47) Bloodwork, bewilderment, blasts, and barfs (Interim Maintenance II)

The past week has been whirlwind. On Tuesday February 20th, we returned to our satellite hospital for scheduled bloodwork. The previous week, E had been neutropenic, and our trip to SickKids for a lumbar puncture had been pushed back a week. E's blood was great this week, so we were told to proceed to SickKids for a lumbar puncture. We would be starting Interim Maintenance II on Wednesday. I messaged my mother, and she hopped on a GO train to come out and help. On days where we have a lumbar puncture and we need to get E down to SickKids early, my mother or my mother-in-law will sleep over so they can get J off to daycare and we can get a jump on the traffic.

E riding the halls of Rouge Valley Centenary

Wednesday February 21st, we ended up not waking up as early as I had liked, and we were a little late getting on the road. Combined with the pouring rain, it was a miserable 90 minute trip to downtown Toronto. E's lumbar puncture & chemotherapy went without incident, but he woke up after only 30 minutes, so my wife had to lie on the stretcher with him to try and keep him horizontal until an hour was up. Cancer patients need to lie flat for an hour after a lumbar puncture so that the chemotherapy is effective, and also so they don't get a headache.

E riding the halls of SickKids

Around lunchtime on Thursday February 22nd, the phone rang. I was on the computer, and my wife answered the phone in the kitchen. I wasn't listening in, but I overheard her say "I'm not sure what you're telling me. Should I be worried?" I then focused in on the one side of the conversation I could hear, but most of it was my wife repeating affirmative words: yes, uh-huh, okay. I didn't know what was going on, but I started having a panic attack. I felt a sense of vertigo, my vision went wonky, and my ears felt like they filled with blood. I could still hear sounds, but it felt as though I was listening underwater. I was transported back through time to July 22nd, E's diagnosis day. I felt like I wanted to vomit.

We've all had a few minor medical issues as of late. At first, I thought the call was about my wife. Immediate panic. If something is wrong with her, I can't do this all on my own. Somehow, I came to the realization that whomever was on the other end of that phone was talking to her about one of our sons. We had some bloodwork done for J recently, and we found out that he is anemic. Not surprising because the kid literally doesn't eat. I was panicking, thinking that they were calling because they found something else in his blood. Maybe J had leukemia too. Maybe it was something else. After what seemed like an eternity, but was actually at most a few minutes, my wife got off the phone. She told me that it was E's oncologist from SickKids, and that they had spun his blood after the lumbar puncture, and they had found a few blasts. My heart immediately sunk. The oncologist had said not to worry, that they see this from time to time, and it was definitely not a relapse. At E's next lumbar puncture they will take more blood, and check it again. Our oncologist said that when this has happened before with other patients, the blasts are usually gone by the next test. The good thing is that he has chemotherapy drugs in him after a break of a couple of weeks. There is nothing to do, and nothing we can do right now since the oncologist doesn't want to have to put him under anesthetic again.

It's been stressful, but we're trying to remain positive. They don't mess around with oncology patients. If the doctors are concerned about something, they tell you to go to your satellite, or come in to SickKids. SickKids is, if not the best, then one of the best children's hospitals in the world. If they're not panicking over this, and telling us to come in to the hospital ASAP, then it will hopefully turn out to be nothing. A Facebook leukemia support group that had I joined provided some answers, with one parent stating:

"It can happen when they're neutropenic. The bone marrow is trying to push out any cells they can to help their body recover and in the process they push out Young blood cells that aren't fully formed. Blasts are "forming cells" Don't freak out. I know it's terrifying though."

E had been neutropenic the week before, so this answer did quite a bit to soothe my anxiety. However, I am a worry machine, and it's one of the things I do best. We'll just have to wait until the next lumbar puncture, but the waiting is the hardest part.

On Friday February 23rd, and Saturday February 24th, we had our first two nausea induced vomits. I guess we've been lucky so far, in that E has been pretty good about not losing his appetite during chemotherapy. He has vomited during treatment before this, but those vomits were directly related to his sensitive gag reflex issue that we are still trying to work through. This time, there was no gagging or choking. His lunch went in, then for no apparent reason at all, it came right back out again like a science fair baking soda volcano. We have a prescription for an anti-nausea medication named ondansetron (I laughed when I firs heard the name, because I thought it sounds like the name of a Transformer), but we usually only give him the meds for 24 hours after a chemo treatment. It's difficult with E being only 22 months, since he doesn't have the words to communicate to us of how he feels. Everything we do is guesswork; our interpretation of how we think he's feeling. I gave him a dose of ondansetron, put him in the bath, and then he was able to keep down a bottle of milk. Solids later in the day were kept down no problem. E must have been feeling better later on, because he was running around playing (fighting?) with his brother.

E & J, mesmerized by PAW Patrol

Overall, I'm happy that Delayed Intensification I & II are over. I have a number of questions for E's medical team about the presence of the blasts. We've been told to not worry, so I'll just have to try to keep that thought front and centre.