Saturday, January 26, 2019

38 Days in the Hospital

After five weeks and two days, I am finally home!

This hospital stay was much longer then we expected, but it thankfully wasn't too bad. Compared to our many previous extended stays, this was a relatively calm one. The last week or so really tested my nerves because I've seriously felt fine, it was just my ANC keeping me inpatient. My ANC has still not fully recovered. Thursday it was only 50 and they originally wanted to send me home with it at 200. I was really surprised when the doctor came in and said we could go home. I was a little unsure at first because the whole stay we were told my ANC needed to be higher but I came home on antibiotics and with the rest of my blood work showing encouraging upward trends. So hopefully that ANC is going up too!

The stay started out with a rough first day. On Tuesday, December 18 I was scheduled to have my port (central line where I receive IV fluids, chemo, antibiotics, etc.) placed at 11 AM and to be admitted to the hospital following that. I first had to go to the oncology outpatient clinic there so that I could have my blood work checked and see if I needed more platelets before the surgery. To make a long story short, we waited for way longer than we should have at the clinic, getting the platelets took forever, they didn't give me enough platelets so I had to wait then receive another bag, I was unreasonably given IV Benadryl (which I hate because it completely knocks me out) before receiving the second bag (I get pre-medicated with Tylenol and Benadryl before receiving platelets and blood so I don't have a reaction), then I finally went back for my port at 4 PM. The whole day was ridiculous and should have gone a lot smoother. My mom and I prefer going to our outpatient clinic at Voorhees SO much more! Anyway, after that terribly long day, I was admitted and things were mostly fine after that. (I do want to say that that was just one bad day from an outpatient experience. CHOP is a wonderful place to be treated and they have top notch doctors and nurses!)

I started chemotherapy on Wednesday night. The chemos that I got during this visit were Mitoxantrone, Vincristine, and Dexamethasone (which is a type of steroid). The first chemo is known for nausea and hair loss so for a few weeks around the clock I received an anti-nausea medicine called Zofran. It worked because I wasn't nauseous at all throughout the whole stay. Love that stuff! I was also highly amused that the chemo was blue 😂 Vincristine makes my fingertips and toes all tingly. It's a weird sensation. Dexamethasone's side effects I talk about later in this post.
My blue chemo
Because I was going to lose my hair eventually anyway and it's a pain to keep up with long hair in the hospital, on Thursday night I had our friend Michaelann come and cut it all off. She shaved my head the first time I got sick in 2009 and the second time in 2015, so we asked her back this time too. So grateful to her for doing that!

That week I just watched a lot of Christmas movies to pass the time. It seemed like The Santa Claus and The Santa Claus 3 were always playing on Freeform so I probably watched them both at least five times that week. On Saturday, Melony and Mia came up with the rest of the family and we exchanged presents. It was a lovely afternoon.
Decorated for Christmas! We also had a little tree but I didn't take a picture of that :/
Christmas Eve was very chill. The family came and we played a board game and watched a Christmas special. Christmas Day we did the best we could to celebrate even though we were in the hospital. It was also a bit of a rough day for me because I had finished my first round of Dexamethasone and I go through about two-three days of withdrawal when I come off it. The withdrawal makes me irritable, tired, and every muscle in my body hurts. Not fun. So I was feeling that way Christmas morning but I took some Tylenol for the pain and did my best to stay awake for the opening of presents. My parents surprised me big time by having my car shipped home from Utah! I was so confused when I opened a present with my car keys in it and they had to show me a picture of the car in the driveway for me to understand what they had done (remember I was very tired). After opening presents everyone took naps and just hung out. We ordered pizza from Dominos (yes, we were those people) and it took over two hours to get here! So annoying! Word to the wise- don't order pizza on Christmas!

The day after Christmas was, other than the first day, the worst day out of my hospital stay. I had to get a spinal tap. I've done probably over a hundred of those throughout my time as a cancer patient but a lot of different things factored into this one being upsetting. I normally get them done at my outpatient clinic in Voorhees and they take such good care of me. For this one I had people handling me who weren't used to what I liked and I was still post steroids so I was already uncomfortable and moody and it was just bleh. The rest of the day I felt pretty terrible and my mom and I just laid in my hospital bed together and watched movies.

The next holiday was New Year's Eve and it was actually a great day! I sent my mom home so she could be with my dad and Mallory, Marti, and Amber came up. Amber planned some Minute-to-Win-it games for us to play so we did that and we had a lot of fun! Then we had our junk food dinner of pigs in a blanket, buffalo chicken dip, chips and onion dip, and chips and guacamole. And I had a root beer float. Yum. After eating we watched Dumplin' which is a movie on Netflix. It was really cute! After that movie we watched New Year's Eve (the movie) and then counted down to midnight and had some sparkling cider.
Marti, Mal, Amber, me

The next few weeks passed without being too eventful. I continued to get chemo and feel pretty ok!
Mom hiding from the camera under blanket hahaha
I had wanted to be home for my birthday, but that didn't happen so I spent it in my bed at CHOP. I didn't do much during the day but a bunch of the staff came in and wished me a happy birthday and even the cleaning lady sang me happy birthday! That was cute. The fam came up later on and brought me Saladworks and CHOP provided an ice cream cake which was so good!
Candid shot of us being weirdos 🤷
Couldn't really get Mal anything so I made her a poster :)
Child life provided the banner and a poster. Nice of them!
A really amazing foundation called "The M.I.P. (Most Important Person) Foundation" gave me a really great gift bag of stuff to use in the hospital and then surprised me with even more awesome things for my birthday! I might do a post about what I got because it was really great and they are a group that I largely support because of what they are doing for teens and young adults.
The week after that was again, very chill and just waiting for my counts to rise. Then we were finally released on Thursday!
What my room decor looked like at the end of the stay
Keeping my calorie intake up the right way 😉
We kept a sheet of my blood counts every day I was in the hospital. As you can see on the right side I had to get quite a few blood and platelet transfusions.
The biggest relief for me this stay has been that I haven't lost my appetite. In the past it has been really hard to eat while in the hospital and so I've had to get feeding tubes placed. I'm honestly pretty proud of myself for pushing through and eating like I have been. I know it sounds like such a simple thing, but when I'm sick or stressed, it can be very hard to want to eat (not to mention the chemo making me nauseous and my taste buds become dull so food tastes different or doesn't taste like anything at all). But that hasn't happened so far this time and I'm so relieved about it! Another huge relief was that I only had one fever and it only lasted one night without getting too high. They put me on antibiotics since that fever and I think that might have been what kept me from getting another one.

I surprised myself by finding ways to keep myself entertained for five weeks in one room. I read, watched TV/movies, listened to music, listened to podcasts, played games, and did arts and crafts. I read a book called Circe. It's a fantasy and involves greek mythology, which is not what I would normally read but it was Goodreads 2018 book of the year so I thought, why not? I searched Netflix, Hulu, and Amazon Prime for shows/movies to watch and added them to my watch list. My mom and I rewatched the first two seasons of Downton Abbey and I finished season six of One Tree Hill (not sure if I should continue with the next couple of seasons because six ended so good! If you've watched the show, let me know!). If you have any book, movie, or TV show recommendations I would love to hear them! That's what I'm going to be doing for the better part of this year so I'd appreciate any recommendations!

I also was very fortunate to have my family or at least one member of my family visit almost every day my mom and I were there. It really made the day better and it was something to look forward to every night. I also was super grateful for the visits I got from my friends Amber, Libby, and Emily. Unfortunately I wasn't allowed more visitors than that because it's flu season and the hospital has a rule about it.

Some really great news that we got while I was there is that they found four perfect matches for my bone marrow transplant! I honestly don't know a lot about bone marrow transplant yet, but finding four people who are perfect matches for me is a really really good thing. I've had a few people offer to be tested to see if they are a match for me (which is so incredibly kind and generous!) but if you're not a member of the patient's immediate family, then the donor has to come from who is already in the system. If you are interested in becoming a donor and helping someone like me, you can find more information at bethematch.org.

The next step is getting another bone marrow biopsy next week to see if there are any leukemia cells in my bone marrow (which we really hope there's not!) and the doctors forming a plan of what my next treatment will be before going in for a bone marrow transplant.

Thank you for the continued thoughts and prayers! Even though I am home now, this is far from over and we appreciate all the love and support.

Blood counts as of 1/24/19-
Platelets: 29
Hemoglobin: 10.1
ANC: 50

Tuesday, January 15, 2019

Third Relapse, Fourth Diagnosis

Cancer never comes at a convenient time, and it especially doesn't seem to for me. The first time I relapsed, I was in the Missionary Training Center. The second time I was half way through my third semester at BYU and I had to drop all my classes that I had worked so hard in. This time I relapsed a week before finals at BYU.

The way I knew that I had relapsed this time was very similar to my previous relapse in 2017. In October 2017, I noticed some bruising and little red/purple dots on my ankles called petechia. They show up when platelets are really low. I went for my monthly blood work and just that simply, they saw the leukemia cells.

On Wednesday, December 5, 2018 I noticed petechia on my ankles again. I also noticed one on my eyelid and lip. I ignored it for the morning and went to class. After class, on a phone call with Mallory, I started to get really concerned and worked up. Now, my platelets and counts in general had been fairly low since getting my CAR-T cell immunotherapy infusion earlier that year. The doctors said it could take up to a year for blood counts to truly recover from that. I tried not to be too upset but it was like a repeat from 2017's relapse. I went to to work that night and felt exhausted after only two hours. I resolved that I would get blood work done the next morning.

Thursday I went and got my blood work done then went to class. After class I waited for my doctor to call with the results. She eventually did and told me my platelets had dropped from 68 the previous month (which is still pretty low, but safe enough) to the lows 20s. She tried to reassure me that it could just be a fluke thing but I think I knew what was going on. A plan was made for me to get my blood work checked again on Monday. After I got that news though, I was a mess. Even though it wasn't confirmed, relapse was suddenly a big possibility. The rest of that day and Friday and Saturday I just did what I could to distract myself and stay calm. I couldn't bring myself to go to work and thankfully I didn't have class anyway. I watched movies and hung out with my close friends. On Saturday morning a plan was made for my mom to fly out the following evening to help me get through the last week of school and finals.

Sunday came and my best friend, Amber and I decided to just attend sacrament meeting at church. I was exhausted and emotionally spent so it seemed like the best option. We went but by the end I really thought I was going to pass out. As soon as we got home we packed a bag and Amber took me to the Emergency Room. I was shaky and weak. They got me hooked up to IV fluids which made me feel better. I was probably super dehydrated so it helped a ton. They drew labs and it was there in the ER that I found out that the Leukemia had returned. I wasn't surprised. My platelets had dropped more so I also received a bag of platelets. We were there in the ER for over eight hours and my mom finally got there (what a blessing that she had planned to fly in that night!). Shout out to Amber for sitting with me that whole time! My other lovely roommate (also named Amber) also came and sat with us for a while. My mom and I left and went to Primary Children's Hospital in Salt Lake City. They communicate with CHOP (where I'm treated) so that was the best option. We stayed there overnight.

The next day (Monday, Dec 10), I received a blood and platelet transfusion before we were released to go back to Provo and get my things together. My angel friends Amber, Amber, and Emily packed up all of my clothes and things for me which was such a relief! I went back to the apartment that night with my mom to collect the suitcases and I was able to say bye to some of my close friends.
Charlie, Calvin, Amber, Emily, me, Joe 
Amber, Amber, me, Elizabeth (Avenues 232💕)

That night my mom and I stayed at our close family friend's house (the Lundbergs). Tuesday we went back to my apartment one last time so I could say goodbye to my roommates and double check that everything was packed and taken care of. After that we went back to Primary Children's in SLC because in order for me to be considered "safe" to fly home, my platelets needed to be 50 or higher, so I got another platelet transfusion. That night we stayed at our friend's the Monson's. They drove us to the airport the next morning. We decided to fly first class because then I'd be around less people and I'd be more comfortable. It was not how I pictured my first time flying first class, but we were so glad we chose to do that! I needed to be pushed in a wheelchair through the airport and between that and having the advantages that you get with flying first class, we were at our gate in like 10 minutes! It was the fastest that I'd ever gone through an airport, that's for sure. Then it was equally as fast getting out of there when we landed. Way to go Delta.
Blurry, but I had to document my 1st first class flight! 
We made it back to New Jersey safe and sound. It was definitely bittersweet. I would have much rather been studying for finals. By the way, shout out to all of my professors for being so understanding and supportive! I was able to finish out the semester super strong!
Always a joy to be back with Maxwell
The day after we got home (Thursday), I went to CHOP for a bone marrow biopsy and spinal tap. That night Marti and my friend Libby helped me dye a strip of my hair teal because it's something I always wanted to do and I was going to lose my hair anyway.
It turned out more green than teal ://
The rest of the weekend was pretty low key. We unpacked my things and prepared for the month long hospital stay ahead.

I'll write about this hospital stay (yes, I'm still here 🙄) in my next post! Really really hoping for a huge jump in my ANC so I can be home for my birthday on Thursday!

Current blood counts-
Platelets- 14
Hemoglobin- 8.7
ANC- 40

Friday, January 11, 2019

What is Leukemia?

Hey everyone!

I get a lot of questions about how I'm doing and what I'm doing for treatment so I thought it would be easiest to keep everyone informed by keeping a blog.

I thought it might be helpful to start out by giving you some information about what Leukemia is. I have Acute Lymphoblastic Leukemia (ALL) which is a cancer of the bone marrow, where blood is produced.

What is Leukemia?

This video is an extremely simplified explanation of what Leukemia is. (I am treated at Children's Hospital of Philadelphia, not Cincinnati. They just had a good video 🙂)


More information-

Terms to know-

Platelets- helps your blood to clot in response to a wound or cut
Red blood cells- carries oxygen and gives your body energy
Hemoglobin- measurement of red blood cells
White blood cells- fights infection and bacteria 
Absolute Neutrophil Count (ANC)- the amount of neutrophils (type of white blood cell) in the blood
Blood counts- related to the numbers listed above

The blood counts of an average, healthy person range between-
Platelets: 150-400
ANC: 2,500-6,000
Hemoglobin: 12-16

Today (1/11/19) my blood counts are-
Platelets: 24 (which is actually higher than they have been)
ANC: 0
Hemoglobin: 9.1

Right now I am in the hospital until those blood counts recover on their own. My ANC has to be 200 to leave. Blood counts change super quickly though so we're hopeful I'll be out of here in the next week!

If you have any questions, I'd be happy to try to answer them!