I apologize for taking so long to write a good update on Audrey's progress. We just left the hospital today for what was a short second day to her 4th cycle of chemotherapy. Last week we had clinic and were planning to start the 4th cycle last Thursday, but Audrey's levels had once again barely missed the cutoff so we were pushed out until this week. Last week we did find out that Audrey will be receiving 8 total cycles instead of only 4. While I wanted to post this last week, we were meeting with Dr Park, the neuorblastoma specialist, Monday and I figured she would give us more useful information.

While we have been busy focusing on what her scans will show, we forgot that we were still waiting for a test to come back on the cancer's genetic makeup. This finally came back and showed that Audrey's cancer has "deletion of p1"- which in layman's terms means it has a slightly higher chance of recurrence. Dr Park assures us it is still only 10-15% chance of recurrence. Audrey still falls in the intermediate risk category and still has many things in her favor; Namely her young age, overall health and demeanor,  and the fact that it did not spread to her bone marrow or blood. She said Audrey's prognosis is still "excellent." Surgery still depends upon the size of her tumor once we repeat the scans at the end of the month. We will have a long few days the 25-27th but will fortunately be home for Thanksgiving. (Having to push out cycle 4 turned out to be a blessing after all!) 

Because Audrey doesn't bounce back as quickly as they would like, she now has to get an injection after each chemo cycle to help her bone marrow recover and get her counts back up sooner. It means another trip to the hospital but it is nice that she will spend less time in the high-risk-of-infection-zone. 

This 4th cycle is OK so far. Yesterday was our longer day of about 4 1/2 hours. Poor thing got sick last night as I believe we should have given her nausea med sooner but she has been good otherwise. Today was quick and we had the same nurse as yesterday, who we really like. Tomorrow will be quick too as well as Saturday. 

Last week we ran into the little girl we mentioned before is also undergoing treatment for Neuroblastoma and it sounds like they will be done at 4 cycles. We are very happy for their family and can't wait to be at the end of Audrey's treatment. We are still very much hopeful for a miracle when they repeat scans on Audrey in two weeks. We know we are lucky to have avoided any inpatient time during her treatment so far (apart from her initial inpatient stay) and we hope to keep it this way. Since the meds have a cumulative effect and we are well into cold/flu season, we will continue to be hermits over the next couple months to keep our girl as safe as possible. 

Thanks for continuing to pray and think of us! We will update again soon! 

Love

Shannon and Galen 

Weekly Dressing Change

Can't believe it is almost two months since Audrey's diagnosis. Time has went by so quickly. This week we had several appointments and we were able to get more information on what the next couple of months will look like.

Monday we saw Audrey's pediatrician. She was very impressed with Audrey's growth over the past month or so-- our baby is almost 20 pounds! Must be all the butter and cheese we add to everything ;) We discussed Audrey's development and side effects thus far. It was a pretty quick appointment.

Tuesday I got a call from the surgical coordinator to schedule a visit with the surgeon who completed Audrey's first surgery and who is to complete any subsequent surgeries. I told the coordinator that I didn't think the dates were right as they had her surgery scheduled for 10 days after her 4th cycle. Since he couldn't really speak to it (just going off of what he is told) I just let him schedule our consults and thought maybe we really would be preparing for a Nov 15th surgery.

Wednesday were labs and clinic as well as the visit with the surgeon. Audrey's levels had already dipped pretty low whereas before it was taking more like two weeks post-chemo for her levels to drop. Nothing too alarming and no need for transfusions but she is on fever watch again. In her clinic visit I mentioned the surgery date and it seems the communication between oncology and the surgical center was a bit off. Weeks ago the November date was put up as a tentative surgery date and this hadn't been changed. The docs promised immediate follow up with surgery but we still went to meet with the surgeon anyway. Dr Ledbetter (the surgeon) is pretty great. He explained that Audrey's treatment is still somewhat up in the air until we get some sort of progress on what the chemo has done to her tumor. He said at this point we still can't say what Audrey's surgery will look like, if she will need more than one, or if she will need it at all. He walked us through her CT images from when she was first diagnosed (not sure why this wasn't done before) and showed us the affected areas. He also explained what surgery would look like if he had to operate on the tumor as it presented on her initial scans. (Absolutely terrifying!) Because Audrey's tumor is located in a very tricky spot, surgery would be extremely invasive and would leave her with an enormous scar. If this is what we must do, we at least know she would be in very good hands.

Thursday we had another echocardiogram and a visit with Audrey's cardiologist. Her heart still looks beautiful and there will be no changes to her heart meds as of right now. If it weren't for Audrey's cancer we would have been the point where we would only have to see the cardiologist every 6 months but not with everything going on now. We will continue to see them often for the next several months. The one chemo med that they are most worried could damage her heart will be given again for cycle 4, so we will be repeating the echo in a few weeks.

This morning we returned to check Audrey's labs to make sure she didn't need any transfusions. While there we were able to talk to one of her doctors about the next steps. She explained that after the surgery scheduling confusion they discussed with Dr Park (Neuroblastoma specialist) and it should go as follows: After cycle 4 they will repeat Audrey's scans. If her tumor has been reduced by 50% or more she should not need surgery or the additional 4 cycles. If it has not been reduced by 50% they will proceed with the additional cycles of chemo. Then they would repeat scans after cycle 8 and determine then if she needs surgery. This is much better than we had even hoped. It will be an absolute miracle if Audrey can get by with just the four cycles, but at the least we want to avoid surgery. We should know over the next couple of weeks when her scans will be- please pray that the tumor is gone when they scan again.

We will continue to update over the next couple of weeks. So far next week is looking like it will be a quiet one but we will be going in Wednesday for clinic. I also requested that we finally meet Dr Park so that should happen the week after cycle 4.

Thanks for continuing to follow Audrey's fight!

Well we are now three cycles down in Audrey's treatment. Though we don't want to push out her treatment it was awfully nice to have a weekend off where we pretty much knew her levels were back up and we could get out of the house for a bit.

Friday we took her to the zoo- which if anyone remembers it was totally rainy but that was perfect for us! We bundled up and luckily not many people thought the zoo was a good idea. It was nice and quiet and many of the animals were up close to the glass since they didn't want to be in the rain. It stopped raining not long after we got there and Audrey had such a good time. Sunday we took Audrey to the pumpkin patch for the first time. It was perfect weather and a nice big farm area so we didn't have to worry about being in close contact with everyone. It was such a good "normal" weekend where we could forget about her condition for a little while and just enjoy what we have.

Monday was a short visit. They confirmed her levels were high enough to start the third cycle and we were scheduled to come in bright and early Tuesday morning.

Though our longest day, Tuesday was pretty smooth. We had the best nurse ever- she was sweet as can be and loved playing with Audrey. She also suggested we meet another family whose beautiful little girl is also undergoing Chemotherapy for Neuroblastoma. It was really nice to be able to relate to someone else for a minute but our heart aches for them. Their situation is slightly different but also very similar. Audrey and their baby girl were diagnosed within a day of each other and were inpatient at the same time. They were both in to start their third cycle Tuesday and we were able to chat for a little while before poor Audrey got irritable and then sick :( It was at the very end of the long day and she probably needed her nausea med sooner. She was pretty sleepy the rest of the day.

Wednesday and Thursday were short days. It only took about two hours from checking in to leaving. Crazy how fast two hours goes by when you have just been in for over 8 the day prior. So now we are back at the waiting for her levels to dip phase. She will go in next Wednesday to check in and Thursday she will see her cardiologists. We also see her pediatrician next week for the first time since she sent us to the ER in August. We hope and pray that we can have another smooth couple of weeks and we can take on cycle 4 without any complications.

Today Galen sent me a picture of an adorable gift basket for Audrey that was dropped off at his store, in addition to $$ from fundraising that was setup through work. We are basically speechless at this point. We seriously work with the GREATEST people. I don't know how we will ever truly show our gratitude for the generosity that we have seen throughout the last couple of months but we will certainly try!

We will update next week but hopefully it will be a boring one ;)

Well we were supposed to be starting Audrey's third cycle of chemotherapy today but her system hasn't fully rebounded from cycle two. We visited her doctors last Wednesday and her platelet count was getting low. This meant we had to return Friday and Sunday to check again and make sure she didn't need a platelet transfusion. Low platelets mean Audrey is at risk for bleeding and bruises really easily. Poor thing bruised her head just from bumping it with her empty bottle. We went back in yesterday to see her doctors again and everything had bounced back expect for her ANC- which means no chemo yet. Fortunately we have been able to avoid transfusions since our first one for her anemia and we haven't had to be admitted for any fevers thus far. The more time we can be at home throughout this process, the better. We will be going back Monday to double check her ANC and hopefully start cycle 3 on Tuesday.

Audrey has been cruising along without much for immediate side effects (nausea and hair loss thus far) but it's really the long term effects that scare us the most. She has continued to gain weight- finally up over 19 pounds! We continue to get praise over what a good and patient baby she is at each visit. I guess they expect her to be putting up more of a fight or screaming at being messed with- but she saves that for home ;)

We were able to celebrate Audrey's first birthday over the weekend. We only had a couple of family members over due to her neutropenia but she had a lot of fun. Audrey got many new toys, a couple of which she stands to play with and we have noticed her walking has improved just over the last several days. We continue to be amazed at Audrey's strength.

We are looking forward to getting through the next couple of cycles so that we can get new scans and hopefully a miraculous report. We will be visiting Audrey's cardiologists week after next as we were scheduled to check in with them before all the recent developments. We pray her heart continues to stay strong against the harsh medications of treatment. Once we get through early next week we will update again. Please think of Audrey as she goes through her third cycle.

We really can't express our gratitude for all of the support for our family. We are so looking forward to the day that Audrey is cancer free and we can help others in similar situations.