Tuesday, July 17, 2012

A Mixed Bag

Mirrored on our CaringBridge site here: http://www.caringbridge.org/visit/danieljmiller/journal


After a week's delay to the start of our last intensive phase (next comes "maintenance"), today Daniel's blood counts were high enough to start the "Delayed Intensification" phase.  We've been looking forward to this one with mixed emotions.  It has all the promise of indeed being intense, but we're also looking forward to getting to the other end of it.  There will be nothing easy about the next 3 years, but it will definitely be better than what we're facing for the next 2 months.

Today started with the "good" news of decent blood counts and being able to start phase IV, but has pretty much gone downhill from there.  Forgive me if this sounds like "venting", but that's what it is. It's been a tough day and I feel like sharing.  Sorry to make you the beneficiaries, but think of it as a rolling prayer request. ha ha.

As I write this, Daniel has thrown up all his dinner and is now fighting the dry heaves.  I think it's the extra heavy does of anesthetic he got, but not really sure.  Could also be any of the three chemo drugs he got along with it.

During the spinal tap procedure they had trouble getting him completely "out".  This has happened before and they just keep pumping the anesthesia into him until he goes out.  But once he was finally out (the procedure itself went fairly smoothly) his heart rate & blood pressure dropped dangerously low.  There was some concern for awhile, but he came back on his own and other than a little nausea, was doing fine and filling me in on all the components he needed to get in "Monster Hunter" (his favorite Wii game) to get to the next level.

I had gone into work this morning and was waiting for confirmation that his blood counts were a "go" before leaving for the hospital.  Unfortunately, they were WAY late in getting the blood drawn and by the time I got word that we were g2g - I had to FLY down to the hospital to get there in time.  By the time I got there, he was already in the O.R., prepped, and ready to go.  He was upset and nervous as usual and his pulse was already passing 100.  I took over from mom with a back & neck massage and started a conversation about Monster Hunter and we got it back down to the low 80s before the doctor arrived.  I prayed through most of the procedure (since, if you recall from previous posts, the only time I can't watch a medical procedure is when it's this doctor and my son.)  But other than a little trouble getting him "out", it went well this time (the doc's getting better! :)

Afterward, in the recovery room, we had the tense moments about the low B.P. and then Daniel was complaining of being cold.  We were informed that the knob had broken off the thermostat and the vent was directly over the bed. (Great engineering guys - NOT.)  

As Daniel continued to wake up, I had a fairly long conversation with the doctor expressing my growing frustration at not getting any traction on his continued lack of growth.  I think she finally "understood" me when I used the word "unacceptable".  But we'll see.  In fairness, this doctor is somewhat caught in the middle between me and the other doctors who are the ones that need to be looking at these other issues.  As the oncologist, what I'm after is not her specialty, yet she is the one through whom everything has to go.  Anyway, we'll see how this plays out.  I realize nothing is going to happen physically until we're through this intensive phase, but what I'm not happy with is that there is no discussion, no plan, no ownership, and no "next step" in place.  Is that the engineer, the project manager, or the DAD in me coming out?  Doesn't really matter - they're stuck with me.

As we prepared to leave, we go the low-down on what the rest of this phase will look like.  Unfortunately, one of the primary drugs they'd wanted to give him ("Pegallated Aspariginase") turns out to give him a fairly severe allergic reaction.  They tried twice and then gave up a couple months ago.  So the "plan B" is a different drug that has to be given 6 times (on 6 different days) for each single dose the Peg-Asp. would have been given.  This means we're heading back to Riley every other day for a week and a half each time.  

Hmmm. Didn't know that.  

We also found out, it can't be administered through his port.  It has to be given my intramuscular injection - in the thigh.  

Hmmm. Didn't know that.  

Depending on the dosage he'll receive (which they didn't have yet today), they may have to give half of it in two different locations ... one in each leg ... every other day ... for a week and a half ... and they HURT.

Hmmm. Didn't know that.

Daniel REALLY doesn't do well with needles (yes, even after all he's been through).  As they were describing to us where to apply the Lidocane (a topical anesthetic cream) before he comes in, he caught on.  We played it way down talking about how much smaller injection needles are than the blood-draw and access needles he's used to.  I think we made some progress there. But the fact that these injections will make the muscle hurt didn't come up.  That's going to be a big problem ... especially as they keep injecting into the same area every other day.  This will be rough ... very rough.

My mood was going downhill fast this afternoon.  As we left, we stopped by the pharmacy downstairs where the doctor had called in a prescription about 45 min earlier, only to be informed it would be another 30-45 minutes.  Great.

As we sat there waiting, Andrea and I were talking about some financial issues predicated by our Family Doctor that I won't go into except to say that it didn't do my deteriorating mood any good at all.  I left Andrea & Daniel in the pharmacy waiting area and headed back to work since we'd driven separately.  The rest of the day at work didn't go much better, but at least I got 7 hours in.  How productive they were was another matter as my head was in a million other places.

As I left work, I found myself at the tail end of the thunderstorm that blew through minutes earlier.  REALLY need the rain - but did it have to be right when I wanted to drive home ... and in the same direction.  I know - gift horses and all that.  As I pulled in the drive way, I was accosted by the pesky little neighbor girl who was adamant that she needed to come in the house with me - if not to play with Daniel (whom I told her was not feeling well), then to be allowed to cook the can of soup she was carrying around in our microwave.  What?!  So I got this convoluted story about how they don't have a microwave, and couldn't find the cord to the hot plate, and the stove costs too much money, and ... Um no; not playing this game.  You'll have to have your parents get you something to eat.  I'll have to find out what all that was about another time, but not tonight.

Since I got home, Daniel has been getting more and more nauseated until he finally lost all his dinner and now is fighting the dry heaves.  I can't even get an anti-nausea pill into him for fear it'll just come right back up.  He feels miserable.  The good news is that this has been a very rare thing for him to get this sick.  The bad news is that he's this sick.  He's supposed to start another oral chemo drug tonight, but I'm obviously not giving it to him in this condition.  He's had enough for one day, and it can wait an extra day.

Andrea has been through the ringer these past few days (actually, I could just as easily insert "weeks", "months" or "years" there too) as well.  We think she's had a stomach bug and the family doctor she visited yesterday thought the same thing.  She'd done a sleep study a couple weeks ago and this visit was supposed to be reviewing the results, but they didn't seem to notice that they hadn't yet received them from the hospital yet. So despite frantic, last-minute calls, that didn't happen.  So now there will be another office visit once the results are in.  They'll no-doubt prescribe another several pills for her to start taking that won't be covered by insurance and will add to the hand-full she takes every day as it is.  I think I'll be attending that next meeting as well if at all possible.  Hope I don't need to start looking for another family doctor again, but I won't hesitate if I think things are not going in the right direction.

OK, I'm going to stop there.  My apologies if you've made it this far.  I feel better. LOL. :)  The truth is, we have an ENORMOUS amount to be thankful for that we DO know about, and way more than we could dream of that we don't know about, but Scripture promises.  I have a wonderful family and we're together this day and the future looks bright - next month, next year, and 1000 years from now.  We have much goodness to look forward too.  We knew this phase was going to be a mountain that needed climbing.  It's height and ruggedness came a little more into view today, but it will just be that much sweeter to be on the other side of it WHEN we get there ... and we will.

Lord please let us learn ALL that you have planned for us in these coming days - don't let any single second of difficulty or pain or struggle be lost for the good that You desire to bring from it.  We cling desperately to your promise that A.L.L.(*) things work together into a pattern for good ... (Rom 8:28)  Thank you.  Thank you for everything about today. Thank you for loving us and being here beside us every step of the way and for keeping our eyes on the far horizon.  Teach us to trust, teach us to love, teach us to enjoy "life in every breath."

Amen!  Thanks to everyone who is also running this race alongside us or cheering or handing us a water bottle on the way by.  We love you and appreciate every one of you.  Please keep your prayers coming - they are by FAR what we value and covet the most.  

Please also remember to pray for Joey, Nick, and Elizabeth Keller as often as possible.

I'm off to set up the air mattress beside Daniel's bed for the night.  

Grace and Peace,

- Tim -

Thursday, July 12, 2012

Daniel & Joey

Mirrored from http://www.caringbridge.org/visit/danieljmiller/journal

Daniel & Joey


It's been a good couple of weeks for the Millers.  We completed Daniel's last "planned" hospital admission and thereby, the last portion of the "Interim Maintenance" phase of chemotherapy near the end of June.  We had about a week and a half of "vacation" before the start of the next phase (called "Delayed Intensification") and so we quickly put together Daniel's 10-1/2 year birthday party.  A few years ago, we moved his party to the summer time so he could do more with his friends, take advantage of warm weather, and not be lost in the midst of the December holidays. 

This year, it was a bit harder to get planned and executed, but other than the short notice to friends and family, it went off very well.  We even had great weather and temps below 90 at the very end of the heat wave.  God is good.  Daniel came home with more LEGOs and having had lots of fun with his friends and cousins as Southeastway Park.  Many thanks to all who attended - in person or in spirit.


Tuesday, we were to start the Delayed Intensification phase - the last intensive phase before going into "Maintenance" which will last about 3 years.  Unfortunately, his white blood cell count was too low and we were sent home to wait another week.  In truth, none of us were too upset.  The good news is that, although it will push out the end of this phase, it won't push out the final completion date.  But at this point, that's so far down the road, it's hardly even worth thinking about.  We'll be glad to get through this last intensive phase that none of us have been looking forward to.

In general, Daniel's energy and appetite have been slowly recovering and having the extra week off is probably a good thing.  I've been pushing him to get more sunshine (which ironically has been more difficult with the searing heat wave we just came through), fresh air and exercise.  We're getting there gradually, but the months of inactivity have led to some bad habits of video games, TV, and lounging around indoors that are proving hard to break.  Andrea has gotten him out for some play-days and a swim day recently though that's been good for him ... mostly.

The mysterious white cell count continues to bounce around all over the place though, and is often frustratingly low.  It's an indicator of his immune system (but not his actual health).  The Riley staff tell us that it could be almost anything that causes it to remain low, but is likely due to minor bacterial or viral infections.  I believe this must be due to exposure to various bugs "going around" either through Andrea & I having been exposed and bringing them home, or directly from interactions with his friends.  Andrea and I can't do much about our own exposures, so it's really difficult to try to find a balance between wanting to let him play with his friends and my instinct to want to keep him in a "bubble".  I believe very strongly that the psychological side of our health is every bit as important as the physical side.  If he stays lonely and depressed, I feel he's likely to remain more "sickly" than being able to laugh and run and play even if it means exposure to more infectious agents.  It's difficult to find the balance and the disagreements between Andrea and I have at times been rather unpleasant.  We're working through it and trying to find the best ways to communicate and find agreement in the day-to-day decisions and activities.

Unfortunately, Andrea's health has been quite a roller-coaster ride recently as well.  She's been knocked completely out of commission several times lately and has a lot of trouble just finding the energy (much less enthusiasm) to even get out of bed in the morning.  Her courage, character, (and Facebook) keep her going though. :-)  It does make it more challenging for me to try to keep up with work as well as the household chores.  Cleaning in particular is something I need to do a lot better at keeping up with for both Daniel's and Andrea's sakes.  Seeing his persistently low blood count numbers and her constant battles with various bugs really drive this home.


When Daniel and I showed up at Clinic on Tuesday, we were happily surprised to have Joey and Elizabeth Keller join us in the waiting room.  Daniel & Joey got to spend a few brief minutes linking their Nintendo DSes together to play Super Mario Cart (or something like that) while Eliz and I talked about our respective challenges.  Unfortunately, theirs currently dwarf anything I can even imagine much less relate to.


We were able to attend Joey's 9th birthday party this past Saturday and here is a link to some pics from the party on Facebook: https://www.facebook.com/media/set/?set=a.3604906886693.2126038.1394270143&type=3


We feel very close to the Kellers and, though only in a very small way, can relate to some of what they're going through.  They're amazing people and we love them to pieces.  So I was in tears this morning reading Nick's latest post about what Joey is going through.
http://www.caringbridge.org/visit/joeykeller/
Please, please pray for Joey, Nick, and Elizabeth as they stare this dragon in the face and march forward in faith with sword in hand.  Scripture assures us that God's desire is ALWAYS for us to be whole, healthy, and free from sickness and death.  I am absolutely confident in this. This is NOT what we were designed for, and God grieves alongside us through all our trials and tribulations.  We don't always understand what sometimes prevents God from healing us, but we do know that PRAYER changes things.  We also know that ALL things work together for good for the Called.


Please join with us - frequently - as often as you can - in persistently PESTERING God about healing Joey and delivering him from this awful cancer (Luke 11:8; 18:5).  Yes, this is actually what He wants us to do!  (Read the two passages if you haven't made this amazing discovery.)  Pray for Joey to be completely healed. Pray every time you think of it, and think of it often.  Pray specifically that every cancer cell and every form of cancer cell in his body would be destroyed, and that all damage would be healed restoring him to complete health.  Also pray for the protection, peace, endurance, patience, and faith of all three of them.  This is a long and difficult race for them, strewn with pitfalls and robbers along the way.  They are amazing people, and Joey is an absolutely amazing, faith-filled, brilliant and insightful little boy.  I have been learning from all three of them regularly as we watch them fight this battle.  We seek to help them "hold their arms up", in any way we can and hope you can join "TEAM JOEY" alongside us as well.

Grace and peace,

- Tim -