was a “death sentence.” It’s true. Even just 10 years ago, Tanner’s chances of beating this would have been notably different.

So, I try to ask myself, “If a doctor came to me when Tanner was diagnosed and said, ‘She will die within a month without treatment, but the treatment is very tough and can have some lasting side effects,’ what would we choose?” Of course, we would choose the opportunity for life. If it means she’ll never be a super athlete, it’s still better than the alternative, right?

I’m trying to learn to be more grateful for the treatment. For the chemo, the steroids, the plethora of medicine. It’s so easy to despise, but really, it’s a lifesaver… literally.

Love,
Beth

A Nice Weekend

Just a quick post to say we had a nice, normal, relaxing weekend. Aside from some occasional nausea, Tanner continues to feel really good even though she has been taking IV chemo for the past four days and continues her daily oral chemo through Thursday.

Thursday is her last day of chemo for Delayed Intensification! John and I cannot believe it. We’re going to have a little Bye, Bye DI party for her (just us, of course, since her counts will likely be very low) with a cake, etc. It is a huge landmark in this journey and one that marks the end of the really rigorous portion of leukemia treatment. We feel so lucky to have made it this far with so few delays. This portion of treatment is supposed to last 6-9 months and Tanner has made it in 6 months so we feel really fortunate.

We played at the playground (see Tanner’s post earlier today) this morning and met some other kids. Tanner asked initially for her hat to cover her head, but got busy playing and handed it to John to hold. She was hanging on a little bar that glided across a fixed crossbeam, a zip-line of sorts, with two other kids and having a great time. It was a little nerve-wracking since her port was accessed, but she made it very clear I was not to tell her to be careful in front of her new friends! Those kids never asked about Tanner’s hair. In fact, at one point, she asked them if they knew why she didn’t have any hair and the boy said, “You have cancer,” and that was the end of that. I love kids… they’re so accepting.

Great weekend, looking forward to an uneventful week. We’ll be pretty isolated since we have to assume her counts are really low, but we’ve been enjoying this good weather and taking advantage of it.

We’re lucky, all things considered, to have arrived at this point without any more difficulty than we have had.

Love,
Beth

Clinic Day #21

I love this picture of Tanner.  I think she looks so at peace with who she is.

I love this picture of Tanner. I think she looks so at peace with who she is.

November 12, 2009 Today was our fastest clinic day ever, which seemed only fair since last week was our longest! Tanner’s counts had dropped, but not terribly. Her neutraphils were down to 900 from 1,100 last Friday, which means she is neutrapenic, but is still so much better than I expected. The chemo takes 7-10 days to drop counts and we started back on the at-home IV ARA-C chemo today, so the doctor warned us that in the next couple of weeks, we should expect to see those counts go down significantly. We will administer the ARA-C at home for the next 3 days and she will continue to take the oral 6-TG until next Friday. The next two weeks, we just go in for counts and to be sure she doesn’t need a transfusion. If her neutraphils are back up to 1,000 at week 3, we will start Long Term Maintenance on Dec. 4. Unbelievable!

The doctor said we will need a couple of months of maintenance under our belts for her to be cleared to return to school. Tanner reminded him that we also couldn’t go back if flu season was bad (she really did!). So, maybe February… that would be such a gift.

After clinic, we went for shrimp scampi at Captain D’s (Have I mentioned her recent obsession with shrimp? It was pizza for a while, now shrimp and I think we might be moving on to chicken noodle soup!) and stopped by John’s office so a few co-workers/friends from out of town could come down and give her a hug. Then, we went to pick up Jake at Aunt Beth’s house. On the way home, she fell asleep in the car and stayed asleep for a while after we got home. She had a playdate with Corinne and Laurel and was tired again at bedtime. Maybe yesterday wore her out!

Anyway, it was a good day and a good clinic visit. Jake continues his cold and I continue to be terrified that Tanner will catch it. Have you ever tried to keep a two-year-old from spreading his germs? Impossible.

Thanks for all the love and support coming our way. We are carried by the love, prayers, good wishes and acts of kindness of friends and family. People never seize to amaze me. Last week, I looked out the window to find my neighbor blowing the leaves off of the front lawn. When he was finished, I went out to thank him and give him a hug. He is a cancer survivor himself and while we embraced he said simply, “I just want to do something to help.” I don’t even know what to say about this and the countless other kindnesses that have come our way. Thank you doesn’t seem like enough.

Love,
Beth

How Much Chemo Does it Take…?

November 11, 2009 How much chemo does it take to keep a good girl down? Apparently more than Tanner has had, and that’s saying something. Tanner continues to feel good and her energy level is actually increasing, despite the fact that her counts are likely tanking. I tried to tell leukemia that it picked the wrong girl!

We played all morning at Liberty Park playground. She set up an entire Barbie neighborhood while Jake napped, we did some homework, she wrote two stories for her teacher, she had her lesson, ate dinner, played wii and then she read two stories to Jake before bedtime. I was tired, but she didn’t seem to be.

Tomorrow is clinic day. We’ll just go in for counts and an IV dose of ARA-C. Then, she’ll come home accessed again for another 3 doses of ARA-C, like last week. She continues to take 6-TG oral chemo daily until next Friday. Then, we are done with DI… yay!

Jake has a yucky nose so pray she doesn’t get it (or that I don’t for that matter, since I can’t seem to get a cold without getting bronchitis these days).

Also, special prayers for Madelyn, the little 3-year-old who was diagnosed with ALL when we were in the hospital last time. She is still at Vanderbilt and I know how tired her family is getting and how badly everyone wants to get home.

Tired, late, going to bed.

Love,
Beth

Courage

November 10, 2009

Tanner, Jake and I went in search of an uncrowded playground yesterday. We ended up at River Park in Brentwood. There were a few little boys Jake’s age, but not really any one else around. Tanner and I sat on a dinosaur together and watched Jake play with three little boys. She was not wearing her wig… she hasn’t worn it for even one minute since she shaved her head… and had a Hannah Montana bandana wrapped around her head.

While we were sitting there, another Mom sidled up to us and tactfully said, “Where does she go?” She caught me slightly off guard, but only for a second before I replied, “Vanderbilt.”

She told Tanner she liked her bandana and then stood next to me as we watched Tanner run off to play. Then she said, “My son went to St. Jude, but finished his treatment at Vanderbilt; we lost him when he was 12.”

We hadn’t even exchanged names yet, but I already knew her. I knew the long hours she spent in hospitals, dosing out medicine, waiting for test results, soothing a sick child, wishing it could be her instead of him. I knew her without saying anything else. I knew her except for that hole in her heart, which I have had to face but never had to actually accept.

After telling her how sorry I was for her loss, I said, “I can’t possibly know what it feels like to lose a child, but I can imagine it… because I’ve had to.” She just nodded.

John and I have had to face the possibility that Tanner might not live at least twice; once when she was lifeflighted to Vanderbilt for a drug reaction and doctors could not tell us whether she would live or die; and the other when she was diagnosed with leukemia. It’s a feeling you can’t really appreciate unless it’s happened to you, just like the feeling of actually losing a child is something I’ll never truly understand, although I think I might have a better idea than most.

The thing that struck me about this woman, who had lost her son just 4 years ago, was that she smiled when she talked about him. She explained that just last weekend, they had hosted the Hoover Run for Hope in Brentwood, in honor of her son, Liam Hoover, and that they had raised over $40,000 to give to St. Jude and Vanderbilt to help families of children with cancer. She and her husband had found a way to turn their grief into something positive and she was amazing in her strength.

This Cancer Parent Club is not one I ever wanted to join, but now that I’m here I find I meet the most amazing people. Fighting this horrible disease can sometimes bring out the best in someone. It’s a by-product of facing your worst fear every day and trying to make the best of it. I’m better for knowing the people I have met through this process, including Michelle Hoover, Liam’s mom. I’m touched by the stories they choose to share and by the way they unfailingly put aside their own worry or grief to try to soothe mine.

My Mom sent me an email from a friend of hers that had a quote at the bottom that struck her as appropriate and meaningful and I agree:

Courage does not always roar. Sometimes it is a quiet voice at the end of the day, saying… “I will try again tomorrow.” –Mary Anne Radmacher

Yesterday, a quiet voice sidled up to me at a playground and showed me how to keep trying even when everyone would understand if you gave up.

Love,
Beth

Still Feeling Well

November 9, 2009 Despite being somewhat fatigued, Tanner continues to do well under this deluge of chemo, which proves that I will never understand this whole process. Seems like the simplest thing (steroids) takes her completely out and then she does well under the heaviest treatments. She definitely does not have her normal energy level; she spends a good portion of the day sitting or lying down, but she is still able to get out and ride a bike or play briefly on a playground. She is having a little bit of nausea, but it is very controllable with zofran. We are so grateful.

Although we’re ecstatic she’s feeling so well, there is still this weird creepy feeling; we know this chemo is designed to kill everything that hasn’t been killed to date, so her counts are most certainly plummeting, despite her feeling pretty well. These are dangerous times as she will be very susceptible to infection. We are holding our breath to see if we can make it though the remainder of DI (Delayed Intensification) without another hospital stay or a life-threatening infection.

I’ve been administering a daily IV chemo called ARA-C to Tanner and she is taking a daily oral chemo (TG) as well. Tomorrow is her last dose of the IV chemo until Thursday, when we will go to clinic. There, they will check her counts and give her another dose of ARA-C. Then we will administer a dose-a-day for three days afterwards. She will finish taking the TG oral chemo in 10 more days and then that is the end of chemo for this phase. The remaining two weeks are for counts recovery as neutrapenia (neutraphils below 1000) is described by the doctor as “inevitable” during this phase. Tanner’s neutraphils on Friday were at 1100, just 100 above what they needed to be to start this last two weeks of treatment, so we expect them to be very low by the end of this week. Scary stuff, to say the least.

So, we’re laying low at the Page house. We’re really not taking her anywhere these days; just trying to make it through to long-term maintenance and, hopefully, a great increase in freedom. We’re even keeping Jake out of school when her counts are low to try to prevent him bringing anything home to her.

I didn’t realize how little actual chemo she had left in this phase until today. The chemo roadmaps they give us are sometimes a little difficult to read and I thought the chemo would last the whole next month, but the last two weeks are reserved for counts recovery so we can then begin Long-Term-Maintenance. I had a moment of disbelief… could this day we’ve been working towards since June be almost here? I want to celebrate, but would seem to be tempting fate. It’s just 10 more days of chemo, but her counts will take a little while to recover so it’s a month-long or more period where she will be very susceptible. It’s a little like a minefield and I feel the tension of making our way through with setting off a bomb.

So, we’ll do what we have done so often during this whole process… we will choke back our fear and take it one day at a time.

Maybe we should just start over and ignore everything I’ve written prior to this tonight. Here’s my new post: Today was a good day.

That’s all we need to know for now.

Love,
Beth