Saturday, September 3, 2011

129 days later

It has been 129 days since Mark was first diagnosed with leukemia, and I am thrilled to announce he is DONE with his consolidation treatment. He has battled through fevers, nausea, vomiting, hair loss, weight loss, chest pain, nerve pain, and a seemingly endless list of other side effects in the last 129 days, but now we are both taking a deep breath and enjoying our first day of "freedom". One bummer is Mark was diagnosed with shingles on Thursday (the day before his final treatment) so he is in some pain right now, but his meds are really kicking in and he is doing well now. Thankfully, they were still able to give him his last arsenic trioxide treatment Friday despite the shingles outbreak.

So what's next? Well, Mark gets to take the next few weeks to let all the treatments leave his system and rest before returning to work at the end of September or beginning of October. He is allowed to drive again (I may be more excited than him about this). Actually, he drove today for the first time since April 22nd. He is also allowed to eat whatever he wants again. He has had a salad every day for the last three days. He has had plums, a smoothie, a medium-cooked burger and steak, and probably several other things he has not been allowed to eat since April.

Mark is still taking potassium and magnesium because the arsenic can still drain those minerals, which could cause him some problems. He is also taking celexa for any anxiety or depression, which has not been a problem. He is also taking an antifungal (V-Fend) for the congestion in his lungs that has been there since April. Add the 6 pills a day to deal with the shingles, and he is taking about 11 pills a day, but that is fine with us. Mark also had his PICC line removed Friday, so that increases his ability to play with Brodie and overall freedom. On Monday September 12th I will take Mark to the hosptial for another bone marrow biopsy, those results will probably take a week or so. That is just to make sure one more time that Mark is still in remission before releasing him to return to work. Then he will have a biopsy every 3 months for the first year and every 6 months for the second year to continue to monitor his remission. Other than that, we know he will start taking the ATRA medication again for his "maintanence" phase of treatment which will last 2 years and work to ensure permanent remission.

So just a little reflection from me:
When Mark was first diagnosed, I found myself getting really irritated when people would complain on tv, radio, facebook, etc about whatever minor irritation they were experiencing at the time. Thankfully, I quickly realized I should feel grateful that these people (some I know, some I don't) are not experiencing the same struggles I am facing. Whatever the minor irritation is in that person's life is a big deal to them, and I am thankful for that. I have also realized that so much in life is simply not worth getting upset about anymore. Lots of things in life are out of our control and all we can do is take each event and day at a time and stay positive through it all. Positivity is crucial. Positivity builds hope and I truly believe positivity can change events. Staying positive allows you to have a different approach to life events, which changes everything.

I am incredibly grateful Mark is in remission and the second phase is behind us (just one phase left). I am grateful our little family will be able to return to a semblance of normalcy, though I honestly don't remember what that old "normal" was like. I am grateful God has given me even more experience to build a stronger testimony for the world. I am grateful for all the family and friends who have really shown their love through this struggle. I pray for continued strength as we face the maintanence phase over the next two years and work to restructure our lives and continue to recover physically, finacially, and emotionally from this ordeal.

Saturday, August 6, 2011

Crazy Two Weeks

Sorry it has taken so long to post again, the last two weeks have been crazy.

First, Mark started his arsenic trioxide treatments on Monday July 25th. These treatments are pretty uneventful. One problem is the arsenic drains potassium and magnesium out of Mark's body, so he has to get extra magnesium and potassium almost daily which takes 2 hours a bag (and take potassium and magnesium pills daily). Other than that, pretty routine.

On August 1st Mark started week 2 of arsenic, which was the last day I could take him to his treatments because I started back to work on Tuesday. It makes me anxious that I will not be with him each day and know all the details of what is happening each day. Unfortunately, Mark developed a fever on Monday evening so he is now in the BMT unit at Northside. This has been difficult because I have to go to work so I cannot stay with Mark, which would make everything a little easier. Plus I am keeping Brodie at home with me the nights I don't visit Mark and he wants to know where's daddy. Thankfully he accepts my answer of "daddy's at the doctor getting medicine" all hours of the day and without much argument. That does make things a little easier. Actually, one day he asked where daddy was, I gave the usual answer and then he said "you didn't take daddy to the doctor for his medicine", I said no and Brodie said "cause you have to work...to get money". I love that child, he is so smart and in tune to what is going on around him.

Mark's fever has continued to rise and fall throughout the week. The doctors now think the fever is caused by the arsenic rather than an infection because all the tests have returned negative. The concern right now is Mark's cell count. His white blood cells, platelet, and hematocrit levels have returned to normal already after the chemo. However, his absolute neutrophile count is still literally zero meaning his body is susceptible to infection. So, yesterday (Friday) they gave Mark a shot of Neupogen, which stimulates his body to create neutrophiles. In less than 12 hours, his neutrophiles went from 0 to .5 (we are shooting for 1.5). Once this count is up to 1.5, we think they will let him go home even with a fever.

Unfortunately, one side effect from the neutrogen seems to be muscle and bone pain. Mark has severe pain in the back of his neck, lower back, and hips when he stands, walks, sits up, or moves in general. The doctors are working to manage the pain with muscle relaxers and pain medicine. At night, hopefully they will continue to give him oxycodone because it is the only thing that helped enough last night so he could sleep.

So, it has been an interesting week. I got on to Mark for getting sick the one week I had transportation arranged for him. Now I will finish getting transportation arranged for this coming week with the assumption he will be coming home in a couple of days. I know one little boy who will be so happy to see him.

I want to finish with a quick thank you to all the friends and family who are offering rides and food for us as we continue through this last month of treatment, especially our loving church Union Baptist for all the meal offers. I appreciate it all so much. Pray for Mark to get to come home very soon, for the pain to disappear, and for the rest of the treatment to go on without problems.

3 more weeks and we are done!!!

With a thankful heart,
Amanda

Saturday, July 23, 2011

One Week Down, Five to Go

I am writing this blog from the BMT unit of Northside hospital. Mark was admitted last night because he had a fever of 102.7 degrees. One good thing is Mark's white cell count is still between 7 and 8, so they were not too worried about infection, but still better safe than sorry. By the time we arrived at the hospital, Mark's temp dropped to 100.4 degrees and this morning it was back down to 97 degrees. The doctor said they think Mark's fever was a reaction to the antifungal medication they started giving him Monday. So now they are discontinuing that specific medication and he will start a different antifungal on Monday when he starts his arsenic treatment. Thankfully, Mark feels like a new person today. His color looks better, he isn't as nauseas, and he is fever free.

The rest of the week went pretty well. Mark's treatment quickly became routine. We show up at the BMT Clinic after a morning of nausea and vomiting, they give Mark nausea medication, start fluids, give him pre-meds and antifungal, and then do whatever chemo is necessary. Thankfully, Mark is done with the chemo part of the consolidation phase. He finished daunorubicin on Wednesday and they unhooked his IV pump of cytarabine on Thursday.

The week did become difficult on Thursday when Mark starting feeling sick and vomiting. he felt miserable and I could not do anything to help except try to make him take his medicine. Again, thankfully he feels better today, though he is still feeling nauseas. At least he finally ate a little today at breakfast (first food he has eaten since about 10:00 Thursday night). Now we are simply sitting in the hospital waiting for them to discharge him. The doctor said he should be able to leave this afternoon, but they are struggling to get his potassium level to normal. After two bags of potassium, it is still low so we are waiting to hear back from the pharmacist about what they want to do next.

So, continue to pray for Mark's side effects to subside so he can make it through the next few weeks as comfortably as possible; pray they are able to get his potassium normalized; and pray we can go home today.

With a thankful heart,
Amanda

Tuesday, July 19, 2011

A colorful couple of days

These three days are colorful days. Mark is taking one bright yellow IV medication and one bright orange medication, which very quickly turns his urine peach. We knew to expect it, but he said it is still pretty funny.

Mark started his consolidation treatment yesterday. It was a long day that started with us meeting Mark's mom late Sunday evening to give her Brodie because Brodie was throwing up. That's right folks, the day before Mark starts chemo, Brodie starts throwing up. Thankfully, GG (Mark's mom) was able to get him, and he did not get sick any on Monday. At 8:45 am on Monday, Mark and I got to Northside to begin the next phase. The first three days of his consolidation phase he receives 2 different chemo drugs. As soon as we get into the clinic and they draw blood for his lab work, Mark gets a bag of fluids which take about an hour. While he is getting the fluids, the nurse gives him his pre-meds, which help lessen or avoid some side effects of the chemo. His pre-meds are simply benedryl (knocks him out cold), tylenol, and a nausea medication. He also has to put steroid eye drops in his eyes 4 times a day for this entire week to try and avoid eye irritation that can be caused by one of the chemo drugs. After the pre-meds and the fluids, Mark gets an anti-fungal to continue treating a fungal pneumonia-like thing in his lung (he has had this for a few months now). Then the first chemo, daunorubicin, which only takes about 15 minutes. Then just before we leave, they hook Mark up to an IV pump that he has to wear constantly until we come in Thursday morning. The pump dispenses the second chemo, cytarabine, continuously for 24 hours. Then we go home. The first day we arrived at 8:45 and left just after 1:00 (the pharmacist did have to consult with us before he could start the treatment, so hopefully today won't take as long). We are doing the same exact treatment today and again tomorrow.

We have to mone into the hospital Thursday, Friday, Saturday, and Sunday to get the anti-fungal IV medication (which is bright yellow) and some lab work but that is all until Monday. Monday Mark starts his treatment of arsenic trioxide, which he will get Monday through Friday until August 26th.

So, now a little information about the chemo drugs for those of you interested.

1. Daunorubicin - bright orange drug given to Mark using his PICC line.
    - Takes about 15 minutes.
    - Common side effects are:
               - decreased blood count (makes Mark susceptible to infection and difficult to clot his blood)
               - nausea and vomiting (we have meds to help with this, so we will see how bad it gets)
               - temporary hair loss (funny thing is the hair he lost before is growing back baby soft and blond, so who knows what he will look like in a couple of months)
    - Less common side effects:
               - can cause heart damage if taken too long or too much so the doctors are constantly checking his levels and he gets two EKGs a week.
     
***Mark did not have any problems with this medicine last time, just normal nausea, vomiting, minor hair loss, and decreased blood count.***

2. Cytarabine - boring clear IV drug dispensed using an IV pump in a bag over 24 hours.
    - Common side effects are:
              - decreased blood count
              - nausea and vomiting
    - Less common side effects:
              - elevated liver enzymes (they monitor these daily)
              - change in coordination (they monitor daily)
              - pink eye (he is using eye drops to prevent this problem).

3. Arsenic trioxide - clear IV medication
    - Gets Monday through Friday from July 25 - August 26
    - Common side effects:
              - increased white blood cells
              - changes in heart rhythm (monitoring with EKG twice a week)
              - fever, fatigue, headache (we have meds for these)
              - nausea/vomiting (we have meds for these)
              - changes in electrolytes (monitor daily and give him electrolytes as needed)     
    - Less common side effects
              - Muscle pain/weakness
              - Confusion, tiredness
              - Increased liver enzymes (monitored daily)

So that is the treatment plan for the next 6 weeks. Today Mark has had a little nausea and he is currently sound asleep (the benedryl knocks him out). His potassium is a little low, so they are giving him 2 IV bags of potassium (2 hours per bag) in addition to everything else, so I am just going to get comfortable and try to get some homework done.

Pray for Mark to stay well during this time and avoid any infections.
Pray if Mark must have side effects, they are minor and easily managable.
Pray for God to send us those with a servant heart, willing to transport Mark to and from the hospital for his treatment when I have to return to work on August 2nd.

Anyone wanting to provide some transportation or bring meals to our home, feel free to call, text, or email me
678-975-4954
kashepherd1@gmail.com

With a thankful heart,
Amanda

Monday, July 11, 2011

Remission!!!

I have waited 77 days to say this "Mark is in remission!!!". It feels as good as I hoped it would feel. So what does 'remission' mean? First of all, Dr. Soloman, the oncologist, said Mark is in complete remission meaning they did not see any leukemic cells in all of the extensive tests they ran on Mark bone marrow. This is wonderful news. Now that we have finished the induction phase and reached remission, Mark begins the consolidation phase. Basically, the consolidation phase means more treatment to completely kill off any stray leukemic cells that they could not find. This phase is a critical part. I have read lots of research that shows many patients who skip the consolidation and maintenance phase (that's the last phase) have a relapse that could have been prevented. So consolidation greatly increases the chances of our ultimate goal "permanent remission" which in my mind equals "cure".

So, what is in store for Mark during the consolidation phase. First of all, as long as Mark stays well and has transportation to the hospital each day, the whole phase can be outpatient. YAY!!! Secondly, Mark will go in a couple days to get a new PICC line (they took the other one out about a month ago just in case it caused the infection that made him sick in June). Just like the induction phase, the PICC will be used to give Mark all his IV medications and take any blood tests that are needed, so he does not have to get jabbed every time. Probably the first of next week, Mark will get 3 days of chemotherapy. The two chemo drugs are daunorubicin (this is the same chemo he had in the induction phase) and cytarabine. After the 3 days of chemo, he will get a few days off from treatment (but good chance we will still have to go to the hospital daily to have lab work done.

After a short break (just a few days), Mark will go in 5 days a week (Monday thru Friday most likely) for a daily dose of arsenic trioxide. He will continue the arsenic treatment for 6 weeks. Once he completes the arsenic treatments, the doctors will evaluate how he is doing and it is likely he will be approved to drive and return to work. He was really excited to hear that he might be able to return to work in about 2 months, seriously really excited. This will be the end of the consolidation phase. At that point, Mark enters the maintenance phase, where he will take the same ATRA pills he just finished taking. This time he will take the pills for 2 weeks, every 3 months, for 2 years. That sounds easy after overcoming the induction and consolidation phases.

So, obviously we are all ecstatic to know that Mark is in remission. He is responding to all the treatment exactly how the doctors want him to respond. The upcoming chemo treatment will drop Mark's cell counts back to zero. This means he will be neutropenic again and extremely susceptible to infection. Hopefully, any side effects can be easily managed and infections avoided so Mark can stay at home during the treatment. He will also have probably daily trips to the BMT clinic at Northside for lab work and to receive any medications or blood products he needs - since his cell counts will drop, it is pretty much guaranteed that he will need some blood products such as red blood cells and platelets.

At this point, I am just grateful for the blessing of remission and ready to take on the consolidation phase. I again thank each of you for your love, support, and prayers throughout this journey. Please continue to pray for Mark's health. It is so important that his body copes well with the treatment. We pray to stay outpatient, which means he has to avoid germs (good luck with a 3 year old and an educator in the house, but we will certainly try). Pray for continued remission and eventually permanent remission. Pray for strength and courage for our entire family to face the coming challenges with the same tenacity we faced the first challenges. It is important to remember that all is for God's glory, and I am so thankful to Him for all the blessings in my life.

With a thankful heart,
Amanda

Wednesday, June 29, 2011

Biopsy Day

Today was Mark's bone marrow biopsy. In about a week or so, we expect to get the results which will hopefully tell us that Mark is in remission. Mark was really anxious about the biopsy because the first two were really painful. Actually, while we were waiting, the lady getting a biospy in the next room started screaming bloody murder. It was terrible. The nurse was even shaken up by the woman's reaction. Thankfully, Mark's biopsy went much better. The nurse (same nurse that the neighboring lady had) was excellent. The biopsy went really quickly (about 10 minutes) and Mark did not seem in near as much pain as the other two biopsies. Don't get me wrong, it was still very painful, but Mark was able to take deep breaths and manage the pain well. It also helped that the nurse was able to the bone and marrow samples they needed very quickly. So, please pray that the results show Mark is in remission and pray that the next round of treatment goes smoothly and without complications.

On a happier note, Brodie turned 3 on Monday June 27th. We celebrated his actual birthday by taking him to see Cars 2 in the movie theater. This was technically his 2nd movie in a theater (when he was one month we took him to see Wall-E - he slept in his baby carrier the whole time). This time he sat in his daddy's lap, then his GG's lap, then stood up. He cheered and laughed - it was adorable. At one point, he walked up to me and said "I love you mommy" and gave me a kiss. I love that boy.

We had his birthday party on Saturday - it was Lightning McQueen themed. He had so much fun. Friends and family together, laughing, cupcakes, and presents. Brodie got some light up Lightning McQueen shoes that he may take off his feet one day, remote control cars, clothes, books, sidewalk chalk (which he begs to play with daily), and lots of other stuff. At one point someone said "who gave you that present" and Brodie in his precious innocence said "Santa Claus" - see why I love him so much. When it was time to sing happy birthday, Brodie sang right along with us; it was hilarious. Then he went outside with Kaitlyn (my friend's 3 year old) and the two of them played in the little swimming pool for a long time. He had so much fun. Thankfully, he exhausted himself and slept for about 3 hours or so. He slept so hard that I was able to take him out of his car seat, carried him into the Varsity, ate lunch with Mark and our friends, put him back in the car seat and drove home without him waking up once.

So, long story short. Life is actually pretty awesome right now. We are blessed in more ways than we can count. I am getting lots of quality time with my family and learning daily to count it all as blessings and appreciate it all (though sometimes it gets hard to remember that part). There is always anxiety about the present and the future, but I know God will see us through it all. I appreciate all the thoughts, prayers, love and support each of you have given throughout this process. Please keep them coming.

With a thankful heart,
Amanda

Thursday, June 16, 2011

A Glance at What's Next

Well, we are back home (actually went home Tuesday). The doctor thinks Mark caught a virus that ran its course, they never actually identified anything particular. We basically hung out at the hospital for 3 days watching Turner Classis Movies and waiting to go home. Mark feels perfectly fine now and has not had any problems since leaving the hospital. We went to the doctor today for his weekly blood levels check and everything looks great. We don't have to return again until Tuesday, so we are taking a couple days to hang out while Brodie visits Grandma Crawford.

The doctor did give us a quick overview of Mark's upcoming treatment. Basically, Mark finishes his ATRA on Friday June 24th. A few days later they will do a bone marrow biopsy to Mark is in remission. That result will take a couple of days. Once the remission is confirmed, Mark will begin the consolidation phase of his treatment. The pharmacists overview basically told us that Mark will get another round of 2 chemo medicines over about 2 weeks, then he will take a week off. After the week off, Mark will start getting arsenic 5 days a week for 6 weeks. Once he finishes the arsenic, he will begin the maintanence phase. The maintanence phase means Mark will take ATRA for 2 weeks, every 3 months over 2 years.

We are pretty excited to have at least an idea what is in store for us next with Mark's treatment. Thankfully, I am out of work until the first of August, so I will be able to take Mark to his chemo treatments and possibly the first week of arsenic. My current prayer is for help getting him to his daily appointments for arsenic. The pharmacist said the treatment can be all outpatient as long as Mark stays well AND we are able to get him to every appointment. Once I have a detailed schedule, I will start figuring out a schedule and know for sure what dates I will need help getting Mark to appointments.

Continue to pray for Mark's health and avoiding any further infections. Also, pray for continued comfort and strength as we continue this adventure and take further steps towards Mark's being cured of cancer.

With a thankful heart,
Amanda