Consolidation 2 Cycle 6

Drugged up immediately after a bone marrow biopsy and preparing for a spinal tap in 20 minutes.

Erika was three weeks behind schedule to get a bone marrow biopsy done because her blood count would not bounce back up. Yesterday, she was scheduled to get one done regardless of how high her blood count was. Although, for the spinal tap her counts do need to be high enough. 

As usual, the biopsy was painful yesterday. Whenever there is a shift in pressure in the bone, pain is the signal the brain chooses for the change. They had to take an extra vial of bone marrow for the clinical trial, which equates to extra pain. On top of that, they needed to get a bone fragment specimen as well for bone structural examination. After the biopsy, her blood count results came in and it was high enough to proceed with the spinal tap.

Twenty minutes of recovery was all she had after the bone marrow biopsy was completed before she was taken down for the spinal tap. This procedure consist of extracting a small fluid from the spinal cord for examination, and then inject a small dose of chemo into the spine. This was painful for Erika as well, but not as painful as the one she received back when she was in the Central Nervous System phase. 

Immediately after the spinal tap she was sent back up to receive her next cycle of chemo therapy. This time around her treatment cycle did not include two other chemo for they were causing major side effects. As she recovers and show sign of improvement, then will doctors include the rest of the chemo medicine back into the treatment.

Today, Erika is recovering from all the beating yesterday and has been feeling very poopy. Yet, about an hour ago, we were given some good news. The hospital called and told us that the result from the bone marrow showed that Erika is still in remission. WOOO HOOO!!! Erika's battle with cancer is looking promising.

For those who aren't aware, Erika and I will be doing a walk on Saturday, October 12th to help raise funds to fight this cancer and stop it completely sponsored by the Leukemia and Lymphoma Society. These funds not only helps with those with Leukemia, but all those with cancer in general since everything begins at the cellular level. Please help join her team in this walk by clicking here (please scroll down to the bottom and click the red JOIN button.) If you are not in Utah, no worries, you can still help by donating to the cause.

Thank you all for your support.

Holding Nothing Down

She wanted to get out, like a normal person, but ended up on the couch sleeping.

Since Thursday, Erika has been dealing with nausea. Over the weekend she has not been able to keep any food down...not even her recent favorite food, broth. She's getting pretty good at projecting vomit, straight into the food disposal though. I don't know what else to feed her. We'll see what the doctor has to say Tuesday on her next appointment.

PEG

Erika's blood count was still low to begin a spinal tap and bone marrow biopsy. So they will push those procedures back a third time to next week.

Today they took a blood sample for a genetic testing to see if her body produces a particular enzyme that metabolizes 6-mecapto purine, a chemo drug, slower than normal so they know how to better schedule her doses in the future.

Since Erika has not been experiencing pains in her hands and elbows, but just the legs, doctors feel it is most likely safe to continue on with PEG-aspiraginase today to completion. We both feel the increased chances of survival with this chemo far outweighs the possible risk.

The battle continues...

PEG No PEG

Erika's bone marrow biopsy and spinal tap was rescheduled to be done next week Tuesday. Yesterdays clinic visit, we were told Erika will continue on with PEG-Asparaginase beginning today. Dr. Ashe, the head of clinical trials at LDS, advised completing the last three doses of PEG since it will dramatically increase Erika's survival rate. Before the chemo treatment began today, we had to meet up with Dr. Miller, the pain doctor. During the consultation, Erika described how her pain was not manageable, even with the increased dose of her pain meds. Erika described how she now feels pain in the joints of her hands and elbows. Dr. Miller nearly doubled the dose of her pain meds to try out this time. 

Dr. Hoda came in to consult before the PEG treatment began and discussed how he disagrees with giving PEG since Erika's pains are increasing as well as they are appearing in places that is not known, besides the hips. He believes that the infarcts are solely the cause of PEG and not the steroids since they are not the typical avascular necrosis caused by steroids. PEG causes blood clots and these infarcts may have been the result of it. Therefore, PEG will not be administered today. Erika's blood thinning shot she gets every night will be quadrupled in strength to be given twice a day to help free any clots that still may exist in her body.

If she recovers from all of this and has the strength, they will revisit the possibility of continuing PEG to completion. 

"There and Back Again"

Still nauseated and in pain.

Today, Erika will be discharged with a higher dose of pain medication, which helps alleviate a lot of the pain. Erika has never been this nauseated during her treatment until now. Her appetite has decreased significantly the past couple of weeks, which freaks out her poor Mom. Sprite, saltines, and broth have been her new favorites lately.

Since being admitted late Sunday night, Erika had a UTI which caused a fever and may have been the reason for her nausea, got blood cultures done which came back negative, and an MRI done on both her legs. The result of the MRI showed she also had bone infarcts near the knee area in the tibia, fibula, and femur. This is the reason why Erika has been dealing with leg pains.

We were told bone infarcts are similar to vascular necrosis but the cause is different. Necrosis is due to no blood circulation. Doctors believe the chemo PEG-asparaginase, the clinical trial medication, caused a blood clot near the area of the knee and the hip which blocked blood circulation. A combination of the steroid Dexamethasone may have contributed as well. She still feels neuropathy in her finger tips and the bottom of her feet due to the chemo vincristine.

PEG-aspsaraginase, dexamethasone, and vincristine will be eliminated from her treatment. This is good news for she will not deal with as many side effects. Yet, the chances of curing her has dropped as well. This visit has been very emotional for us due to not being able to know what's to come and why things are happening the way they are.We have been able to meet some wonderful people here that have relapsed recently and one passed away. 

Erika's next bone marrow biopsy and spinal tap will be done next week Tuesday to see if she has any malignant cells. Hopefully she is still in remission. So far, any scheduled chemo treatment has been put on hold until they get the results of the bone marrow and spinal tap.

Labor Day Weekend

Erika's nausea has gotten worse and her pain is still the same. She was admitted Sunday. They are running another blood culture since she's getting the shivers.