Busted -- Again

Seriously?

Seriously.

The month has been fairly uneventful for Emma as far as cancer is concerned. She finished the second round of interim maintenance like a super star. Her hair is coming in like soft baby fluff.

Earlier today she got a blood draw and her counts are good enough to start maintenance tomorrow. It will be a pretty big day... we'll learn which track of the study she will be on. That determines the dosing and timing of her chemo over the next couple years.

This afternoon, though, Emma broke her leg.

She was playing, put her right foot into the recliner between the footrest and seat, then stepped on the footrest and put it down on her own leg, fell over onto it adding pressure, and, well...

Screaming ensued. Emma hasn't really reacted to pain much since cancer; she just gets along with stuff that she can handle in a way that is atypical for a 5-year old. The screaming didn't go away and sounded hurt, rather than offended. I was pretty quick to decide on a visit to the after hours kid care where they are beginning to recognize us. The x-ray shows a busted tibia.

She came home with a splint. Tomorrow while we are already at Primary Children's for clinic and a lumbar puncture, we'll see the orthopedist as well.

And here is another great picture of Emma's photo shoot in February because she's so stinkin' cute.

Busted

Emma broke her arm this weekend. Hairline fracture on both forearm bones of her left hand near the wrist. It isn't a growth plate or a compound fracture. It would heal fine without a cast if she would avoid straining and pressuring it while it is healing; but she is 5. It gets a cast.

Also, here's a great picture of Emma. A friend suggested we get some professional photos done when she lost her hair, and I may start dropping those in from time to time.

Emma started Interim Maintenance part 2 on Tuesday. She had a lumbar puncture with some intrathecal methotrexate, and she had some I.V. Vincristine. We go back Friday for an increased dose. Interim Maintenance 2 is similar to IM1 in that they accelerate the dose until we reach her highest tolerance level or until we hit day 57.

Each dose will be count dependent, therefore, to determine if she is reaching her tolerance levels for the drugs.

Our First ER Visit

Thursday after music Emma was pretty tired. This is normal: she tends to be tired in the afternoons, particularly after an outing, even just a blood draw at the lab down the street. Also, for background, Clinton and the boys heroically fought colds last week and this week it was my turn.

When her temperature stays above 100.4 for an hour, or when it reaches 101, we call the doctors, and they treat it like an infection which surely means going to clinic or ER and possibly hospital admittance.

Emma stayed pretty lethargic, so we started watching her temperature. At about 6:00 her temp was 100.8. At 6:30 it was 101.9 and we called. While we were waiting for the on-call oncologist to return the call, Clinton and I tossed stuff into a suitcase for an overnighter. Dayna called as I was zipping up and said to come in.

Emma and I jumped in the car and got to Primary's Emergency Room just after 7:00. As we walked through the door, the receptionist asked if this was Emma and we went right in. Incidentally, 20.8Kg is her highest weight, and probably will be for a while since we're off steroids.

They accessed her port, took blood, gave her an antibiotic, some tylenol, and some fluids. The doctor was concerned about her tummy being so tender. She's been battling constipation - a common side effect of her treatment.

They did an X-ray of her tummy. Her fever came down a bit. We watched Swan Princess. Her X-ray showed a lot of constipation and impacted blockage. We started another movie. Her temperature got to normal.

The doctor explained about typhlitis and wanted to be sure we weren't getting that, which would be a really bad thing. At 11:00 she took the contrast (dye) for a C/T scan, which takes an hour to work through the system. At midnight we went in for the C/T scan. At about 1:15 the C/T scan came back negative. YAY! Discharge orders, de-access port, and we were home right at 2:00 a.m.

Next day the fever did not return. They figure it's viral; but we need to keep a watch on her. And we get the weekend to try to clear the constipation with miralax and prune juice before taking more aggressive action. Ugh, I know. Gross; but that's one of the complications of treatment for Leukemia.

Email to family Sunday

Update,

White blood cells are low, red blood cells are low, platelets are low. This could indicate a few different things,  among them,  leukemia.

Chest xray shows a little bit of enlarged on one side of the heart. This could indicate a few different things, among them,  leukemia.

There was also a bit of cloudiness in one lung, which looks a bit like pneumonia, or it might be an indicator for leukemia.

She has a lot of bruises on her legs, feet, and back. We don't suspect physical abuse, but even aside from that, she's an active kid; but the bruises can also be an indicator for leukemia.

She's been complaining of pain in her feet and legs- and where it hurts moves. Serious limping sent us to instacare Saturday. Bone pain can mean growing, or other things, or Leukemia.

Emma's blood under the microscope doesn't definitively tell. They see suspicious things, but no absolute. 

We are waiting for an operating room. Once they pin together all the broken elbows and stuff, we will go in for a bone marrow aspirate and biopsy. The marrow will tell definitively whether we have leukemia. They have a couple other possible diagnoses; but you can see the evidence.

They don't allow plants, so no flowers.

Primary children's is a good place for a 4-year old to be in the hospital. Emma has a pile of polly pockets, an xbox, coloring books and crayons, a pinkalicious puzzle, and princess memory, in addition to cable and movies. She can request any other toys and books, too.

We went to 30-minute sacrament meeting. Our ward is on alert.

We will let you know anything else. Thanks so much for prayers and support.

Clinton,  Merinda, and Emma