Tag Archives: Consolidation

Day 45: New Page

I’m having a good time slowly redesigning the blog. While this has been a great way for us to keep family and friends updated, I have bigger plans! My hope is that, eventually, this website can be helpful to other parents who are, sadly, furiously googling, “My child has leukemia.”

So I added a new page under the Elsa’s Observations tab: Elsa’s Leukemia FAQ. If you don’t feel like following the link or you’re reading this in an email, here is what it says:

What the heck is going on with Elsa?

On July 21st, 2011, Elsa was diagnosed with Pre-B cell Acute Lymphoblastic Leukemia (ALL). Needless to say, that was an awful day. After Elsa’s first surgery on July 23rd, one of our doctor’s approached us, smiled serenely, and said “Now we can start fighting back.” We are taking that to heart.

What the heck is leukemia?

Here is how we, as parents, understand the disease: ALL is a cancer of the bone marrow and blood. Your bone marrow is responsible for making all of your blood cells, but in ALL, your marrow goes nuts and starts making billions of idiotic, immature, white blood cells called lymphoblasts. These lymphoblasts are supposed to grow up into mature, infection-fighting, white blood cells. Like I said though, they are idiots and never grow up and do their job. They are permanently stuck in their tween years, insisting on being driven around everywhere by their parents while they sit in the car, sulking and texting their friends all day long. When you ask, “How was school today lymphoblast?” they reply with a shrug and say “Boring. Gawd Mom, why are you so annoying!?” Lymphoblasts never say ‘please’ and ‘thank you.’

So these lazy leukemic cells sit around in Elsa’s marrow and blood stream, crowding out all the other good cells. By the time she was diagnosed, the lymphoblasts had turned Elsa’s bone marrow into a thick, useless soup. Our doctor said that, on diagnosis, when you try and pull out some bone marrow for examination (known as a bone marrow biopsy), it’s hard to draw the marrow out because it is so thick with stupid teenager cells. They can’t even put their cell phones down long enough to be biopsied!

Since bone marrow makes red blood cells (to carry oxygen), platelets (for clotting), and white blood cells (to fight infection), kids with ALL have trouble with all these things. Their bone marrow can by up to 95% stupid cells, which only leaves 5% capacity for making normal, useful cells. We were lucky because Elsa’s only symptoms, at diagnosis, were bruising and petechiae (little red spots that indicate bleeding under the skin), because her platelets were so low. A lot of kids can be much sicker at diagnosis with fevers, bleeding, and pain.

Left untreated, ALL is fatal within weeks or some months. Our doctors said that Elsa’s leukemia probably had started approximately three weeks prior to her diagnosis. I couldn’t help going back and checking, “What were we doing three weeks prior?” Turns out: it was actually a great day full of bike-rides and time spent with friends. I’ve had a few cancer survivors give me advice that starts with, “Don’t let cancer ruin . . .” or “Don’t let cancer take away . . .” I like that leukemia didn’t ruin our ride with the new kiddy bike seat.

It was a good day.

What the heck causes leukemia?

From what we understand, researchers are not sure. Most likely, it is some combination of genetic and environmental factors. There are a few risk factors that can predispose kids to cancer, but Elsa didn’t have any of those. I’m sure 50 years from now, we will know for sure and have the chance to beat ourselves up for whatever caused this nonsense.

When the heck is she going to get better?

Obviously, the most shocking part of all of this is being told your child has cancer. Coming in at a close second: The moment they tell you your child will need chemotherapy for 2.5-3.5 years! Luckily, girls generally only require 2.5 years of chemo – though that can be stretched over a longer period because the treatment schedule is not always precise. If everything goes as planned, she will stop chemo on or around her fourth birthday.

What the heck? Seriously, what the heck . . .

I know. It is really awful. Cancer is the worst. A friend sent us a card that said, “Cancer is suck a dickhead.” And seriously. It is a total dickhead. When I’m feeling down about this whole cancer thing though, I try and think of the following chart:

It’s easy to get lost in the Awful Stuff column, but the Great Stuff column always sneaks up, taps me on the shoulder and says, “Remember me?” I mean, not even the most awful, Awful Stuff column can withstand the strength of such a great, Great Stuff column.

Day 38: Today and Tomorrow.

I’m very lucky to be related to a really wonderful woman who has sent me some excellent advice over the last 38 days. She is a writer, a photographer, and a cancer survivor, herself. Since we received the news of Elsa’s remission, I find myself revisiting something she wrote me:

One challenge that all cancer patients (and their families) face is dealing with what is known rather than succumbing to the fear of what MIGHT happen. What MIGHT happen exists only in your head. It is not reality. So when it grabs you by the throat, just give yourself a mental hug and say, “Awwww, poor baby. You’re scared, aren’t you?” Being scared is not a nice feeling. Be sympathetic to yourself, because often you don’t share that fear with everyone.

Yes, Elsa is in remission and that is wonderful news. Yes, I am boundlessly thankful for her speedy response to the first month of treatment. There are moments though. Moments where I get stuck deep down in what MIGHT happen. What MIGHT befall my sweet, small one. I read a blog about another little boy with ALL who was told he was in remission on Day 29. Then, days later, they came back and said, “Sorry. We made a mistake. You are actually sicker than we thought and you need a bone marrow transplant immediately.” I know, I know. This is where you tell me to “Stop reading those damn blogs Georgia!”

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When Elsa was first diagnosed, our doctor and his team sat down with us for two hours to go over what MIGHT happen. Having an airline pilot father, I can’t help but imagine Dr. Parikh as our captain, making announcements over the loudspeaker:

“Welcome aboard folks to Flight 300, traveling from Acute Lymphoblastic Leukemia into the unknown future. We are happy to announce that there is a very good chance you will exit the plane in two and a half years with a cured child in your arms [everybody on board cheers and claps enthusiastically!] Before we take off, please direct your attention to the flight attendants at the front of the cabin as we go over some of the safety regulations on this aircraft. There are some serious risks associated with flying our airline, but, unfortunately, the risk of not flying is certain death. [everybody on board groans]. While myself and your cabin crew will take every precaution necessary to ensure your safety, please prepare yourself for the possibility of: learning disabilities, partial paralysis, blindness, brain damage, severe allergic reaction, severe kidney damage, and death. . .”

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I know I’ve already said it, but Elsa’s total 180 degree turn around this week has been wonderful. The majority of this week, I have spent enjoying our time as a renewed little family. We have spent an inordinate amount of time dressing up dollies, playing peek-a-boo, reading books, singing “Head, Shoulders, Knees and Toes,” and affixing stickers to every surface in the house. From time to time though, I’m struck by a sudden need to return to our treatment protocol binder and furiously search the internet for what’s next. What new drugs will she have to take? What horrible side effects will they bring? I have brief moments of horror where I look at her and realize, this is nowhere near over.

Then I realize I am getting caught up in what MIGHT happen. And this is not reality. I cannot know what MIGHT happen. I cannot anticipate how she will weather her future treatments. I can only know that, today, Elsa wants to dress up in a winter hat and three different bathing suits all at once and then laugh maniacally over her clever choice of outfit. So today, wearing a winter hat and three bathing suits: that is our focus. And tomorrow, whatever we MIGHT face: That hasn’t happened yet.

Always dressed to impress.