Phinally, Some Good News

Hey there Phin phans! Dustin here with an update. This one’s pretty good! I love it when I get to deliver good news, and I’m sure if you’re reading this, you’re probably ready for some, so let’s get into it.

Phin’s in remission again! The results of the bone marrow aspiration he got before he left the hospital on March 20 show that there’s no detectable disease in his bone marrow, which is where this kind of cancer lives. 

Here’s what it means: 

• The cancer responded to the chemotherapy like it did the first time. Over the past four weeks, we’d seen the withering effects of the chemo on Phin’s body, but we had no way of knowing for sure what it was doing to the disease itself. Among our greatest fears since Phin relapsed was that the drugs wouldn’t work on it a second time because his cancer had “learned” or mutated or developed a resistance to it. According to the lab report, it doesn’t seem like this has happened. 
• Phin can advance to the next phase of treatment–bridging chemotherapy, or BT. My understanding of this phase is that it’s like a “bridge” from the reinduction phase he just completed to the bone marrow transplant phase that comes next. It will involve more chemotherapy to maintain his current state of having no detectable sign of disease. Again, I’m not a medical professional and my comprehension of this stuff relies almost entirely on metaphors, so when I tell you I think this is the part of the MMA match right after a fighter falls, when the other one immediately climbs on top and starts pummeling their head into the mat, take it for what it is; the cancer just took a devastating hit and went down, but it will almost certainly pop right back up unless Phin and his doctors keep hitting it. 
• Reaching the bone marrow transplant phase is more likely now. For relapsed AML patients like Phin, there’s only one treatment option–get into remission again and do a bone marrow transplant. However, the patient can’t get a bone marrow transplant unless they have organ function above a certain threshold, and the longer it takes to get back into remission, and the more chemo it takes to do it, the lower the patient’s organ function drops, and the more unlikely it is they ever make it to the bone marrow transplant. Without the bone marrow transplant, it’s game over. That’s why it’s extremely good news that Phin went back into remission so quickly. 

Phin’s enjoying a few days at home between rounds right now. He entered the children’s hospital on February 15 and left on March 20. If all goes well, he’ll have another week home before he goes back in. He spent his first couple days of freedom running around outside, going out for ice cream with his sisters after they got out of school, riding his bike, and hanging out with Sundae, our family dog. Today–March 23–is the second anniversary of the day Phin entered the hospital in 2022, and Phin, Neesha, and I spent it with two of our favorite organizations: Camp Sunshine and Oatland Island Wildlife Center. We all had an amazing time today.

   

You can expect another update soon with some more info, but for now, let's just enjoy the win. I'll wrap this one up with a thing I used to do last time Phin was inpatient for chemo and recovery–a kind of roundup of each phase by the numbers, heavily inspired by the Harper's Index. So I'll leave you with that. Thanks as always for being a part of this.

[February-March, 2024]

The Phindex

Units Phin received of blood: 4

Of platelets: 6

Consecutive days of chemotherapy: 6

Length of inpatient hospital stay in days: 34

Bandage changes: 7

Sedations: 3

Bone marrow aspirations: 2

Spinal taps: 1

X-rays: 1

CT Scans: 1

MRIs: 1

Hospital leprechauns caught in St. Patrick’s Day leprechaun trap: 1

Factor by which visits from leprechauns outnumbered visits from the tooth fairy: 2

Completed laps around the pediatric specialties unit floor in ride-on SUV: >20

Friends’ end-of-treatment bell ringing ceremonies attended: 2

Ratio of visits from ponies to visits from dogs: 1:4

Ratio of visits from martial arts senseis to visits from magicians: 1:1

Hospital room sleepover parties with his sisters while they were on their spring break: 5

Percent increase from 2022 in visits from his sisters now that hospital COVID restrictions have lifted: 100%

Approximate percentage of Phin's total lifespan spent in the hospital: 6.7%