Thursday, October 29, 2009

A big bad adventure

Well, we are back from San Francisco. To say that this trip was a bit of a fiasco would be an understatement! The plan was to arrive Tuesday morning, meet with UCSF neuro-oncologists Tuesday afternoon, meet with the Radiation oncologist Wednesday morning, meet with the Pediatric endocrinologist Wednesday afternoon, and then fly out Thursday morning. It was going to be a quick trip. All went according to plan for about the first half of the first day.........

We arrived Tueday morning, and spent a few hours wandering around Union Square. After lunch we headed over to UCSF for Matt's appointment with the neuro-oncologist. We waited for over an hour and a half. That's not such a big deal - I never mind waiting, as long as the doctors take a lot of time with us. This appointment went very well. We talked about Matt's diagnoses and treatment history. There were actually two doctors and they told us that the treatments Matt has had so far are exactly what they would have done there. That was very reassuring! We also talked about treatment options, should Matt's tumor begin to grow again. The appointment was coming to a close and the doctor was performing a neurological test on Matthew. She wanted to watch him walk and noticed him limping a bit. She had him take off his socks and shoes and examined his legs and found his left leg to be swollen and red. She suspected another blood clot and so sent us across the street to the ER.


The ER was, well, interesting, I suppose. Let's just say that the ER in a big city made me REALLY miss our little Primary Children's Hospital! For one thing, UCSF is not a children's hospital. It is huge and the ER sees some crazy stuff. There's lots of security and signs everywhere telling the staff how to deal with homeless people, drug addicts, and people with the flu. Matt was taken up pretty quickly for an ultrasound of his leg and, sure enough, a clot was found. Long story short, we arrived at the ER about 6 pm, I left at 10:30 pm to take Audrey to the hotel once we learned that Matt would be admitted, and Matt didn't get a bed in the hospital until 3:00 am. Warren was not amused.........

The protocal at UCSF is that patients who are receiving IV Heparin (which they use to treat blood clots) must be treated in the intensive care unit. Wednesday morning, I called the answering service for the radiation oncologist to pass along the message that we would not be able to make our 8:30 am appointment. We spent all of Wednesday in the ICU, trying to convince everyone we spoke with to let Matt go. :-) Hanging out in the ICU of a hospital in another state, during flu season, with an infant is not exactly a great time. Thankfully, they kept Matt in an isolation room and they did allow Audrey to stay with us (infants who are not patients are not allowed in the ICU at Primary's). During the stay, it was found that for some reason Matt's Lovenox levels were not right. He was on the very low end of the therapeutic range last week but when they ran the labs again, his levels were not in therapeutic range. It was decided to increase his dosage of Lovenox.

Miraculously, the last doctor we were to meet with, Dr.Lustig, happened to be the attending doctor the night we were in the hospital. Even though we had to miss Matt's clinic visit with him, Dr.Lustig was able to come up to the ICU and meet with us right there. Ultimately, even though the trip didn't go as we had envisioned, Matt was able to meet with two of the doctors we had scheduled, and the other was able to call us and we had a telephone conference. It all worked out! I'm so thankful they found the clots. It was quite a good catch, as we hadn't even been visiting them for that purpose. It was a blessing!

Matt was released after only about 48 hours in the ICU. While we were in San Francisco there was a problem with the Bay Bridge and it was closed. Of course, the Bay Bridge is on the way to our airport....... Between a stay in the ICU, excess cab bills back and forth to the hospital from our hotel, and a $200 cab ride to the airport (we had to go clear around to another bridge), this turned into quite an expensive 'little' trip!

The doctors at UCSF presented Matthew's case at 'Tumor board' the day he was released. All of the doctors we had met with were present. It was determined that they agreed with all of Matt's treatments he has had so far. They wouldn't have done, for instance, a different chemotherapy, or radiation. They also agreed that our plan of not doing anything right now, while his tumor is stable, is the right choice. We will continue to watch the tumor closely and if it begins to grow, we will do radiation at that point. Also, all the doctors agreed that a vagotomy (the surgery that will hopefully help stabilize Matt's weight) wouldn't hurt future options for his cancer treatment. I think we are going to go ahead with the surgery. It seems like a pretty minor procedure that could have very major benefits to Matthew. He has gained 12 kg. since his last visit to SF 4 months ago - that is almost 27 lbs. The potential side effects of the surgery seem less problematic than the side effects from obesity. We pray we are making the right choice. We have considered our options for several months and are feeling pretty comfortable with the decision.

Tuesday, October 13, 2009

San Francisco here we come!

Matt has a follow-up in San Francisco with the hypothalamic obesity specialist in two weeks. For awhile now I have been feeling like I wanted to get another opinion on other aspects of Matthew's treatment for his cancer issues. UCSF is a brain tumor consortium hospital and I wondered if they might have some different treatment ideas for Matt's unique set of issues. I have put off making the calls to arrange a visit with other clinics at UCSF and decided to call today even though I was pretty sure it would be too late to make the arrangements. I was so excited when I started to call around and found that everyone was really willing to make things happen for Matt! Now, over the span of two days, Matt will meet with the pediatric neuro-oncology practice and a pediatric neuro-radiologist, along with the Endocrinologist we've met with previously. The oncology doctors will review Matt's chemo protocols (they call this his 'roadmap') that he has already done. They will discuss any treatment options we may have overlooked and will recommend a course of treatment. Then the radiologist will discuss Matt's radiation future. We are most interested in meeting with her because she will be able to talk to us about whether the surgery for the obesity would be a bad idea in light of the future radiation treatment Matt may need. We will discuss which type of radiation would be most beneficial for Matt's particular case and determine whether SLC has the capability to perform that radiation. Some larger centers have different fancy radiation abilities. We'll see what might be best for Matt. Lastly, we will be meeting with Dr.Lustig to discuss the vagotomy surgery for weight management. It will be a whirlwind of a trip but I am so excited to meet with these specialists. I feel so thankful that everything worked out so smoothly. It is meant to be!

Sunday, October 11, 2009

A girl in a house full of boys....

After church, Will was playing with Audrey. Unfortunately, her bow fell off. Fortunately, she had a big brother there to remedy this crisis!

Friday, October 09, 2009

A moment of motherhood perfection

Once in awhile, amid the complaining, fighting and screaming, I have a moment that makes me suspect I'm not totally ruining my children. It seems that all those family home evenings about loving our brothers (and sister) and doing nice things for them, and sticking up for them when someone is being mean might have sunk in. Perhaps Will was actually listening to General Conference when President Monson talked about true Christian service - you know, the 'warm fuzzies talk'?? Anyhow, the other day William did this for Matt.

Sometimes I forget that my other children are participants in this whole cancer experience, as well as Matt. They are acutely aware of Matt's medical routine. Will knew exactly what medications to set out for Matthew, where they were kept, that he ordinarily takes his evening medications with milk, and that he needed a shot. This is one of the reasons we have decided to allow Matthew to take a trip through the 'Make a Wish' foundation. It promises to be a spectacular experience. We are looking forward to a whole week where we will all have a fabulous time, and hopefully, our 8 and 6 and 2 year olds will forget for a moment that they have a big brother with cancer. Of course Matt is the 'wish child' and he had the experience of choosing his wish and will be the spotlight of the week BUT I feel like our other children deserve the trip as well. Matt's siblings deal with many unanswered questions. And they are totally and completely patient as they deal with Matt's repeated hospitalizations and almost weekly day-long doctor visits two hours away. They remain cheerful and are wonderful for Matthew. They keep his life as normal as possible, and I think they understand their important role better than I give them credit for!