At Her Parents Resting

After a full strenous week, Erika can finally take a break. Spinal taps were still painful but she got through it. Radiation so far have been manageable.  Erika has two more sessions of radiation next week Monday and Tuesday. A final spinal tap will also be done on Monday. Phase CNS, #3, will finally be over soon.

Enjoying the sunset

CNS Day 3 and Spinal Tap

Update: Radiation therapy went well. It was controlled mostly by taking high doses of pain medications. Her spinal taps still resulted in pain from the spasms. It's been a crappy day for her.



Heading down for day 3 of radiation and her 8th spinal tap. Her last radiation treatment caused an unbarable migraine. She was in tears for 2 hours. Her last spinal tap was also very painful causing spasm in her lower back. "It felt like someone is clinching my spine and twisting it" is what she said it felt like. Lets hope today is better.

CNS Begins

Radiation therapy is scheduled today, tomorrow, next week monday through friday, and the following monday. Spinals taps is scheduled today, twice next, and the following monday. Her fever broke. Her blood culture no longer shows infection. She is still dealing with a little pain but not as severe as a few days ago. She most likely will be released from the hospital tomorrow after her radiation therapy.

Radiation Consultation

Today Erika had a consultation with the radiologist regarding her radiation therapy treatment this Friday. Her treatment with be a total of 10 days, beginning this Friday, everyday except Sunday. To prepare for the treatment they made her a head mask to keep you mounted to the bed of the gamma ray machine. They also did another CT scan of her brain to plan for the treatment.

Erika's temperature has gone below 100 but at the night it goes back up to 101 to 102. Her neutrophil count is still 0, so no immunity. Her blood culture shows a small sign of an infection. She will be released from the hospital when her counts are back up and when she's clear from any infection. If her counts are not up by Friday, her radiation therapy will be pushed back to Monday. Erika is still in pain from the infection.

Trying to smile with pain

Pressing down the soft plastic mesh to form around her face

As the mask is cooling on her face, they're getting a scan of her brain

Being scanned

Erika's personalized mask for Halloween next year. This mask will keep her head in place exactly in the same spot every day she gets radiation therapy. The ceiling and walls have a laser that beams down onto the mask for accurate placement.

Fever

Waiting to get a CT scan

Erika was admitted into LDS hospital for the first time for something other than her planned phases of chemo therapy. Earlier in the week she had experienced pains in the lower portion of her body. She was given medications to alleviate the pain, which didn't help. The pain kept getting worse. What was more concerning was the fever she was running between 100 to 102 degrees consistently since Friday. With her neutrophil count at zero still, this is a serious matter, for she may have an infection. She got a CT scan of her lower body to figure out the source of her pain and is having a blood culture done to check for infections. She will be at the hospital for at least two days, until they can get her fever to break.

Central Nervous System Phase

Monday April 15th, Erika will be meeting with a radiologist to get measurements of her head in order craft a helmet, needed for the radiation therapy. The CNS phase consist of 2 spinal taps a week along with the radiation therapy to the brain. If her blood counts look good next week on Thursday, CNS phase will begin the following day, Friday April 19th.

Happy Pho After

Right after transfusion

Blood Transfusion

The hospital called this morning to inform us that Erika is low on platelets. She will need a blood transfusion today.

Update: Her hermatocrit (red cells) is also low so she will be getting a blood transfusion for that as well.

Receiving platelets.

Bag of platelets.

Hematocrit

Back at home sound asleep after a long day of pain and nausea.

Erika's blood work is in the clear regarding infections. Although there are signs that show she is dehydrated which may be the cause if her body pains. She is drinking pediatric electrolites. She is also neutropenic, so she is back on antibiotics and antivirals along with her other medications.

Full Body Pains

Back at LDS Hospital to resolve body pains.

Waiting for lab results.

Leg Pains

Side-Effects of PEG-Asparaginase

Round 2 of Asparaginase

According to the National Library of Medicine, "Asparaginase injection will no longer be available in the U.S. after December 31, 2012." So why does Erika's treatment include it? Erika is in a clinical trial which is studying Asparaginase's effectiveness in young adults. Asparaginase has been used as a pediatric medicine for children diagnosed with ALL the past 40 years. Those case studies have shown an 80% survival rate (survival = 5yrs+). So why is it no longer available? Past studies of Asparaginase administered to young adults and older resulted in an allergic reaction. Asparaginase is a form of E. Coli. which effectively hinders the reproduction of leukemia cells, yet, not every body can handle it's foreign presence in the system. Because Erika is in this case study, Asparaginase will be administered in a small dose to allow her body to build a tolerance. Therefore, future administration of a higher dose will less likely result in an adverse reaction. The LDS pharmacist stated that any reaction, if any, usually results between the 2nd and 4th injection. Erika has received her first during the Induction  phase, which was the very first in early January. Today she will receive her second. Let's all hope NO reaction occurs. 


Update: So far no reaction after the chemo completed 5 minutes ago @ 3:50pm. It is a 2 hour release via IV.