Showing posts with label MD Anderson. Show all posts
Showing posts with label MD Anderson. Show all posts

Monday, September 7, 2009

Here’s your epic Part 1

Here’s your epic Part 1:On Thursday, July 30, Chicago White Sox pitcher Mark Buehrle pitched a perfect game. He had to rely on a mindblowing defensive play from one of his teammates near the end but he did most of the work. In the Sports Illustrated article that chronicled the event, writer Lee Jenkins put the feat into perspective this way (the best way to put any great baseball moment into perspective) - with stats:In baseball history, starting in 1900 as far as most historians are concerned, there have been 263 no-hitters but only 18 perfect games (27 up-27 down). That’s out of 779,118 starts which is .0023%!That’s pretty special and worth celebrating. I’ve been officially amazed by it and have been thinking about it a lot, lately. I mention it here because it has kind of framed my mindset recently. I’ve been narrowing down the things I’ve been celebrating lately, trying to get the most quality out my everyday experiences. I’ve been loosely following the various sports I like and trying, as always, to find new musical wonders but the sports have been slowly fading in my mind the last week or so and I’ve ramped up by musical exploration. I’m going to miss most of the UM/FSU football game tomorrow and I’m ok with that. Yeah, I know, sacrilege! I have, however, discovered a new appreciation of older singers/instrumentalists I used to not be able to stand. One being Judy Garland.My seemingly incoherent babbling has a purpose. Last week, we thought we had a pretty good handle on Charlotte’s cancer, her proton radiation treatments (conducted at world renowned MD Anderson Cancer Center in Houston, Texas) were over, we were all finally home and ready to begin the rest of the customized chemotherapy developed by researchers at the same MD Anderson.We got a call from the folks at MCV confirming an MRI appointment scheduled for early Wednesday morning and we just assumed it had been ordered by Dr. Kahn or Dr. Tye since we had an appointment in the Nelson Clinic later that day. There we go assuming again.So I scoop up Charlotte early Wed morning and we go get an MRI. As usual, when they’re not familiar with a patient, medical professionals tend to make their own assumptions and when the anesthesiologist mentioned starting an IV in CJ’s arm, I said, “Oh no you’re not. She’s got a central line.” The doc said, “We still like to have it available. We’ll do it while she’s out and cap it before she wakes up; she won’t know a thing.” I was confused as to why they would need to do this and told him I really didn’t think that was necessary. They’ve never done that to her before. Finally I showed them her Hickman double lumen (sp?) line and the lightbulb went off. I can’t tell you all how many times we have had to head off doctors and nurses diving for the needles. Shouldn’t these things be written down in her chart somewhere? I will say for the thousandth time (I’m sure it’s not the last) be your child’s strongest advocate!I also saw the Klauers before they got started. (congrats on Reese’s clean MRI!)After they took her in, I took the time to head up to the 7th floor to see one of our Romp n’ Roll employees, Lindsay, who got into a car accident and was recovering on the “older kids’ ward” of the 7th floor (that’s the infamous ward where CJ caught the nurses lying to her about medication in her chocolate milk).Lindsay’s hand was seriously injured and she’ll be undergoing several surgeries in the next few months. Her whole family has had a very bad run of medical situations in the last little while so they could use a boost of positive energy. If you would like to help Lindsay, or more importantly, her mother Laura, let us know here and we’ll pass it along. They don’t have a CB site yet but I’m pestering them to start one.So I found out Lindsay was hanging in there and headed back down to the recovery area. I timed it just right and they were just bringing her out when I got there.CJ woke up without any complications and after a little chocolate milk, we headed down to eat, where else, at Chick-fil-a! We met a woman expecting her second child (a surprise baby!) and we talked a bit. For some reason, I found it very refreshing to talk to someone who was at MCV for a very different reason than us. Her situation, risk for gestational diabetes, was almost novel (although I don’t want to belittle it at all). It’s just that is was nice to talk to someone about something other than cancer for a change.Next we went to the Nelson Clinic and signed in nice and early. Charlotte settled in with a few books and I pulled out the laptop. When they called us in, after vitals, we popped a DVD in the player and waited for mommy and Dr. Kahn. Mommy arrived not long after we went in. Dr. Kahn’s timing was kind of bad. Charlotte normally jumps for joy when she sees Dr. Kahn but this time she was so engrossed in the DVD (Strawberry Shortcake) that she didn’t want him to come in.It actually wasn’t a problem because, much to our consternation, we were greeted with complete surprise when we told him about the MRI. “You had an MRI this morning?!?” So off he went to look at the MRI real quick.Here’s where everything starts getting mucky. Dr. Kahn came back in after a little while and says that after looking at this MRI and the post 3rd surgery MRI, he can see there have been changes. Here’s your insight into the world of “Dr. Speak” for these types of situations. When they say “changes,” they don’t usually mean changes for the good. He couldn’t find the July MRI we did at MD Anderson, (they probably never sent one to MCV) so he didn’t have that one for comparison. Compared to the May MRI, parts of the cancer have grown. The thing is, it might be that the cancer grew more after the May MRI and the latest MRI might show that it has actually shrunk since then. If so, that’s good and we can hope the updated chemo protocol (which seemed to have a positive effect earlier) will finish the job.If the three MRIs show steady growth even through the proton radiation treatment, well, that’s bad. Very bad. The other thing is, Dr. Kahn only had a small amount of time to look at the scan and Dr. Tye wasn’t even a part of the conversation, so there was very little information to be had which made us feel like we were being left in the dark. That’s not the best state in which to leave our fertile, imaginative minds. I actually had the stereotypical “kicked-in-the-gut” feeling you hear about and the “all over body ache” was back.It certainly wasn’t what we had hoped or expected. Did the super hi-tech proton radiation, the hottest thing in the world of cancer treatment, work at all? Was the time in Houston a gigantic waste? Did we do all that for no reason?We felt so down for a bit that I didn’t talk about it with anyone I didn’t have to.The next day, Rachel was feeling sick with a cold so we switched Romp n’ Roll shifts. I went down in the morning to help with camp and she came in the afternoon to do Open Gym (less chance to get kids sick).Gotta admit, camp was rockin’! We had 20 kids all doing mostly what we wanted them to do. The co-op band pics on Facebook are a testament to that.Here’s also where my new appreciation of things really shows up. The co-op band “event” is not something that will change the world, just like a perfect baseball game won’t, but it was something that will be hard to match and, I think, worth remembering. I keep looking at Charlotte in those incredibly precious moments I get to spend with her and trying to devour everything about her. Every moment with her is a bonus that I cannot adequately describe in words and I want to remember them. I want to sear them into my memory no matter what happens.After camp, Charlotte and I went back down to MCV to see Lindsay and her mother, Lauren, who, despite being in a wheelchair at the moment, has been staying with her at the hospital. The night before, Charlotte drew her a picture of some food which we presented to Lindsay when we got there. Then we popped in Finding Nemo and they watched it together on her bed. Once CJ was settled, I went back down to the Nelson Clinic to be the proverbial squeaky wheel to make sure things were in motion as far as the July MRI was concerned.When I went up to the window, I thought I clearly explained to the woman at the reception desk/window that I wanted to leave a message for Dr. Kahn, making sure the MRI ball was rolling. She was obviously distracted and not listening to me and was confused about why I was there. “No I don’t have an appointment, I just want to leave a message for Dr. Kahn.” When I saw him through a window, I mentioned, “There he is right now” and she became defensive saying that he was with a patient and he wasn’t available. She also made me feel, and not for the first time, that I was somehow imposing on her by being there. I sometimes get that vibe from the other receptionist as well; almost like we’re kids being pulled into the principal’s office for breaking some rule. I can only think that the “normalcy” we’ve mentioned before that comes after being/working around very NOT normal circumstances for an extended period of time has clouded their perception of why they (and the parents with whom they interact) come to the Nelson Clinic in the first place. Just lately, I’ve been a lot less reluctant to let people know what I think (not that I was that shy before) and I may be something of a problem parent if I feel something needs to be said.Anyway, after getting the message straight, she took the piece of paper on which she was writing back to Dr. Kahn and of course, he came right out to talk to me. (In my mind, I’m childishly sticking my tongue out at the receptionist. It’s amazing what you’re reduced to in these times.) He told me he had talked to Dr. Tye and that he concurred with Dr. Kahn’s opinion. About the July MRI, he said the best thing I could have heard: Joanne is working on it. We’ve mentioned her before. Joanne is Dr. Tye’s right hand nurse and she is a force. If she’s on it, it will get done.After that, I felt a little better and went back up to Lindsay’s room. They were still watching the movie and I, unfortunately, had to do the nasty trick of skipping a few scenes to get the movie to end. We had an invitation to meet with the Randolph-Macon College Women’s Field Hockey team at the end of practice and eat dinner with them. We were getting to the point where if we didn’t leave very soon, we would be seriously late.The drama was minimal, though, so in a small amount of time, we were zooming north on 95 towards R-MC. We got there just as practice was ending and we got to meet the team and “warm down” with them. Charlotte was being her typical shy-at-first self but I was coaching everyone how to ask her about her favorite colors, her age, favorite restaurant, etc…and before too long, she was opening up a bit. At dinner in Estes Dining Hall, she sat in my lap and kind of didn’t want to do much but I needed something to eat, so I asked the girl sitting next to me to hold Charlotte while I ate something. CJ was ok with it and the girl happened to be Lindsay Walker, one of the co-captains of the team. I’m not sure what it is about Walker (as everyone calls her), but Charlotte just fell for her. She snuggled up to her and they seemed to bond very quickly. So I ate and it was pretty good.I also got to see a couple of old students of mine from when I taught there which was really great. I certainly miss it. Maybe someday…Rachel was still not feeling well by Saturday so I taught her morning class. Fortunately, she at least got to come by to see everyone since it as the last class of the session. It was nice because some of the kids will be going to preschool or taking a break until spring and it will be a while before we see them again. Big changes can take place in that amount of time.We all headed back home for a bit to rest and recuperate before CJ and I had to leave for the season opener for the R-MC field hockey team. We got there just before the half and stayed through the rest of the game. I’ve talked about the rest. It’s a great thing the Friends of Jacyln organization does.Somewhere in all the mess, Rachel and I had one of THOSE conversations. It was in Chick-fil-a with Charlotte sitting beside me eating her chicken strips dipped in Barbeque sauce. We had both been stewing over the last conversation with Dr. Kahn, thinking dark thoughts, and going through worst-case scenarios in our heads. I think one can’t help doing that sometimes and I do it all the time no matter how good things are going. I actually it’s one of the things that has helped me cope so well so far.So there we are in Charlotte’s favorite restaurant, speaking practically about “what-ifs.” By far the most morbid but functional conversation we’ve ever had. Neither of us is the kind to shy away from difficult subjects and we both think it’s wrong to not think about possible outcomes simply because it’s hard to face. Denial has wreaked its own havoc on the world throughout history. I know, so has “the sky is falling!” mentality. Try not to worry. We’re definitely not there yet.In our various conversations lately, we’ve established that when CJ was first diagnosed, she was in the 80%+ survival rate category. When the cancer grew through the first couple rounds of chemo, we figure she dropped down to maybe 60%. If the scans show growth through the radiation, she reaches the 50% or less group. These are horrible things for a parent to have to think about but we wanted everyone to know where we are right now. We’re not good. We’ve had some very difficult days since last Wednesday.We have by no means given up hope. All this darkness is mostly because of what we DON’T know. We’re actually kind of mad at MD Anderson because everyone was supposed keep everyone else in the loop and it didn’t happen with the July MRI. Having to wait for MD Anderson to get the scan to MCV is the worst thing right now. Who knows, the scan could show all kinds of progress. We just don’t know and of course, that’s where most fear comes from, right? Fear of the unknown? As before, if we had clear answers/options, we wouldn’t have nearly the stress level.This is actually only part of what I want to write but it’s already overwhelming to read. I’ll post another update later. Please keep the positive energy flowing.Love,Rog

Wednesday, September 2, 2009

The word of the day is inconclusive.

The word of the day is inconclusive. I don't like that word. Our day started early and has been pretty hectic. The MRI went off pretty much as planned after some early insurance confusion. Also, for some reason the anesthesiologist didn't realize she had a central line and wanted to give her an IV. Fortunately, Roger intervened!! Once the MRI was done, they headed up to the clinic. I taught my 3 morning classes at Romp n' Roll. It was great to see the kids and my great staff again! I met up with Charlotte and Roger about 1 PM and Dr. Khan came in to greet us a little after 1:15. Overall, he is impressed with her progress. We went over all the vitals (eating, sleeping, pooping, etc.). Talked about the H1N1 stuff. She can get a regular flu shot but cannot get the H1N1 vaccine due to her suppressed immunity so don't be surprised if we are ultra germophobic and hermetic in a few weeks/months. This may be the first year we all get flu shots. We don't normally and none of us ever get the flu. I think she's due for a few other vaccinations as well (that she should have gotten at her 4 year well visit) but they may have to wait.Now to the MRI results: First of all, Dr. Khan was kind of surprised that we had an MRI today, which was kind of weird. We thought HE was the one that scheduled it. I am not positive but I think that this MRI was scheduled a long time ago (before we went to Houston) and was never taken off the books and then it just coincided with our return to Virginia. In any case, he looked at the scan and compared it to the scan from her post-op MRI on May 29th. Unfortunately, they don't have the July 14th MRI from MD Anderson. We thought they did. The problem is that the MRI does show growth from the May 29th scan to today's scan. Dr. Khan needs to know, however, if there was MORE or LESS growth in the July scan. If there was a progression from May to July but there has been less growth (or stabilization) between July and now, that is good. That means that radiation, chemo, something is hopefully working. If there is more growth now than there was in the July scan...well...that's bad. Really bad. Unfortunately, Dr. Khan didn't have much more to tell us today but we did discuss starting her new protocol next week and we are hoping to have some answers from MD Anderson (the July scans) by the end of the week. Roger and I are frustrated and disappointed. This is definitely a case of "no news" NOT being "good news". You all know how much I hate ambiguity in these situations and the fact that there wasn't news of LACK of growth in any way is a pretty bad omen to me. In the meantime, I need to try to focus my energy on something productive as there is MUCH to do. Unpacking, organizing, making PT/OT appointments. Lots to do.Since my post last night, we have realized that our neighbors decorated their mailboxes and porches with pink and purple ribbons and balloons. Our house was decorated as well. The "welcome home" was very touching. We also found some food that had been "mysteriously" left in our refrigerator and I understand more is on its way this afternoon. Thanks! Roger is off to work for the evening and I'm here with the princess. We'll keep you updated as we know more.

Saturday, August 15, 2009

Riddle me this, Batman...

"Riddle me this, Batman..."Why would Humana One, our illustrious insurance company, pay for IV topotecan treatments which require a visit to the clinic, supervision by at least one medical professional, and the actual drug which costs well over $1000 just for the little package they hang on the pole (not to mention all the medical waste created when tubes, swabs, even the covering on the table, all have to be thrown away) and then refuse to cover the little liquid oral syringes manufactured right here at the hopsital, which we can do at home without supervision, and which costs about $800 for 14 days worth (and all we throw away is the little syringe)?Well, that's what they're doing. If you're looking for places where the wasted money goes, there's one. I would think other policy holders of Humana One or even shareholders of the company might be interested to see that inefficiency.
I just paid over $400 for a week’s worth of the oral version (It’s certainly not a financial hardship thanks to all of you filling up CJ’s account) and Charlotte took it with very little trouble. Dr. Wolff recommended this avenue because he said, “You have to get out of town; you have to go to Disney World.” The oral version offers us a lot more flexibility all around. Going into the clinic everyday is an acceptable pain but being able to forgo the visit is a very attractive proposition. I’m sure they don’t cover it because it hasn’t been “approved.” I think they ought to approve it. Otherwise, I’m pretty sure we wouldn’t be able to maintain that outflow of cash for the long term and we’d have to go back to the IV route.
Charlotte doesn’t really give a hoot either way.The other, and much more serious insurance development: Humana sent us a letter saying that the proton therapy is considered out of network. This would be much more than a "convenience" issue and would normally have us extremely concerned except that we already got a coverage waiver (serial number and all) way before we even came out. Our angel in this matter, Yvette, is out of town, however, so she’s not available at the moment to check things out. Another person in the radiation dept. talked to me and after a little minor investigating, it looks like all the important information is still there in the computers so when Monday rolls around, hopefully this can get nipped immediately.
I groused at the person manning The House front desk this morning for turning out the lights on me while I was using the kitchen, twice. I told her it was a matter of being polite and all she had to do was ask me if it was ok or at least warn me she was going to do it. She, for her part was calm and tried to explain policy, electricity costs, yadda yadda yadda (of course I wasn’t interested in listening because I was mad) but after a short bit, I realized, again, that it’s really not that big of a deal.
Then after all that, Charlotte melted down because I had cut up the apple which was why I was using the kitchen area in the first place.
OI!
I see my irritation level rising slightly, which is weird because things seem to be going so well, but I get over most of it pretty quickly. Mostly because I’m not shy anymore about letting the offending party know that I’m irritated and then I let go of it right away. Keeps it from swirling around in my mind and making me stew over things. Makes far less bad energy in the long run. I could still use better judgment as to whom I aim my grousing.
So yesterday…Not a bad day again. Charlotte has started getting “the look” again so I wasn’t surprised when later, I got a call from the Children’s Clinic saying they wanted to give her a transfusion next Monday. Her numbers are still a little low but not going down but they wanted to make sure and I don’t think it’s a bad idea at all.
Rachel comes in tonight and Merilee Beasley is watching CJ for our date. No real plans this time. Just mingling auras.

A small yet massive victory today and it had nothing to do with poop.
A friend of my cousin Jeff’s, Larry, lives in Houston and we meet up today to hang out and get a little break from The House. At Charlotte’s request, we went to Chick-fil-a (surprise!!!). She ate like a champ and then told me she wanted to play in the playroom.
We got her hat, shoes, and brace off and she started climbing up the play “thing.” She got three tiers up when a boisterous older boy came whizzing down and bonked her on the head with his arm. No harm but lots of tears and I had to go up and get her down.
I held her at the table while she got herself together. She ate some more and to my surprise, she asked to back into the play area. I told her the big boys were still in there and she said, “That’s OK.” That’s my girl! She started back up the steps and I only helped her a little and once she go up high enough that I couldn’t contort myself any more, I asked one of the boys, David (pronounced Dah-veed), to just watch that she’s ok and he agreed (nice kid). I think he actually helped CJ onto the slide and down she came! It took a very long time but she was tenacious, determined, and never even hinted at giving up. That’s my girl.
I tell you, I’ve seen more and more of the old Charlotte every day (not wanting help getting off a couch, actually sitting up in bed on her own, trying suggestions I’ve given her as to how to bend over to pick things up, etc…) and today was a big glimpse of her. Warmed my heart.
Just though I’d pass that along. Thanks, Larry, for a fun afternoon.

Thursday, August 13, 2009

Update from Daddy and Mommy

I promise that when we publish the book, we’ll fix all the atrocious spellings and grammatical errors!
Yesterday, the New Mexico trio headed back to Farmington/La Plata but not before showering Charlotte with gifts, taxiing us around all over the place, paying for lunch, and revealing that they (Uncle Notsohairy actually) had caps made in purple and pink with Charlotte’s name stitched into them. Pink stitching on the purple hats and visa versa.
Aunt B has agreed to shave her head for a cancer walk they are doing in September but only if I can get Charlotte there for the event. Hmmm…MAN! I really would love to see that. We’ll see.
After we made our goodbyes and they left for the airport, Charlotte and I spent most of the late afternoon in the room with me catching a cat nap here and there and CJ watching videos and waking me up every time one section ended to tell me plot highlights. She got her legs back after a while and we headed back downstairs. Southwest Airlines was serving dinner so it was smelling pretty good down there.
We also met up with a new family with 3 boys and a 9-year old girl (the patient) named Mikayla. Mikayla has become a new bff (dear God, I didn’t really say that, did I?). She and Charlotte seemed to really hit it off. Charlotte doesn’t seem to mind the attention Mikayla gives her and Mikayla really seems to like looking out for CJ. It gave me the chance to get dinner, play a little piano, read a little, stuff like that. The rest of the family seems great too. Dad and the three boys all have their heads shaved in support of Mikayla.
We had a very early (7:30) appointment with the eye doctor Wednesday (yesterday) morning so I had to get CJ into bed as early as possible. It was still well after 10pm.
I slept like doggie doo doo. Not getting enough sleep this week. I’ll try to do better.
So I got her up early and decided to try to dress her in the Dora and Diego scrubs Grandma Bonita made for her. I understand she wouldn’t wear them earlier so I didn’t have much hope. I accidentally happened on the way to get her to wear almost anything: threaten to leave her in her nightgown to go see the Drs. She’s developing such a sense of “style” and fashion that going out in jammies is a complete fauxpas! She left wearing the custom scrubs, surgical cap and all!
I hadn’t actually walked the two blocks to the main hospital since I’ve been back so I forgot that it only take 5-10 minutes to get there which means we arrived at around 7:15 for our 7:30am appointment. Then we waited. The hours on the door said the office didn’t even open until 7:30. Why book a 7:30 appointment when it’s obviously never going to happen at that time? The staff was a little late opening the office so I was a little growly when I went in. Not too bad, though.
We eventually went into the office around 8:05. The “techs” got so much more out of Charlotte this time than the Dr. got last time. We even got dilating drop into her eyes with a minimum of drama. Then when the Dr. actually did come in, my theory was proven correct. CJ remembered her and really wanted nothing to do with her. We ended up having to hold her and force her eyes open so they could look at the optic nerves. That was pretty traumatic. In hindsight, I can’t believe I even allowed it let alone participated in it. Remember, this is the same Dr that asked all the bad questions last time. This time she kept saying things like, “Just do this one thing and we’ll be done.” And then she would do more, making Charlotte realize the next time she heard that phrase that the Dr. was full of crap. I finally had to be a bit rude and tell her in no uncertain terms not to do that anymore. I tell you, she knows a ton about the eye but not much about kids. I told Nurse Rhe about it and she said she’d check into it. The end result is that they left eye still has some very slight swelling around the optic nerve which may just be leftover from everything so no one is too worried about it right now.
There just has to be a better way to do that sort of stuff.
Next on the printed schedule was supposed to be proton therapy at 12:30 with a follow-up visit back to Dr. Wolff at 1:30. Hopefully you can see this wasn’t going to happen. Treatments are about an hour long with 30-45 minute recovery times.
With that in mind, I went into the Children’s Center hoping to get squeezed in before we had to leave for proton. That place is always such a breath of fresh air. Both Rhe and Nurse Carmen came out to talk to her and oogle her scrubs. Charlotte LOVES Nurse Carmen and I guess they have a little ritual conversation/routine they do getting back to the room. Unfortunately, my showing up early put Nurse Carmen at a disadvantage since before, CJ always got there after proton and they could talk about food. Carmen was quick on the uptake when I coughed out “NPO!” and she steered the small talk elsewhere.
Then Dr. Wolff came in and did a masterful job of filtering the crap (most of it mine). When he asked me what was new, what had happened lately, I started grousing about the eye doc and he quickly redirected my energy onto more constructive paths. “Ok, BESIDES the eye doctor, what has happened.” “OH! You actually want me to talk about Charlotte?!? I rarely have felt better about being scolded for being stupid. Especially as an adult. The decision was to start topotecan on Friday
I messed up the schedule yet another way because the blood draws/counts he would have used to decide what to do with the next type of chemo drugs would have been drawn by the proton center and since I hadn’t been there yet, there were no draws to study. Not to worry, we got blood drawn right there and then and we headed off to the proton center. We timed it just right and the MDAnderson shuttle was just starting to pull away when one of the volunteers (God bless ‘em!) ran out and placed her body down in front of the tires to stop the bus.
(OK, so I might be exaggerating just a little.)
The bus driver remembered CJ and I learned his name was Walter Johnson. He mentioned he shared a name with the old-time baseball player. Being more ignorant about baseball than I care to admit, I had no idea who he meant so, in perfect form, I googled him and when the bio came up, I felt even worse about my ignorance. Walter Johnson was arguably the best major league pitcher in history! 115 shutouts! Over 3,000 strikeouts!! Over 400 wins!!! Good name, I told Walter Johnson the shuttle bus driver.
We got to the proton center perfectly on time. I just walked right in, they got vitals real quick, and into the gantry we went. She was really tired already so no Frosty this time.
The other not so good thing was that when she was done recovering, I called The House to make sure the shuttle would stop to pick us up. They said the next shuttle leave at 2:30 and would be there to get us. Just to make sure I called about 2:30 to confirm and they said, yes, you’re on the list. We’ll about 3:30 I called and they had somehow forgotten me. Grumblegrumblegrumble. So they called a cab for me and I took a $4.00 ride. Not too bad. I got over my ruffled feathers pretty quickly.
The rest of the night was pretty standard…CJ read books in the room while I dozed here and there. We went back down and Mikayla was there. FREEDOM! Even if to eat in a smidgen of peace. CJ got her appetite back and devoured a bunch of animal crackers, two cups of Mandarin oranges (one of which had her accutane in it), and three slices of turkey coldcuts.
Then up for Madagascar 2, books, and bed.
So that’s where we are. Tomorrow’s proton appointment is blissfully scheduled for 10:30am!

Take care,
Rog

Update:

Well, I'm not exactly sure how things are out in TX but I know that I have had a GREAT day.

It started early with an 8 AM appointment with Dr. Bitsko but we had to do some flexing with the schedule so that I could see him before I left again for Texas. I'd been having kind of a rough time emotionally since some of Charlotte's recent medical developments and I think coming home (and being by myself to ruminate over it) just makes things worse. Anyway, we had a good talk and he helped me get some perspective on things. Always very helpful and encouraging.

From there, I went to Divas for my SPA DAY! Thanks to the many people who helped make this possible, including Jackie, Meredith, Walter, Sherry, my parents, Becky, Tracy...who did I forget? Anyway, they got me a full day experience at Divas and I had a manicure, pedicure, facial, hydrotherapy treatment, lunch, and a one-hour massage. It was so relaxing and very nice to do something that was just for me.

I did actually go in to work for a bit (Thanks Annette for covering a few extra hours) and then met up with some old work friends for drinks and dinner.

So overall, I really couldn't ask for a better day. I really have work to get done that must get accomplished before I leave again on Saturday but I guess I will get there eventually. Big day at work tomorrow and then I'm on the 24 hour countdown again. Time is flying by and I guess that's a good thing.

So Roger is calling me so I must go talk to my family.

Rachel

Friday, August 7, 2009

Another Good Day

More FUN facts about proton radiation therapy:

1. Protons are injected via a vacuum tube into a linear accelerator and in a few microseconds, the energy equals 7 million volts!!

2. The energy increases to 70-250 million volts which allows the beam to enter the body at various points.

3. Protons move through a series of magnets that shape, focus and direct the beam.

4. At maximum energy, a proton beam travels 125,000 miles per second (or 2/3 the speed of light)!!!

5. From the Hydrogen canister to the patient, a proton travels 313,000 miles!!!

And we thought the trip from Virginia to Houston was far!
***************************

Another good day. Today started out early because of our check-in at the clinic with Dr. Wolff. He is very happy with her progress so we are down to 1x/week checking in with the radiation oncologist and 1x/week checking in with the the oncologist. Plus the daily proton treatments. We will discuss further chemo next week and he is going to begin working on her plan for when we leave and go back to MCV.

The hair just keeps falling out but in typical Charlotte fashion, it doesn't seem to bother her. She was really hungry when we got out of radiation today so we stopped at MDA for a snack (cheetos and apple juice) and then headed back to RMH. I cleaned our room and did some laundry and Charlotte was actually pretty social today.

My friend Kim sent her a farm animal lacing set and she is LOVING it. A good replacement for those shoelaces. Her OT practice is going very well and today she spent a LOT of time lacing and unlacing the horse and the pig. The other kids were really interested in what she was doing too and we had a bunch of the RMH kids working on their fine motor skills. I'll just hang out a shingle and open a clinic here.

The evening was fun because the University of Miami Alumni
Association (Houston Chapter) hosted an ice cream social for the kids here at RMH. Got to meet some fellow 'Canes (none of whom went to school during mine or Roger's tenure). Lots of recent grads. Charlotte ate a LOT of ice cream (chocolate in a pink cone with sprinkles!! and she socialized with everyone.

By the way, she keeps telling everyone "I have two boyfriends...Larson and Wyatt." Depending on the day, she changes who her "favorite" is. Of course, if anyone asks if she has brothers or sisters, she tells them that her two "brothers" are also Larson and Wyatt so I guess she's a little confused. I get lots of weird looks when she says she has 2 brothers but I say she's an only child. She also says she has "two girlfriends" but doesn't say their names.

She also has developed this adorable habit of getting my attention by saying "Tweet Tweet mommy!" That means she wants to tell me something. She's my baby bird!!

So we are settling in for the evening and getting ready for the family to come tomorrow. Hooray! I know she will be very happy to see Daddy and we are looking forward to the visit from Aunt B, Aunt Lynn, and Uncle Terry too.

OH! I learned a very good thing tonight: proton therapy patients get to stay at RMH for up to 60 days before having to vacate so we won't have to worry about appealing for more time or finding another place to stay. I also talked to one of the other moms whose kid is getting proton radiation and she said that their last treatment was supposed to be on a Monday but they are "concentrating" his last 5 treatments so that they can finish on a Friday. I'm going to have to ask about that as her current schedule has her finishing on a Monday. It would be really nice to finish on a Friday and spend the weekend packing up for home...

Lots to do and must rest too (hey, that rhymes).

Happy weekend, y'all!

Rachel

Thursday, August 6, 2009

Facts about Proton Radiation and an Update

Some fun facts about Proton Radiation:

1. The first attempts to use proton radiation for cancer/medical treatment began in the 1950s but it was only in the last decade that it has become possible to develop proton beam facilities in conjunction with established medical centers.

2. Radiation is delivered through large gantries. Each gantry weighs 190 tons, sits three stories tall, and is 35 feet in diameter.

3. 2/3 of the proton therapy center is build below ground level. The walls are 8 feet thick and 50 feet high. A 20-story building could be constructed with the amount of concrete poured for the proton therapy center (and it's only 3 stories tall!).

4. The equipment for the machinery weighed 1600 tons when it arrived from Japan at the Port of Houston and it took a 31-truck caravan to bring it to the construction site.

******************************************
On a more personal note:

She's had a good day. She did start losing her hair today. Lots of little hairs on the pillow this morning when she woke up. It's falling out in little bits and clumps, and there is obviously not a whole lot to fall out anyway.

The major issue of the day seems to be getting her accutane prescription filled. For those who do not know, Accutane is usually an acne drug and it is HIGHLY dangerous to unborn babies. Causes very severe birth defects. For that reason, any female of childbearing age who is on the drug must be on TWO forms of birth control AND must take a pregnancy test each month. In order to prescribe the drug, physicians must be registered through this system called iPledge and you can't get the prescription except through an approved provider. Furthermore, as a patient you have to register on this iPledge site. If you're of childbearing age, you have to take a test so that they know that you understand the risks of pregnancy, etc. Obviously, we don't have to do that for Charlotte but we do still have to follow all the other rules. Well, we ran into a few glitches trying to get her prescription refilled here:

Glitch #1: The prescription was originally written in VA under Dr. Khan so in order to transfer the prescription and have Dr. Wolff write the script, I had to go on to the iPledge site and transfer to Dr. Wolff as my primary doctor. It took us forever just to figure out that we had to do this.

Glitch #2: When Dr. Wolff went in to approve me (well, Charlotte) as a patient, he couldn't find her in the system. We worked on this all day (in and out of treatments) and while the system kept telling me my application was in process and awaiting doctor approval, Dr. Wolff couldn't seem to find Charlotte as his patient waiting approval. We were lost in cyberspace. It only took me coming back to the clinic after radiation and both of us getting on the telephone help line with the iPledge folks to get it resolved.

Glitch #3: I took the prescription to the MD Anderson pharmacy to get it filled. At this point, it was after 4 PM. They said if I wanted the prescription compounded into liquid form (I did) it would take almost 2 hours. So we headed back to RMH to wait. Meanwhile, Charlotte ate some dinner and we've been relaxing. I go to call the pharmacy about quarter to 6 to see if it's almost ready so we can walk back to MDA and the pharmacist tells me that she tried to call me (obviously called the home number which doesn't help much) and the insurance is not approving the prescription. No idea why since they approved it before. It may be because we are trying to get it compounded into liquid form. Needless to say, it will cost $300+. Basically, I don't care about the cost at this point, I just want the meds. She says, "Do you need this today?" and I said, "YES!!!". She didn't get her morning dose and I'm not waiting any longer to get this stuff into her. So she said it would be another hour...or so. Sheesh.

So we will be heading back over to MDA in a bit. At least the weather will have cooled a bit so we can walk. Fresh air and exercise will do us good.

Otherwise, everything is ok. As ok as it can be. Thanks for all the positive vibes and support we have been getting. It really means a lot. One step. One day at a time. That's all I can do. Dr. Bitsko called me this morning and we talked so that was helpful. One more day of treatment till the weekend. And two more days till we get to see DADDY! Yay!

Wednesday, August 5, 2009

A Difficult Day

"There are two ways of meeting difficulties: you alter the difficulties, or you alter yourself to meet them." --Phyllis Bottome

It's been a rough day. Plain and simple.

First of all, it's hotter than Hades here. Heat index was WAY over 100 today and we spent as little time outside as possible. No walk, no exercise for me.

Her appointments went well. The clinic was VERY busy. The busiest I've ever seen it in the lobby (standing room only). They did get us in pretty quickly, though. Then we just waited for Dr. Wolff. Her labs look pretty good. White blood cells are low but everything else is looking ok. So as long as she doesn't get a fever, we're still good.

Had to run through some rigamarole trying to get her Accutane prescription renewed. Still haven't filled it yet but I should be able to do that tomorrow.

We left the clinic with JUST enough time to wait for the shuttle, jet over to the proton center, and go right into radiation. Second day running on time. We're going to get spoiled! And after today, her time bumps back to before 1 PM! Yay! That will mean (hopefully) earlier time slots and less time NPO.

We came back to the RMH and she has been watching movies most of the afternoon. She got a great care package today from Aunt Kimmie with some new horse figurines to play with and some new videos so she's in 7th heaven at the moment. Didn't eat much (one corn dog bite and some chocolate milk...that's it!) but she had a poopie. Second day in a row for that!

Now to the tough stuff. I got onto the MD Anderson website last night to check some reports. One of the great things about MDA is that all of her medical reports get posted online and we have access to it. We also have all her appointments and can cancel, reschedule, and request appointments as well as contact anyone on her medical team. It's a really great website. Anyway, I knew that Dr. Wolff had been able to compare the post-surgery (May 29th) MRI with the MDA (July 14th) MRI (finally) and had taken it to the tumor board on Monday. Low and behold, he had posted a report.

And I quote: "The images from May 29th and July 14th were compared and reviewed....Some of the tumor lesions which had been left behind after the surgery became smaller during that time but there were new contrast enhancing lesions and leptomeningeal disease which appears to be new. This has to be judged as a mixed response-progression."

So what that means in lay-person terms is that while it looks like some of the tumor left over from surgery actually got smaller (yay) there are new tumors/lesions forming and the cancer has most definitely spread to the spinal fluid (NOT yay). Dr. Wolff and I had quite the talk about this today. He is still confident that the proton radiation will help shrink the current tumors; however, he realistically does not believe that radiation alone will be enough to fight this. We are looking at a cancer that grows very quickly, very aggressively, and is starting to spread into her spine. Not good. He mentioned a new drug (Velcade) that is used as a chemotherapy agent with many patients who have resistant tumors and this will probably be an option after radiation. We will continue to push the Accutane and possibly Topotecan (we can alternate the two every two weeks) during radiation and then revise the protocol following radiation to include a new mix of meds (some of the latest ones and maybe the Velcade).

It is so hard to hear this. It is so hard to know that while some of this treatment is working, it may not be enough. This is a very tough battle. I have always been a very positive person. Those of you who have known me a long time know that I pretty much try to see the glass as half-full. Always try to put a positive spin on things. And I am stubborn. I rarely give up (to a fault, I'm sure!). But every time we get a report back on an MRI, I keep getting knocked down a peg or two (or ten). Hope is there. Faith is there. But it is a weak candle that threatens to be dowsed at every turn. Here we are back in the middle of the hurricane and my tiki torch is getting drenched.

Please keep the prayer cycle flowing. Please keep the positive energy up (for me and for Roger...and for all of us). And just understand that I may not be the happiest person right now. I live life one day at a time. No faster....Perhaps I will feel differently tomorrow. Today it's a difficult day.

Thank goodness I have an appointment booked with Dr. Bitsko already for my return next week. And my "spa visit" is next Thursday. Much needed, don't you think?

On a funny note, I called the MCV clinic today to try to get Matt Bitsko's email address and check in with him on this issue (I seemed to misplace his email address) and the person that answered the phone said, "That person no longer works here." WHAT????? was the only thing I could say. Since when? What's going on? I didn't recognize the voice or name of the person answering the phone but he said someone from the office would call me back with more information. I just about went into a panic attack. Well, I decided to call Matt's voicemail (I did have that number) and just as I reached it, my call waiting beeped and it was the clinic calling me back. The same person was on the phone and apologized saying that he had gotten confused and had misspoken. Holey moley! Don't tell a woman in crisis that her therapist is no longer available!!! That's just WRONG!

So I guess that's really all I have to report. Sorry for the downer of a post. If you need a laugh, just go to yesterday's and look at the "funny Charlotte sayings" post.

I will add one more that I forgot: Another "latest thing" is that when we go somewhere, she always picks what animals/toys she will bring (usually Mickey but sometimes one other item) but she ALSO decides what I get to bring (mom, you get to bring the tiger and the snoopy!). Oh, gee, thanks. While I'm not already schlepping around the portable DVD player, your favorite books, diapers, and all the other accoutrements and necessities, I need my own stuffed animals, apparently. Ha! I have told her that I can only bring one animal with me and that usually satisifies her. She now has a Sorcerers Apprentice Mickey that she calls "Wizard Mick" but he gets to live on MY bed. She is FUNNY I tell you!!

Ok, that is all,

Rachel

Wednesday, July 29, 2009

Another Good Day

Another good day...except NO POOP (I feel like I'm becoming a broken record).

She slept in again this morning and barely got up when we were jetting off to the clinic. Had a nice walk over to MDA and they got us in almost immediately (plus we were early!). Dr. Wolff spent a great deal of time with us following up on things. We are still trying to track down the MRI that Joann sent so while we were talking with Dr. Wolff, he zipped an email off to Dr. Khan, Joann, Dr. Mahajan...pretty much anyone involved in her care...trying to track down the MRI. Also found out that she should have been on the accutane over the weekend. Again, typical hospital miscommunication where we thought we were waiting for the meds to be compounded and they assumed we would give it to her ourselves with our stash. I told him we would start giving her the meds this afternoon and he wants to see us again tomorrow to get the Accutane situation straightened out. He also said that he wants to get her blood drawn at least 3 times a week instead of just once per week (just in case). He was concerned about the non-poop issue and wanted to order an enema. He said I could give it myself but I didnt' feel comfortable doing that for multiple reasons:
1. I'd never given her one myself (just witnessed and assisted the nurses when she'd had them before) AND (more importantly)
2. I don't need her associating MOMMY with any more negative procedures.

The only problem was, we were only about an hour away from her proton radiation time and they didn't want to give her an enema and then have her "lose it all" on the radiation table. That could cause a whole host of problems. So we left with an appointment for 8 AM tomorrow and a prescription for lactulose which she started this afternoon. Fortunately, she took all her meds (the accutane went in the applesauce and the lactulose went into the chocolate milk) so we're good for tonight. Who knows. Maybe she'll poop before tomorrow (we can only hope...)

After the clinic, we headed over to proton center and didn't have to wait TOO long. They only took her 15 minutes late today. That's progress. Unfortunately, someone was celebrating the end of their treatment. Good for them, I guess, but there was food EVERYWHERE in the lobby. Charlotte didn't seem to mind but I really just about lost it when this very chatty woman who was waiting for her husband came over with cookies and some kind of pudding in her hand. She not only offered food but when I politely told her WHY Charlotte couldn't have any food, she continued to hold the food in front of her face and engage me in a huge conversation about her life. Oh joy. No offense to her, but I didn't really want to hear her life story and I REALLY didn't want her hanging food in front of my daughter's face (or mine for that matter since I was hungry myself).

Sometimes I really understand Charlotte's seemingly antisocial behavior. She's really not antisocial, per say, but she definitely likes her alone time. And I can totally understand that. Sometimes it's nice just to sit there with a book or a puzzle and not talk about cancer or medical treatment, or...whatever.

Anyway, after she was called in to the gantry and put to sleep, Grandpa and I went to get her prescription filled and get me some lunch. We timed it all just right and came back to find her in recovery. We were out of there by four pm. I think that's a record.

We came back to the house and she took all her meds (as mentioned) and ate some good lunch/dinner. Now it should be my turn for dinner soon. Rumor has it Ronald McDonald is coming to visit tonight!

Update:

POOOP!!!!

Yes, ladies and gentlemen, Charlotte has pooped. Maybe the lactulose finally kicked things into gear. (Plus all the "prayers for poop"!) It was kind of small (considering the amount she's consumed in the past week) but NOT hard (yay) and things are finally moving again. Maybe we can even avoid the enema tomorrow. See what the doc says.

She also ate even more tonight, having some cheese, chocolate milk, and bread crusts from the garlic toast (she likes the crust, not the soft middle). She watched the Ronald McDonald magic show from a distance but didn't want to get a picture with him or meet him.

On a slightly concerning note (it's always something, ain't it?), she is having trouble bending her knees. She's refusing to bend down to pick anything up or bend down to be changed. Have to check again with the doc about that. Apparently, pediatric PT services are hard to come by at MDA so I'm not sure what we can expect.

Have a good evening, y'all!!

Rachel

Tuesday, July 28, 2009

She is Doing Pretty Well

Another good day...except NO POOP!! Otherwise, she is doing pretty well. She slept about 11 hours last night. I let her sleep as long as she wanted to reduce the amount of time that she is NPO and she got up a little after 9. That gave me the morning to write a few thank you notes, read my book, and toodle around on the internet. Plus, I got to eat my breakfast without having her watch me.

We got up and decided to walk over to the MDA main building for the shuttle to the proton center. She walked over a block all by herself (her choice). While she was slow, she did a great job. It actually wasn't unbearably hot as there has been a steady breeze blowing for the last 24 hours. Still hot but at least breezy and the walk from RMH to MDA is pretty well shaded. We caught the shuttle and made it over to the proton center with plenty of time and they got her right in for her appointment with Dr. Woo. The ladies at the center (all the nurses and assistants) make such a big deal over her. Today she was extra cute with her superstar sunglasses. Dr. Woo didn't seem ultra concerned with her lack of poop and was happy that her weight was stable and she doesn't seem to have any other aversive symptoms related to the proton therapy. After he was happy seeing her, we were given the option to go back to the lobby or hang out in the exam room. CJ chose to stay put so I read my book while she read books and watched videos and was greeted intermittently by the proton therapy staff.

Grandpa and Juanita arrived around 12:30/1 PM and she went out to greet them. Then she decided she wanted to go upstairs and check out the playroom there. Boy, was our timing good. The child life specialist had just arrived with some new toys, one of which was a pink and purple doodle-pro that she said she picked out "with Charlotte in mind". Charlotte played with that for quite a while and then read a few books. Finally, around 2:30 (an hour late...again) they came to get her. Off to lunch again for mommy and she went to be irradiated.

We came back and she had just gone into the recovery room and woke up about a half hour later. We went back to the "camping truck" at the RV park for dinner and Charlotte ate a whole ear of corn, some chicken, and some chocolate pie. She was pretty talkative and has been in a relatively good mood (despite the constipation).

While exploring the camping truck, Charlotte found a honeydew melon and decided it would be fun to put a hat on it. Then we found some markers and decorated it. Result: Grandpa Honeydew. Pretty cute and we all had a good laugh.

We came back to RMH and a gift was waiting for us: Aunt Lynn had donated one of those Koala Care diaper changing tables for the RMH and the company had matched it with an additional gift (and covered the shipping). Hooray and thanks, Aunt Lynn. I am sure the folks at RMH will be appreciative.

Now Charlotte and I just finished having a heart to heart about pooping. I am becoming more and more convinced that she is holding in her poop as she talks about "I don't like to poop. I only like to pee.". We have talked about how necessary it is to poop to stay healthy and that if she doesn't poop she's going to end up back in the hospital. Sigh. We'll see if it works.

Talked to Roger briefly but it sounds like he has had a good day. We are back to the clinic and then back to proton therapy tomorrow. At least we have a routine.

Rachel

Friday, July 24, 2009

All is Much Better

We all had a much better night last night and day today. We keep getting rides in ambulances and I think Charlotte is developing a thing for one of the "Ambu-Guys," Isreal. It must be the ponytail, goatee and earring. Hey, wait a minute!!! ::-)
The Bonitas are uber-helpful as usual. When we got settled in the hospital room, Juanita stayed with Charlotte and Dad and I went to get dinner downstairs. It was wonderful because I got to have Chick-fil-a for the first time in 2 weeks or so. It was also bad because I haven’t had hardly any fast food in that amount of time so the fried food sure did a number on me! Still working that out (so to speak).
Sitting down with Dad was so strange. Mostly because I wasn’t sitting next to Charlotte and I wasn’t freaking out about anything. And boy, did I feel tired!
So this am she ate a little and we had a relatively quiet morning. She still seemed a little sullen but her fluids sure are "fluiding."

The ambulance folk showed up at about 1:30 to take CJ to the proton center this time Isreal came with Laura (who reminded me a huge amount of one of our fellow Romp n’ Roll franchise owners). This time we got there very early and waited for about an hour until our appointment time. Grandpa held her on his lap for most of that time. She sure loves her Grandpa!
After she went in (with the accompanying rendition of Frosty. I hope she doesn’t get sick of it but her little hand out for “STOP!” just tickles the staff to no end) the Bonitas and I went back to The House so I could check mail (stuff keeps coming in, thanks), get a few things, and eat. Juanita made me some amazingly good stew and we were treated to another big o’ hairy thunderstorm that dumped a large amount of rain on our area.
Radiation treatment #3 went fine and CJ was in the recovery room when we got back. The Bonitas (isn’t that a kind of sport fish?) had to go check on the dog and awnings on the RV so they left planning to meet back up at the hospital.
Not much else happened until the ambu-guys showed up to take us back. It was Laura and Isreal again (that guy keeps showing up! Gotta go clean my shotgun! If I had one, that is). One thing I’m going to say about the drivers, they have to have super senses of direction because the maze that is MDAnderson Cancer Center is mind boggling. I do pretty well with directions and I’ve been so turned around multiple times, if I had been alone, I would have ended up like Jack Nicholson in The Shining.
Charlotte was actually feeling much better and was chatting up a storm. Laura had never seen the real Charlotte and was amazed.
So after we got resettled in the hospital room, Dr. Wolff came by to do what he does and work out what he thought might be a good plan of action. The short-term plan is to keep watching her at least one more day, do the new routine of hang out here, ride the ambulance ( Isreal is off tomorrow so I don’t have to worry about him!  ), and see how she improves. He was happy with the looseness of her legs but her neck is still stiff. She interacted with him pretty well and smiled for him. It definitely helps that he’s a friend of Dr. Kahn, “one of my favorite doctors!”
As far as the chemo goes, he is deferring to Dr. Mahajan (radiation oncologist) who feels uncomfortable having her on the multiple drugs for which her protocol calls so I think they will only be doing one. Dr. Wolff mentioned Acutane but that’s the one that really dries out the skin so that may not end up being the one.
After Dr. Wolff left, the Bonitas came back and Dad and I turned right around and went to the Target for sinus headache stuff for me (nothing happening now but just in case) and a Clifford video. We didn’t find one but I found a cheap Thomas video and one with several Nick Jr. characters doing bedtime stories including, but not limited to, Wonder Pets, Blue, and Dora. Perfect.
We got back to Juanita teaching CJ about swimming in chocolate pools (not a bad thing at all) and to say “AWESOME!” (could be a bad thing). She was feeling restless so we went for a walk!!! She was raring to go and didn’t have to asked twice. It’s the first walking she’d done since Wednesday and that wasn’t much. I guess it was the first real walking since Tuesday night.
The rest is actually nice and boring. The Bonitas left, Charlotte and I snuggled on the bed for a bit, I got into my jammies, and here I am typing the update. I can deal with boring for a few days.
There! Got it done in under 3 pages!

Thursday, July 23, 2009

Charlotte Admitted to the Hospital

I know everyone is probably chomping at the bit for some kind of update. I can't do it justice so Roger will need to give the full rundown but suffice it to say it's been a rough 24-48 hours or so for Roger and Charlotte.

Here's the brief update:
First day of radiation ran late and really long.
She got nauseous and started vomiting about 1 AM.
Had second day of radiation BUT also saw oncology doc and there were concerns that she might have some kind of bug. She got admitted to the hospital so they could give her fluids and monitor her progress. Hopefully won't be admitted for long.

That's about as much as I know.

Also (fortunately) Bob and Juanita are now in Houston so Roger has some backup support.

I will let him supply further details. Last time I talked to him, he was really tired. I'm hoping he got some rest.

As for me, I'm hanging in there. Working a lot and can't believe it's almost my turn to go to TX. Had a really good meeting with Dr. Matt yesterday (always helps) and work has been going well. I've had some great angels bringing me meals, flowers, and other bits of sunshine to brighten my days.

Gotta go get ready for another busy day.

Rachel

Update:

Guess what? This one’s tipping 5 pages in Word! Rachel's post was pretty much IT in a nutshell so if you only want shells, that's all you need. Go get some coffee. If you want nuts keep reading. And go get a whole pot!
MAN! I hate it when I'm right (and I'm right so rarely I should appreciate it).

The last couple of days have been brutal. I haven't felt awake enough, or had enough free time while awake to post on CB but hopefully my little blurbs on Facebook helped some of you get at least a partial fix. Not sure I can make it long tonight. (Actually I didn’t. I had to put down the laptop and sleep. It’s now 4:45am)

So we're in the hospital. I mean the actual hospital, admitted for observation because Charlotte isn't eating and threw up four times today. including once right in front of Dr. Wolff.

But I'm getting ahead of myself.

Yesterday (Tuesday) started her proton therapy treatments and Charlotte had trouble from the start. We had to wake up at the buttcrack of dawn to try and get her to eat something before she went NPO at 5:30am. No-go. She wasn’t interested and I don’t blame her. My problem at the time (and there were many on Monday) was that she wasn’t going to get to eat all day and there is always food floating around The House. I wanted to minimize CJ’s suffering by at least getting her to eat something. As I Said, no-go.
So I let her sleep and she didn’t eat all day. It really wasn’t an issue because she hasn’t been eating much and she didn’t ask for anything. Her appointment at the proton therapy clinic was (supposedly) at 2:30pm. On MYMDAnderson.com, it actually said 2pm and, as I have since found out, the clinic had 3:30. But I didn’t know that so let’s not taint the post too early.
She slept in again and I didn’t disturb her to make the time between awake and food as small as possible. When we finally got up, we did the usual, watch a video, go downstairs, play with shoestrings, etc.
I mentioned her “stiffening up” before and it has been slowly but steadily getting worse. I was going to mention it to the Drs. at Wednesday’s appointment. She’s getting to the point that she doesn’t like to sit up. She’s also very lethargic which isn’t a good sign.
There are shuttles that go around the medical center from The House and the only one that would get us to the proton center on time for the 2:30 appt. leaves at 12:45 so we had to take that one and get there early. Not a problem, I always have stuff for her to do. She hasn’t really been the mood to do anything except be held or play with shoestrings anyway.
So we got there very early and checked in. Who knows? Maybe they could get her in early. (Writing that now I think to myself, “you silly, naïve little man.”) At least they got her in to get the vitals. Then we went out the lobby and waited. And waited. And waited…(Remember the John Houston version of the story of Noah?)
Finally, at about 3:30, I asked someone to go check and they came back and told me they were backed up (REALLY?!?) and Charlotte is up next. Well in proton radiation-speak, that could mean a long time. Most of these treatments are at least an hour long, the place has a steady flow of patients, and there are three “gantries.” The hours stack up. Which is why we were sitting there at 4pm waiting for what was originally supposed to be a 2:30pm appointment. Charlotte never complained or told me she was hungry the whole time. She was not feeling well I could tell and I just bundled her up and held her on my lap while she slept and I stewed. It was a very hard time sitting there letting my thoughts spiral around like they will do when I get riled. It also let in the “what if” demons and a couple times I just about lost it right there in the lobby. What really bugged me was that no one seemed concerned enough about us to at least keep us informed.
And then, with a lobby scattered with patients, many of whom are almost assuredly NPO (couldn’t eat), one of the doctors actually comes out and starts offering people chocolate! WHAT?!? I’m sure it was a gesture made with the best of intentions but incredibly unenlightened.
FINALLY after 4:30 (Charlotte was going on 20 hours since she ate last), they took her in and hardly anyone apologized for the delay and the sorries I got were superficial and insincere. I was livid by the time I carried her in to the Gantry that I had a hard time even talking to anyone. I wanted to break stuff, call people names, and write nasty emails. They know from before that CJ love Frosty so they had the lyrics already printed out and waiting and even that didn’t help. Charlotte wasn’t feeling great anyway so we didn’t sing. I really wanted to appreciate the scope of what was about to happen to her but I just took a couple pictures and left. Man! I was mad.
Now that she was in, I could eat something and when I went to get a snack, insult was added to injury. In retrospect, I realize this is a very silly thing to get upset over and a waste of energy but here’s where my head was at the time: In a rare attempt to eat healthy, I was going to get something other than the honey bun I got last time and realized the only thing remotely healthy was a little bag of peanuts and I just didn’t want that. I noticed anything of any “heft” was $1.25 so I stuck my $1 in and pulled out another dollar to chase but the machine wouldn’t take more than one dollar at a time. I didn’t have a quarter. Apparently neither did anyone else around me. It didn’t take $5s. There was no change machine. Internally, I blew up. My thoughts went from dark to biggest, meanest, hurricane storm cloud black. Had anyone spoken to me, or worse, asked me how I was, I think I would have just screamed in their face uncontrollably. I mean, these guys are supposed to be the absolute best IN THE WORLD at what they do and they have taken pains to make the environment as calm and “healing” as possible but they couldn’t think of a little detail like a freaking change machine or machines that take more than a dollar?!?
THEN! Noone called me back to the recovery room once she was done so it was almost two hours later (reminded of the time by my lovely wife) before I popped my head in to ask what was up. She had already woken up in the back and was getting her wits back. Talk about “when it rains it pours!” Things kept piling up so much I was beginning to think I had been set up.
Breathe. In-out-in-out
OK. Now you know how my annual freakout works. As I’ve said in a previous post, it’s turned into a monthly occurrence. I’m actually keeping a close eye on myself to make sure I’m not seriously losing it. That in itself is probably a warning sign, eh. Need to ask Matt about that. I’m doing “guitar therapy” on myself, staying very focused on CJ (once she was out of my control was when I melted down so I will need there distraction of working at Romp n’ Roll all the time) and trying to stay connected to everyone. Not doing regular CB updates takes its toll too. I’m telling you, it’s therapy.
Moving on, I did write that nasty email to MDAnderson and actually got results. They actually have a patient advocate and she filed a complaint in our name which is fine especially if they refine their policies.
OK, I said moving on. Charlotte went through her first therapy with no hitches and when I got back to her, she ate a fruit cup. The process had taken so long, we missed the last shuttle back to The House so they called us a cab. It’s not far and only cost $5 or so. I’m not sure but the woman (and her little boy) who rode back with us paid the fare and wouldn’t take any money from me. “Next time,” she said.
When we got back, they were playing BINGO and giving out some really amazing donated prizes. Charlotte wasn’t interested of course and just wanted to go into the playroom. That didn’t last long and it was off to bed. Good because we had an early appointment in the morning at the main hospital. I was feeling pretty wrung out so I just closed everything up and was asleep by 10.
Now there are few sounds in the world that strike fear into the heart of a parent than the tell-tale gurgling of a child about to throw up; especially in the middle of the night. I heard those sounds at around 1am. It yanked me from my sleep but I wasn’t fast enough with the bucket it went on the bed. I held her up, let her finish, and then got her cleaned up and gave her a zofran. I also stripped the bed and started a late night load of laundry (Man, is THAT a nice perc of The House.)
She threw up again about 4:45 and once more at around 6 but there was no fever and I figured it was just a little side effect of the proton therapy. I think in the end might have been part right. After the last episode, we just got up and got ready.
We walked to the main hospital because for some reason, CJ refused to get out of her stroller to get into the bus. No biggie, I need the exercise. When we got there, what I thought was a regular Dr.s visit ended up being an opthomology assessment. It was a bust because by now, CJ has become the most anti-social, uncooperative patient ever. It didn’t help that the eye doc kept shaking toys in her face and asking her 5 questions in a row without waiting for an answer and she asked “bad” questions at that. Rachel would have had a field day with her. Finally, I had had enough of it and ended the pointless berating telling her we would have to reschedule. My observation: a drawer full of toys doesn’t make you good with kids.
Can you tell I’m becoming disillusioned with MD Anderson at this point?
Next I went next door full of my daddy self determined to get some answers and see some people who, for some reason, weren’t communicating with us after we made it abundantly clear multiple times that we needed that. I checked in, told the receptionist that I really needed to find out what was going on with the chemo schedule and what we needed to do next. She got us squeezed in to see one of the nurses who took blood from CJ and then they put us in a room to wait for Dr. Wolff whom I had already seen running around looking very busy. I wasn’t feeling optimistic.
Then Dr. Wolff went and spoiled my mood. He single handedly renewed my faith in our purpose by coming in relatively soon, bringing his crew including Nurse Reh, who is his version of Dr. Tye’s Joanne, and did what I like second best about him (the best being that he’s a darn good oncologist), he sifted through the crap around the story, compiled information in his brain out loud right in front of us, and in a very short time, convinced me that CJ was actually dehydrated, had a bug that was probably easily treated, decided to admit her for observation and noticed the stiffness without my help. He actually said it was a classic sign of meningitis or a related condition although he said if it were really full blown meningitis, she would be a lot sicker.
He also asked me questions about what I think! Imagine that! I told him the impression I had gotten from my discussion from Dr. Vats about the tumor growing and the cancer cells in the spine. I think what I said jibed with his discussions with Dr. Vats so he finally told me what he thinks. He doesn’t think the tumor has grown but he needs the previous scan to tell for sure. Dr. Kahn was supposed to have sent it but no one can find it. Rachel is going to try to get a copy on disc to bring with her on Saturday.
(And now for something completely different: my belly makes a great laptop table!)
OK, I’m back. Dr. Wolff also suspects the cells in the spine have been there longer than everyone thinks. Another clue that it probably isn’t growing. He also said something interesting. He had mentioned how busy they were and the lack of rooms and I said I was sorry for throwing a monkey wrench into his day.
“Nonsence!” he said. "She’s a sick child, I love to treat sick children. The sicker they are the better.” I don’t think it came out quite right but I know what he meant. He’s up for it.
He didn’t want to interrupt the proton treatments because if it was actually something caused by the tumor, he didn’t want to get in the way of that. So Nurse Reh arranged an ambulance ride for us! Charlotte got to ride on a gurney through the halls and then in an ambulance to the proton center. First time I’ve ever been in an ambulance too. No lights or siren though. Oh well, I’m actually thankful we didn’t need them.
Before we left however, they hooked up a bag o’ fluids to her and she got rehydrated. Talk about a difference! She perked up and became quite chatty. By the way, she can see fine. She can see tiny pictures up close and identified pictures out in the hall from inside the room.
Day two at the proton center was like Charlotte after she poops (I just couldn’t have a post with no poop references!), completely different. We actually got there a bit after we were supposed to be there but right on time for the appointment and they rolled her right in. I carried her in to the Gantry and this time she was into the singing of Frosty (me too). She even did the “STOP!” with her hand when we got to that part. Then the happy juice kicked in and the last I heard was, ”That’s my favorite {zonk!}
In anticipation of the upcoming slumber party, I took the MDAnderson shuttle back to the main hospital intending to walk over to The House to get provisions from the room. I called my dad to see where they were in terms of getting into town and they said they were just getting ready to park at the main hospital! That was handy. So we met up, drove over to The House and I got stuff. We drove back to the proton center just in time to go see Charlotte in the recovery room. When she woke up and saw Grandpa KATIE BAR THE DOOR! I hadn’t seen that much energy out of that girl in a week. She sure loves her men. Grandma Juanita Bonita was all over her too “gettin’ lots o’ sugar.”
We got another ambulance ride back to the hospital and got settled in to our private room with shower. By the time we got here, she had closed back down and I don’t think she’s very happy to be here. Nice facilities, though. That’s another post.
Last night she had some juice and this morning she ate 4 crackers, a large pretzel, and most of a bag of 100 calorie pack Girl Scout cookies so at least something is going in.
So here we are at 8:15am, she went back to sleep pretty easily after some Blue’s Clues. Can’t wait to show her the playroom here. Pretty boss dude! Think she may need a diaper change.

Update:

A relatively short update:

The end

Sunday, July 19, 2009

A Journal Post from Rachel

So I realized that I hadn't done a journal post in quite a while, so here it is...

Life without hubby and daughter is surreal, kinda lonely and VERY quiet. I'm definitely busy with work so when I come home I pretty much just veg out in front of the TV or on Facebook or something brainless like that.

It's funny how much longer it takes the dishwasher or laundry basket to fill up and it's SO much easier to keep the house clean (especially when nobody is living in it). It helps that my parents and Kolbey did a major house cleaning while we were in TX so I came back to a sparkling pad (thanks).

I have really appreciated all of the kind words and support that have come to me through emails, facebook updates, folks stopping in at romp n' roll, etc. I've had invites out and meals cooked for me (thanks, Beth!) and I am really feeling nurtured and supported. That is great. I think I am also (finally) accepting the fact that it is OK for me to take some time to do NOTHING on occasion. That's not a natural way for me to live my life but constant stress will help you realize how important a break from work and daily activities can be. I'm learning how to "treat" myself and put myself first every once in a while. As any mom can tell you, that's not an easy thing to do.

Yes, I'm still sad. The news of the week was definitely not a morale booster. This cancer keeps hanging heavily over our heads and our hearts and it still makes my heart (and body) ache. I am convinced that we are in the right place and I think of all of the fortuitous events that got us here:

If Charlotte had been older, we would have started radiation immediately (rather than waiting and starting chemo first). If that were the case, we would most certainly have stayed at MCV and probably would never have explored the option of proton beam radiation. It probably wouldn't have even hopped up on our radar (yes, pun intended!). By going the chemo route first, we have been able to see how aggressive and mean this tumor is but it has enabled us to connect with the amazing doctors at MD Anderson. I am grateful to Dr. Khan for his knowledge, experience, and connections to such a fabulous facility. I don't think we would be in Texas right now if it weren't for him. Also, while it's hard to be away from each other right now, I think Roger and I have now developed a better rhythm in terms of how we are dealing and coping with this event on our lives and that makes the separation a little easier right now (as opposed to six months ago). Yes. Tomorrow will be SIX MONTHS since her diagnosis. We have reached the half year mark.

I just want to segue for a moment and brag about my husband. Yes, he is a GREAT DAD. You all know that and helped to get him the recognition he so deserves. He is also my partner, my teammate. We've been married for almost 12 years and we've been together for almost 15 years. That's a long time. We don't always agree and we frequently drive each other crazy but I could never imagine my life without him and we wouldn't be dealing with all of this as well as we are without that strong bond. I just wanted to take a moment to get "mushy" (as Roger would say) and acknowledge what a great person he is and what a great team we are.

Ok, collective: AWWWWWWWW....

I must switch gears, close up shop, and get ready to go to work. My next "day off" from romp n' roll will be in a week. When I will be in Texas. Crazy life we lead....

Rachel

Thursday, July 16, 2009

Some Bad, But Not Unexpected News

Hi all,
Huge post ahead.
Some bad, but not unexpected news: While Charlotte was in her neurocognitive assessment playing games with the two ladies (whose names I've already forgotten, sorry), I got to look at the latest MRI scans with Dr. Vats (Dr. Wolfe's colleague). We didn't have the post-3rd surgery scan for comparison but the tumor is definitely still there in bits and pieces and possibly still growing. I'm going on the assumption that it's growing.

Dr. Vats also said that there was evidence that it has spread into the upper spine (again, not altogether unexpected) although the computer he used to show me the scans didn't have enough resolution to pick up what he saw on his own computer so I didn’t actually see it. I’ll take his word for it.

Now, before anyone totally freaks out, it's certainly not good news by any stretch of the imagination but the proton radiation protocol has already accounted for the possibility and now we know that it was necessary to plan for head and spine after all. That starts next Tuesday.
Dr. Vats was still very positive and confident that we’re headed down the right path. He did say that he would bring Charlotte’s case before the “tumor board” on Monday to elicit opinions and also that he would explore the possibility of injecting chemo drugs directly into her spine via an LP once every two weeks, adding to Dr. Tye’s recommendation of “throwing the book at it.”
On a good note, CJ wowed them in the assessment with her vocabulary. They’ll get back to us with the official results of the testing as soon as they tally up everything. Dr. Vats was also happy with the recovery of CJ’s left side.
I’ve had several messages from people worrying about how I’m doing emotionally and all that. First off, thanks for the concern. It does mean a lot to me to have so many folks concerned about us.
I’m hanging in there. I’m nowhere close to thriving and I have my off moments but I feel like I’m dealing pretty well. I’ve been thinking very deep and hard about my/our situation and I feel about as focused as I’ve ever felt in my entire life. Crisis sure brings perspective down to a pinpoint, doesn’t it? Nothing else matters besides my daughter’s fight against the cancer. If I have any concerns for myself, it’s how I will deal with things after everything plays out (however it plays out). Different scenarios (best and worst) run through my head all the time but so far they haven’t distracted me from the here and now. I guess I’ll have to figure that out when I get there.
I can’t really speak for Rachel but I think she’s doing a little better. Today’s news didn’t help but she’s using her resources at home, MCV (mostly Dr. Matt), and within the circle of friends & family, and finding more solid footing. Romp n’ Roll is keeping her occupied (my turn when we switch) and Meredith orchestrated a day at Diva’s for her so that will help too! Anyone wanting to donate to that cause can send checks to me.
We will need support in Houston as the proton therapy and chemo kicks in and leaves CJ less functional. My dad has offered to come out as early as next Wednesday and stay for about a week. If anyone was planning to come out, we could use someone after that. Don’t ask me when we want you; tell me when you’re available and willing to come out between then and the end of August and I’ll plug you into the schedule.
The Beazleys have been fabulous and will continue to be. Merrilee is watching CJ tonight so I can go see Harry Potter (Brought my “Muggle” t-shirt and everything, just in case!) and they’re letting me borrow a car this weekend in the guise of having me take them to the airport tomorrow.
Now back to the important stuff, Charlotte. We went to the circus last night and although she liked the pretty horses and she got downright excited to see the elephants, she didn’t make it to the intermission. She was pretty mellow through the pre-show stuff but perked up when the lights went down. Unfortunately they were definitely trying to be Cirque de Parfait which didn’t work in such a large venue and they lost CJ pretty early on. The ringmaster was actually a pretty good Broadway-style singer from Houston who had been with the circus for a couple years now. There was a lot more song and dance stuff than I remember from the one time I saw Ringling Bros. before. There was a moderately silly Jets vs Sharks thing during the Act I finale but one thing really grabbed me. One group of clown “henchmen” came out bouncing on what I can only describe as innertubes with saddles. They did some very cool flips and such off and onto them and now I want one for my own. They also did the motorcycles in the ball trick but they kept adding more and more riders until there were 7 in there. I can’t for the life of me figure out how they all fit in there without knocking each other’s ankles.
Throughout Act I, Charlotte became more and more clingy and finally just climbed onto my lap facing me, put her head on my shoulder and zonked. She slept through the extremely loud finale so I just grabbed everything and headed out when the lights came up for intermission. I was quite the site heading up the stairs with CJ’s unconscious body in one hand, the stroller in the other, and the backpack on my back. At least she was awake on the way down to the seats.
I was going to just call a cab and go back to The House but I just happened to run into the manager of the outing and she called the bus to come get us.
A nice side line, the bus driver told me her story as we rode back to The House last night. Her son was diagnosed with leukemia back in 2000 and spent the next 4 years being treated at MDAnderson. She lived in The House for 4 years while he was treated. She gave up everything to be with him including a successful business and most of her friends and family back home. He’s now 18 and going into college and she now drives the bus for The House. She feels such a connection to the families here that she’s always willing to come in on her day off to help or cover shifts or whatever it takes to make the families’ lives just a little easier. Yet another inspirational story out of a sea of them.
So keep the positive vibes aimed at Houston (with a little left over for Richmond). We’re keeping up the good fight from our end.

Love to everyone,
Rog, Rach, & CJ

p.s. I'm using Facebook for photos and Caringbridge for updates (mostly). If you don't have Facebook and want to see pics, please have someone show you. I don't want to fool with photobucket or the others.

Tuesday, July 14, 2009

An Update from Houston

Let's settle in for a nice long one, shall we?

I'll try to get this done by midnight.

The day started off pretty good with Rachel getting off at a decent time (thanks to Robert and the Houston Ground Angels for the lift to the airport). I understand she upgraded to business class. The ticket agent offhandedly quipped, "you deserve it." and Rachel said, "You have no idea!" You got that right!

After that, I got to get ready at a leisurely pace since our first appointment wasn't until 10:15am. I woke up Charlotte, got her ready, and we walked over to MD Anderson to start our day.

The first appointment was a chest x-ray on the 3rd floor by Elevator 7 (the world of MD Anderson revolves around what elevator your appointment is near). We got there super early and I expected to wait a very long time but I guess they didn't have all that much to do and they got us right in.

The only drama was when CJ saw the actual x-ray equipment. She's had x-rays before but this looked a little more intimidating than the other times and she started getting scared but she's smart and after I explained what was going to happen and how I PROMISED it wasn't going to hurt, she was game. They actually made her stand, which was a new one, and she did whatever the x-ray technician told her to. I got to wear this big o' lead-lined glove to both protect her lower back from the x-rays and my arm from frying while I helped hold her in place. She thought is was funny.

BTW, she has started picking up the phrase, "big o' (whatever)." She used it twice today. Sometimes she adds "hairy" to it like I do once in a while: "Charlotte, you've got a big o' hairy stinky diaper!"

But I digress

So the chest x-ray was pretty easy, early, and painless so then we tooled over to Elevator C 7th floor which is the Peds clinic where we went before to see Dr. Wolfe. We wew actually slated to go to teh second floor but they re-reouted us to the 7th floor because that's where we were supposed to be anyway. The 2nd floor is for adults.

The place was hoppin. The playroom was full of kids, the music therapist was there and he had the kids wrapped around his finger. I was a little soso on him the first time but he was jammin' today. The child life specialist from last time was there too and she remembered us, remembered where we were from, and even some little details about Charlotte's favorite things. That always impresses the hell out of me.

This segment of the day went well too. Miss/Nurse Toni drew the blood, gave CJ a little Snoopy dog (she got a "Fleece" Beanie Baby before the chest x-ray and a platypus Beanie Baby at the Proton Center yesterday!), and we headed back to the "Imaging Center" for the scheduled MRI/assessment starting at 11:30.

Now things started slowing down. It seems there was a problem with one of the machines so they were running behind. Remember that Charlotte was NPO for the second time in as many days. No food all morning and it was getting to be noon-y. Never once did she complain. We read books, watched Sid The Science Kid and Blues Clues videos until the battery in the DVD player petered out. and talked to a couple other patients there. I think the batteries petering out scared them into doing something for us so they at least let us go in the back to wait. I plugged in the DVD player in the back and we finished the Blues Clues that got interrupted out front.

Then before you know it, it was our turn. We went into the MRI room, CJ was holding on pretty tightly but not really freaking out. Again, I told her what was going to happen and it helped, I think. She got the goofey juice, she conked out and I got the next 45 minutes to myself. I went and got lunch!

The time was just after 2pm. It was supposed to start at 12noon. And the MRI lab was pretty chaotic because other doctors were trying to cram other patients in an already full dockett. Like at the Proton Clinic, CJ slept far longer than normal and this time, they had her hooked up to saline for fluids, and by the time I changed her diaper, it was a big o' hairy saturated diaper!

Well my eyes are fighting me so I'll try to finish this tomorrow.

Buenos noches and adios amoebas!
Rog

Monday, July 13, 2009

Interesting Day Yesterday

I never heard from the media folks at the Houston Astros so we decided to just go and buy tickets. They have a cool deal for the summer that children get in free. We drove down to Minute Maid Park and found a tremendous parking spot right across from the Left Field entrance. Cancer really, really sucks but some of the percs are very nice, like handicapped parking!

We got in an got settled in our very nice seats. The weather is extremely hot and humid and we were "angsting" about where we would sit so the sun wouldn't be shining right on Charlotte and where we could retreat from the heat if it got too overwhelming. We held up the line at the box office trying to get just the right seat. Turns out we didn't need to worry; the roof was closed and the weather inside was fine.

All morning long, CJ had been kind of lethargic and I was starting to get worried that maybe she was getting sick or something. The "or something" part was actually really worrying me. It's been a brutal couple of weeks within the Caringbridge community and several of the children whose stories I've been following have passed away. Whenever I hear of a child passing, I go back in the journals and read several of the posts leading up to the passing annpouncement to see what happened and how things progressed. Yesterday that practice kind of haunted me as Charlotte's energy level kept going down and I got more and more worried about what might be happening to make it happen.

At the Astros game, we went into the store to get her a hat or jersey (pink, of course) but she would have none of it. She just wanted to be held and bury her head in my shoulder.

She had no fever, she wasn't feeling sick, she wasn't in pain, and she was eating (certainly helped make a dent in a bag of popcorn and some ice cream). She even wanted to walk after a bit (bored I guess) and we walked about 3/4 of the way around the stadium before she petered out and made me carry her.

So I was at a loss to figure out what was wrong and the fear was threatening to take over.

We lasted until the 7th inning stretch and then headed home. Charlotte conked out on the way back to the house (the only other warning sign) and I took a nap too. When we got up we headed over to our hosts, the Beasley's, home for dinner. Charlotte was STILL lethargic and I was wondering if we were going to have to take her to the emergency room. The thing was, other than the low energy and the nap, nothing else stood out.

So my habit of checking out the lead-up posts on all those other Caringbridge sites was backfiring on me because I was starting to go through worst-case scenarios.

Then, all of a sudden, she seemed to brighten up remarkably and told me, "Daddy, I pooped!"

That was it. Rachel remembered her mother saying something about that kind of pattern before and we also realized that it had been multiple days since her last BM. It all made sense.

So it all comes back to poop. The theme of our lives.

After that, Charlotte was like a different kid. She was sitting on the couch, entertaining herself like usual, singing to Mickey, rading stories to herself, watching the occasional video...

We headed back to the other house (where their daughter lives) and tried to get to bed at a decent time because we had early Monday appointments. Of course CJ was now wired and we had to set her up with books and videos while we rested. Fortunately, she took my word for it that we needed to go to sleep so she let me clear things off the bed and pull up the covers.

This morning we headed out early and got the MD Anderson in plenty of time for our whirlwind day of waiting.

I keep trying to put my "day of fear" into some kind of perspective and I just can't right now. It was mostly irrational fear fed by looking at other kids' sites, most of whom had conditions not related to the PNET in Charlotte's head. I need to digest it a while longer. I also don't think I'm describing it adequately. I don't even think Rachel has a clear idea of how I was feeling. Guess she will now, sort of.

The best news of the day is that we called Ronald McDonald House and they have room for us!!! We'll be heading over tonight to get settled in. SO that means we need to contact the Hoston Ground Angels to see if they can give Rachel a ride to the airport tomorrow on very short notice.

I'm on it!

Update:

Welcome to our new home away from home. We have been admitted to the Ronald McDonald House and can be here for the next 45 days if needed. At only $25 a day, you can't beat the accommodations! It is fabulous with a play area, lots of space for cooking, we have our own room with 2 beds and a bathroom, and even the "house dog"...a labradoodle named Mogie.

We can receive mail while we are here. The address is:
1907 Holcombe Blvd
Room 27
Houston, TX 77030

The morning was pretty much spent with paperwork and an anethesia assessment and now we are just resting before our trip over to the proton center at 3 PM. Charlotte had to be NPO at 5 this morning because of the anesthesia they will use and, of course, she did not get up at 5 AM to eat so we are all trying not to eat in front of her. But mommy and daddy have to keep their strength up so we are sneaking bits of cracker and granola bar here and there. She is holding up pretty well. We will have to FEAST tonight.

I'm very glad that we have the housing settled before I have to leave tomorrow morning. I am not looking forward to leaving the 2 most important people in my life for almost 2 weeks but we do what we gotta do!

I think we're off to play and explore so we'll talk to everyone soon.

Rachel

Update:

What a long day. A good day. A productive day. But a L-O-N-G day.

As mentioned earlier, we have found our lodgings here at the Ronald McDonald House. It's such a great place for families in our situation. We are about a mile from the main MD Anderson campus and the shuttle can take us pretty much anywhere we need to go. It even goes to the grocery store once a day. They have full kitchen facilities for us to use and lots of community items like seasonings, eggs, condiments, etc. so that cooking is pretty easy and doesn't always have to be ramen noodles!

Plus, almost every night, a community group comes in to provide dinner and sometimes even additional activities. Southwest Airlines is bringing a group tomorrow and rumor has it that their events are not to be missed. Some of their volunteers are already here starting to roast the brisket for tomorrow night (can you tell we're in Texas?).

After we left RMH (as we will probably refer to it in future posts), we took the shuttle over to the proton center which is pretty much on the other side of the hospital area. It's about a 20-30 minute ride by shuttle. Charlotte was pretty quiet and mellow most of the day. She hadn't had anything to eat since last night and they'd only allowed her about 4 oz of juice after 10:30. Amazingly, she only told daddy one time that she was hungry. When he told her she couldn't eat until after she saw the doctor, she never asked again. What a trooper. I, on the other hand, was famished!! But didn't want to eat in front of my NPO child.

We got to the proton center and had very little wait. We immediately met a string of professionals including our Nurse Practitioner, the oncology fellow, and then Dr. Mahajan who is her radiation oncologist. We discussed the treatment plan, they went over all the possible side effects, and then we discussed the fact that she would be having whole brain and spine radiation after all. Roger and I were confused for a little while, mainly because Dr. Wolff and Dr. Khan had maintained that proton therapy was not necessary for whole head and spine radiation and that we were going to focus on the tumor area. Turns out that's not exactly the case and in fact, she stands to benefit more from whole head/spine radiation due to the location of her tumor and should receive less effects from the radiation on areas such as her thyroid gland and other vital organs by receiving the proton therapy.

After we met with the radiation oncologist, the anesthesiology crew came in. Dr. Porche is her primary anesthesiologist and she is such a sweetheart. She just swooped Charlotte up in her arms and began to sing to her and ooh and ahh over her. So nice! The nurse anesthetist (sp?) also informed us that while she was receiving proton therapy, they would change her dressing twice a week, do all the line flushes, and basically take care of anything else that needs to be done with her lines. Hooray.

Finally it was off to the simulation. Charlotte got to actually "administer" her own juice by starting the pump and pushing the syringe to flush the line. As tired as she was, she was out in no time. Then we got to meet with the research nurse to go over permissions for them to study Charlotte's blood and DNA as well as participate in a longitudinal data study for basically the rest of Charlotte's life to help them study long-term outcomes of proton therapy. This means that data such as hormone levels, cognitive tests, etc. will all be collected at regular intervals on her. Anything that will help kids down the road, that's what I say!

We also met the Child Life Specialist who told us about some upcoming kid's events and offered some ways that their services could be helpful.

Did I miss anyone? There were a lot of people to meet. Soon enough, Charlotte's procedure was finished and we went to meet her in recovery. It took her FOREVER to wake up but she finally roused (with some assistance from us) and we shuttled her back to RMH with some dinner. Roger took Merrilee's car (she had left it for us at the proton center) back to their home in Jersey Village and collected all of our belongings and made his way back to RMH all in one piece.

We must make yet another (although I'm sure it will not be final) note of thanks to the Beazley family for their most gracious hosptiality and help with this process. they have gone above and beyond and we are grateful to them as well as to Mitch and Meredith Hayes for making the connection.

So we are basically "moved in" and settled. Clothes are unpacked and put in dresser drawers. We have a moderate supply of groceries and snacks that will last until the next grocery trip. I have given Roger many final instructions and reminders on her appointments, etc. (I tend to be the "manager" of all that information. Surprised?). I am leaving early tomorrow morning and only taking my big purse/tote bag with me. No clothes (they can stay here for my return trip), no diaper bag (whoopee), no stroller. Just me, myself and I.

See many of y'all back in Richmond. I've got a lot of work ahead of me and Charlotte and Roger have quite the adventure ahead of them.

Rachel