Monday, September 28, 2009
First Week At Home
Alisha's first week home went relatively well. The only snag happened early last week was when Ashley caught herself a bug from school. As a precaution the girls were kept separated, and within a couple of days Ashley was back to normal. Alisha has been responding very well to all treatment, medicines, etc. Everyone has been getting into their roles of assisting her quite nicely, and quite effectively. Alisha definitely has a very good and strong support system.
On Friday September 25, 2009 She had another chemo treatment. To date she has not had any of the nausea that often accompanies it.
Today, September 28, 2009, she started home school and thoroughly enjoyed it!
Alisha's new diet seems to being a good part in increasing her energy levels. Though she isn't always keen on the taste.
Alisha at times seems to be acting just as she did prior to falling ill. She is back to coloring and reading for hours.
Monday, September 21, 2009
Good News
Today is the day! After 22 days at Children's Hospital of Orange County Alisha was finally released!!
On top of that her Blast count was 2%. What does that mean you ask? The aim is to induce a lasting remission, defined as the absence of detectable cancer cells in the body (usually less than 5% blast cells on the bone marrow). This, however, does not mean the treatments stop. She is still looking at about two and a half years of treatments.
Sunday, September 20, 2009
New Pictures
Here are some recent pictures of Alisha!
The puzzle was worked on over a period of four days.
A Missing Tooth
Today was a good day for Alisha. During the night her temperature returned to normal. If her temperature remains normal through Monday morning she could be sent home!
She was more talkative, and expressive today. She actually laughed a couple times while watching The Lion King.
During breakfast one of Alisha's top front teeth fell out, and her other one is loose. The teeth being loose and/or falling out have nothing to do with any of her medications.
Saturday, September 19, 2009
Round 3
Well today was round three for the chemo. Alisha was placed back on her I.V. as she had a fever. This fever has caused her to be placed in isolation until all blood cultures come back "negative."
Wednesday, September 16, 2009
Blasts
Today Alisha's CT Scan showed lesions in her kidneys. The Doctor says this is normal and it should clear up with the aid of anti-fungal medication. The bone marrow biopsy results show blasts at 24%. Blasts (premature white blood cells (leukemia cells)) showing under 5% would be considered "in remission."
Alisha was thrilled that she had her i.v. removed today as she gained more range of movement.
On the lighter side, Alisha has been diligently working on a 550 piece puzzle of a cheeseburger. Alisha has commented that she does not want to go home because she likes hospital food.
Celebrities
CT Scan
Doctor estimates her discharge date to be this Thursday. This was delayed as a result of a 2-hour fever on Sunday evening. A CT scan was ordered right before lunch was served and Alisha was asked to fast for 4 more hours. I could not see my child go hungry again for over 10 hours with hardly any breakfast, having to drink this awful liquid for the CT and suffer the charming side effects of steroid - enhanced appetite and amped up grouchiness. After countless hours of discussions and to the chagrin of the doctor and nurses, Alisha didn't have to fast and drink the foul-tasting liquid before the CT scan and it was postponed until tomorrow.
Abdomin
Abdominal distention was the highlight today. With the LP and bone marrow, Alisha couldn't have food and water for over 15 hours on Friday, 9/11. As a result, plumbing was a bit backed up causing discomfort in the tummy.
Immune
Since her immunity was so low, one of the other side effects from chemo is mouth, tongue and throat sores - mucositis. Antibiotics were given to prevent further mouth sores, but the existing ones were a bear. Alisha had a liquid diet to get through this rough time.
Friday, September 11, 2009
Round 2
Today is to be Alisha's second round of chemo. Along with that she is to undergo another LP (spinal tap), and she is to have a bone marrow biopsy to determine the Minimal Residual Disease (MRD). This determines how many bad white blood cells are still present.
Assistance
Alisha's family is very thankful and appreciative for the of the outpouring of support, prayers, and gifts, as well as the offers to prepare meals, run errands, pick up school work for Alisha, and help in taking care of Ashley.
Today a social worker came by with some order forms for a wig for Alisha. Since Alisha does not know about the hair loss side effect. Amy picked out a wig and cap for her. Depending on her preference Alisha's wig can be made from either her own hair or that of her Mom's.
There have been several individuals who have volunteered to shave there hair when Alisha starts to lose hers.
Alisha was told by the Oncologist that if she does not start walking she will have to remain in the hospital. Her wheel chair will be taken away tomorrow (Friday September 11, 2009).
Alisha does have some stomach distension due from the steroid Decadron.
She received a transfusion of another bag of blood platelets to ensure a count of over 75,000 is reached before the second round of chemo and procedures.
Thursday, September 10, 2009
Wednesday, September 9, 2009
More Meds
Today Alisha will be receiving two intramuscular shots. One to each thigh. The medicine is called asparaginase (PEG).
Asparaginase (EC 3.5.1.1) is an enzyme that catalyzes the hydrolysis of asparagine to aspartic acid. It is marketed under the brand name Elspar, to treat acute lymphoblastic leukemia (ALL) and is also used in some mast cell tumor protocols. Unlike other chemotherapy agents, it can be given as an intramuscular, subcutaneous, or intravenous injection without fear of tissue irritation.
The rationale behind asparaginase is that it takes advantage of the fact that ALL leukemic cells are unable to synthesize the non-essential amino acid asparagine whereas normal cells are able to make their own asparagine, thus leukemic cells require high amount of asparagine. These leukemic cells depend on circulating asparagine. Asparaginase however catalyzes the conversion of L-asparagine toaspartic acid and ammonia. This deprives the leukemic cell of circulating asparagine.
Alisha was moved out of the isolation part of the OICU. She now has a roommate. There is also a good chance that she will be going home Saturday September 12, 2009.
Side Effects
Alisha had a couple of problems today. Her blood pressure was elevated, and she had a blood sugar count of 237. These are both common side effects of the steroids she is on.
On a positive note, she started school in the hospital.
Monday, September 7, 2009
A Laugh
Sunday September 6, 2009
Today was probabaly the best day of this whole ordeal. For the first time in a week Alisha smiled and laughed when she heard some of her favorite music. She also colored, engaged in some crafts, and played with legos.
She had slight pain in her legs. This is common with this type of disease.
Peaceful Day
Saturday September 5, 2009
Alisha was feeling much more comfortable as the chemo from last night and Thursday had pushed the WBC count down. After her shower she watched countless hours of Sponge Bob Square Pants.
Alisha made no complaints of her spine or pelvis hurting. She was complaining of pain where the Port-a-Cath was inserted.
Port-A-Cath
Today they placed the Port-A-Cath in Alisha at 3:30 p.m. The procedure took one hour. Because of her having to have this done Alisha went 18 hours of no food and water even though steroids were given to enhance her appetite.
The Port-A-Cath is inserted just under the skin in the upper left side of the chest. The tube is then inserted in to the aorta. This allows the medical staff to draw blood, give meds, etc from one area. While in the hospital Alisha will no longer be poked for samples as all of it will be done from her current I.V. lines.
Alisha's pain started to subside today due to Thursday's chemo.
This evening she received a full scale chemo treatment.
Spinal Tap
Alisha underwent a lumbar puncture (LP) also known as a spinal tap. The reason for the LP was to see if there were any cancer cells in her Central Nervous System (CNS). The LP showed that Alisha is CNS Negative (CNS -).
Even though Alisha is CNS neg. cytarabine (type of chemo) was given to kill possible white blood cells (WBC) hidden in the CNS just as a precaution.
She also had her abdomen scanned since she was retaining a lot of water and her tummy was sticking out due to gas from mouth breathing.
Her spine and hips were still causing her great pain making it difficult for her to walk.
Transfusion
Today Alisha underwent a blood transfusion. The reason for this was to increase her red cell count and her platelets for Thursday's Lumbar Puncture (spinal tap).
Alisha was still in constant pain in the spine and pelvic area.
More Blood Tests
Alisha underwent a series of blood tests. It seemed an endless parade of phlebotomists!
Alisha was in almost constant pain centralized around her spine and pelvis.
General Information About Childhood Acute Lymphoblastic Leukemia
Definition
Acute Lymphocytic Leukemia (ALL) is a type of cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.
The word "acute" in acute lymphocytic leukemia comes from the fact that the disease progresses rapidly and affects immature blood cells, rather than mature ones. The "lymphocytic" in acute lymphocytic leukemia refers to the white blood cells called lymphocytes, which ALL affects. Acute lymphocytic leukemia is also known as acute lymphoblastic leukemia and acute childhood leukemia.
Acute lymphocytic leukemia is the most common type of cancer in children, and treatments result in a good chance for a cure. Acute lymphocytic leukemia can also occur in adults, though the prognosis is not as optimistic.
Causes
Acute Lymphocytic Leukemia occurs when a bone marrow cell develops errors in its DNA. The errors tell the cell to continue growing and dividing, when a healthy cell would normally die. When this happens, blood cell production goes awry. The bone marrow produces immature cells that develop into leukemic white blood cells called lymphoblasts. These abnormal cells are unable to function properly, and they can build up and crowd out healthy cells.
It's not clear what causes the DNA mutations that can lead to acute lymphocytic leukemia. But doctors have found that most cases of acute lymphocytic leukemia aren't inherited.
Diagnosis
Amy took Alisha to Children's Hospital of Orange County (CHOC) on the advise of her pediatrician. In the emergency room, a battery of tests were run to include urinalysis, blood, and chest x-rays.
The blood work came back as positive for Leukemia. Later it was pinpointed as Acute Lymphoblastic Leukemia, Pre-B.
She was then transferred to the Pediatric Intensive Care Unit (PICU) where she remained overnight. She was then transferred to the Oncology Intensive Care Unit (OICU). On Thursday September 3, 2009 at 2:00 p.m. she was transferred to the Restrictive wing of the OICU where she is currently at. This section is on complete lock down, and has a 2 to 1 nurse to patient ratio.