July 10 - Thursday

Good morning,

Yesterday was a busy day for Sam and his treatment. We gave Debbie and Katelyn the day off (Karly is in PG with the BC Summer Games Basketball Team) and Sam and me went to the hospital for the day. We only have a 13 minute commute now to the hospital which is a huge difference (it was a 45 min to 60 min trip from white rock). We are all really enjoying the house we are 'borrowing' for the summer. Our previous children's pastor and her children are staying in our house in PG so it is kind of nice that we can all share and help each other out.

Anyway, we arrived at the hospital at 9am and then Allison accessed Sam's VAD. This sounds wierd and actually it is a little wierd. First she finds the device located under the skin on Sam's chest. Then she removes the EMLA cream which we place there so that it numbs the skin around where he'll get poked. Then she takes out a little needle with two butterfly wings on the top and a tube running off the wings. She pokes it right into his chest, tapes it all down and connects the IV. It takes about 3 minutes for these amazing professionals to do their thing and Sam never feels a thing. It is amazing.

We start with takinga bunch of blood for the blood tests and then an IV for anti-nausea medication (ondansetron), which we know is gonna be needed, and then regular saline. We get the blood tests back in about 20 minutes and it all looks good except for the hemoglobin which is only at 66 (adults can pass out with a hemoglobin around 70) and explains why he had such a bad headache last night. Hemoglobin transports the oxygen around your body so if you don't have enough of it, you don't have much oxygen and that makes you feel very tired and listless. For us, this means a long day because we have to get a blood transfusion and that takes 3 hours.

But, he's got a lot of stuff going on today as well and the blood transfusion can't start until the afternoon. Allison is on all this stuff and she gets us in to see Dr. Lucy right away and we start his first procedure. The first procedure is his weekly LP (lumbar Puncture) which is a needle into his spine, the draining of spinal fluid for testing and then an injection of methotrexate (15mg) into his spinal column (CSF - cerbral spinal fluid). This medication will travel up and down the spine and actually wash his brain as well. The cure rates for A.L.L. improved dramatically when they found that the leukemia cells hid out in the spinal column and they started injecting chemotherapy directly into the spine. They sedate Sam but he still feels it and moans throughout. Dr. Lucy is amazing though and its all over in a few minutes. As he's waking up, they get the next procedure ready and three nurses come in with all their gowns and protective gear on.

They bare his legs and on the count of three all three needles get inserted into his thigh muscles. This is an IM (intra muscular) injection of PEG - asparaginase, an enzyme, which wipes out the building blocks the cancer cells need for reproducing. Unfortunately, allergic reactions are quite common to this drug so they watch Sam carefully for 3 hours. This also means we don't get to have his transfusion until the risk of reaction is gone.

They wheel Sam into his room for the day and he goes to sleep. I read the Leukemia book I took out of the library. Eventually I go to Starbucks and get something for us to eat for lunch. Unfortunately, Debbie was going to bring us lunch but I took her keys and so she's stuck at home today.

One of the great things that people did for us was give us Starbucks cards. We got a lot of Starbucks cards after Sam's first diagnosis and we wondered how we'd ever use them all up. But, it is amazing to be able to go to the Starbucks in the hospital and use a card that someone gave to you. I would rarely go there if people hadn't given us this gift because it is so expensive and we know this is going to be a 'lean' couple of years while Sam is in treatment. What a great gift to be able to use these Starbucks cards at the hospital. People have been so generous to our family - Debbie and I are just amazed by how people have supported our family.

I come back to the room and Sam is still sleeping. I read my book (finish it) and then Sam wakes up at about 1:30. He's not hungry. These drugs have taken away his appetite and he's now losing the weight he put on during the first month. Its a good thing he ate so much that first month because he's not hungry much at all now.

Finally Sam wakes up and they bring his chemo medication. They hang a bag of Vincristine (2mg) and run that through. This was the medication Sam received his first day of treatment and has had it many time since then. All of this medication makes him feel lousy and we know what's coming. Debbie's sister Donna comes by and says hello, picks up the keys and goes to take them to Debbie.

The blood arrives, Allison checks all the tags carefully to make sure he's getting the right blood and that he's the right kid, and then we're set to wait for 3 hours while it all runs through.

I go and find the game battleship, come back to the room, talk Sam into playing it with me and we have a great game of Battleship for about 2 hours. He eventually wins by coming up with a creative grid which eventually finds all my ships. I really didn't like losing to an 11 year old, drugged up kid, and I tell him that and we have a good laugh. He watches TV for the last 45 minutes. And then, it's 4pm and Allison comes back in.

She de-accesses his VAD by pulling out that butterfly needle in one quick motion, puts on his bandaid and gives us a smile. "You're all done!" See ya!

We drive home and because the commute is so short, Sam doesn't even feel sick.

We have a nice dinner, play outside for a bit, Sam and Kate go to watch TV, Debbie talks to a friend on the phone and I go next door to see how our neighbor is doing. He's 84, lives alone and is a super nice man. He is having a hip operation next week so I told him that I don't mind doing his yard work while he's recovering from his hip replacement. We have a nice talk for about an hour and then I walk home through the tall Cedar trees.

God has blessed us. We have many, many things to thank him for each day. Wonderful nurses and doctors, an incredible treatment with a great chance of a successful outcome - a long and hard journey but potentially live-saving, amazing friends and family who support us, a great place to stay close to the hospital (our friends have been so generous to let our family use their home), a fantastic family, our heavenly father who never leaves us and walks alongside our every moment, and a little boy who faces each day with the courage of a champion.

Early in the day I asked Sam, "Is there anything I can get you?"

He said, "Yeah, you can get me outta here."
"Wait 7 hours and I can make that happen for you," I replied with a smirk.
"Thanks Dad, I'll hold you to that!" he said with a smile...

... and he did.

Ger