Sedations: 1
| "We Show Up" banner on a parking structure outside Phin's window |
| "We Show Up" banner on a parking structure outside Phin's window |
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| Phin and Caroline pose for a celebratory post-chemo photo. |
Through all of these rounds of chemo, Phin's numbers have gone up and down (a relief to know that the medicine is doing what it's supposed to do), and his energy levels and moods have bounced around a bit, too. His sense of taste has changed, as most anyone who's had to do chemo will attest is a thing that happens; he's off sweets but really digging savory and salty. He can't tolerate the heat outside for very long (but lately, who can?). His hair got pretty thin, but he's kept a little bit. So far, he's refused to let us buzz it or trim it up.
But if that's all there is, we'll take it with gratitude and gladness. We won't know for some time (perhaps a very long time) the true toll that the chemo took on his cells, tissues, organs, and systems. All we can do in the meantime is to hope that the damage to Phin himself is temporary and minimal, and to hope that the damage to Phin's leukemia is irrevocable and absolute.
And, of course, to celebrate while we stay in the hospital for another 20(ish) days as he recovers! It's been a long journey since these treatments began in March, but he got through it, and we're so proud of him.
Phin and Molly point to a sign on his door announcing his final chemo admission. |
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The chemotherapy drug ARA-C drips into Phin's CVC line. |
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| The patient all snug in his bed with visions of animals-with-Santa-hats frolicking in his head. |
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| No Christmas is complete without lights and a tree. |
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| Big Monkey Johnny ready for Santa. |
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| Phin decorates a snowman for the Playroom. |
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| The stockings were hung... |
Hi Phin phans! Dustin here. I'm a little bit all over the place with my thoughts right now, and my feelings-—those are like what happens when you put a bunch of charging cords and cables in a box and they turn into a huge, jumbled wad, with everything all twisted up and knotted together.
But I wanted to give a quick update at the start of Phin's fourth chemo admission so here goes.
Medical Updates Phin got the all-clear to return on Tuesday, meaning that his counts were high enough that he could check back into the Children's Hospital and immediately start another round of chemotherapy. This round involves four days split into pairs—Days 1 & 2, and Days 8 & 9. He'll get chemo every 12 hours for each of those days, and in-between and afterward, he'll rest here at the hospital and recover his counts. The target for the length of this round is 29 days.
Also starting up again—steroid eye drops every six hours. Just on chemo days, though.
Phin On the Daily It really seems to be slowing Phin down this time.
Someone on his healthcare team described it in running terms. "It's like when you're training for a race," she said. "You run a mile, you're feeling good. You run two miles, still strong. Then you decide you're going to do four miles, and you can still do it, but you're not feeling as fast or as strong as you were on mile one."
He's sleeping more. Lying around more. Throwing up more. I asked if the main chemo drug (Cytarabine, or Ara-C) is in a stronger dose this time, but apparently it's not. He's just been running this chemo race for a long time now, and his body's tired.
Anyway, he's about to get a little reprieve for a few days. Hopefully he'll feel better going into Days 8 & 9.
Finally, here's our "how it started vs. how it's going" attempt to recreate a family picture from four years ago moments before we packed everyone up and drove Phin back to the Children's Hospital. Thanks to Heather at Heather Cahoon Photography for taking the gorgeous shot of the kids when they were younger.
What's up, Phin phans! Dustin here with an update. Here we go!
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Phin leaves the hospital, still feeling a little weird from that morning's anesthesia. |
To be clear, he wasn't receiving chemotherapy that entire time. Like always, he got blasted with chemo every twelve hours for a sequence of days at the beginning (five, this time), and then he stayed in the Children's Hospital for 24 more days while the effects of that played out in his bone marrow and blood. He's scheduled to return for his fourth round on July 12.
The big unanswered questions from Neesha's update last week are, what happened with the girls and Covid, and did everybody get it? By some miracle, both of the girls only ever had mild symptoms. Neesha confined them both to a bedroom, cared for them until last Friday when they both produced a negative test, and somehow managed not to become infected herself. She had the harder job, for sure. I was holed up far away, binge-watching Ted Lasso in an N95 across the room from Neesha's brother, Kiran, who, like me, had been exposed to Covid from the girls, but not for as long. Both Kiran and I tested negative for enough consecutive days that Phin's doctor eventually allowed me to return and tag out our hero, Aunt Seale.
As far as microscopic pathogens go, viruses get a lot of attention--so much so that in English we make a linguistic association to them with anything that can be quickly reproduced and distributed. "Going viral" does have a better ring to it than "going fungal," or "going bacterial," or "going protozoal," but fungi, bacteria, and protozoa all occupy the microscopic world alongside viruses. There are untold trillions of these pathogens, and each will readily exploit any opportunity to colonize new territory.
The middle of the 19th century brought a shift in the way we think about Nature, as the Transcendentalists helped to reposition the wild outdoors as a source of serenity, balance, and sublime beauty instead of a place of physical and spiritual danger, the dominion of beasts, evil spirits, and demons. Many of those ideas are still with us, and rightfully so. Nature can indeed be sublimely beautiful and restorative, which makes it easy to forget that it's also a war zone.
Sign at Oatland Island Wildlife Center that explains types of forest succession. |
Something like this process also happens in the wilderness of cells. For most of us, an army of white blood cells stands at the gates. When we dive into a freshwater lake or river and our organs aren't subsequently devoured by amoebas, or when we scrape our knees on the pavement and we don't get sepsis, we have these tiny heroes to thank. They dutifully fend off endless assaults from legions of mindless invaders. But should they fall, into the breach these enemies would pour, driven on by a principle of nature that applies to every creature from the tiniest sporazoa to the tallest redwood.
Phin, who spends a month at a time in a hospital room trying to rebuild his white blood cell fortifications, will tell anyone who asks about his eagerness to get back into nature and to be around creatures. The thing is, he never left nature--none of us have--and there are always billions of creatures nearby, too small to see, but doing exactly what creatures do.
| Phin's new CVC |
The latest report on Phin's bloodwork is from July 5, and it indicated that his white blood cell, platelet, and neutrophil counts were all creeping back up toward normal levels. Who knows what they're doing now, though. Phin's physicians had suggested he might be stable enough to be discharged the previous week, but then his numbers suddenly dipped. Then they crawled back up a little. Then they dipped again. And so on. Up and down like that until finally they achieved a threshold that allowed him to leave. But they could be plummeting at this moment, as his body continues to respond to the poison it received a month ago. It is entirely possible that his scheduled return to the hospital for more chemo next week will have to be delayed in order to allow his system to further recover.
Phin On the Daily
There was only one thing on Phin's to-do list this time: bats.
He wasn't specific about what that meant. Probably it was something like that scene from Batman Begins.
In any case, we've already checked the box.
I (to exonerate Dustin and make clear who's taking guilt--it's me, Neesha) take full responsibility for what I'm about to share.
In early March before Phin was diagnosed with AML, I signed the girls up for their most favorite camp ever. Av had gotten sick last year with a severe case of mono that landed her in the hospital for a few nights and had been unable to complete the camp. For a ten-year-old, who'd landed herself a sweet speaking and singing role at camp in her first ever show, it was devastating. Her mono, which some of you may recall, had been initially hard to diagnose since the test kept coming up negative. She'd been to Urgent Care and the pediatric ER, to the pediatrician at least twice before his concerns for her airway closing prompted him to ask the newly opened Children's Hospital to direct admit her instead of going back through the ER until they could find out what was wrong. They determined, despite the negative test, that she did have mono, the rapid test was "trash" and she had some of the most extreme symptoms they see: enlarged spleen that caused back pain, high fever, extreme weight loss, enlarged tonsils that were being kept from closing off her airway by a steroid. They were in discussion about an emergency tonsillectomy. It was bad. The whole thing, at the time, was pretty traumatizing for her and for us (little did we know it was just a warm-up) and, truth be told, she had some PTSD and lingering effects for months. (Insomnia because she was afraid to fall asleep and wake up gasping for air as she did when she had mono; lethargy that lasted through the start of the school year; so little energy and strength that she couldn't walk halfway around our lake to the pool; lots of crying from fear of the mono returning...for months after the major symptoms subsided.) She was uncertain of whether she wanted to return to the same camp she'd been at when she fell ill (despite us telling her again and again that she'd definitely contracted mono well before the camp even began). Just talking about it brought back some of the mono trauma, so when she determined back in early March to return, to set aside her anxiety and try it again, it felt like a big step in her overcoming her trauma and I wanted to encourage that momentum.
But this was all before Phin's diagnosis or, The Before Times, and Covid seemed under control.
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| Av painting her way through her mono hospital stay Summer 2021 |
| Les Filles 3 and Belle |
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