In case it hasn't been clear in our blogs I wanted to give some information concerning Anya's treatment plan.
Anya will have three stages of chemotherapy treatment by the time she is finished: induction, consolidation, & maintenance. She is currently in consolidation and will be for about the next six months. Right now they are focusing on her nervous system (intrathecal chemotherapy) - hence the weekly spinal taps.
When Anya gets a spinal tap the doctor pulls fluid out to check for leukemia cells and pushes in a chemotherapy drug. Thankfully, thus far Anya has been leukemia free in her nervous system. This is one of the factors that has put her in a standard risk category. (According to the American Cancer Society, someone in the standard risk category has a 65-85% chance of cure.)
When consolidation is complete, Anya will begin the maintenance phase. It is my understanding that it will last for two years and will require treatment a couple days a month.
Anya is now in remission, meaning less than 5% of her cells are leukemia cells. If she would not have reached remission by the fourth week she would be considered "high risk" which brings with it higher doses of drugs and other treatment (and a lower overall chance of cure).
The doctors do not forsee that Anya will need a bone marrow transplant. Transplants are reserved for patients that are not likely to reach long-term remission with chemotherapy alone. They also do not expect that Anya will need radiation therapy. We praise God for this because radiation therapy can cause problems with growth & mental development in children.
Hope this overview helps answer some questions. If you have more, please feel free to ask!
Sources: http://www.cancer.gov/ and http://www.marrow.org/ (and of course, our wonderful doctors at St. Vincent Medical Center)
Friday, September 7, 2007
Rash
One more word about the rash: Anya's doctor said that she was unsure of the cause of the rash. She assumes that it is either an allergic reaction to one of her chemo drugs (Peg-Asparaginase) or an allergic reaction to something in the home like laundry detergent or soap. She hopes that it is the latter because if Anya is allergic to Peg-Asparaginase they will have to discontinue its use and the replacement drug is expensive and difficult to obtain. The replacement is only produced in France and of the handful of children she has treated that needed it only one of them were able to get it.
PS. Anya just woke up and I asked if anything was bothering her. She said that she was sleepy but that it was probably because she "took a long time resting". :) I love her optimism!
PS. Anya just woke up and I asked if anything was bothering her. She said that she was sleepy but that it was probably because she "took a long time resting". :) I love her optimism!
Friday Update
Yesterday Anya was sleepy and developed a rash on her legs. We contacted Anya's nurse and she suggested that we keep an eye on the rash and take her to the ER if it worsened. She also asked that we come in today for bloodwork for a CBC (complete blood count).
Fortunately the rash did not get worse so she just had to visit the clinic this morning. In order to do the bloodwork the nurse only had to poke Anya's finger. We are grateful that they didn't need much blood in order to run the labs but strangely it seems like the poke is more traumatic for Anya than when they access her port! Israel said that Anya cried from the minute the nurse walked in the door until they left the room.
While obviously the poke wasn't any fun for Anya we are thankful to know that Anya's blood counts have recovered some from the chemo. She now has an ANC (absolute neutrophil count) of 2.8 which is within the normal range*! This means we are free to take her in public as long as there are no noticeably sick people around her! Of course, we will still take precaution because anyone can contract an infection and for Anya an infection means an admit to the hospital and postponing chemo. But we are thrilled that she can attend a church service or visit the library.
Right now Anya is taking a nap and has been asleep for two hours. Until yesterday she seemed to be experiencing very few side effects from the chemo medications but she has become sleepy, mildly fussy, has an achy jaw and stomach, and constipated. But today the doctor said that all of this is normal and reaffirmed that it could be much worse.
*Neutrophils are a type of white blood cell that fight infection. Normal is considered between 1.5 and 8.0 and risk of infection increases when the number of neutrophils drop below this number - called neutropenia. If the number of neutrophils drop below .5 the risk for infection is especially high.
Fortunately the rash did not get worse so she just had to visit the clinic this morning. In order to do the bloodwork the nurse only had to poke Anya's finger. We are grateful that they didn't need much blood in order to run the labs but strangely it seems like the poke is more traumatic for Anya than when they access her port! Israel said that Anya cried from the minute the nurse walked in the door until they left the room.
While obviously the poke wasn't any fun for Anya we are thankful to know that Anya's blood counts have recovered some from the chemo. She now has an ANC (absolute neutrophil count) of 2.8 which is within the normal range*! This means we are free to take her in public as long as there are no noticeably sick people around her! Of course, we will still take precaution because anyone can contract an infection and for Anya an infection means an admit to the hospital and postponing chemo. But we are thrilled that she can attend a church service or visit the library.
Right now Anya is taking a nap and has been asleep for two hours. Until yesterday she seemed to be experiencing very few side effects from the chemo medications but she has become sleepy, mildly fussy, has an achy jaw and stomach, and constipated. But today the doctor said that all of this is normal and reaffirmed that it could be much worse.
*Neutrophils are a type of white blood cell that fight infection. Normal is considered between 1.5 and 8.0 and risk of infection increases when the number of neutrophils drop below this number - called neutropenia. If the number of neutrophils drop below .5 the risk for infection is especially high.
Wednesday, September 5, 2007
Happy Birthday!
Today is Anya's fourth birthday! We are planning to celebrate tomorrow evening at my parents' house with cupcakes with ice cream and presents. Of course it will only be our family for the party to avoid more risk for infection. But it will be a joyous celebration; we are so thankful that God has given us these four wonderful years with her!
Tuesday, September 4, 2007
Tuesday Spinal
Anya left a few minutes ago for her weekly spinal tap. She will be getting a different drug this week than last week and she will also get a shot with another kind of chemotherapy. We are praying that Anya's body would react as well to these drugs as the ones she was was taking the past few weeks.
She was such a trooper this morning - not complaining too much about not being able to eat and not crying when it was time to leave. We praise God for the dramatic change we've seen in her since the beginning of treatment.
She was such a trooper this morning - not complaining too much about not being able to eat and not crying when it was time to leave. We praise God for the dramatic change we've seen in her since the beginning of treatment.
Monday, September 3, 2007
Family News
As those of you in Kansas City already know, Israel went back to KC for a visit this weekend. He loved seeing everyone and attending Scott and Summer Taylor's wedding on Saturday evening. He was blessed by all the hugs, tears, & kind words that were shared with him concerning Anya and our family. We appreciate you all!
Many of you have expressed interest in how the kids are growing up and changing so I'll share a few things here: Anya has started writing her letters and she loves playing outside. Esther is such a talker! She will be two in a few weeks and talks all day long, usually in complete sentences. She is as sweet as ever and quite the jokester. Isaiah is now almost five months old. He is very content, smiley, and lovable. He just started spending time in an exersaucer and is around 15 pounds!
Many of you have expressed interest in how the kids are growing up and changing so I'll share a few things here: Anya has started writing her letters and she loves playing outside. Esther is such a talker! She will be two in a few weeks and talks all day long, usually in complete sentences. She is as sweet as ever and quite the jokester. Isaiah is now almost five months old. He is very content, smiley, and lovable. He just started spending time in an exersaucer and is around 15 pounds!
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