Bad Biopsy News

About a week back, the Unknown Son had a CT scan that showed some suspicious spots in his right lung. He had his biopsy today.

Unfortunately, the news wasn't good. His cancer (Wilms Tumor) has recurred. According to the surgeon, there was at least one clear tumor (pea-sized) in his right lung, and clear evidence that it had also metastasized into some of the lymph nodes. I'm currently in the ICU with him as he recovers from the biopsy, and I'll spend the night (the Unknown Mom will take over tomorrow).

He's awake and in good spirits. Looks like we'll be watching Sponge Bob DVDs for a while longer, followed (hopefully) by sleep).

I'll post more information as I get it.

update: It's the morning after, and he's doing well - his fever has broken, he's talking up a storm, getting all the tubes out except for his chest drainage tube, and about to start drinking fluids on his own.

Forecast For Blogging - Light

It always seems strange to see someone post that they won't be blogging for a couple of days - it's like saying that your readers need your regular spewage so much that they'll have troubles without their regular fix. I have no such illusions.

Nevertheless, some weeks just need to be mentioned. The last cycle of the Unknown Son's chemo went fairly well – by the end of the week, they’d figured out the right mix of drugs to knock down the nausea, and he was doing pretty well. He had minimal nausea or other issues in the day or two later.

This time, it’s a different story. First off, the cocktail he’s on this time had to be infused over a 7-8 hour time frame (instead of the 4 hour infusion time last cycle), so it involved us getting there by 9 and not leaving until about 5 o'clock. Add in the 1 hour commute each way, and it made for a very long day. In addition, this time around, the chemo cycle only ran over three 3 days of infusion, so we did it on Tuesday, Wednesday and Thursday of last week. Come Thursday, we were thinking "This is a snap. No problem."

Advice to self - don't say or think that. Just don't - it tempts fate.

Then the fun started.

Friday morning, we had to go bring the Unknown Son back to the clinic for repeated nausea and vomiting. He got IV fluids and some anti-nausea meds, and we were out by 2:00. Then we had to go to the local Emergency Room (it's 10 minutes away versus an hour, so it made sense) Saturday night at 9 for a repeat performance. Sunday was fairly uneventful, with a little bit of nausea in the early afternoon. He had one or two more episodes later that afternoon, but his new medication Marinol , which is a synthetic form of the active ingredient of marijuana) seemed to work. After taking it, he slept for a while, and woke up quite hungry (in other words, he got stoned and ended up with the munchies). A warm bath, and another dose before bed, and he was out like a light.

At 4:00 this morning, we were back to the vomiting. So, it’s off to the clinic once more (the Unknown Wife is there now). With luck, they can get a handle on this – he’s lost about 4 pounds this week, and unlike his dad, he can’t spare the weight. He'll spend the night there, and Unknown Mom will stay with him (unfortunately, I have a commitment I can't get out of tonight). If he requires a second night, I'll relieve her after my night class tomorrow night.

Luckily, the Unknown Mother-in-Law (who is a saint, by the way) can come over to stay and help out with the Unknown Daughter.

So, blogging might be light for the next couple of days.

This Week's Another Big Ball-O-Crazy

Posting will be light this week, since life is far over the line into CrazyTown:

• It's a chemo week for the Unknown Son, so every day I'm either teaching or (on my non-teaching days) taking him to chemo.
  
• I've got a conference deadline tomorrow (for the Southern Finance Association meeting)
• In addition, I'm teaching two nights this week in a professional program.
• Somehow in the midst of all this, I have to write an exam for my case course.
  

Finally, in case I forgot, when I wake up tomorrow, I'll probably have to shovel upwards of a foot of snow before I take Unknown Son to the clinic for his chemo?

Ah well - I guess I'll have to plan on sleeping Friday night. By then it'll all be over.

Update on The Unknown Son

So far, Unknown Son is recovering nicely from his surgery on Monday. It looks like he'll be getting his chest drainige tube out today. That means the only tube left in will be the IV that gives him fluids,

Last night he ate two small pancakes with peanut butter (a taste he got from his DaD), he even took a couple of short walks (about 50 feet). Today, we'll go for as many walks as he can handle.

In the meanwhile, there are always videos. For now, it's the Muppet Movie. What can I say - I believe in a classical education.

It'll still be a couple of days before he gets discharged, but for now - Wocka Wocka Wocka.

Updated 1:30 -- he just got the chest drainage tube out, and they've capped his IV (it was only giving a minimal amount of fluid, anyway). So, he might conceivably be home tomorrow. But we'll see.

Bad News

We just got som bad news regarding the Unknown Son. As many of my regular readers already know, he's gone through a lot - he's a two-times cancer survivor.

In 2002 he was diagnosed with Neuroblastoma, a particularly nasty and resistant childhood cancer. After a great deal of chemotherapy, surgery, radiation, more chemotherapy, and experimental treatments (including an autologous (i.e. "self") stem-cell transplant, he went into remission in 2005.

In January of 2008, he was diagnosed with a Wilms' tumor (a kidney tumor), which resulted in the removal of his right kidney and, after more chemo, he was given another clean bill of health this summer.

Now it looks like he has another tumor - in the lower part of his right lung. We just found out about it two days ago as a result of routing follow-up scans. He's scheduled for more surgery this coming Monday (the 29th). He'll get the tumor removed, which will give us the best information as to what exactly it is. He'll probably have about a week-long hospital stay, and we'll then know if this is a recurrence of the Wilms, tumor or something else (it could be a recurrence of his neuroblastoma, but that's unlikely because there was no indication on his latest MIBG scan a couple of weeks back).

So, please keep us in your prayers.

If you're one of my "non-blogosphere" friends (or a regular reader who knows me by my real name) and you want to keep up with what's going on, we maintain a website that we use to keep family and friends abreast of the little guy's treatment. Drop me an email and I'll send it to you in case you want the url.

Another Crazy Couple of Days

It's been a busy few days. On Saturday, Unknown Son and I took part in his Cub Scout troop's annual popcorn sale outside a local supermarket.

I gave him a little coaching on the way over (i.e. make sure you ask everyone that comes out, look them in the eye, don;t take the first "no" without asking again, and so on). The kid absolutely hung the moon. He sold about 50% more than the other two kids that were there, and the grownups standing around really got a kick out of watching him. It's hard to say no to a determined, charming, and extremely cute 9-year old (of course, I'm completely unbiased).

Sunday was mostly used for prepping for my week's classes (I teach MBAs on Monday evenings, and other classes on Tuesdays and Thursdays). Unfortunately, U.S. started getting a fever Sunday night. We took him into the oncology clinic Monday morning (he had a regular appointment set up anyway), and they sent us home, feeling that it was likely a virus of some kind (no evidence of anything on his scans, and no signs of a bacterial infection). But, by the time I got out of class at 9:00, his fever was spiking to 103.

The doctor didn't seem to feel like he needed to come back in (it's about a 30 mile drive), so we gave him Tylenol, Motrin, and a cool bath, and his fever eventually broke around 1:00 in the morning.

So, I guess I start the week sleep deprived. What else is new.

ed: I had previously written that Unknown Son was 19. That's only in his ability to argue. Chronologically, he's only 9.

A Rare Sighting

The Unknown Son recently went to a day camp. While there, he got a little "work" done. T he following picture actually made the front page of the morning edition of our state's major newspaper.

My colleagues thought the clown makeup merely increased the resemblance to his father. Those who know me can judge for themselves. He's done with his chemotherapy, so his hair is starting to grow back. This means that the resemblance should rapidly fade over the next month or so.

Fun With Nausea

Unknown Son had his regularly scheduled chemo round yesterday. Unfortunately, it was followed by nausea and vomiting starting about 5:00 and continuing throughout the night. So, this morning it was back to the clinic for anti-nausea meds and fluids (that much vomiting leads to dehydration, which isn't a good thing).

By the afternoon, he was back up to code, and we came home. Unfortunately, we had another incident later on at home. Without going into too many details, let's just say that our plans to get a new couch (our old one is about 10 years old) have now been accelerated...

Ah well, "stuff" happens (sometimes figuratively, and sometimes literally).

Down With The Flu

The last couple of years, I've gotten a flu shot every year (I've caught the flu before, and I'll take the minor discomfort of a shot to that any day). Unfortunately, a good number of flu cases this year were from a strain that wasn't covered by the vaccine. The Unknown Family had four of those cases. They're now mostly over it, but I've developed my yearly case of bronchitis as a result. It's funny how the timing worked out - Unknown Son started spiking a fever of 103 Thursday night. Since fevers over 100.5 are cause for concern for cancer patients (with a surgical port and a possibly compromised immune system, infections are a constant concern - if he gets one, it's serious). So, we went to the ER at about 10:00 Thursday night. It turned out to be the flu, which, while not trivial, is far better than infection. In any event, they gave him fluids and antibiotics, and we were back home by 11:00.

Unfortunately, I had to get up the next day at 5:00 to get to the CFA Level 2 accounting review I was taking (it was several hours' drive to the hotel where it was being held). Let's just say that it was a bit difficult focusing in accounting for 16 hours over two days with a sleep deficit and the onset of the flu. Having said that, John Harris' workshop was outstanding. He may well be one of the best instructors I've seen in my life. For anyone with concerns about their grasp of the accounting material, I'd highly recommend him.

After that, I had to fly out of town Monday morning to attend the dissertation defense of one of my students from my previous school (they passed, by the way). After the defense, I spend the afternoon working on a paper with my coauthor (who's also the aforementioned student's major professor). It's always easier to write with both authors in the room, since the give and take is critical.

In any event, I managed to survive the week. The Unknown Family is pretty much over the flu. Unknown Son had low white blood cell counts on Wednesday, so we postponed his weekly chemo until next week. It was likely just an aftereffect of the flu rather than from the chemo, but it's better to be safe in these cases. I still have the bronchitis, which will take another week or two to completely recover from. But on the plus side, the frequent violent coughing spasms have stopped anyone from asking me to volunteer for any new assignments (no one wants to get close enough to ask). So even bronchitis has its upside.

In any event, that's about enough. Unknown Son is watching a movie with a friend, and a friend of Unknown Wife is coming over tonight to babysit. So, we get a rare night out. Woo Hoo!

Fun With The Tooth Fairy

We try to put as much humor and "magic" into the Unknown Children's lives as possible. One of the recurring jokes in our house is how the Tooth Fairy leaves very unusual notes whenever they have a tooth fall out. In fact, I recently set up a Gmail account for the Tooth fairy so that Unknown Daughter could write her an email (both Unknown Daughter and Unknown Son have email accounts, but only Unknown Wife and I have the passwords, so we can control access). So, UD sent the following email last night. BTW: In case you're wondering about the "Momma" reference, Unknown Daughter has recently gotten into the habit of calling the Unknown Wife "Momma", which irritates her to no end. So I thought I'd lend a hand:

Dear Tooth Fairy:
I have a loose tooth - I can feel it wiggling. Do you think it'll fall out soon?

Love,
The Unknown Daughter

She got an email back this morning:

Dear Unknown Daughter:

Your tooth will probably fall out sometime soon - in the next week or two (or three). You don't need to keep wiggling it - once it gets a bit looser your mommy (remember - she doesn't like to be called Momma) or daddy can get it out for you.

In case you're wondering how I know about you calling your mother "Momma", I heard it through my Spy Teeth Listeners. Most people don''t know this, but I can listen in to what's happening around anyone through their teeth.

Of course, if no one in a house has any teeth, it doesn't work. And false teeth don't count.

Love,
The Tooth Fairy

We occasionally hear the Unknown Kids sharing these things with their friends - classic.

The Unknown Son's Cancer Treatment

It's been a month since I wrote that the Unknown Son had been diagnosed with cancer, so I thought an update was in order. It took a while to get everything straight, but we now have our answers, and a pretty good idea as to what the next few months will involve.

Unknown Son has a stage 3 Wilm's tumor, which is one of the "better" types of cancer to have (it has five year survival rate exceeding 90% for most variants). It might seem strange to put comparative terms like "better" with cancer, but compared to neuroblastoma (his cancer the first titme around), this is a relatively straightforward thing to treat. Here's what the treatment will involve:

• A couple of weeks back, he had a surgical port installed, which makes getting chemo, blood draws, and other input/output pretty easy and relatively painless. It was accessed for the first time this last week for his first round of chemo, and it was probably the easiest injections he's had since we can remember - they numb the skin over the port with some analgesic cream and put a needle through the port into the vein, and he hardly noticed it).
• He had his first round of chemo this week (more details below), and seemed to tolerate it pretty well. There was some nausea later on in the week, but much less than we'd expected.
  
• He also had his first two doses of low-level radiation (again, without much problem).

Here's what's ahead for the little guy: He gets about 25 weeks of chemo, involving three drugs: Vincristine, Actinomycin, and Doxyrubicin. He gets the Vincristin every week, and will alternate the other two drugs (i.e. for every three week cycle he gets Vincristine and Actinimycin on week one,Vincristine and Doxyrubicin on week two, and Vincristine alone on week 3 ). They alternate the meds because some of them take a few weeks for the body to recover from.

He also receives low-level targeted radiation for six days. He had two doses last week (Thursday and Friday), and will have four this week.

So far, he's had a bit of nausea the last day or two, but a couple doses of Zophran appeared to control it pretty well. We really don't know if it's from the chemo or from the virus the Unknown Daughter has had this week. But either way, the meds seemed to work. He's also had some mouth sores, but the analgesic mouthwash they gave (it primarily contains lidocaine and benadryl) did the trick.

So looking ahead, he'll be getting radiation every day next week and then chemo once a week for the next six months or so. The chemo will typically be scheduled on an "off teaching" day (I teach on a TuTh schedule this semester), so I'll be able to make most of the chemo appointments.

I'll keep you posted as to how it goes.

One Kidney (and One Tumor) Gone, and He's Going Strong

Unknown Son went under the knife today. And a long day it was.

We got to the hospital by 9:30, and had him on the table by around 11 or so. They completed the first step of the surgery - made a small incision, cut a piece of the mass off, and examined it (by about 1:00 or so).

The good news is that, while it is cancer of some sort, it does NOT appear to be recurrent neuroblastoma. The surgeon said that it seems at first look to be either a mesoblastic nephroma or a sarcoma (we don't know much about these types of cancers, so we'll get back to you with more information later). However, both these possibilities are far less serious than recurrent neuroblastoma, so we take it as good news. We won't know for sure until the full pathologist report comes back, probably on Thursday or Friday.

The next step was to remove the kidney (a "nephrectomy" in medical terms). It took quite a while -- about 7 hours (rather than the expected 4) because of the scar tissue from his previous surgery and radiation. But that's just fine with us - the surgeon wasn't in a rush to get home, so we'd rather he took as long as necessary.

The Little Guy is resting comfortably in the PIC (Pediatric Intensive Care) unit. He'd better be with all the drugs they pumped into him. In fact, since he's got a breathing tube, they'll keep him well sedated until tomorrow morning at the earliest. So, he's sleeping about as soundly as possible, and probably a lot better than his folks.

He's comfortable, and there won't be anything happening until morning. So, since She Who Must Be Obeyed and I will probably have our share of sleep-deprived nights in the near future, we took the option of going home to sleep in our own bed. We'll come back in the morning for the waking of the lad and the removal of the tube.

Unknown Son has lately gotten interested in Greek Mythology ( was a big fan when I was his age, and I think I gave him the bug), so I'm sure I'll be reading some (actually, a lot of) stories from the books on mythology I got from the library yesterday (we figured he'd be here for a while, so we did plan ahead).

Stay tuned - I'll update when we know more.

Some Disturbing News

The Unknown Household just got some disturbing news. As I just wrote, Unknown Son has had some stomach issues lately. We thought it was just severe constipation, but we has an additional scan done today just to be sure.

The ultrasound revealed a mass of approximately 2 inches in length near his right kidney.

Unfortunately, without further tests, we can't tell if this is a recurrence of his original cancer, a new cancer, or just a benign mass. So, we go in for more tests tomorrow - an MRI, a bone marrow sample (he's mildly anemic), and a consult with his local oncologist and a surgeon. After that, we will likely have a biopsy on Friday or Monday. Until then, we won't know much, so it's still early to panic.

We're big believers in the power of prayer. So if you have a minute, send one up for us.

And we'll keep you posted.

Like Father, Like Son

Unknown Son has had a tough month. In Mid December, he had pneumonia. The antibiotics took care of that in short order, but he's continued to have intermittent stomach cramps - usually about an hour after eating.

We finally took him to to pediatrician, and the CAT scan showed that he's seriously constipated. Without going into too many details, let's just say that with fiber supplements and suppositories, we're working on the problem from both ends.

And yes, my friends have almost to a one said that he comes by the condition honestly - after all, just look at his father.

Meanwhile, even though Unknown Daughter only just got her order form Friday afternoon, she's already sold over a hundred boxes of Girl Scout cookies. She hit up everyone in our neighborhood by Saturday afternoon, and is already plotting her attack on all the nearby developments.

Unknown Son even did her a solid by asking the technician giving the CAT scan "if she'd like to support my sister by buying some Girl Scout cookies." He signed her up for five boxes - peanut butter patties, in case you're interested.

Now THAT's teamwork.

Boys Day and Night

The Unknown Daughter is going for a sleepover tonight at her cousin's house (about 80 milkes away in an adjoining state). So, Unknown Wife is using the opportunity to take an overnight herself at her sister's house (she lives near where the sleepover is, and this'll save an additional trip).

That means Unknown Son and I temporarily have the house to ourselves. He gets to watch Pink Panther Cartoons most of the day (he got the 6 Disk complete set for Christmas) while I spend my time going over material for CFA level 2. I teach in a prep program starting in about four weeks, and I'm taking the exam myself this June (assuming I passed level 1), so it's a good opportunity to get a bit ahead.

He's been having intermittent fevers (on one day, off the next) for the last couple of weeks. We know he had pneumonia, and is almost done with his antibiotics. But maybe he caught another virus. Either way, he's content to sit around and watch classic cartoons.

I'll probably watch some too.

Plus, this means I get to watch the buildup tonight to tomorrow night's big UFC fight between Hughes and St. Pierre.

Tis The Season To Be Phlegmmy

Unknown Son has had intermittent fevers for the last couple of weeks - one day he has one, the next he doesn't. Finally, we took him to his pediatrician.

Turns out he has a mild case of pneumonia. So, it's back on antibiotics (nasty tasting stuff, there) for a couple of weeks.

The good news it that I have yet another excuse to avoid grading my last few projects - I have to be home with my son.

Of course, I could have just taken the projects home with me, but that wouldn't be any fun...

On the bright side, I've just about finished reviewing the Quantitative Methods section of CFA Level 2. Good thing, since I teach it in a few weeks.

Head Wounds Are Always Bleeders

Growing up in a family of boys, you quickly learn that any cut above the neck (no matter how small) bleeds far out of proportion to the seriousness of the injury. After all, there're a lot of blood vessels in the skin in the face and head. Yesterday, Unknown Son and Unknown Daughter found out too.

Since it snowed two days ago, he went sliding with the neighborhood kids, and promptly slipped on an icy patch - right into a classic face plant. So, Unknown Daughter comes running in, and when I look out the bedroom window, I see U.S. lying on the snow on his back with a large red spot staining the snow beside him and several kids standing over him with worried looks.

I ran out with a handful of paper towels (rule #1 - always swab the blood away to see how bad it really is before panicking). Luckily, it was only a bloody nose. So, I picked up U.S. and carried him back to the house (he could walk, but if you can't get carried when you're covered in blood, you can't get caried any time), and we watched Tom and Jerry for a while. Bloody noses DO go better with slapstick old-school cartoons.

He was extremley impressed a few hours later when he pulled a huge clotted bloody booger from his nose. Of course, he just HAD to show it to Unknown Wife and Unknown Daughter - he is a boy child, after all.

More snow today - just spent an hour shoveling it off the driveway and drove to Dunkin Donuts for the traditional Unknown Household Snow Day Breakfast: powdered sugar for the kids and chocolate covered for She Who Must Be Obeyed. As for me, I'm not picky as long as I have coffee to wash it down with.

Winter wonder Land - feh.

More Good News On the Cancer Front

As I've mentioned previously, the Unknown Son was diagnosed with neuroblastoma shortly after his 4th birthday. He was successfully treated at Children's Hospital of Philadelphia, Memorial Sloan Kettering in New York City, and Johns Hopkins Hospital in Baltimore. We believe he went into remission about 3 1/2 years ago (see this previous post for more details, and an explanation why we can't say exactly when). But, since there was still one spot on his leg that showed up faintly on the scans , we continued to go to back to CHOP for quarterly checkups. We were fairly sure that it was a ganglioneuroma rather than active cancer, but we still had to play it safe.

We just got back from the latest checkup. This time around, U.S. had his first totally clean scan. So, we can be a lot more confident now that he's in remission.

Nice to get an early Christmas present, eh?