November News

Anya's November clinic went pretty smooth. Israel took her this time, and it was a pretty standard visit. The nurses did have some difficulty getting a return on her port, but they didn't get worried about it this time and were just hopeful that it would work next month.

Here are a few recent pictures:

The girls recently completed a series of swim lessons at the YMCA. They loved learning to swim!

They had an excellent instructor and we can't wait to keep practicing their skills in the pool!






Here is a picture of all the kiddos taken by a good friend at church.

Can you see Anya's hair getting longer?!

Outdoors!

I love Fall! I love the changing color of the leaves, harvest decorations, Pumpkin Patches, hay rides and the cool, fresh air outside. Too bad that Winter is just a few months away!

The kids and I took advantage of a beautiful fall day yesterday out in our backyard; here are a few pictures of our time outside.

October Appointment

Anya's October appointment was this morning. Everything went smoothly; she received her regular chemotherapy through her IV and had a great time playing in the playroom.

One of my (Anna) favorite things about going with Anya to her appointments is having the opportunity to meet other children who have leukemia or other forms of cancer and their families. Today we met a 13 year old girl who travels over 200 miles 4 out of every 6 Fridays for chemo treatment to fight a tumor behind her eye. On top of dealing with her own physical problems, less than two years ago she lost her mother to a cancerous brain tumor! So her now single father is responsible for her medical care, and the regular care of her younger sister while grieving over the loss of his wife. When I meet children like this, I am reminded of just how blessed we are. Thank you, Lord.

Improvement!

We've seen marked improvement in the way that Anya has been feeling! She hasn't complained of feeling 'miserable inside but not out' in over a week! Praise the Lord!

Why the Spinal Taps?

During the Maintenance Phase, Anya's doctors will continue give her a spinal tap once every three months to inject chemo medication directly into her spine. Thankfully, the doctors have never found leukemia blasts in her central nervous system but they give her this "intrathecal chemotherapy" to prevent it from developing/spreading there.

My understanding is that recent research has shown that without this preventative therapy, some patients later develop leukemia in their CNS which is more difficult to treat. Early in Anya's treatment, the doctors explained to us that each of us has a protective barrier between our body and our CNS. If the leukemia can break through this barrier, they find the conditions there good for growth and multiply quickly. Therefore the doctors choose to be "better safe, than sorry".

September Clinic Visit

Anya's spinal tap went much better yesterday than the one she had a couple months ago! It wasn't perfectly smooth, but it was a big improvement and the doctors are confident that they can have the medications regulated for the next one. Praise the Lord!

In general the visit was a good visit. Anya didn't experience as many bad side effects from the pain medication, she recovered quickly and was able to get home by lunchtime. Hooray!

While they were at the clinic, Israel asked the doctors a couple questions. In case you are interested, here are a few of his questions and their answers.

Question: How do you know that Anya has not relapsed since you are not doing bone marrow aspirates anymore?
Answer: When a child relapses, there are several signs that would indicate the leukemia has returned. Anya doesn't have any of these symptoms. One of the first indicators of relapse is when a child's platelet count consistently decreases from month to month. Anya's platelet count fluctuates up and down and up again from one month to the next.

Question: How often after Anya finishes treatment will she have to be tested to see if the leukemia has returned?
Answer: Anya will have to be tested every month for the first year after she finishes treatment, and every two or three months for the next year. After that we'll just look for signs that she is developing properly. For example: Is she is hitting puberty at the appropriate time? Is she is generally happy and healthy and growing?

Question: For several weeks, Anya has been feeling sick more often and is generally more fussy than she usually was the past several months since she started Maintenance. What do think is causing this?
Answer: Methotrexate, one of Anya's chemo medications, can give kids an indigestion-like feeling that they usually don't know how to explain. This discomfort can be further irritated by the other medications she is on. The timing corresponds with when we increased the Methotrexate and Mercaptopurine medications. She needs to take a daily dose of Pepcid-AC.

So we've started the 'daily' Pepcid-AC. Hopefully this will help!

Miserable Inside But Not Out

Off and on the past three weeks Anya has been feeling more sick than her 'usual' since she started this last phase of treatment. She frequently tells us, "I feel miserable inside but not out". We're not sure exactly what that means but we know that we hate that she feels sick!

Some days Anya seems fine, but then other times she is especially sensitive and fussy. In her previous phase of treatment, we asked her doctor about her fussiness and she just reminded us that Anya's medications take a toll on her body and that the fussiness is to be expected. I guess we hoped for some type of "make it all better" pill. But since things were better for a while, and they have recently upped her medications, we plan to ask the doctors about it again this Friday at Anya's clinic appointment. They'll probably say the same thing as before, but we always hope there will be something we can do for her.

Speaking of Anya's next clinic visit...this Friday Anya will have her second spinal tap since we've returned to Kansas City. As you may recall, the last spinal tap was very painful and overall a terrible experience: most of all for Anya (who had to go through it all) but also for Israel (who had to watch it all) and for me (who had to hear about it all). Let me tell you...I was NOT a happy momma when I heard what she went through.

In Toledo, Anya's spinal taps were always done under "conscience sedation" - basically she was asleep. However the Children's Hospital here in KC uses a different type of sedation medication and for some reason weren't able to regulate it properly during the spinal tap procedure. So we're desperately hoping that things will be better this time. Anya's new doctors make no promises, only expressions of their desire that things will work the second time around. If they don't, we'll probably make a STRONG push for them to use the type of medication for Anya that was used in Toledo unless of course, it is not in Anya's best overall health interest.