BMA

Tomorrow around 830 Mikayla will have her bone marrow aspirate (BMA). This test will determine if Leukemia is still present in her bone marrow. The results hopefully will be in no later than Friday night. If the Leukemia is spotted then we will begin chemo straight away. If not we will begin to consider taking the dreaded break from the hospital. The test requires that they do a spinal tap at the same time to look for Leukemia in her central nervous system. During the exam they will inject the chemo drug Ari-C in her spinal fluid to help with killing the hard to find cells that may or may not be hiding there. If Leukemia is found it is not considered a relapse, but rather that the induction phase of chemo was not successful. They will no matter what continue to the consolidation phase. If at the end of consolidation Leukemia is found then we change tracks and start using experimental drugs not commonly used in Leukemia, but have showed glimmers of hope in the fight against it. She will be somewhat of a lab rat in the experiment to futher understand if the drugs are a benefit or not.

Dancing

Test from phone

Slip of the tounge!

We have just finished talking with our doctor. Turns out the earlier post about an early bone marrow transplant was just a slip of the tounge. The rounds doctor misspoke and said "bone marrow transplant" instead of "bone marrow aspirate". HUGE difference! Not being here it is hard to visualize being surrounded by 5 to 10 doctors and having none of them correct the other when they say something like they did. Us as parents suck to the place we were at when we first heard of the cancer. I think I have learned not to listen to the rounds. They are the ones that told us she would not need a BMT and 20 minutes later her doctor said we did. Anyway, things are a bit different. Because of her counts we may see that the Leukemia has come back. This was expected and isn't really alarming. If it is the case then she will start next round of chemo on Friday. All of which is completley understood.

Trouble Brewing

All her CBCs are dropping. Today we were notified that she now has blasts showing in her blood. Blasts in laymens terms are Leukemia. We were told that we should be prepared for the possiblility of a bone marrow transplant by the end of the week. In all reality her whole course of treatment is going to change. She looks good and is playing well, but inside she is not functioning right. The rounds Dr. said it is unusual that her counts have not gone up, but seem to only be going down now. Normally they will see a small fluctuation daily until you see a permanant rise. Mikayla did that for 4 days then has steadily declined. The doctors said they are not being alarmist, but rather don't want us caught by surprise when and if her therapy changes. We really don't know what to read into all of this. It's as if they are withholding a tiny piece of the puzzle that we can't see. There is always a chance of relapse of Leukemia. More than a 50% chance by this stage. Usually from what we hear and read that is the reason we come back for 2 more rounds of chemo. Not fully understanding why a rounds doctor would even mention that we may end up with a BMT by the end of the week. She said the reason for the BMT was because of the blasts. Truthfully we are trying to get her real doctor in for an education session. We will be able to better understand what is happening after we speak to him.

Not going home for break just yet

This is a little confusing to me so if I lose you I apologize. We are concentrating on two number the ANC and APC. To make the ANC higher you need to produce APC. Her ANC was on the rise for the past few days, but today it went back down to zero. Her APC looks good (don't know the actual number) and the doctors say that her ANC should be back on the rise. To constitute a trip home her ANC needs to be a minimum of 250 and to have been on the rise for the last 3 days. Next up was her bone marrow aspirate. Her aspirate will determine her Leukemia count. It was scheduled to take place on her 28th day here or August 4. Because her ANC is at zero the test will be delayed. Delaying the test delays the amount of time spent at home. Her next round of chemo should start around 2 weeks from now. With the tests that need done as well as waiting on results and ANC numbers to increase at max she may get a week at home. Overall she seems pretty damn good. She still plays all day and is eating well. Her weight is becoming more and more normal Mikayla weight. Her hair seems to have stopped falling out, but will continue to do so when chemo begins again. She now wants to be a nurse when she grows up. The nurses here let her do most everything she wants. We should talk to our own doctor sometime very soon and he should help me understand better as to how long we wait and if her counts are typical.

Saturday and Sunday

Saturday we were told her ANC was 140 which is great her target is from 250 to 500. We were also told by the rounds Dr. that we should go home Monday. On Friday, however, her real Dr. said it would be around Friday this week. Who knows. I think I can gaurantee that we will get to go home sometime real soon for a small break before her next round of chemo. She had alot of visitors Sunday. Most of the time she sleeps late like 1030 or 11, but I made her lay down at 9. Rea has been explained what to do while at home and has yet to share the information. Some more details will come shortly. Thanks