Tuesday, September 23, 2014

And so it begins... - Feb. 18, 2014

Friends, 

I have been asked by several for a more detailed run-down of all that is 
going on with Asa (and us).  This is not private info, nor a complete 
list 
this should have gone out to, so share as you like. I'm sure there will 
be 
some better mode of sharing in future, but for right now*  If any of 
this is 
stuff you know, skip that part and skim on.  I've gotten all sorts of 
good 
questions from many of you and keep asking them.  Many of them are 
alerting 
us to stuff we should be asking. 

On Tuesday, Feb 11, I took Asa in to the pedi.  Pedi office called at 
noon 
that day and switched the appointment to my pedi's partner.  I was very 
frustrated by that, but it was part of God's plan.  We had been feeling 
that 
Asa's tummy was very hard and tight and were a bit concerned - didn't 
seem 
quite normal to us.  Dr. Shoemaker, Dr. Singh's partner, felt the same 
and 
sent me stat over to Tomball hospital for an ultrasound and they found a 
mass in Asa's belly.   She was a total joy to work with and pointed out 
to 
me from the get-go that God knew this before, knew what was going on 
now, 
and had the future in His hands.  What a doc! 

Dr. Shoemaker immediately referred us over to Texas Children's (TCH) and 
began working on a game plan to get us in to the right specialist the 
next 
day.  We went home to have poor Allen's 15th bday dinner with kids and 
we 
got a phone call from Tony's neurologist (neck doc) down at Methodist 
Hospital downtown.  He had a cancellation for Wednesday at noon and 
wanted 
Tony to come in.  The neuro's assistant who made the appointment advised 
us 
to speak to him about Asa.  No coincidence. 

Wednesday the pedi was still working on a game plan and we drove down to 
neck doctor prepared to go from there to TCH.  While in the office 
meeting 
with the neurologist about Tony's neck, the pedi called and gave us 
directions to go down to the ER for fast track.  They were expecting us. 
Dr. Baskin (neuro) stopped his neck discussion,  felt Asa's tummy and 
stopped all and started making phone calls for us and hooked us up with 
the 
top surgeon at TCH.  His assistant used to work as a nurse at TCH and 
knew 
the system. We arrived after a block's walk to the ER with the surgeon's 
resident waiting on us, bypassing the nightmarish ER system wait here. 
That's a big deal. 

We spent a while in the back rooms of the ER before being admitted and 
waiting on a ultrasound to be done and not being allowed to feed Asa the 
whole time because they didn't know if he needed immediate surgery. 
Ultrasound was done, along with bloodwork, and we were admitted. 

Thursday was a nightmare of meeting with random docs with weird names, 
random residents (teaching hospital!), not feeding baby again much of 
the 
day, waiting on an MRI that happened finally at 5:30-6ish.  We were 
supposed 
to get results late that night, but the left hand didn't communicate 
with 
the right and that didn't happen.  Their suspicion at the time was a 
number 
of things from very benign issues to types of liver cancer.  The 
bloodwork 
indicated a somewhat elevated AFP (alpha feta protein) level, which is  
high 
in babes anyhow, but might be a marker for a type of liver cancer. Not 
necessarily. Both surgeon and oncology were all over the place with this 
and 
seemed to be discussing amongst themselves a lot, but not that much with 
us. 
Asa woke up from his MRI sedation a total starving bear and ate and 
puked 
until they gave him Zofran and he went to sleep.  It was an interesting 
and 
long day. 

Oncologist sat down with us yesterday, Friday the 14th and that is what 
our 
current status update is based upon.  Asa woke up a bit improved after 
all 
his MRI recovery, so at least he was pseudo-pleasant that day.  The 
oncologist told us that she is about 95% sure this is a hepatoblastoma, 

liver cancer that hits children.  It's very treatable.  We are really 
not 
given staging in this like adults (at least what said thus far) because 
evidently this one is discovered at about the same stage in most kids - 
when 
there's a lump in the tummy.  It is attached to the left lobe of liver 
only. 
It is very large, though that doesn't seem to concern them since it 
seems to 
be located only there.  There is an unbelievably tiny unknown spot on 
the 
lungs that could be related and change diagnosis a bit, but that 
investigating that further on Tuesday to make sure there are no more 
strange 
things on the CT scan.  That's all that can be found elsewhere and they 
don't even know if it's anything at this point and if it is, it appears 
minimal.   

Though we don't know all the details, after meeting with the chemo 
oncology 
guys that will be our long term docs, the upcoming scenario is as 
follows. 
There will be 2-3 rounds of chemo with 4-6 weeks between.  Chemo will 
always 
be done inpatient at TCH and take about 3 days.  The expectation is that 
this reduce the tumor very significantly and allow them to remove it 
without 
causing a lot of trauma to Asa's little body.  Then this will be 
followed 
with several rounds of chemo again.  Each week I will have to take Asa 
into 
clinic here at TCH twice for check up.  We've been told to expect 6 
months 
plus. 

Good things.  This is treatable.  Childhood cancers are much easier to 
treat 
than adult cancers.  We are in one of the best places regardless of this 
scenario being better or worse - they handle this type of cancer several 
times a year and there are very few of these cases in the US each year. 
This was identified and caught.  We don't have any understanding of how 
long 
it has been there, nor do docs.  And, this cancer has an easy marker as 
to 
how it is responding to chemo - you can measure the AFP (alpha feta 
protein) 
in the blood. 

Bad things.  It is cancer.  This is a pretty long haul or it seems that 
way 
as we look into the dailiness of it.  Kids are situated, but there will 
be a 
lot of juggling to do.  Tony still needs neck surgery at some point in 
near 
future.  My brother-in-law is also battling cancer. 

We would appreciate prayers.  As a friend pointed out, Asa's name means 
"physician or healer."  His  middle name is Josiah - Yahweh has healed.  
We 
are praying for healing and trusting God to care for Asa and give us 
wisdom 
as to how to deal with him and the docs and that He will be faithful to 
work 
this out to His glory.  I think we are still in an auto-pilot fog at 
this 
point, handling details non-stop, trying to understand everything with 
harder days ahead, days where our emotions will catch up with reality a 
bit 
more. 

This week entails testing on Monday, a biopsy Tuesday morning, chemo 
Wednesday thru Friday.  Sometime thereafter supposedly we will be 
released 
home to try to stay well with a house full of other children.  Whee! 

Thank you for your love and your friendship!, 

Mimi and Tony 

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